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Medical Informatics Section History

Developed by the section for the MLA Centennial, 1998

Founding
1986 was an important year for medical informatics in the United States. MEDINFO, the World Congress of Medical Informatics, was held in Washington, DC, in conjunction with the Symposium on Computer Application in Medical Care (SCAMC), and members of the Medical Library Association (MLA) took the first step toward establishment of a Medical Informatics Section.

Peter Stangl, then director, Lane Medical Library, Stanford University, and Anthony Aguirre, then librarian of the College of Physicians of Philadelphia Library, organized the first informal meeting of the section's precursor, the Medical Informatics Roundtable, on May 20, 1986, at MLA's 86th Annual Meeting in Minneapolis, MN. At that time there was little or no MLA programming devoted to digital data and no obvious organizational home for the development of such programming. Setting a pattern that has endured, the first roundtable meeting focused on planning programs. Mr. Stangl and Mr. Aguirre took the lead to develop both a regular program session and a medical informatics tutorial for the 1987 Annual Meeting.

Peter Stangl can be considered the founder of MLA's Medical Informatics Section. In addition to his work in 1986, he organized the second and third meetings of the Medical Informatics Roundtable: on May 18, 1987 in Portland, OR, and on May 25, 1988, in New Orleans, LA. He organized, raised funds, and chaired the roundtable's program sessions in 1987 and 1988. These were held jointly with the Medical School Libraries Section because the more informal roundtables were not eligible to sponsor programs on their own. The success of the roundtable's programs—not to mention Mr. Stangl's success as a fundraiser—increased MLA's interest in bringing the new medical informatics group into the association's formal organizational structure. Mr. Stangl collected the signatures required to petition for section status in record time, prepared the application, and was elected chair, pro tem of the provisional section on May 25, 1988. The section was provisionally accepted by MLA's Section Council and approved by the MLA Board of Directors at the 1988 Annual Meeting.

The provisional section, then known as the "Section on Medical Informatics", saw its mission as "establishing bridges between medical librarians and medical informatics professionals", and had three initial goals:

  • to move toward permanent section status,
  • to elect officers
  • to develop a program for the 1989 meeting.

This pragmatic approach has proven to be a lasting section characteristic. (To date, there has been little or no section interest in philosophical questions, e.g., is it possible to build bridges between overlapping fields? Where does medical librarianship end and medical informatics begin?) By 1989, the name of the section had changed (at least in the MLAAnnual Report) to Medical Informatics Section. At the 1991 annual meeting in San Francisco, CA, the MLA Board of Directors approved the recommendation of the MLA Section Council that the Medical Informatics Section be granted permanent section status.


Growth
From its inception, the Medical Informatics Section has had a relatively large membership and a healthy budget. The 1988/89 annual report of the provisional "Section on Medical Informatics" stated that as of February 28, 1989 the membership stood at 173 and the treasury at $841.43. At the 1989 dection meeting in May, the first Membership Committee was appointed to develop a plan for section member recruitment and retention. The committee proceeded to develop an excellent section logo, brochure, and recruitment strategies—not the least of which was the sponsorship of excellent programs.

By January 31, 1993, the Medical Informatics Section had 412 members and $12,520.29 in the treasury. The growth in the budget reflected both the increased membership and the section's share of the income from the 1991 and 1992 post-conferences it sponsored. Registration fees for pre- and post-conferences associated with the MLA annual meeting are set by headquarters under guidelines for continuing education (CE) activities. The break-even point is set conservatively. If a conference attracts more than the projected number of attendees, a sponsoring section receives a share of the profits. The fees charged for special section programs have been a topic of considerable discussion between section leaders and MLA headquarters over the years, with section leaders attempting to use section funds to lower charges to participants.

As of May 1998, there were 476 section members and $24,523 in the treasury. The section now ranks third in size among all MLA sections, behind the Hospital Libraries and Consumer and Patient Health sections.


Programs
The Medical Informatics Section has always focused major attention on organizing outstanding programs for the annual meeting. The first Medical Informatics Roundtable/Medical School Libraries Section program in Portland, OR, in 1987 set a high standard. The theme, echoing that of the annual meeting, was "Medical Informatics: Confluence of Medical Informatics, Research, Education, and Patient Care with Information Management", and the speakers were Jack D. Myers, M.D., developer of the Internist medical expert system, University of Pittsburgh; Robert A. Greenes, M.D., Ph.D., Harvard Medical School; Anthony G. Gorry, Ph.D., Baylor College of Medicine; and Mark S. Tuttle, substituting for Marsden S. Blois, M.D., Ph.D., University of California, San Francisco, who was ill and could not attend.

This first session began what has been an uninterrupted series of programs sponsored by the Medical Informatics Section at annual meetings. It exhibited many of the characteristics of subsequent section programming: a timely and appealing theme, experts in the field of medical informatics, and co-sponsorship with another MLA section. A Tutorial on Medical Informatics, also organized by the roundtable, was held just prior to the 1987 annual meeting.

Although the founders of the section were interested in permanent section status in part because it conferred the right to organize programs independently, the Medical Informatics Section has always been interested in collaborating with other MLA sections on the development of programs for the annual meeting. The goal has been to design programs that are interesting and useful to many association members and to illustrate the relevance of informatics to medical librarianship and vice versa. To date, the Medical Informatics Section has co-sponsored one or more sessions with thirteen other MLA sections and groups:

Consumer Health Section

Educational Media and Technologies Section

Hospital Libraries Section

Library Research Section

Medical Library Education Section

Medical School Libraries Section

Medical Society Libraries Section

Molecular Biology and Genomics Special Interest Group

National Program Committee

Public Health/Health Administration Libraries Section

Public Services Section

Research Section

Technical Services Section

Except in 1990, when the National Program Committee asked the Medical Informatics Section to help organize an information services track for the annual meeting, the section has developed one or more programs for every annual meeting since 1987. Regular programming for the 1998 Annual Meeting was typical: the section co-sponsored four sessions with three other MLA sections. In addition to its regular program planning for future MLA annual meetings, the section is currently working with the Scientific Program Committee for the 8th International Congress on Medical Librarianship, to be held in London in 2000, to develop a special informatics session for that meeting.

Beyond sessions during the regular annual meeting, the Medical Informatics Section may hold a record for the most pre- or post-conference symposiums sponsored or co-sponsored in a decade—five since its founding in 1988:

  • Unified Medical Language System (UMLS) and its Applications for Integrated Academic Information Management Systems (IAIMS) (1991)—with the American Medical Informatics Association (AMIA)
  • Electronic Imaging and Interactive Video (1992)—with the Educational Media and Technologies Section
  • Building the National Health Information Infrastructure: the Role of High Performance Computing and Communications (1994)
  • Telemedicine: Supporting Decisions by Patients, Caregivers, and Administrators (1996)—co-sponsored with AMIA
  • Impact of Genomics on Twenty-first Century Medicine (1998)—with the Molecular Biology and Genomics Special Interest Group

Each of these programs attracted 75-100 MLA members and received very favorable evaluations.

The Medical Informatics Section also organized highly successful CE courses on "Topics in Medical Informatics" and "Information Technology Survival Skills for Librarians" for the 1992 and 1993 annual meetings respectively.

Over the years, section members have exhibited a strong tendency to dispatch administrative matters quickly so that more time can be devoted to developing programs. In one memorable example, those attending the 1994 section business meeting moved, seconded, and voted approval of by-laws changes before the section chair had finished distributing the text of the proposed amendments. (To be fair, the nature of the changes had been briefly explained before the vote.)


Communication
From the outset, section leaders communicated and conducted business via e-mail. The Medical Informatics Section was also a relatively early adopter of electronic communication as a means for reaching the membership. The section newsletter premiered as a print publication in 1991, began electronic distribution in 1993, and became a Web publication in 1995.

James Shedlock established the newsletter, shepherded its transition from print to listserv to Web, and hosted the listserv and then the Web site at Northwestern until 1998 when it moved to MLA. The newsletter has served as a vehicle for conveying information about section business and programs, for announcing and reporting on other medical informatics programs, opportunities, and developments, and for informing members about topics of interest., e.g., establishing Internet connections without institutional support. The section's Centennial programs were announced on the Web site well before the annual meeting.

Between the 1994 and 1995 annual meetings, Nancy Start, founder of MEDLIB-L, approached the the section's Executive Committee to discuss the possibility that the section might assume responsibility for this listserv. The section leadership concluded that it would difficult for a distributed group of people to operate a listserv and that a section could not hire and supervise the required part-time staff person to operate the list. The matter was referred to MLA's Board of Directors for discussion and action at the 1995 Annual Meeting, and subsequently MLA assumed responsibility for MEDLIB-L.

In the sole example of a declared objective that was not actually achieved, from 1994-96 the section attempted to start a series of critical research review articles on topics related to medical informatics for publication in the Bulletin of the Medical Library Association. Several section members started work on such articles, but were forced to abandon them due to the press of other commitments.


Scholarships
Attendees at the 1992 section business meeting proposed the establishment of a scholarship that would support section members in attending medical informatics programs, including MLA post-conferences and CE courses, the Symposium on Computer Applications in Medical Care (SCAMC) and other programs sponsored by the American Medical Informatics Association, etc. The proposal reflected a concern that the cost of informatics programs was prohibitive for many members and an interest in providing opportunities for mid-career librarians and those just entering the profession.

By 1992 the section's budget was well able to support a scholarship program, and the first deadline for submission of applications was March 1, 1993. Although several section members benefited from the scholarship program, the number of applicants was disappointing, and the section explored various ways to increase its visibility. To this end, in 1996 the section scholarship became the Medical Informatics Section/MLA Career Development Grant, which is open to all MLA members and recognized at the annual MLA awards ceremony. The award provides up to two individuals $1000 to support a career development activity that will contribute to advancement in the field of medical informatics. The first two recipients of the grant were Julie McGowan, Ph.D., and Linda Hogan in 1997.


Relationship with the American Medical Informatics Association
The American Medical Informatics Association (AMIA) was formed by the merger of several organizations in 1989, a year after MLA's Medical Informatics Section was granted provisional status. Section leaders immediately moved to promote collaboration and interaction between MLA and AMIA. As a young organization, AMIA did not have its meeting locations set far in advance. Its first president, Donald A.B. Lindberg, M.D., and Board of Directors accepted with enthusiasm the section's proposal that AMIA hold its 1991 annual Spring Congress in San Francisco, CA, immediately following MLA's annual meeting and that MLA and AMIA collaborate on a joint program. The one-day program constituted a post-conference for MLA and the first day of AMIA's spring congress, establishing a model that was repeated in Kansas City, MO, in 1996 and in Philadelphia in 1998.

The Medical Informatics Section proposed and organized the 1991 and 1996 joint programs. The AMIA board proposed the 1998 joint program to the MLA board, at the instigation of section members serving on the AMIA board. In recent years, MLA and AMIA have also collaborated on public policy issues of interest to both associations. A Medical Informatics Section member serves as MLA's representative to AMIA's Advisory Council.


Summary
The relatively short, but highly successful history of the Medical Informatics Section might be summed up as follows: many section members planned and organized exciting programs, people came, and the section prospered.


By Betsy L. Humphreys, AHIP
8/6/98