Morris Collen, MD *

Dr. Morris Collen has had a profound influence, not only on the creation of the field of informatics, but also on healthcare delivery and the creation of new models of payment and prevention. Dr. Collenís remarkable career began in 1942 when he was selected by Dr. Sidney Garfield, a surgeon, to join him as an internist in a California group practice. Drs Garfield and Collen subsequently worked with the industrialist Henry Kaiser, who is credited with creating one of the first comprehensive prepaid health plans for both office and hospital care. This led to the establishment of Kaiser Permanente in the post-World War II period plus a comprehensive infrastructure of hospitals in the Bay Area near San Francisco and near Portland, Oregon. In the subsequent decades, the Kaiser organization grew to become a nationwide healthcare provider with millions of enrollees. Dr. Collen rose to the positions of Medical Director of the West Bay Division and Physician in Chief, San Francisco and served as a member of the Executive Committee of The Permanente Medical Group, which he chaired from 1949 to 1973. Dr. Collen had obtained a degree in electrical engineering before engaging in medical studies. In the 1950s, the need to gain efficiencies in health care led him and Dr. Garfield to re-engineer health care delivery in their environment. Together they pursued a grand scheme of converting acute care into disease prevention, and beyond that to health maintenance. This led him to introduce a fundamentally new tool, which recently had become available to businesses, into health careóthe computer. He used computers to track his members' health status, and to run comprehensive periodic health checkups on healthy plan members. This "multi-phasic screening" approach, introduced during the fifties and early sixties and delivered in the streamlined architectural environment of a multi-phasic health screening center, included physical examinations, comprehensive laboratory tests, electrophysiology tests, radiographs, and an automated self-administered medical history. Within a decade, Dr. Collen accumulated several millions of health checkup data sets on more than a million subjects, creating in the process not only a prototype electronic health record, but also a phenomenal and unique basis for research, and this despite the immaturity of the technology available in the fifties and sixties. For the pursuit of the scientific aspects of his work, Dr. Collen founded the Medical Methods Research Division within Kaiser Permanente in Oakland, to which he added the Division of Technology Assessment in 1979 that he directed until his retirement in 1983, at age 70. By the time of his retirement that year, Dr. Collen listed some 150 publications in his scientific output and had held appointments at multiple first-class universities, including Johns Hopkins and Stanford. He was elected to membership in the Institute of Medicine of the National Academy of Sciences (1971), and has served in many capacities on many committees of the National Library of Medicine. Since the mid-1950s, the emphasis of Dr. Collenís voluminous writing has shifted from clinical studies to electronic medical records, and hospital and health information systems. This includes a book on Hospital Information Systems and a book on Multiphasic Health Testing Services, both of which have become classics. Adapted in part from a tribute written by Jochen Moehr, J Am Med Inform Assoc. 2003 Nov-Dec; 10(6): 613ñ615. Written on the occasion of Dr. Collenís 90th birthday, the JAMIA article provides additional information on his accomplishments after election to ACMI fellowship in 1984.