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Managing medical information: from statistics to computers

Card sorter, United Kingdom, 1967

Card sorter, United Kingdom, 1967

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Medical diagnosis relies on collecting and interpreting medical facts, and technology that manages large amounts of information is central to medicine. Computers transformed medical practice. They collected, analysed and used more medical data than before. By the late 1900s the majority of diagnostic practices were performed by computers rather than doctors.

Collecting medical information

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Medical facts were initially collected about individual body functions. During the 1800s medical scientists gathered facts about large groups of individuals. These population data were known as medical statistics. They revealed information about the cause or spread of ill health. Scientists such as Francis Galton used population data to develop a now discredited theory of human inheritance called eugenics.

Technology transforms medical data

From the 1800s, tabulating machines were data-sorting devices that transformed how medical information was kept. Medical statistics, hospital patient records and other medical data were recorded by punching holes into cards. The devices rapidly sorted large numbers of cards to produce useful medical information.

Machines discover the cause of lung cancer

Card tabulators were useful within epidemiology, in population studies to discover the cause of disease. In 1950 the doctor Richard Doll and the statistician Austin Bradford Hill published the results of one of the 20th century’s significant epidemiological studies. Between 1922 and 1947, lung cancer deaths rose by 1500%. Doll and Hill used a tabulating machine to analyse their data, and demonstrated smoking was the biggest factor linked to lung cancer.

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Computers revolutionise hospital diagnosis

Computers changed diagnostic practises from the 1950s. Rapidly collecting and analysing medical information created powerful diagnostic tools. Computers advanced medical imaging far beyond X‑rays. In 1971 a CT scanner, built by Godfrey Hounsfield, took the first image of a living brain. It used computers to store and analyse thousands of X‑ray measurements needed to produce the detailed picture. Imaging machines such as MRI and PET also used computers for image reconstructions.

Diagnostic tests were transformed by computers. In the early 1950s chemical tests were performed by hand. In 1958 Leonard Skeggs built the AutoAnalyzer, one of the earliest automated laboratory machines. Computer-controlled machines made diagnostic testing more rapid, reliable and economical. Computerisation also increased the range of diagnostic tests.

The internet transforms patient experience

Computers significantly changed the relationship between doctors and patients. The growth of the internet since the 1980s saw a huge increase in health information directly accessible to patients. Patients may easily research medical information online, and can use it to question and challenge their doctor’s decisions.

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Computers and the human genome

By the 1990s, the role of genetics in health had begun to be understood. However, revealing the entire genetic human blueprint could only be accomplished through immense computing power. Between 1990 and 2003, the Human Genome Project used supercomputers to process the 6 billion DNA bases that make us human. Medical scientists used computers to track specific parts of the sequence and identify genes affecting our health. These are stored in online databases, so anyone can access the human DNA sequence.

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Bibliography

J Bronzino, V Smith and M Wade (eds), Medical Technology and Society: an interdisciplinary perspective (Massachusetts: MIT press, 1990)

M Collen, 'A brief historical overview of hospital information system evolution in the United States', International Journal of Biomedical Computing, 29 (1991), pp 169- 89

J Diaz, ‘Patients’ use of the internet for medical information’, Journal of General International Medicine, 17 (2002) pp 180-85

S Dickerson and P Brennan, ‘The Internet as a Catalyst for Shifting Power in Provider-Patient Relationships’, Nursing Outlook, 50 (2002), pp 195-203,

S Erdem, and J Harrison-Walker, ‘The role of the Internet in physician-patient relationships: The issue of trust’, Business Horizons, 49 (2006), pp 387-93

E Higgs, ‘The statistical Big Bang of 1911: ideology, technological innovation and the production of medical statistics’, Social History of Medicine, 9 (1996), pp 409-426

J Howell, Technology in the Hospital: Transforming Patient Care in the Early Twentieth Century (John Hopkins University Press, 1995)

E Magnello and A Hardy, (eds) The Road to Medical Statistics (New York: Rodopi, 2002)

S J Reiser, Medicine and the Reign of Technology (Cambridge: Cambridge University Press, 1978)

Glossary:

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