Kaiser Permanente is partnering with The Tech Museum of Innovation in San Jose (Calif.) on a new exhibit that shows how technology can help people understand and manage their total health. We’ve been sharing that message with our members for decades, and The Body Metrics exhibit makes it accessible to anyone.
But before Kaiser Permanente became a leader in electronic health records, even before Kaiser shipyard doctor Dr. Morris Collen first used an International Business Machines mainframe computer to analyze medical test results in the 1960s, Henry J. Kaiser relied on IBM to process payroll records in the WWII shipyards.
At the time, these behemoths weren’t even called computers – they were elaborate electromechanical devices called “machines.” In the Richmond yards, IBM assigned seven engineers to keep them in working order.
The use of punch cards to process simple alphanumeric data began with the 1890 U.S. Census, and was a success. This led to the Tabulating Machine Company, founded in 1896, and then the Computing-Tabulating-Recording Company (IBM’s precursor) in 1911. In 1928, IBM introduced an updated version of the punch card with rectangular holes and 80 columns, which became the industry standard for years to come.
The Richmond shipyard magazine Fore ‘n’ Aft described the complicated payroll calculation process in July, 1943:
Six days a week the time checkers and IBM thrive on the sticky detail of keeping track of the thousands of men who work on
Richmond ships, breaking the man hours down according to each job, and compiling tax and security reports for Uncle Sam. It takes about one man in each hundred hired to keep track of the other ninety-nine.
An electric accounting machine-familiarly called a “printer” by IBM operators–is just one step short of a robot. On the basis of intricate telephone-like lines hooked up to a board on the left side of the machine, it will do virtually anything but think.
The field time checker turns in cards marked with hours worked by workmen. The time office force sorts them by number, and posts earnings in a board control book, sends cards to the IBM operators in neatly wrapped bundles of 500. IBM gang punches the cards with holes corresponding to rate and hours worked, then sorts them by badge number of each workman, files them away for a week. At week’s end, six daily time cards are translated into a single master time card from which your paycheck is written.
Further steps involved printing out the paychecks on a continuous fold form and delivering them to the paymaster’s office, where the checks were mechanically signed. Finally, the checks were sorted according to badge number, trimmed out to individual pay stubs (thus the expression “cutting a check”), and taken to payroll booths for distribution.
IBM and KP would maintain a strong relationship over the years. In 2001, Dr. Collen recounted this story to Kaiser Permanente contract historian Steve Gilford:
IBM made all their money in punch cards and then eventually got into computers. We got some of their early systems, 1440’s [for early efforts to process medical data]…Relevant to that is that [Thomas J.] Watson Jr., the son who took over IBM, came through and made rounds [during the late 1960s].
I wanted to get him to put up money to go into the overall system. I remember telling him, “If you support this, it will be good for you, good for us, and IBM will stand instead of for International Business Machines, they’ll be called International Blessed Machines.” He laughed but nothing ever came of it although eventually we did develop contracts with them.
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In August, 2013, I had the pleasure of interviewing Jim Gersbach, retiring senior hospital communications consultant for Kaiser Permanente’s Northwest region. Jim was the unofficial historian for that part of the Kaiser Permanente world, and as such, had developed a keen sense of the value that our deep roots had for expressing our mission.
Here is one of his stories:
As a communicator I have to communicate to large audiences, I have to be persuasive, I have to say things that are based on facts. I can’t just say “I believe this so, therefore it is.” I work for an organization that has a long, and deep, and rich history. I’m interested in the history, so I’ve made a study of it, I’ve known a lot of people that lived a lot of that history and frankly, having worked a quarter century, I strangely enough find that I have personal memories about what has now become historical periods of time.
Over and over again I come back to that history because it’s so helpful for me as a communicator to be able to say to people, well it’s not just today that we’re been interested in this. We’ve been doing this for 20, 30, 40 years, even back in the 1940s. It’s really about saying, “What are the consistent values at Kaiser Permanente that don’t change over time?”
I remember at the 60th anniversary of World War II in Vancouver, (Washington) in 2005 we’d invited anyone who’d worked at the shipyards to come to the Kaiser Permanente booth up in the Fort Vancouver Reserve. We had a big display about Henry Kaiser’s life, and the Kaiser Permanente program, and how it came out of World War II and it came out of the shipyards near there. A lot of ex-shipyard workers were there, and there was a gentleman who was deaf and someone was sign-language interpreting for him.
He had worked as a young teenager at the shipyards, and told a story about how the school for the deaf was in Vancouver. The deaf teenagers mowed the lawn for [shipyard manager] Edgar Kaiser’s home, which was near their boarding school. They had tried to apply at the shipyards. There was a demand for workers, and they’d read it in the papers, and said, well maybe we should go down and apply. They were basically shooed out – “A bunch of deaf people, you’re not going to be able to work in a shipyard, you’ll hurt yourselves.”
Edgar Kaiser got wind of it when somebody said “Oh, I can’t work at your shipyard.” They weren’t complaining though, they were just resigned to going back to mowing lawns. But when Edgar found out that they had not been allowed to get work, he called his chauffeur – I guess he didn’t drive – and he communicated to the deaf teens, “We’re going down to the shipyards and you’re coming with me.”
They went down to the shipyard office where the teens had tried to apply, and Edgar asked “Who is the hiring manager?” through an interpreter. They said “This guy.” Edgar walked in and said, “You will find appropriate work for these people.”
That’s what I pull from the history of Kaiser Permanente. When someone says, “What’s Kaiser Permanente doing to help people with disabilities?” that’s our history of doing the right thing.
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On April 12, 1945, President Franklin Delano Roosevelt suffered a stroke and died while on a vacation in
Warm Springs, Georgia.
Two days later, the S.S. Bradford Island, a tanker, was launched from the Kaiser Swan Island (Portland, Ore.) shipyard before a somber audience.
A bugler mournfully played taps. The master of ceremonies asked the shipyard flag be lowered to half-staff, then he delivered a brief elegy to the popular fallen president.
Roosevelt had visited the Vancouver (Wash.) Kaiser shipyard on September 23, 1942 on a secret trip to review Home Front production, and was a strong supporter of the Kaiser shipyards and workers.
This audio clip comes to us from an archival set of master recordings on glass disks, capturing the gravity and loss of a community that had suffered much in the past years:
“By the proclamation of Harry S. Truman, president of the United States, this is a day of national mourning for the death of Franklin Delano Roosevelt…
“We have lost a great leader and a true friend. We mourn with the other people of the world who have also sustained this loss…
“There is perhaps a no more fitting way to commemorate his passing from us as a mortal being than the launching of this ship. For although death has come to Mr. Roosevelt, it came near the hour of victory towards which he led us, and the sturdiness of his dauntless spirit and faith is with us.”
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Kaiser Permanente physician Monte Gregg Steadman (1921-2010) enjoyed a prestigious career as an outstanding head and neck surgeon and teacher. Throughout this conventional career, he also struggled against conformity, militarism, and prejudice in many ways, and made his mark as a committed humanitarian as well.
For a former military physician and athletic male who had played football at UCLA, perhaps being tackled by a potentially fatal disease revealed his bravery best. In 1966, Steadman was diagnosed with breast cancer and had a radical mastectomy, which he wryly noted “Ended his chance to be a world-class handball champion.”
This 2005 poster featuring Dr. Steadman was a stunning public education message about the disease few men think will affect them; that warning still rings true.
Confronting and overcoming obstacles
In 1954, when he was appointed chief of Head and Neck Surgery at the new Kaiser Permanente hospital on Geary Street in San Francisco, he was denied membership in the SF County Medical Society because he worked at KP. “It was felt at the time that we were a threat to private practice,” he later said.
In 1969, he met and mentored a young plastic surgery resident at Stanford Medical Center, Dr. Robert Pearl, now the executive director and CEO of The Permanente Medical Group. TPMG’s 8,000 physicians serve KP in all of Northern California. Steadman retired from Kaiser in 1982.
An item in the December, 1959 staff newsletter KP Reporter described another way in which he defied conventional norms:
Drs. Monte Steadman and John E. Hodgekiss came down from San Francisco to help us out in ENT clinic. Dr. Steadman’s method of transportation fascinated us to no end as he arrived on his dashing motorcycle equipped with crash helmet and suede jacket. Behind him rode his briefcase and necessary charts, neatly tied to the seat with nylon cord. Ah, how wonderful it is to be young!
Dr. Steadman was equally outspoken about social injustice. In 1962 his strong anti-war beliefs drew him and two other men to sail into an atomic test zone off Johnson Island in the Pacific Ocean in an attempt to stop the test and draw international attention to nuclear disarmament.
The following year a KP Reporter article described further his commitment to social change:
Dr. Monte Steadman, of ENT at Geary, appeared on TV station KQED recently. As a speaker on the program “Dissent,” he urged society to reject force and violence whose use we freely condemn in our enemies. He praised the Negroes of the South who, with their Northern supporters, are resisting injustice without retaliating in kind for the mindless violence done to them.
We salute the fearless physicians like Dr. Steadman who have contributed to the mission of Kaiser Permanente, which exists to “provide high-quality, affordable health care services and to improve the health of our members and the communities we serve.”
Kaiser Permanente continues to be a leader in tackling breast cancer, especially early detection. In 2012 the National Committee for Quality Assurance reported that KP breast cancer screening rates for women were the best among health care providers in all the regions KP served.
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