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The increasingly complex informatics technology that evolved since 1950 created a new domain of knowledge and a new professional discipline. In this chapter we discuss the foundations and evolution of the fi eld of medical informatics, focusing on the role of publications, professional organizations, government, and industry in promoting the fi eld's growth, success, and impact. The earliest reports on biomedical applications of computers began to appear at conferences sponsored by professional engineering societies as early as 1947. The English term, medical informatics , was successfully introduced at an international meeting held in 1974. Subsequently the range of topics and the fi eld's scientifi c base have broadened, while academic informatics programs have been established at a growing number of institutions. The number of informatics articles published annually has grown rapidly, as have peer-reviewed informatics journals, the fi rst two of which were launched in the 1960s. The fi rst comprehensive medical informatics textbook (published in 1990) is now in its fourth edition. Starting in the 1960s, multiple organizations have been formed to focus on medical informatics; as their activities and infl uence increased, mergers followed, ultimately resulting in the creation of the American Medical Informatics Association (AMIA) in 1988. Other key players have included nursing, industry, academia, and the federal government, especially through the National Institutes of Health (NIH). More recently the fi eld has been further nurtured at the federal level by the Offi ce of the National Coordinator (ONC), which has championed the diffusion of electronic medical records, and the National Center for Advancing Translational Science (NCATS), which has funded clinical translational science awards and their supporting information systems.
The increasingly complex informatics technology that evolved since 1950 created a new domain of knowledge and a new professional discipline. In this chapter we discuss the foundations and evolution of the fi eld of medical informatics, focusing on the role of publications, professional organizations, government, and industry in promoting the fi eld's growth, success, and impact. The earliest reports on biomedical applications of computers began to appear at conferences sponsored by professional engineering societies as early as 1947. The English term, medical informatics , was successfully introduced at an international meeting held in 1974. Subsequently the range of topics and the fi eld's scientifi c base have broadened, while academic informatics programs have been established at a growing number of institutions. The number of informatics articles published annually has grown rapidly, as have peer-reviewed informatics journals, the fi rst two of which were launched in the 1960s. The fi rst comprehensive medical informatics textbook (published in 1990) is now in its fourth edition. Starting in the 1960s, multiple organizations have been formed to focus on medical informatics; as their activities and infl uence increased, mergers followed, ultimately resulting in the creation of the American Medical Informatics Association (AMIA) in 1988. Other key players have included nursing, industry, academia, and the federal government, especially through the National Institutes of Health (NIH). More recently the fi eld has been further nurtured at the federal level by the Offi ce of the National Coordinator (ONC), which has championed the diffusion of electronic medical records, and the National Center for Advancing Translational Science (NCATS), which has funded clinical translational science awards and their supporting information systems.
The genomics community has frequently compared advances in sequencing to advances in microelectronics. Lately there have been many claims, including by the National Human Genome Research Institute (NHGRI), that genomics is outpacing developments in computing as measured by Moore's law - the notion that computers double in processing capability per dollar spent every 18-24 months. Celebrations of the "$1000 genome" and other speed-related sequencing milestones might be dismissed as a distraction from genomics' slowness in delivering clinical breakthroughs, but the fact that such celebrations have been persistently encouraged by the NHGRI reveals a great deal about the priorities and expectations of the American general public, the intended audience of the genomics-computing comparison. By delving into the history of speculative thinking about sequencing and computing, this article demonstrates just how much more receptive to high-risk/high-payoff ventures the NIH and the general public have become. The article also provides access to some of the roots and consequences of the association of "innovation talk" with genomics, and the means to look past that association to the less glamorous (but arguably much more important) contributions of the NHGRI to building the field of genomics.
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