Electronic Health Records

February 23, 2009

Kaiser Permanente’s Congressional Testimony about Electronic Health Records Dates to 1966

Dr. Jack Cochran’s recent U.S. Senate testimony evokes memories of when Morris Collen, MD — one of Kaiser Permanente’s pioneering physicians — testified in 1966 before a U.S. Senate special committee about the promise of electronic health records.

As newsworthy as it was for The Permanente Federation Executive Director Jack Cochran, MD, to testify before Congress last month, in fact Congressional testimony about electronic health records is nothing new for Kaiser Permanente. It turns out that Morris Collen, MD, blazed the trail as early as 1966.

John H. Cochran, MD, left, and Morris F. Collen, MD

Morris Collen, MD, right, receives from Jack Cochran, MD, executive director of The Permanente Federation, a California State Legislature resolution recognizing Dr. Collen’s lifetime achievements in medicine.

Kaiser Permanente’s Heritage Resources team recently found, in The National Archives, Dr. Collen’s testimony before the United States Senate’s Special Committee on Aging. In that testimony, Dr. Collen detailed Kaiser Permanente’s work on using multiphasic health screening techniques to help detect and prevent chronic diseases — work that was praised by senators, health professionals, and others in that committee session.

“They (Kaiser Permanente) have opened the gate. No one has demonstrated a better method to get the show on the road,” said Lester Petrie, MD, the Georgia Department of Public Health’s director for the Branch of Preventable Diseases.

Collen, 95, is among Kaiser Permanente’s pioneering physicians and established the Kaiser Permanente Division of Research in Oakland, Calif. Sidney R. Garfield, MD, Kaiser Permanente’s founding physician, asked Dr. Collen to lead the organization’s efforts to use computers in health care. Dr. Collen soon was one of the international leaders in founding the field of Medical Informatics. By 1966, he and Kaiser Permanente were the center of global attention with the first “on-line” program for multiple, computerized medical tests.

John H. Cochran, MD, left, and Morris F. Collen, MD

Depicted is the cover of the U.S. Senate Subcommittee on Health of the Elderly of the Special Committee on Aging document from Sept. 20 – 22, 1966, complete with Dr. Collen’s signature, lower right.

That work led to Dr. Collen being asked to testify before a three-day U.S. Senate special committee hearing on Sept. 20 – 22, 1966, chaired by Senator Maurine Neuberger, D-Oregon. Among Dr. Collen’s remarks was this passage:

“...there is no question but that the installation of automated and computer equipment will provide a more individualized service for the patient which was not previously possible. ... Because the automated, multitest laboratory is able to perform a certain amount of the routine repetitive procedures which the physician has had to do before, it frees up the time of the doctor, so that he can use his time better for the unique contributions he can make in the decision process of diagnosis, and in advice and counseling. ... Now that many of the routine procedures have been performed, the physician now has more time to spend with the patient on treatment matters.”

Based upon other testimony captured in The National Archives, Dr. Collen’s testimony captivated senators and other attendees:

“...Using a battery of automated procedures with built-in computer analysis and read-out results, (Collen’s) multitest laboratory completes in about two hours clinical tests and health history that would require very much more time by conventional methods. Thoroughness, speed, accuracy and economy of money and personnel time, particularly physician time, are special features of this approach.” — C. J. Wagner, MD, Assistant U.S. Surgeon General.

“I believe that at least 5 to 10 more projects of similar magnitude should be undertaken promptly. ... We need programs like that of Dr. Collen to test the limits of what can be accomplished and demonstrate what should be available to all persons five years from now.” — Lester Breslow, MD, Director of Public Health, State of California.

“Witness after witness before the Neuberger committee testified that the most promising approach ... is called ‘multiphasic testing,’ a program that the California-based Kaiser Foundation Health Plan has been offering its members ever since 1950.” —Time magazine, Sept. 30, 1966)

“The most advanced program cited at the hearing was begun ... by the West Coast’s Kaiser Foundation health plan.” — Newsweek magazine, Oct. 3, 1966

Read more about Dr. Collen through this News Center piece, which includes a link to a recent front-page profile of Dr. Collen in the Los Angeles Times.