40 years of clinical computing
They may not be pioneers in the traditional sense, but Drs. Howard Bleich and Warner Slack certainly are trailblazers in the world of clinical computing.
Forty years ago the two doctors teamed up with other Harvard faculty to give birth to clinical computing. The result is the highly advanced medical records system in place at Beth Israel Deaconess Medical Center and Brigham and Women's Hospital. The applications that connected the two hospitals served as the prototypes for multiple commercial medical computing products, including those offered by Meditech, Epic and several other companies.
"Howard and Warner are giants in the field of clinical informatics," says Charles Safran, the division chief of clinical informatics at BIDMC. "So much of what we take for granted today was pioneered by these two men and their many colleagues here at BIDMC. Over the past 40 years, we have had 19 physicians and two nurses from six countries train as fellows within our division and today they are informatics leaders at Harvard and within their institutions and their countries."
The Division of Clinical Informatics was among the first academic divisions in the world to concentrate on the use of computers for patient care, teaching, and medical research. The goals have been to improve the quality and reduce the cost of medical care, to enhance the quality of medical education, to improve the relationship between doctor and patient, and to explore innovative approaches to research through computing.
Beginning in 1976, the faculty and staff designed, developed, implemented and studied hospital-wide, integrated computing systems for doctors, other clinicians, and students that would give the results of diagnostic studies immediately upon request; offer access to the biomedical literature with PaperChase (the first program of its kind, which in turn gave rise to a new field of literature searching and spawned numerous derivative programs); offer advice, consultation, alerts and reminders; assist with communication by electronic mail (with the Division's home-grown system, which was the first e-mail to be installed in a clinical facility); assist with order entry; and assist in the day-to-day practice of medicine, both for inpatient and ambulatory care.
"These products help in the care of millions of patients around the world," said Mark Zeidel, MD, Chief of BIDMC's Department of Medicine. "Paper Chase, which for the first time permitted physicians to search the medical literature, was the forerunner to PubMed, which we all use regularly. It is fair to say as well that UpToDate would not be what it is today had its founders not had the opportunity to interface constantly with the Division, its faculty and its graduates."