Masic: Historical Background of Medical Informatics Development – Preface

Izet Masic: At the very beginning of its development, Medical informatics is considered a discipline that could be helpful but not necessary a discipline

Prof Izet Masic MD, PhD Photo: Social Media

The history of Medical/Health/Biomedical informatics had begun between the fifties and sixties of the last century. In the wake of the Second World War when a few doctors and researchers were exploring the role of computers and when they tried to involve their possibilities for improving the diagnostic and treatment of health conditions of patients and helping to better diagnose diseases.

They used logic and probabilistic reasoning to tackle specific healthcare problems in biology, physiology, and a few disciplines in medicine.

The initial step was Lee Lusted’s and Robert Ledley’s article published in 1959 in the respected journal “Science” in which authors described their idea of using data analysis in medical research and diagnosis. Robert S. Ledley and Lee B. Lusted published “Reasoning Foundations of Medical Diagnosis,” a widely read article that introduced computing, especially operations research techniques to medical professionals.

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Ledley’s and Lusted’s article has remained influential for decades, especially within the field of Medical Decision-Making. Guided by Ledley’s late 1950s survey of computer use in biology and medicine the National Institute of Health in Bethesda, USA (NIH) undertook the first major effort to introduce computers to biology and medicine. Drs. Lee Lusted and Robert Ledley promoted formalizing statistical approaches for modeling medical decision-making as a way of reducing errors, among other benefits. At that time computers were not yet advanced enough to provide individual care providers and hospital systems with the tools to conduct these analyses.

Medical informatics as an academic and scientific discipline is relatively young if we compared it to other biomedical disciplines.

The development of Medical informatics was a direct correlation with the advent and widespread use of digital computers and the development of information and communication technologies (ICTs) based just on these computers. In previous decades medicine and health care services have changed significantly thanks to developments in biomedical informatics and its Izet Masic application in medical education and health care protection, especially in medical diagnostics.

In the period after the Second World War USA was the leading country in the field of Computer science and the leader in using the first computers in medicine and healthcare services. The last two decades of the 20th century were particularly important for the development of Medical informatics, with the great influence of the Internet by medical professionals at every level of the health care system.

Today, we can hardly imagine diagnostic procedures, such as, for example, Magnetic Resonance Imaging (MRI), Computerized Tomography (CT), Positron Emission Tomography (PET scan), etc. MRI is a medical imaging technique that uses a magnetic field and computer-generated radio waves to create detailed images of the organs and tissues in your body. CT of the body uses sophisticated X-ray technology to help detect a variety of diseases and conditions. CT scanning is fast, painless, non-invasive, and accurate. In emergency cases, it can reveal internal injuries and bleed quickly enough to help save lives. A PET scan is an imaging test that can help reveal the metabolic or biochemical function of your tissues and organs. The PET scan uses a radioactive drug (tracer) to show both normal and abnormal metabolic activity.

Most of these sophisticated machines contain excellent software for access to medical knowledge without access to numerous databases, or electronic storage of data relating to patients, without information technology in medicine.

At the very beginning of its development, Medical informatics is considered a discipline that could be helpful but not necessary discipline.

However, today it is one of the bases in medicine and health care in general. That is why, a lot is expected of Medical informatics, in terms of providing support to health care services in all parts of the world as well as in contributing to its quality and efficiency, and innovation in biomedicine and research in biomedical sciences. The process of its growth continues so that today’s work is tomorrow’s history. A ‘historical’ discussion of the area is its history to date, a report rather than a summation.

When talking about the development of Medical informatics, the important place has an international non-profit organization IMIA (International Medical Informatics Association), and its branch associations, especially European Federation for Medical Informatics (EFMI) that whose work covers all continents and comprises more than 70 academic institutions and more than 50,000 individuals. In the promotion and spreading out of knowledge and experiences of Medical informatics as a scientific and academic discipline, both have a great impact in spreading medico technological knowledge worldwide.

Its role in this rapid development of Medical informatics is presented by its objectives: promotion of ICTs in health care, public health, and biomedical research; stimulating research, development, and everyday promotion of education and responsible behavior ̧ moving ICT from theory to practice in all areas of health care and stimulation of progress, implementation of new technologies and research.

Everything mentioned above couldn’t be realized without the contributions of the great scientists and their discoveries and achievements.

Thanks to them today we can speak about the great improvement of health care protection on every level of the healthcare systems in almost every country in the world. Comprehensive and essential content on Medical informatics, but also the aspects nurtured by the main „schools of Medical informatics“ – Anglo-Saxons (Abbot, Anderson, Barber, etc.), French (Gremy, Remond, etc.), German (Reichhertz, Wagner). et al.), American (Collen, Warner, Greens, Hammond, Ball, Shortliffe, et al.), Middle and East Europe (Dezelic, Masic, Zvarova, Naszlady, Mihalas, etc.), whose terms „Health Informatics“ (Abbot) and „Medical Informatics“ (Gremy and Reichertz) have entered the European and world medical literature.

For those studying the subject or working in the field, the experiences of others who use Information and Communication Technologies (ICTs) for the better of health care can provide a necessary perspective.

But, the most influential association became the European Federation for Medical Informatics (EFMI), established on September 11th, 1976 in Copenhagen with members of 10 national representatives (Barry Barber (UK), Antonio Perens de Talens (Italy), Francois Grémy (France), Rolf Hansen (Norway), Mogens Jorgensen (Denmark), Hans Peterson (Sweden), Peter Leo Reichertz (Germany), Jan Roukens (Netherlands), Jan van Egmond (Belgium) and Ilkka Vaananen (Finland) who adopted Statute of EFMI and other documents and prepared the first MIE Conference in Cambridge (UK) in 1978. Today EFMI represents the leading European medical informatics professional organization representing 31 European countries and institutional members. EFMI is organized as a non-profit organization concerned with the theory and practice of Information Science and Technology within the Health and Health Sciences sector, in a European context.

Finally, the Editor of this book shortly described important facts about the history of the development of Biomedical informatics in the world including in South-Eastern Europe countries, and pointed out facts about biomedical experts’ contributions during the long period of his participation in IMIA General Assembly and EFMI Council. As well as its successes, the history of Health/Medical/Biomedical Informatics is populated with visionary promises that have failed to materialize despite the best intentions.

Some of the chapters in this book already were published in the book “Contributions to the History of Medical Informatics” in the First Edition edited and printed in 2014 by Izet Masic and George Mihalas, after organizing the Special Topic Conference about History of Medical Informatics, held in Prague in 2013, organized by Professor Jana Zvarova and chaired by George Mihalas, Casimir Kulikowski, and full papers presented at this Conference were published in the journal Acta Informatica Medica and, also, involved in this book.

Development of Medical informatics in other parts of Europe and in the world, including a description of contributions of most influential academics, scientists, and experts within this field of medicine, the author described with 30 co-authors from all parts of the world, in the mentioned book and, also, in other two monographs – “Honorary Fellows of EFMI” and “Honorary Fellows of IMIA” (published in 2017 and 2018).

Also, some other authors, most influential medical informatics academics, and experts described some important historical facts about the development of Medical informatics in the past.

Editor of this book in his Chapter “The Most Influential Scientists in the Development of Medical Informatics” described Curriculum Vitae and bio sketch formats of a few most influential biomedical experts in the scientific and academic field of biomedicine with their important contributions in the biomedical informatics. In this chapter, we tried to describe a short fact about some of the most influential medical informaticians during the history of the development of this scientific discipline. The number of 31 published CVs in the biomedical journal “Acta Informatica Medica” (the journal founded by Izet Masic in 1993) were printed in the issues, published from 2014 until 2021, and deposited in PubMed, PubMed Central, Scopus, and other databases.

Also, some of the chapters in this book were published as articles in Acta Informatica Medica journal and in the International Journal on Biomedicine and Healthcare, issues printed during 2018-2020 (the journal is founded by Jana Zvarova in 2013, and she was Editor-in-Chief during period 2013-2017, and Izet Masic, who is Editor-in-Chief from 2018 to present). Mentioned published articles are re-published with permission of the authors of the chapters in the book and Publisher “Avicena”, Sarajevo and Academy of Medical Sciences of Bosnia and Herzegovina (both journals are official journals of the Academy – AMNuBiH). Acta Informatica Medica journal is, also, the official journal of the European Federation for Medical Informatics (EFMI).

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