Describes aspects of the pioneering automated multiphasic screening and diagnosis program at the Kaiser Foundation Health Plan, the origins of their medical informatics system, developed by Collen and colleagues at Kaiser with the help of mathematicians/statisticians Dantzig and Neyman. Also by Robert M. Baer and A. B. Siegelaub. Collen directed the development of medical informatics at Kaiser Permanente. By 2017 this was probably the most advanced system of electronic medical records management. Digital facsimile from PubMed Central at this link.

This is the first comprehensive book on the subject. The authors describe in detail, with numerous references, the limited hospital computer systems in operation at the time both in the United States and in Europe. The editor, who was responsible for the development of the most advanced system at the Kaiser Permanente Medical Group, and provides a detailed account of it here, began his preface with this statement: "A variety of computer applications in medical care has been developed within many hospitals in the U.S. and Europe over the past ten years. In the first half of 1973, there was not yet in existence a single completely computerized hospital information system, although considerable progress had been achieved in utlizing the computer for many inpatient and out patient services."

'In 1968 Morris F. Collen, MD and his team at KP’s Medical Methods Research (MMR) built a medical information system that peers described in the era as the most advanced of its kind. It was an aspiration of medical informaticians throughout the country, and KP was uniquely qualified to deliver on the promise.

"In 1963 the MMR team used an IBM 1440 computer to store patient clinical data collected in a discrete unit involved in the early detection of disease. The fledgling information system designed for the multiphasic screening exam stored patient identification data, physician examination and patient history data, lab results, and EKG and X-ray interpretations. Programmed rules and algorithms alerted physicians to diagnostic results that fell outside of normal limits. Patient histories were accessible to physicians for comparison study throughout the life of the patient. The system also advanced epidemiological research and evidence-based protocols.

"With this as a starting point, MMR aspired to design a comprehensive information system with the patient record at its core and with ancillary subsystems for the storage of pharmacy and lab pathology data; administrative information (patient identification / account services); and hospital information (admissions, bed utilization, inventories). With computing ability to store and retrieve pertinent data amassed over years, the design called for real-time reporting and 24/7 communication of essential medical data at all points of service, with robust security protocols to protect member confidentiality.

"By 1969 system design had matured and the National Center for Health Services Research and Development Agency funded a five-year pilot implementation at the San Francisco Kaiser Foundation hospital and medical offices.

'Within four years the San Francisco Kaiser Foundation hospital and physician offices were recording and storing patient registration data and physician diagnoses from 13 outpatient clinics for 2000 visits daily in its medical, surgical, pediatric and obstetrical clinics. Pharmacists in the outpatient pharmacies entered 1,200 prescriptions daily into the appropriate electronic patient records. A clinical laboratory subsystem handled data for 3,000 daily lab tests. Electrocardiogram, pathology and radiology reports were recorded via IBM magnetic tape-selectric typewriters. All systems data was fed via phone data line from a Honeywell mini-computer on-site in San Francisco to the central IBM computer in Oakland.

"Though the project terminated in 1973 when the granting agency went out of existence informaticians viewed the KP San Francisco integrated system as a milestone achievement in medical information systems" (http://www.clinfowiki.org/wiki/index.php/Multiphasic_Health_Testing_System_(MHTS), accessed 02-2018).

Second edition, edited by Morris F. Collen and Marion J. Ball, and published the year after Collen's death at the age of 100, retitled The history of medical informatics in the United States (New York: Springer, 2015).