Canada teaches world to cure sick with computers

Health care continues to dominate the national agenda, and often IT is looked upon as a means to repair what’s perceived to be a broken system. What’s not well-known is that Canada was in fact a pioneer in developing medical computer systems.

In the mid-sixties the Manitoba government decided to build a new hospital adjacent to the University of Manitoba. The Victoria General Hospital was meant to replace an existing facility in downtown Winnipeg.

The new administrator approached me while I was at the university to see if computers might play a role in the new hospital. We conducted a feasibility study and quickly showed how an integrated hospital information system could be developed at a reasonable cost.

As far as is known, that study led to the first hospital design in the world to provision for computer terminals in every patient room, necessitating what at the time were some significant architectural design considerations.

The response to the feasibility report was also phenomenal. As many as 3,000 copies were requested from all around the world. I was invited to speak to a vast array of medical groups across Canada, the U.S. and Europe.

The presentations focused on how computers could aid with diagnosis, to accept the various orders given by doctors, accept test results, monitor prescriptions, help in the preparation of nurses notes, maintain the patient record, and similar topics related to patient care. These were all new concepts. Next we decided to develop a pilot system, at which point a development team was assembled, made of nurses and doctors, as well as pharmacy and administrative representatives.

In addition, an official from the Harvard Medical School and the Massachusetts General Hospital flew to Winnipeg from Boston once a month to review progress and give advice. He was involved in some of the early hospital automation activity in Boston.

It’s clear now that the project was at least two years ahead of any other in North America at that time, a view confirmed by visitors from, and visits tom various hospitals and installations in North America and Europe, with one exception to be shortly discussed.

Most hospital computer systems up to this time (there weren’t many) had concentrated on the rather mundane patient billing and insurance activity. The new Victoria General Hospital system linked the physician with the labs, x-ray, pharmacy, and other patient-oriented situations, all tied together through the physician’s order. This was the key to its success.

There was one exception to its uniqueness — the Mayo Clinic system developed by Lockheed Missiles and Aerospace. Upon learning of our project, they phoned me and asked “is your system for real?” It was a legitimate question in view of all the published garbage of the period. They visited Winnipeg three times, while I visited their project at the Mayo Clinic in Rochester, Minn. It was uncanny how we had independently gone through the same thinking processes and arrived at the same solutions.

There were only two differences in what we had developed. Lockheed had the physician enter one order at a time, while we allowed the doctor to initiate several at once, leaving the computer to keep track. The other difference was in the application software; we used a single generalized program while Lockheed had a separate program for each application.

The way the system operated will be the subject of my next column.

Hodson is an Ottawa-based IT industry veteran who has helped develop Canadian computer science programs. Contact him at [email protected].

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