MEDICAL INFORMATICSNEWSLETTER

A Publication of IFLP-IMTA(International Medical Informatics Association)

Vol. 15 No.lEditors: O. RIENHOFF (resp.), P. DEGOULET (Europe),D.A.B. LINDBERG (North America), K.C. LUN (Asia),

A. MEHDAOUI (Africa), R.J. RODRIGUES (Latin America)March 1990

American Medical InformaticsAssociation Founded

The merger of the American Associ-ation for Medical Systems and Infor-matics the Symposium on ComputerApplications in Medical Care and theAmerican College of Medical Inform-atics into the new American MedicalInformatics Assiciation (AMIA) isnow complete.With the dissolution of AAMSI inNovember and SCAMC in January,the AMIA Board of Directors met onJanuary 9, 1990, prepared to moveforward as the single organization inthe United States solely focused oncomputer applications in health care,education and research. Pening themeeting, the President, Donald A.B.

Officers and Directors

President:Donald A. B. Lindberg, M.I) .

Treasurer:W. Edward Hammond, Ph.D.

SecretaryPart Jacobs, R.N., M.N.Board of Directors 1989

Michael J. Ackerman, Ph.D.G. Octo Barnett, M.I).Morris Collen, M.D.

Daniel K. HarrisEdward J. Hinman, M.D., MPH

Frank Holden, M.D.Clement J. McDonald, M.D.Helmuth F. Orthner, Ph.D.

Judith G. Ozbolt, Ph.D.Edward H. Shortliffe, M.D., Ph.D.

William W. Stead, M.D.Homer Warner, Ph.D.

Acting Executive DirectorMichael Hamm

Lindberg, Director of the National Li-brary of Medicine, commented on thebright future of the organization, andthe active role it hoped to play in bothdomestic and international mattersrelated to medical informatics.The highly regarded and well attendedSymposium on Computer Applicati-ons in Medical Care (SCAMC) willcontinue to be held each November,but now as the official annual confer-ence of AMIA. The program for the14th Annual Symposium, to be heldNovember 5—8, 1990, is now beingassembled under the leadership of Dr.Randolph Miller and the University ofPittsburgh. More than 2,000 comput-er and health care scientists are expec-ted to attend. Organizations represent-ing denistry and veterinary medicinehave joined as co-sponsors, and areexpected to make major contributions.Meanwhile, AMIA announced its in-tention to conduct smaller, focussedmedical informatics meetings in thewestern part of the U.S. each spring orearly summer. The first of these is tobe held at Snowbird, Utah, June20-23, 1990 (cf. page 8 - COMINGEVENTS). Hosting the meeting willbe the Department of Medical Infor-matics at the University of Utah in SaltLake City. Dr. Joyce Mitchell of theUniversity of Missouri serves as theProgram Chair.For further information about AMIAand conditions for membership pleaseapply to: American MedicalInformatics Association1101 Connecticut Av., NW; Suite 700Washington, DC 20036 / U.S.A.For information about the SCAMCConference, contact:SCAMC - Office of ContinuingMedical EducationGeorge Washington University2300 K Street, NWWashington, DC 20027 / U.S.A.

Maria Ball and Thomas Piemme representedAMIA at MEDINFO in Singapore.

Dr. Lindberg has formed the AMIAInternational Affairs Committee,which has begun on some of the fol-lowing initiatives:1. To make a conscientious effort to

have formal American representa-tion on each of the IMIA WorkingGroups.

2. To form an international travelcommittee to be chaired by Dr. PhilR. Manning in preparation forMEDINFO 92 and other IMIA ac-tivities, Working Groups and Euro-pean meetings.

The six individuals who constitute thecore group are: Dr. Marion J. Ball(Chairman), Dr. Richard K.C. Hsieh,Dr. Charles Flagle, Dr. Morris Collen,Dr. Thomas Piemme and Dr. PhilManning.For further information, please feelfree to contact Dr. Marion J. Ball,Chairman, International Affaire Com-mittee:Dr. Marion J. BallAssociate Vice PresidentInformation ResourcesUniversity of Maryland at Baltimore610 West Lombard StreetBaltimore, Maryland / U.S.A.Tel. (301)328-2004Fax: (301)328-8459EARN: Bitnet MJB at UMAB

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IMIAAims:- to promote informatics in health care

and biomedical research- to advance international co-operation- to stimulate research, development and

routine application- to further the dissemination and ex-

change of information— to encourage education and responsible

behaviour; and- to represent IFIP with the World Health

Organisation and any other relevant pro-fessional or governmental organization

EXECUTIVE BOARD:J.L. WILLEMS, Belgium (President)S. KAIHARA, Japan (Past President)F.H. ROGER, Belgium (Vice-Pres. EFMI)V. YACUBSOHN, Argentina

(Vice-President IMIA-LAC)R. SALAMON, France (Secretary)A.R. BARKER, The Netherl. (Treasurer)M.J. BALL, U.S.A. (Trustee)J.H. FLINT, Canada (Trustee)J. MICHEL, G.D.R. (Trustee)Z. OUYANG, P.R.C. (Trustee)J.R. SCHERRER, Switzerland (Trustee)

IMIA NEWSLETTER:Technical and responsible editor:O. RIENHOFFInstitute of Medical InformaticsPhilipps-UniversityBunsenstrasse 3D-3550 Marburg/F.R.G.Regional editors:Europe - P. DEGOULET, FranceNorth America- D.A.B. L1NDBERG, U.S.A.Asia - K.CH. LUN, SingaporeAfrica - A. MEHDAOUI, MoroccoLat. America - R.J. RODRIGUES, BrazilFor addresses see list of IMIA represen-tatives.Please apply to the IMIA Secretariat, atthe address given below, for copies of theIMIA Newsletter and to be added to (orremoved from) the mailing list.The Secretariat can also answer inquiriesabout IMIA.The IMIA Newsletter may be reprinted,translated, and reproduced, in whole orin part, except for material specifically de-noted as copyright protected. Reprintingin national and local information pro-cessing periodicals is encouraged. Ac-knowledgement to IMIA would be ap-preciated. In order to reprint materialprotected by copyright, apply for permis-sion to the IMIA Secretariat, giving allpertinent details.Kindly submit material for the Newslettertwo months before the publication date.

Published by:IMIA Secretariat16 Place LongemalleCH-1204 Geneva/SWITZERLAND

Printed by:Offset-Druck R. Lindenhain GmbHGleiwitzer Strasse 2 aD-3012 Langenhagen-Godshorn/F.R.G.

Who is Who in IMIA?

Prof. Dr. Jos L. WillemsNew President at IMIA

Div. Medical InformaticsUniv. Hospital St. Rafael-GasthuisbergHerestraat 49B-3000 Leuvel/BELGIUM

On December 9Ih, 1989, IMIA electedtheir new President on the occasion oftheir annual General Meeting held inSingapore, prior to MEDINFO (Part II).

Prof. Willems was born in 1939 in Zolder, Belgium, and graduated inmedicine from the Catholic University of Leuven, in 1963. For thefollowing six years he specialized in cardiology at Leuven and Leiden, andthen spent two years (Oct. 1969 - Oct. 1971) as a Research Fellow of theWorld Health Organization with Dr. H.V. Pipberger in Washington, D.C.,gaining experience in cardiovascular data processing.

Returning to Leuven, he was appointed firstly Assistant-Professor (1973)later Associate (1979) and then full Professor (1988) in Medical Infor-matics at the Medical Faculty of Leuven University. Since 1971 until todate he has been Chairman of the Division of Medical Informatics at theUniversity of Leuven. In this function he teaches Medical Informatics tostudents of the Medical Faculty and the School of Public Health. Togetherwith his team he has developed an extensive computer network for theUniversity Hospitals of Leuven.

In 1978 he became President of Belgian Society for Medical Informatics(MIM) for a term of 4 years. Since that time he has been representingthe MIM in the General Assembly of IMIA. In December 1989, he waselected President of the International Medical Informatics Association(IMIA). He is member of the editional board of four scientific journals,and of several national and international professional sicieties. He isauthor or co-author of over 250 scientific papers.

Since 1980 he has been project leader of a large international concertedaction striving at "Common Standards for Quantitative Electrocardio-graphy" (CSE), which is supported by the European Commission. Investi-gators from 25 European institutes, six from North America and one fromJapan participate in this project. In his role of project leader he has beenvery active to obtain standardization of Computerized Electrocardio-graphy, first for standardized ECG measurement and next for diagnosticFCB computer programs. Recently he has launched a proposal to developstandards for interchange, encoding and storing of digital ECB data.

Prof. Willems is married and father of three children. Besides listening toclassic music, he likes windsurfing in summer.

MEDINFO 89 SINGAPOREClosing Address at the 6th World Congress on Medical Informatics

MEDINFO 89, Part II in Singapore,December, 10-14th 1989

by Jos L. Willems, President of IMIA

Dear Prof. Kaihara, Dear Dr. KC Lun,Dear Dr. Manning, Members of theProgram and of the Organizing Com-mittee, Dear Friends,Now that MEDINFO 89 is coming toan end, it is with great pleasure andadministration - and also with somerelief - that I want to thank you allfor this successful Conference. ThisMedinfo in Singapore after a turbu-lent history, achieved great successon all accounts, i.e. from a scientific,organizational and social point ofview.The scientific papers were of highquality, and for this I want to thankthe speakers and the session chair-men too, many of whom served as re-viewers for the SPC. A number of thedevelopments which have been pre-sented at this conference will have asignificant impact on the provisionand quality of health care in the yearsto come. The slogan for this MED-INFO "Informatics in Support ofGlobal Health" was well chosen.Time is going fast and informationflow almost faster. At this confer-ence, we have observed again a signi-ficant shift from managerial applica-tions to decision support and otherdevelopments, a shift which wasalready apparent at the Washingtonconference, I will not review the con-tents, neither tabulate the themes ofall the papers which were presented.Many things we heard were impres-sive, others promising, but let usremain critical and watch our field. Idare to say, that not everything whathas been said or even printed, is trueor even should be true.We should always carefully assess ourdate, their quality, relevance andimplications, especially when they arestored and handled by computer. Inthis fast moving area of telematicsand networking, we should be verycareful indeed, and be aware aboutethical implications, about confiden-tiality and responsibility, about theuser and the patient. When Dr. TAYENG SOON, Senior Minister forEducation announced in his openingaddress the installment of MediNETfor the health services in Singapore,he assured that confidential informa-tion will be protected. It is indeed ourduty, to take all steps and to verifythat confidentiality remains preser-ved.

We should at our future MEDINFO,and also at other conferences, have arenewed look at the various non-technical aspects of Health and Medi-cal Informatics. It is our duty — and itis great time indeed — that we focusagain on various ethical, legal andsocial issues of modern informationtechnology and information handling.During my term as IMIA President,I will try to do my best to promoteand watch this field.In the footsteps of my predecessor, Iwill try to achieve further the objec-tives that he specified.1. One - to enlarge and broaden thecoordination of the scientific activi-ties of IMIA. That shall be our primeobjective. To this end I will ask for arenewed look at the objectives andstructure of what we so far called theWorking Groups of IMIA.2. Two -- we will try to furtherenhance the international scope ofIMIA. For this we will be looking notonly to the EAST, but also to theWEST and to the SOUTH as well: tothe USSR and the Middle East, andalso Africa, and last but not least, toAMIA, the newly created AmericanMedical Informatics Association.As many of you know, thanks to Prof.Kaihara, IMIA has become an inde-pendent organization. Over the yearsIMIA has grown and the age of 20 or21 - in common accord with IFIP, itsparent organization, can now standon its own feet and be independent,let's hope indeed. Nevertheless, IMIAwill and shall not forget its origin.On the contrary, together with IFIPwe hope to organize joint conferen-ces on technical issues, on softwareengineering and even data protec-tion and legal issues too. And finally,we will need to solve the presentfinancial difficulties of IMIA.As president of IMIA, I sincerelyhope that MEDINFO 92 will be-come a great success. I can assureyou that we have a team whichmakes this possible and which willmake this happen:- Prof. Dr. Jean-Raoul Scherrer,Professor of Medical Informatics atthe University of Geneva, as Chair-man of the Organizing Committee.- Dr. Salah Mandil, Director of theInformation Support Systems of theWorld Health Organization, asChairman of the Scientific Pro-

gramme Committee.- Prof. Dr. Jochen R. Moehr of theDepartment of Medical Informaticsof Victoria University British Co-lumbia, Canada, as Vice-Chairmanof the SPC.— Dr. KC Lun, you all well know bynow, as Chairman of the EditorialCommittee.But before handing the word to mygood friend Jean-Raoul Scherrer, Istill want one more Minute of yourattention. As new president ofIMIA I will try to do my best, butplease do not compare me with Prof.Kaihara, my predecessor. He hasbeen so exceptional.Prof. Kaihara, during his wholeterm as president, but especially du-ring these last 6 turbulent months,has done so much for IMIA, that Icannot find the words to express ourgratitude. Everyone agrees that noother person than him could havesolved the problems IMIA has beenconfronted with. His deep under-standing of the cultures of the Eastand West, his personal touch anddiplomacy, have achieved that atleast some of us ultimately had notone but two successful MEDINFOConference. Of course, much morewas needed than understanding anddiplomacy: hard decisions, hardcurrency fund rising and maybe alsosleepless nights, but that of course issomething that he, as a true Japa-nese, will never us know. For allwhat he did for IMIA, I want tothank Prof. Kaihara wholeheartely.Prof. Lun, we want to thank you tooscincerely. You and your teamdeserve an Oscar, a special awardfrom IMIA for your organizationaltalents and all the work. You haveproven what these joyful, young-looking, dynamic and hard-workingChinese and other people from Sin-gapore can achieve in this prospe-rous City-state. We all enjoyedbeing here in Singapore, eating,talking, shopping.And now, Ladies and Gentlemen, Ishould stop and give the word to theChairman of the new OrganizingCommittee, my dear friend Jean-Raoul, who together vith his dyna-mic team will steer MEDINFO 92 inthat beautiful country, named Swit-zerland. I look forward to seeingyou there in three years.

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MEDBNFO 89 SINGAPORE -A TREMENDOUS SUCCESS December 10-14, 1989

MEDINFO 89 SINGAPORE, Part II of the 6lhWorldCongress on Medical Informatics, was both a resoundingand astounding success. Resounding because theCongress was attended by some 800 delegates fromamong 47 countries. Of these, only 50 were local parti-cipants.Astounding because the organization of the Congresswas accomplished within five months and in spite of avery short lead time, delegates were treated to a first-class scientific meeting and social functions that theywould long remember Singapore by. Said one US dele-gate, "Many of us expected to find a hastily assembledmeeting with the organizers offering apologies becausethings didn't work out. But, my gosh, this is the bestMEDINFO that I've ever attendedl'The concurrentScientific Exhibition involved the participation of 24 ex-hibitors, with the Associatin of British Healthcare Indus-tries (ABHI) leading the group by taking up 12 boothspaces.The venue for MEDINFO 89 SINGAPORE, which washeld from 10—14 December 1989, was Singapore'spremier convention centre, the Raffles City ConventionCentre, which is housed within a huge hotel, business andshopping complex. The majority of the delegates wereaccomodated at the 5-star Westin Plaza and WestinStamford (reputed to be the world's tallest hotel).The Opening Ceremony was performed by Dr. Tay EngSoon, Senior Minister of State for Education and Chair-man of the Committee for National Computerisation. Inhis opening address, Dr. Tay announced plans for thelaunching of MEDINET, a computerised network thatwill link all medical and healthcare professionals,institutions and industries in Singapore. Also invited toattend the Ceremony was Dr. S.T. Han, Regional Direc-tor of the WHO Western Pacific Regional Office, whodelivered a message on behalf of Dr. Hiroshi Nakajima,the WHO Director General.Following the Opening Ceremony, two keynote addres-ses were delivered. The first address was given by Mr.Tan Chin Nam, Chairman of the National ComputerBoard (Singapore) who spoke on "The Role of Infor-mation Technology in Singapore's Healthcare ServicesIndustry". The second keynote address was deliveredby Mr. Michael Fairey, Director of Planning and Infor-mation Technology, Dept. of Health, UK, who spokeon "Management Information: Its Role in HealthCare".Later that evening, Congress delegates were treated to aWelcome Reception at the Empress Place Museum,located on the left bank of the historic Singapore river.During the Reception, delegates had the rare oppor-tunity of viewing some 132 pieces of authentic treasuresfrom the Qing Dynasty, the last dynasty of China. Theexhibits, which had hitherto never been exhibited out-side China, were made possible through high level con-tacts between the governments of Singapore and thePeople's Republic of China. Said Dr. Lun, "We chosethe Empress Place Museum for the Welcome Recep-tion as a consolation to those delegates who were unableto attend MEDINFO in Beijing".

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The scientific meeting began in earnest on Monday, 11December. During the four-day meeting, some 200papers were delivered over 42 sessions. In addition, thescientific program included 21 scientific demonstrations,four pre-Congress tutorials and eight evening workshopswhich were all very well attended. As at the previousMEDINFO - the Meet-the-Expert sessions and theSoftware Exchange proved to be highly popular. Postersessions were introduced at MEDINFO 89 SINGA-PORE and much to the surprise of everyone, the 9sessions generated very keen participation and activediscussions on some 100 posters that were presented.Many of the big names in the computer industry gavesignificant contributions to the success of the MED-INFO Scientific Exhibition. In addition to the largeABHI presence, IBM, Hewlett-Packard, Digital, NEC,Toshiba, Sony, Fujitsu, SW International, Siemens, ICLand other vendors generated keen enthusiasm amongCongress delegates and trade visitors with their state-of-the-art exhibits.The success of the social functions at MEDINFO 89SINGAPORE was largely the result of careful planningto ensure maximum participation and enjoyment ofCongress delegates. In addition to the Welcome Recep-tion, the Gala Dinner which featured a theme party"A Night in Singapore" was greatly appreciated by allwho were present. Top draw among the night's enter-tainment must certainly be the Snake Charmer. He evencharmed Dr. Phil Manning, SPC Chairman, and Dr.Kaikara into having a full-sized python coiled roundtheir shoulders — charming company for the evening!Other social activities included tours to local scenic spots.The luchier once took off for the sunny isles of Bali inIndonesia, Langkawi in Malaysia and Phuket in Thailandafter a hectic MEDINFO in Singapore. While thefriends and colleagues were braving freezing tempera-tures back home, they were getting sun-tanned on someof the best tropical beaches of the world.At the Closing Ceremony, Dr. Phil Manning announcedthe winners of the two gold medals for the two bestpapers presented at MEDINFO. Dr. Thiery Barsalou ofStanford, U.S.A. won one of the medals for his paperon "Hypertext Interfaces for Decision-Support Systems:A Case Study" while the other medal went to Dr. PeterByass from the Medical Research Council Laboratoriesin The Gambia for his paper on "Assessment of aProbabilistic Decision Support Methodology for Tropi-cal Health Care".The Ceremony continued with the passing of the gavelfrom the outgoing IMIA President, Dr. Kaihara to theincoming President, Dr. Jos Willems of Belgium. Then,it was time to say "Farewell MEDINFO 89" and"Welcome MEDINFO 92". A filmlet on Geneva, thevenue for MEDINFO 92 was shown, followed by ashort address from Dr. Jean Raoul Scherrer, Chairman ofthe Organizing Committee for MEDINFO 92 urgingdelegates to attend the next MEDINFO. On that note,MEDINFO 89 SINGAPORE was drawn to a highlysuccessful completion.

Dr. K.C. Lun, Singapore

A MESSAGE FROM THE OUTGOING PRESIDENTShigekoto Kaihara, M.D.IMIA President, 1986-1989Now that I leave the office of President of the Internatio-nal Medical Informatics Association, or IMIA, I shouldlike to express my sincere appreciation to all members forsupporting the activities of our organization during myterm as your president. While serving as such, I have triedmy best to see that IMIA gain more influence globally inthe field of medical informatics. In this pursuit, however,my aspirations often proved to be greater than my abilityto achieve them. Nevertheless, I forged ahead and feel thatwhatever of worth that I was able to accomplish ought tobe summarized, trusting that this review will prove helpfulto future IMIA administrations.

1. Four Goals

When I was elected, there were four goals that I wanted toachieve: to change the basis of IMIA's relations with theInternational Federation for Information Processing(IFIP); to broaden the scope of IMIA's activities toinclude all parts of the world; to coordinate various scien-tific activities in the field of medical informatics; and, tomake our MEDINFO 89 conference a success.Summarizing the results of my endeavors during the pastthree years, though progress was made in achieving thefirst, second, and fourth goals, to my regret, I was unableto contribute as much as I had hoped towards realizing mythird goal - the coordination of activity in the field ofmedical informatics.

2. Independence from IFIPTo briefly recount our history, IMIA's activities had oncebeen a specialized area of interest for a technical commit-tee within IFIP so that its birth as an organization in 1989developed from such a committee. From IMIA'sbeginning, it has always enjoyed good relations with IFIP.Two areas of concern were noted, however, when I be-came IMIA President in 1986.The first area involved administrative complications. Nowin most countries, membership in IMIA no longerautomatically implies membership in IFIP. The situationwas different when IMIA first started, when IFIP mem-bers interested in medical informatics participated in theIMIA activities. Gradually in various countries, indepen-dent organizations interested in medical informatics beganto be astablished, with the result that they sought for IMIAmembership. In these newly-formed organizations, abouthalf of its individual members were medical doctors, whoare not as interested in basic computer hardware or soft-ware as in the application of computer to their fields ofendeavor.Accordingly, as time went on, it was becoming increasinglyapparent that the aims of the IFIP, the parent, and IMIA,the child, were beginning to diverge. Yet, because IMIAwas still administratively a part of IFIP, it had to report toIFIP on its activities and have its budget approved yearly.This was the situation when I became president.The second area of concern involved scientific collabora-tion between IFIP and IMIA. Altough IFIP endeavors aremainly in the field of basic computer studies, some IFIPresearch toughe upon computer applications of IMIAinterest, though there has been very few instances of scien-tific collaboration in the past. Thus IMIA seemed onlyrelated to IFIP administratively but not scientifically, asituation that, for the good of both organizations, neededreversing. This I wished to accomplish.

For his significant contribution to the work of WHO in the ap-plications of Informatics to Health and towards "Health for Allby the Year 2000", Prof. S. Kaihara is the first person whowas awarded a WHO Medal relating to the Informatics field.

Fortunately, Mr. A. Melby, a vice president of IFIP atthe time, was receptive this idea and in 1987, at an IFIPmeeting convened to review IMIA activity, I proposedthat the relationship between IMIA and IFIP be reviewdinstead. Thanks to Mr. Melby, the IFIP General Assemblyagreed and a committee was formed to review the matter.Both Mr. Melby and I were appointed to this committeeand I fondly remember our discussion at Tivoli Garden inCopenhague. This led to IFIP's acceptance of thecommittee's report, which advocated that IMIA beaccorded an associate membership in IFIP, and to IMIA'sadministrative independence.Achieving independence, however, did not mean thatIMIA wished to see scientific ties between the two orga-nization severed, and so I proved that IMIA share IFIP'shead office in Geneva on a fee basis, a proposal that waseccepted. Dr. Scherrer's contribution towards setting upthis new arrangement should be recorded. I am verypleased that this new IMIA/IFIP accord, having beenapproved at the IMIA Annual General Meeting in Singa-pore in 1989, became effective in 1990. It is my sincerehope that IMIA members enjoy their independent statusand that they fully utilize their IFIP ties in the future.

3. World-Wide ActivitiesTo achieve my second goal - to see IMIA flourish in allparts of the world, I followed a policy of holding boardmeetings in cities where no previous IMIA meetings hadbeen convened. Thus, IMIA's Spring Board Meetingswere held in Berlin, GDR, in 1987, and in Rabat, Moroc-co, in 1988 and with Tbilisi in the USSR to be the site for1990. In addition, the 1989 Annual General Meeting washeld in Buenos Aires, Argentina, and MEDINFO inBeijing, China and in Singapore. Further, a medical infor-matics conference, co-sponsored by IMIA, as stated pre-viously, had held no previous activity in any of these cities,and by doing so it has given real meaning to its desire tobecome known as a truely international organization.

(Continued on page 6)

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Continuation of page 5

4. Coordination of Medical Informa-tics Activity

I regret that I was unable to contri-bute much to my third goal - thecoordination of medical informaticsactivity. At this time many newfields are emerging in medical in-formatics, along with many activitiesrelated to medical informatics out-side of IMIA. This is encouraging,but it is neither possible nor neces-sary for IMIA to control all medicalinformatic endeavors in the world.Nevertheless, if the organization sodesires, it is in an enviable positionto coordinate at least some of thesesactivities.To pursue this role, however, IMIAmust activate and utilize some of itsworking groups, as a nuclei for suchcoordination. Previously, few oppor-tunities were available for planningon how IMIA should proceed and,due to the time needed for detaileddiscussions, the IMIA Annual Ge-neral Meeting was not deemed to bethe proper forum. I previously hadasked Dr. Hans Peterson to organizea committee, composed of chairmen,to discuss this aspect of IMIA'sendeavors but too little time wasavailable and my intention has notbeen fully realized. Even so, I waspleased that some discussions werestarted in 1989 at the Singaporeworking group chairmen's meeting,and my hope is that this group willone day serve as a powerful, scienti-fic, coordinating body in the field ofmedical informatics.

5. MEDINFOWho could have predicted four yearsago the unfortunate June incident inBeijing that marred our plans forMEDINFO 89? Here I do intend torepeat the steps taken to solve theproblem, as this already has beenreported in my letter to the membersin July 1989 (see IMIA NewsletterVol. 14, No. 1, July 1989; Ed.). I onlywish to thank both Mr. Ouyang forhis generous fair attitude under verytrying circumstances and Dr. K.C.Lun for his kind assistance in quicklyproviding the additional Singaporevenue. It is difficult to assesswhether my decision was right orwrong, but at least I can say thatIMIA was able to survive the crisisintact.IMIA now has a new and energeticpresident, Dr. Jos Willems. Underhis prudent guidance our organiza-tion is certain to flourish. To him andto all of you my very best wishes.

January 8,1990

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med•nfo

geneva 92Geneva Palexpo, SWITZERLAND. The 7lhWorld Congress on MedicalInformatics, MEDINFO 92, will be presented from September 6-10, 1992by the International Medical Informatics Association (IMIA).The congress will endeavour to promote all aspects of medical and healthcare computing from all countries of the world. Participation will be soughtfrom among health information scientists, medical computing specialists,public health and hospital administrators, physicians, nurses, other alliedhealth personnel, and consultants in the various health fields.The following topics will be focused on: Hospital Information Systems;Clinical Laboratory Systems; Clinical Laboratory Systems; Clinical Depart-mental Systems; Imaging; General Practice/Ambulatory Care; Nursing Ap-plications; Drug Information Systems; Administration and Finance; PatientMonitoring/Intensive Care; Support of Clinical Decision Making; Evalua-tion of Health Care; Medical Research Support Systems; Epidemiology andStatistics; Education and Training; Privacy, Confidentiality and Security;Systems and their Environment; Community Health Care; Preventive andOccupational Care; Impact of New Technology; Net-works/Distributed Systems; Software Systems; FreeText Processing; Modelling and Simulation.

For further information please contact:

MEDINFO 92Administrative OfficeSymporg SA108, route de FrontenexCH-1208 Geneva/SWITZERLANDPhone: (+4L22) 7863744Fax: (+4L22) 7864080

MEDINFO 92

IMIA 11* Annual General Meeting 1989IMIA held its Annual General Meeting (AGM) in Sin-gapore on December 9lh, 1989 prior to MEDINFO 89.

These were the main decisions taken:

Membership

American representative was replaced from AFIPS toAmerican Informatics Association (AMIA). Dr. MarionBall was appointed as US representative. The KoreanSociety of Medical Informatics was accepted as amember.

Nominations

Dr. Ball (USA) was appointed as Trustee for three years.Dr. Flint was appointed as Trustee for one year.Dr. Bakker was appointed as Treasurer.Dr. Peterson was appointed as chairman of the Nomina-tion Committee.

Checking the cash: present and former treasurer,A.R. Bakker, Netherlands (left) and J.H. Flint, Canada

Committees

There was some change of editors of IMIA Newsletter:P. Degoulet, France, and A. Mehdaoui, Morocco werenominated additional regional editors. K. CH. Lun, Sin-gapore and R.J. Rodrigues, Brazil remain regionaleditors. A.S. Gose was replaced by D.A.B. Lindberg dueto the formation of a new North American Association(AMIA). O. Rienhoff remins Chief Editor.

The Public Relations Committee was terminated. Somework will be done by the Chief Editor of the MedicalInformatics Newsletter.

IMIA Transformation

IMIA's transformation from IFIP-SIG to an independentorganization was approved.

IMIA has its seat now at Geneve (IFIP secretariats'soffice) under the Swiss law. The amendments of bylawsnecessary for this change was approved.

New Cuban representative: Ing. Armando Rosales Fernandezof Ministerio de Salud Publica,

who was also responsible for Informatica '90.

MEDINFOsMEDINFO 89 part I

in Beijing was a success with about 700 participants.

MEDINFO 89 part II

in Singapore was an excellent conference with more than700 participants from all over the world. Thanks to theefforts of Dr. K.C. Lun and also to the excellent facili-ties, this conference became one of the best MEDINFO'sin the past. There were very little cancellation of thepresentation of papers; all papers were of excellentquality. Two gold medals were awarded, one toAmerican and the other to Gambian scientists.

MEDINFO 92Dr. S. H. Mandil of WHO was appointed SPC Chair-man.

Dr. K.C. Lun from Singapore was appointed EditorialCommittee Chairman.

Committees members will be appointed in the nearfuture and they will be in full operation soon.

Working Groups

Working Group 11, Dental Informatics was approved.Many new working conferences were proposed.

Next AGM

The next Annual General Meeting will be held in Glas-gow, U.K. on August 18, 1990 prior to the Medial In-formatics Europe (MIE) Congress.

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COMING EVENTSSYMPOSIUM

INFORMATICA HOSPITALARIASINFHOS '90

Barcelona, SpainJune 6-8,1990

OutlineBeing held within the frame ofINFORMAT 90 the symposium is in-tended to find new lines of collabo-ration and coordination between thedifferent public and private institu-tions active in the health sector. Withthe generic subject "New Technolo-gies in the Health Information Sys-tems" the role of new technologicaladvances and the entailed scientificbenefits are to be focused on.

DeadlinesFeb 28, 1990 - Submission of papers

ContactThe Technical Secretary III SINFHOSCollegi d'Economistes de CataluniaAv. Diagonal, 508 l.o, l.aSP-08006 Barcelona/SPAINPhone: 34-3-2371604Fax: 34-3-2182419

First Annual Educational andResearch Conference

Snowbird, Utah/U.S. A.June 20-23, 1990

OutlineWith its two main themes "Comput-ers, Molecular Biology and Medicine"and "Computers in Learning andTeaching" this conference intends:(1) to provide an educational and re-search forum for the informaticsissues involved in the Human GenomeProject, molecular biology, genetics,and medicine; (2) to provide a re-search forum for exchanging and eva-luating progress, new findings andrecent innovations related to the useof computers for teaching and learn-ing; (3) to build bridges and explorecommonalities between the confer-ence participants and the conferencethemes.Computers, Molecular Biology, andMedicine: By the end of the confer-ence the participants will have: an un-derstanding of the biological andcomputing challenges which face thefield of genetics and molecular biolo-gy; an appreciation of the informaticsresearch in the fields of genetics andbiotechnology; an awareness of theadvances stemming from molecularbiology and the Human Genome Pro-ject and how they will affect the prac-tice of medicine and medical informa-tics; had an opportunity to view anduse some of the national computer

8

resources, databases, and other soft-ware important in the field.Computers in Learning and TeachingTo present contributed research andcomputer demonstrations, and tohear invited presentations on: ped-agogy in computer based instruction;valutation of instructional materials;access and outreach to the indepen-dent learner; implementation of in-formatics and interactive technologyin health education curricula; selftesting and self evaluation; innova-tions in instructional technologies.

DeadlinesDec 15,1989-receipt of abstracts of

proposed participationFeb 1, 1990 - Notification of accept-

ance

ContactMichael HammAMIA National Office7tJ«M Connecticut Av., N.W. SuiteWashington, D.C. 20036Phone: 202-857-1189Fax: 202-223-4579

6lh IMEKO CONFERENCE ONMEASUREMENT IN CLINICAL

MEDICINE and8lh HUNGARIAN CONFERENCE

BIOMEDICAL ENGINEERINGSopron, Hungary

August 29-31, 1990

OutlineThe aim of this meeting is to presentand discuss recent developments re-lating to information technology inclinical medicine. The programmewill be designed to reflect the inter-disciplinary nature of the subject andas such should appeal to cliniciansand clinical scientists as well as to en-gineers and physicians. The audiencewill consist of people with many diffe-rent backgrounds who share a com-mon interest in solving problems in aninterdisciplinary way.The general scope of the programmewill be information technology in me-dicine. This will provide an opportu-nity to discuss a wide range of topicsincluding the following items: Intelli-gent sensors and transducers andtheir technological problems (design,production, application); New me-thods in physiological measurementsand data processing including cardio-vascular, respiratory and cardiopul-monary measurement, EEG, EMG,Model-based patient monitoring andcontrol of physiological variables;Medical imaging with special regardto digital and computer-based radio-

graphy and ultrasonics; Biochemicalmeasurements in medicine and datahandling; Artificial intelligence andexpert systems in medicine; Therapydesign with up-to-date informationtechnology; Clinical engineering (me-dial device regulations, quality con-trol and insurance, education).

DeadlinesJan 15,1990 - submission of abstractsApr 15,1990-notification to authors

about acceptance ofpapers

ContactMerestechnikai es AutomatizalasiTudomanyos Egyesiilet(Scientific Society of Measurementand Automation)P.O. Box 457H-1372 Budapest/HUNGARYPhone: (36-1) 531-406Telex: 225792 mtesz h

IMIA Working Conference onSoftware Engineering in Medical

Informatics (SEMI)Amsterdam, The Netherlands

October 8-10,1990

OutlineThe working conference aims a pro-viding a meeting ground to achieve across-fertilization between the twodisciplines of Medical Informatics andSoftware Engineering.The state of the art will be presentedin keynote addresses. Future prospectsof Software Engineering in MedicalInformatics will be discussed.Conference topics will be: Integratedprogramming environments; Pro-gramming techniques: modularity,reusable code, object-oriented pro-gramming; Analyst workbenches andstructured design; Fourth-generationlanguages and program generators;Maintenance management and ver-sion control; Prototyping.

DeadlinesJan 31,1990-final deadline for

abstractsFeb28,1990-notification to authors

about acceptance ofabstracts

ContactSEMI — Conference SecretariatDepartment of Medical InformaticsErasmus University RotterdamP.O. Box 1738NL-3000 DR Rotterdam /THE NETHERLANDSPhone: +31 (10)408 7050Fax: +31 (10)4088118E-Mail: SEMI at HROEUR51.BITNET

COMING EVENTSLatinamerican Seminar on

applications of Mathematics andComputer Science to Biology

La Habana, CubaOctober 31st - November 3rd, 1990

OutlineThis seminar will take place duringthe XI Scientific Seminar of theNational Centre for Scientific Re-search, coinciding with the XXVanniversary of the foundation of TheNational Center for Scientific Re-search of Cuba (CENIC), who arethe who are the organizers of theseminar together with the Latin-american Society of application ofMathematics and Computer Scienceto Biology.Scientific sessions will include confer-ences, contributed papers, workshopsand poster sessions. Conferences willbe held by distinguised guest scien-tists. Papers will be presented orallyfor a limited number of collabora-tions. The remaining collaborationswill be in posters. The topics com-prise:Mathematical Models of BiologicalSystems; Artificial Intelligence inBiological Research; Computer As-sisted Molecular Modelling; Biologi-cal Signal Processing; Image Pro-cessing in Biological Research.

DeadlinesMay 31,1990-submission of abstractsJul 31.1990-notification to authors

about acceptance ofabstracts

ContactDr. Luis SastreDepartamente de MatematicaCentro Nacional de IncestigacionesCientificasApartado 6990La Habana/CUBAPhone: 21-8066Telex: 51 1582 CNICA CU

1st Hong Kong (Asia-Pacific)MEDICAL INFORMATICS

CONFERENCE"Getting Started"

Hong KongNovember 15-18, 1990

OutlineThe conference will focus on the taskof initiating experimental and evalu-ation work, using the techniques andmethods of medical informatics, inthe context of routine clinical practice.The Conference is sub-titled "Gett-ing Started" to indicate that it is in-tended to be a source of support forthe inexperienced and uninitiated.

However, it is also intended as anattraction to specialists in a widerange of disciplines who will beinvited to present their work andindicate how it might be applied inAsia and the Pacific rim.For the purpose of the conference,medial informatics will encompass:Computing in health & medical care;Medical records & clinical informa-tion management; Clinical informa-tion systems; Clinical epidemiologybiostatistics & clinical decision analy-sis; Operational studies in health &medical care evaluation of medicalcare, including economic apparisal.

ContactConference OfficeDepartment of Community MedicineUniversity of Hong KongLi Shu Fan Building5 Sasson RoadHONG KONGPhone: 5-8199280Fax: (852)5-8559528E-Mail: hkucs!hkucc!hdmrajh at

net.uu.uunet (JANET)hkusc!hkucc!hdmrajh atmunnari.uucp (ACSNET)

IMAC 91The Second International Conference

on Image Management andCommunication in Patient Care:

Implementation and ImpactKyoto /Japan

April 11-13, 1991

OutlineThe dates for IMAC 91 begin justafter the 23rd General Assemby of theJapan Medical Congress. The Con-gresses are held every four years,alternating between Kyoto andTokyo. The Congress will cover allaspects of medicine and a variety ofnew concepts in medicine. It is expec-ted to be a highly informative meet-ing. IMAC participants will have theopportunity to attend the meetingsand exhibits of the Congress. In addi-tion to the conference, many PACSfacilities throughout Japan will hostsite visits.

DeadlinesApril 1990 -- Dispatch of secondcircular

ContactMr. H. YamamotoNo. 501, Kenshu Bldg.Hongo, 7-2-4, Bunkyo-kuTokyo,113, JapanPhone: 03(814)5451Fax: 03(811)0676

4"' International Conferenceon Nursing Use of Computers and

Information ScienceNURSING INFORMATICS '91

Melbourne, AustraliaApril 14-17,1991

OutlineUnder the Theme"Nurses ManagingInformation in Health Care" thisconference is convened by theNursing Computer Group VictoriaInc. and cohosted by the College ofNursing, Australia under the auspi-ces of Working Group 8 of the Inter-national Medical Informatics Asso-ciation.The conference will focus on:a) Managing/Using Information inAdministration /Service Manage-ment, b) Managing/Using Informa-tion in practice settings, c) Manag-ing/Using Information in the Edu-cational Environment, d) Uniform-ity of Data, is it necessary? A helpor hinderance. e) Evaluation of theImpact of Use of InformationSystems, f) Access to Informatione.g. Retrieval Systems, g) Strategiesfor Influencing Vendor Develop-ment of Systems, h) Evolving Rolesin Nursing Informatics, i) Influenceof Information Systems on NurseRecruitment and resource alloca-tion, j) Preparation of Nurses forManaging Information in HealthCare, k) Evaluation and Develop-ment of Nursing Knowledge Bases,Phenomena and Science - ExpertSystems/Decisiration of Computersand Nursing; Nursing Role Changes.

DeadlinesNov30,1989-submission of

abstractsMay 1990 -notification of

acceptance of papers

ContactMary MoyanoConference Secretariat1st Floor, 387 Malvern RoadSouth Yarra, Victoria, 3141AUSTRALIAPhone: (03) 824 0022Fax: (03)2400771

9

ADVANCED TECHNOLOGIES FOR MEDICINEAND HEALTH CARE (AIM)

- A PROGRAMME OF THE EUROPEAN COMMUNITY -In 1989 37 international researchprojects have started work on theuse of advanced information andcommunication technologies inthe field of medicine and healthcare. Projects have been selectedfollowing a public call for propo-sals under the European Commu-nity's AIM programme (AIM =Advanced Informatics in Medi-cine) which had resulted in 215project proposals.The financial volume of theseproposals summed up to morethan ECU 400 Million. Thepresent level of funding from theCommunity budget is ECU 20Million, to be matched by thesame amount coming from projectpartners.The disproportion of availableand requested funding obligedindependent experts, evaluatingall the incoming proposals, to beextremely severe in the applica-tion of selection criteria. Theirchoices and proposals were appro-ved by the AIM ManagementCommittee which is made up ofMember State representatives.Work under the AIM programmewill be complementary to theother Community programmesuch as RACE, DELTA, DRIVEor ESPRIT and the same workingprinciples will be applied.These principles include the trans-national character of projects,concentration on precompetitiveR + D, work to follow jointlydefined strategic orientations, thesharing of costs and of R&Dresults.The 37 AIM projects involvesome 250 independent partners.Half of them are Universities andResearch Institutes, 25 % repre-sent industry (information andcommunications industry, phar-maceutical industry and others)and 25% represent hospitals,medical practitioners and otherusers. Current AIM projects areplanned to be completed by mid1990.Like the other above-mentionedprogrammes, AIM will be man-aged by the Commission's Direc-torate General XIII (Telecommu-nications, Information Industriesand Innovation).

BackgroundThe Aim programme is to be seenagainst the background of generaltrends and problems facing themedical and health care sector:The economic/financial problems:Member States of the EuropeanCommunity spend an ever in-creasing proportion of their GDP(almost 10%) on medicine andhealth care systems without me-dium and long term solutions forthe structural problems of thesector being in sight.The technological problem: Theintroduction of new technologies(e.g. information and communica-tion technologies) into medicine,biotechnology and health caresystems is the basis for scientificprogress whilst at the same timerequiring the constant develop-ment and aquisition of new equip-ment and services, the setting upof new clinical units, the trainingof staff etc.The human and medico-socialproblem: the demographic trend,the increased concern of indivi-duals about their state of healthand their quality of life, the urgentneed to combat deseases likecancer and AIDS taken together

create an increasing demand forthe further expansion of medicalservices.All the actors involved in thesedevelopments (i.e. public healthauthorities, insurances, hospitals,medical professions, industriesand academia) agree that advan-ced technologies must be used inorder to

- improve the quality, flexibilityand availability of health careservices,

— improve the productivity of bio-medical and biotechnologicalresearch,

— monitor more effectively healthcare expenditure and better as-sess its economic impact.

These objectives imply a multi-sectoral and multi-disciplinarystrategic which no individual com-pany or a single Member State cansucessfully put into practice.Joining forces and pooling resour-ces across frontiers is the onlyappropriate approach for thesolution of these problems.The European Community's ini-tiative is designed to organize andstimulate this process of collabo-ration and coordination.

Tenth International Congress

Vienna, Austria. From August19-22,1991, the 10th InternationalCongress, MIE '91 is organized bythe European Federation for Me-dical Informatics (EFMI), theAustrian Computer Society andthe Austrian Society for Biomedi-cal Engineering.

Endeavouring to promote all aspects of medical informatics and healthcare computing the organizers expect as participants medical informa-tics and health information scientists, public health and hospital admini-strators, physicians, nurses, other allied health personnel, and consult-ants in the various health fields.The following topics will be covered: Information Systems; Health CareSystems; Expert Systems and Decision Making; Coding, Classificationand Nomenclature; Imaging and Signal Analysis; Biometry and Bio-mathematics; Biomedical Engineering; Hardware and Software Design;Network Systems in Health Care; Computer-Based Tutoring; MedicalInformatics Curricula; Legal and Ethical Issues; Miscellanea.For further information please contact: MIE 91

InterconventionA-1450 Vienna, AUSTRIAPhone: (43) (222) 2369-2641Fax: (43) (222) 2369-648Telex: 111803

10

IMPORTANT ADDRESSES

WORLD HEALTH ORGANIZATIONS. H. MANDILDiv. of Information Systems SupportWorld Health OrganizationCH-1211 Geneva 27, SWITZERLANDTel.: 022-9112 11MANDIL at UNICC.BITNET

WORLD MEDICAL ASSOCIATIONA. WYNENWorld Medical Association28, Avenue des AlpesF-01210 Ferney-Voltaire, FRANCETel. 50407575Telex 385755 F WM ASFVF

IMIA HONORARY MEMBERSW. C. ABBOTTHealth Informatics Consultant55 Forestreet, HartlandBideford, Devon, EX39 4BD, U.K.Tel. (02374)721

J. M. FORSYTHERegional DirectorSouth East Thames Regional HealthAuthorit ies/Thrift HouseCollington AvenueBexhill-on-Sea,East Sussex N393NQ, U.K.Tel. 0424-730073

F. GREMYDepartment de ITnformation MedicaleCentre Hospitalier RegionalHopital Lapeyronie555, Route de GrangesF-34059 Montpellier Cedex, FRANCETel. 067-33 8145

D.A.B. LINDBERGNational Library of Medicine8600 Rockville PikeBuilding 38, Room 2E, 17BBethesda, Maryland 20894, U.S.A.Tel. 301-496-6221BITNET LINDBERGatMCS.NLM.NIH.GOV

H.E. PETERSONStockholm Lans LandstingHealth Care InformaticsHalso-och SjukvardsnamndenP.O. Box 9099S-10272 Stockholm, SWEDENTel. 08-737-5060, home: 08-760-3628

J. ROUKENS207 BrugmannlaanB-1180 Brussels, BELGIUMTel. 032-2-3452206

D.B. SHIRESDalhousie Univ. Medical SchoolOccupational HealthDepartment of Family Medicine5599 Fenwick StreetHalifax, Nova Scotia, B3H 1R2, CNDTel. 902-424-2142SHIRES at DAL.BITNET

IFIP COGNIZANT OFFICERA. MELBYEMorlenesvej 11DK-2840 Holte, DENMARKTel. 02-422912

IFIP SECRETARIATG. ROBERT16, Place LongemallcCH-1204 Geneva, SWITZERLANDTel. 022-282649Telex 428472 IFIP-CH

From: IFIP newsletter, Vol. 6, no. 4, December 1989, published by IFIPSecretariat, Geneva/Switzerland

IFIP ISSUES WORLDWIDE WARNINGON COMPUTER VIRUSES

In view of the potentially serious and even fatal consequences of the intro-duction of "virus" programs into computer systems, IFIP urges

- all computer professionals, worldwide, to recognize the disatrous potentialof computer viruses

- all computer educators to impress upon their students the dangers of virusprograms

.- all publishers to refrain from publication of the details of actual virus

programs

- all computer professionals not be knowingly distribute virus code, exceptfor the purpose of legitimate research in a controlled environmentandall developers of virus detection and prevention systems to stopdistribution of virus codes for test purposes

- governments, universities and computer systems manufacturers to demotemore resources to research into and development of new technologies forprotection of computer systems

- governments to take action to make distribution of viruses a criminaloffense.

The IFIP General Assembly (GA) passed the preceding forceful resolutionat its meeting in September in San Francisco. With the identification ofhundreds of computer virus programs and even more variations on these, thedisastrous implications for computer systems must be recognized by allcountries. The consequences of "viral attack" on computer systems includeserious economic and personal loss and could potentially become a threat tohuman life; for example, in computer-controlled health care systems andindustrial installations. The social and economic losses due to virus infiltrationinto computer systems are large. Those losses and their effects are becoming,moreover, of international significance as computer networks take on globalinformation roles in many enterprises.

Prof. William Caelli (AUS), chairman of IFIP's Technical committee onSecurity and Protection in Information Processing Systems (TC 11), supportedby the chairman (effective in September) of the TC on Relationship betweenComputes and Society (TC9), Prof. Klaus Brunnstein (D), proposed theresolution to the IFIP Technical Assembly (TA), The TA supported it andbrought it to the GA, which adopted it.

Caelli and Brunnstein drew the attention of the GA to the growing numberof virus programs (and similar programs, such as "worms" and "Trojanhorses") being published in inexpensive, widely available books. Such codemay easyly be used and adapted for illicit purposes. They also noted thatin some cases, actual virus programs are distributed with virus detectionand protection software packages, in order to test and demonstrate thosepackages. This practice must stop, IFIP urged, simply because it is too easyfor such test viruses to be further copied and disseminated, even,inadvertently, or for them to be modified further, with unpredictableresults.

All IFIP Member societies are urged to publizice this resolution to theirmemberships and governments.

11

WAI IUINAL,LIBRARYofMEDICINE

Bethesda, Maryland, U.S.A.

transmit the formatted search state-ments to the computer systems whichhouse the relevant databases andreceive the information retrievedfrom these systems; and (5) an out-put processor to merge, organize,evaluate, and rank the informationretrieved to its relevance to the user'squery.

It is probable that multiple imple-mentations of the UMLS functionalcomponents will evolve, each tailoredto the needs of particular groups ofusers or to specific hardware andsoftware environments. NLM itselfwill develop these functional capabi-lities within GRATEFUL MED®,the microcomputer search interfaceto the MEDLARS® databases.GRATEFUL MED has already beenmodified to include basic versions ofsome of the proposed UMLS compo-nents. We expect that other inter-faces which make use of the UMLSknowledge sources will be developedby other institutions and companies,with or without support from NLM.

To ensure that UMLS componentsget actual use as soon as possible,they will be developed through aseries of successive approximationsof the capabilities ultimately desired.Early versions of UMLS componentswill offer relatively modest enhance-ments to current systems with respectto their representation of the inter-relationships among biomedicalterms and concepts. Complexity willbe added in subsequent versions asactual use shows it to be necessary.

Meta-1 and the UMLS SemanticNetwork, First VersionIn mid-1990, NLM will distribute twoUMLS components: the first versionof the UMLS Metathesaurus, to becalled Meta-1, and the first version ofthe UMLS Semantic Network. Thebase set of terms in Meta-1 will in-clude all terms in both MeSH®(NLM's Medical Subject Headings)and DSM-III (The American Psychi-atric Association's Diagnostic andStatistical Manual of Mental Dis-orders). In addition, a set of terms

(Continued on page 13)

Unified Medical Language SystemA major project of the US National Library of Medicine in Washington

will be knowledge sources of interestprimarily to those involved in thedevelopment of information systems.

The UMLS will include at least threenew machine-readable knowledgesources: a "Metathesurus", a Seman-tic Network, and an InformationSources Map. The Metathesauruswill contain information about bio-medical concepts and their represen-tation in different vocabularies andthesauri. It will represent a variety ofrelationships among terms and willsupport mapping from the user'sterms to appropriate controlled vo-cabularies and among different con-trolled vocabularies. The SemanticNetwork will contain informationabout the types or categories (e.g.,"Disease or Syndrome", "Virus") ofterms in the Metathesaurus and thepermissible relationships amongthese types (e.g., "Virus" can cause"Disease or Syndrome" but not viceversa). The Information SourcesMap or directory will contain bothhuman-readable and macine-"pro-cessable" information about thescope, location, vocabulary, syntaxrules, and access conditions ofbiomedical databases of all kinds.

The UMLS knowledge sources areexpected to be of general use to thosebuilding information systems in avariety of biomedical and health-re-lated environments. Although it maybe necessary for system developersto create local addena to supportparticular applications, we hope thatuse of the central UMLS knowledgesources can substantially reduce thelevel of effort required to buildeffective user interfaces to biomedialinformation.

The three UMLS knowledge sourcesultimately will be used by severalfunctional components in interact-ions with users or special purposeapplications systems as well as ininteractions with available files ofmachine-readable biomedical infor-mation. The functional componentsof the UMLS will probably include:(1) a query interpreter to analyze theuser's input; (2) a graphical displayerto provide a picture of the relation-ship among terms and types repre-sented in the Metathesaurus and theSemantic Network; (3) an interactivesearch formulator to help refine theuser's query and translate it into thesyntax suitable for searching relevantdatabases; (4) a search transmitter to

The Unified Medical Language Sys-tem (UMLS™) project is a long-termeffort to build an increasingly intelli-gent automated system that under-stands biomedical terms and their in-terrelationships and uses this under-standing to help users retrieve andorganize information from machine-readable sources. It goal is to facili-tate retrieval and and integration ofinformation from a variety of ma-chine-readable information sources,including descriptions of the biome-dical literature, clinical literature, cli-nical records, factual databanks, andmedical knowledge bases. The UMLSwill compensate for the differences inthe terminologies used in these dis-perate systems and for variations inthe language employed by usersthemselves.

The UMS is not an attempt to imposea single standard vocabulary thatmust be used in the creation, storage,and retrieval of all biomedicalinformation. Nor is it a plan todevelop a standard patient recordformat or to create a single inifiedmedical knowledge base to assistwith diagnosis and treatment.

UMLS Development StrategyA long-term project of the breadthand complexity of the UMLS requi-res the knowledge and skills ofexperts in many fields. For thisreason the UMLS developmentstrategy involves a combination ofinternal research and developmentat NLM itself, competitively awardedcontracts for research assistance withseveral U.S. universities, and a pri-vate company, and advice from pro-fessional associations and otherinterested groups in the privatesector. The American Medical Asso-ciation is assisting NLM by coordi-nating input from the private sectorgroups.

UMLS ComponentsTwo categories of UMLS compo-nents will be developed: knowledgesources or databases and functionalfeatures or programs. Eventuallythese components will be used di-rectly by health professionals, aswell as by special purpose applicationprograms, to interpret questions,identify information sources, trans-late queries into a variety of differenttarget vocabularies, and retrieve,evaluate, and organize informationrelevant to a particular query. Thefirst UMLS components to be issued

12

Continuation of page 12:

for clinical problems and manifesta-tions frequently encountered at fourambulatory care facilities will beincluded. All ICD (InternationalClassification of Diseases), andSNOMED (the College of Ameri-can Pathologists' Systematized No-menclature of Medicine) terms anda small number of CRT (the^AMA'sCurrent Procedural Terminology)terms that can be related to thisbase set by lexical matching tech-niques will also be incorporated andidentified as identical matches,synonyms, or related terms. LCSH(Library of Congress Subject Head-ings) terms for which NLM hasestablished equivalent MeSH ex-pressions will be incorporated.Meta-1 will contain over 30,000 fullyedited records and another 50,000abbrevated records for names ofchemical substances. All terms inMeta-1 will be assigned one or moresemantic types or categories (e.g.,"Disease or Syndrome", "Plant","Idea or Concept").

The first version of the SemanticNetwork will contain as its nodesapproximately 130 semantic typesthat have been assigned to conceptsin Meta-1. A repertoire of about30 relationships will be used todescribe the useful and permissiblerelationships among the broad typesor categories in the Network.

Arrangements for Distribution ofUMLS Components

Meta-1 and the first version of theUMLS Semantic Network will beavailable for experimental use inmid-1990. Those who wish to testthe application of these tools inparticular biomedical informationenvironments will be required to signa one-year experimental agreementwith NLM. The general provisions ofthe agreement will be as follows:1. There will be no charge for the

UMLS products for the durationof the experimental agreement,although there will be a charge forsubsequent versions of UMLSproducts.

2. Those receiving the UMLS prod-ucts must provide feedback toNLM on how the products arebeing used and on any changes orenhancements that would makethem more useful.

3. Those receiving the UMLS prod-ucts may not redistribute them ex-cept as an integral part of the com-puter applications they develop.

NLM wishes users of Meta-1 and thefirst version of the UMLS SemanticNetwork to be fully aware that theremay be substantial changes in thecontent or format of subsequentversions of these UMLS products.

Distribution Formats

The UMLS products will be distri-buted in multiple formats on a single

CD-ROM (High Sierra Format).Meta-1 will probably be available inan ASCII "relational" format, anASCII unit record format, and as aHyperCard application. A singleCopy of the Meta-1 file will occupy120-130 megabytes of storage. The

' Semantic Network will be relativelysmall, less than half a megabyte.Sample sets of Meta-1 records will beavailable on either IBM compatibleor Macintosh diskettes prior to thedistribution of the complete file.

Application Procedures

Those interested in obtaining copiesof the initial UMLS products underthe terms outlined above should sub-mit a letter discribing specificallyhow they propose to use the prod-ucts and whether they prefer to re-ceive sample records on IBM PCcompatible or Macintosh diskettesto:

Betsy L. HumphreysUMLS Project OfficerNational Library of Medicine8600 Rockville PikeBethesda, MD 20894

In the spring of 1990, NLM willdistribute packets with sample re-cords, documentation and Copies ofthe experimental agreement to thosewho have expressed an interest. Toobtain the complete versions ofMeta-1 and the Semantic Network,individuals or institutions will thencomplete and sign, the experimentalagreement and return it to NLM.

The Agency for Health Care Policy and Researchand the

National Library of MedicineIn the Omnibus budget Reconcilia-tion Act of 1989 (P.L. 100-239) theU.S. Congress created a new govern-ment organization that will offerimportant challenges to medicalinformaticians. The Agency forHealth Care Policy and Research,within the Public Health Service, willbe responsible for conducting andsupporting research into the effec-tiveness ("outcomes") of health careservices and for developing guide-lines for medical practice.

This work is quite different fromthe traditional basic research sup-

ported by the National Institutes ofHealth. It is meant to be focused onthe quality of life and productivityof patients subject to the differenttreatment regimens, including thetreatment of "watchful waiting". Thediseases initially selected for studyare four patient problems thataccount for more than S 27 billionin Medicare costs each year. Thesediseares are benign prostatic hyper-trophy, cataracts, low back pain, andacute myocardial infarction.

The legislation assigned to theNational Library of Medicine re-

sponsibility for acquiring and orga-nizing the scientific literature ofhealth services research and torproviding informatics support tothose writing and using the practiceguidelines. Research on patientcare practices and their outcomesis heavily dependent not only ongood medical record keeping buton the application of sophisticatedanalytical techniques. The work ofa new Agency is l ikely to placeadded emphasis on the potentialcontributions that automated in-formation systems of various sortscan make.

13

LIST OF IMIA NATIONAL MEMBERS ANDREPRESENTATIVES

s = member society • r = representative • c = corresponding member (academic titles have been omitted)

ALGERIAc Mohamed El-Hafad NAB

Directeur Infrastructure et EquipementMinistere de la Sante PubliqueAlgcr, ALGERIETel. 65-58-26, Telex 65338 DI 65316 DI

ARGENTINAs Sociedad de Informatica Biomedicar Valerio YACUBSOHN

Primera Junta 349(1642) San Isidro, ARGENTINATel. (54-1) 453950/(54-l) 405755Telex 17877 KKCOAR

AUSTRALIAs Australian Computer Society

P.O.Box 319, DarlinghurstNSW 2010 AUSTRALIATel. 02 211-5855

r D. M. BENNETT22 Tourello Ave. East HawthornVictoria 3123, AUSTRALIATel. 03819-4344

AUSTRIAs Oesterreichischc Computergesellschaft

Wollzeile 1-3A-10H) Wien, AUSTRIA

r Gunther GELLInst. f. Med. Inf., Stat. u. DokumentationUniversitatskliniken, Landeskrankenhaus GrazAuenbruggerplatz 9A-8036 Graz, AUSTRIATel. (0316) 385 3201, Fax (0316) 385 3207

BELGIUMs Belgische Vereniging voor Medische

InformaticaSociete Beige d'Informatique Medicale

r J. L. WILLEMS PresidentAfdeling Medische InformaticaUniv. Hospital St. Rafael-Gasthuisberg49, HerestraatB-3000 Leuven, BELGIUMTel. 32-16-213801BITNET FEKAA01 at BLEKUL11

BRAZILs SUCESUr Roberto J. RODRIGUES Vice President

Hospital Das ClinicasDa Faculdade de Medicina daUniversidade de Sao PauloCaixa Postal, 8091Sao Paulo, BRAZILTel. 001-282-2811 ext 208Telex 1124807 MUSP BR

BULGARIAc D. DOCHEV

Chief Science Secretary, Medical AcademyBoul D. Nestorov 15Sofia 1431, BULGARIA

CANADAs Canadian Organization of Advancement

of Computers in Healthr John Flint Trustee

York-Med Systems Inc.30 Wertheim Court, Unit 13Richmond Hill, Ontario, L4B 1B9CANADATel. (416)764-3703

CUBAs Sociedad Cubana de

Administracion de SaludCalle4407, e / 1 7 y 19Vedado, La Habana, CUBA

r Armando ROSALES FERNANDEZDireccion SADMinisterio de Salud PublicaCalle M No. 260. Vedado.La Habana, CUBATel. 32-9003, Telex 511149 MSP CuFax 32-3871

CZECHOSLOVAKIAs Czechoslovak Society of

Biomedical Engineering

r J. ZVAROVADepartment of Medical InformaticsMedical Faculty of Charles UniversityKaterinska 3212108 Prague 2, CZECHOSLOVAKIATel. 2-4710842, Telex 121293 c

DENMARKs Dansk Selskab for Medicinsk Informatik

The Danish Society of Medical Informaticsr AsgerDIRKSEN

Bispebjerg HospitalLungemedicinsk Afdeling PDK-2400 Copenhagen NV, DENMARKTel. 45(0) 1 811250 ext 7586

EGYPTc Ahmed F. SE1F EL NASR

Director,Center of Technology in Medical Education21 Abd el Aziz al Saud RhodaCairo, EGYPT

FEDERAL REPUBLIC OF GERMANYs Deutsche Gescllschaft fiir Medizinische

Dokumentation, Informatik und Statistik e.V.Herbert-Lewin-Strasse 1D-5000K61n41,F.R.G.

r Otto RIENHOFFProf. f. Medizinische InformatikPhilipps-Universita'tFB Humanmedizin und KlinikumBunsenstrasse 3D-3550 Marburg, F.R.G.Tel. (0)6421 28-3248BITNET HAEGAR at DMRHRZ11

FINLANDs Terveydenhuollon Tietojenkasittelyyhdistys

(the Finnish Society for Medical Informatics)r Matti KATAJA

National Public Health InstituteMannerheimintie 166SF-00280 Helsinki 28, FINLAND

FRANCEs Federation Nationale des Associations

pour les Applicationsde I 'Informatique a la Medecine

r R. SALAMON SecretaryDepartment d'InformatiqueUniversite de Bordeaux II146, rue Les SaignatF-33076 Bordeaux Cedex, FRANCETel. 56986559BITNET SALAMON at FRBDX11

GERMAN DEMOCRATIC REPUBLICs Gesellschaft fiir Biomedizinische Technik

und Informationsverarbeitungof the German Democratic Republic

r J. MICHEL TrusteeInst. fiir Medizinische Informatik undBiophysik des Bereiches Medizin (Charite)der Humboldt-Univ. zu BerlinSchumannstrasse 20/21DDR-1040 Berlin, G.D.R.Tel. 2897305/306,Telex 114589 CHFORDD

HONG KONGs Alfred TANG

Hong Kong Society of Medical InformaticsP.O. 20510, Hennessy Post OfficeHONG KONG

HUNGARYs John v. Neumann Societyr Naszlady ATTILA

John v. Neumann SocietyCraz. Koranyi, TBC esPulmonologiai IntezetKardiologial OsztalyH-1529 Budapest, Piheno ut I, HUNGARYTel. 1-761-551, Telex 226996

INDIAs Computer Society of Indiar A. D. TASKAR

c/o Institution of Engineers15 Haji Ali ParkBombay 400-034, INDIA

IRAQc L. SAL1H

National Computer CenterP.O. 3261-SaadoonBaghdad, IRAQ

IRELANDs Health Care Specialist Group

Irish Computer SocietyShelbourne House, Shelbourne RoadDublin 4, REPUBLIC OF IRELAND

r Diarmuid UACONAILLBiochemistry Laboratory, Mater HospitalDublin 7, REPUBLIC OF IRELANDTel. 01301122 ext 297

ISRAELs Information Processing Association of Israel

P.O.Box 13009Jerusalem, ISRAEL

r J. RAVIVManager Science & Technology IBM IsraelIBM Scientific CenterNuclear Engineering Building, Technion CityHaifa 32000, ISRAELTel. 972-4-232154BITNET RAVIV at ISRAEARN.

ITALYs Associazione Italian di Informatica

e Calcolo AutomaticoPiazzale Rodolfo Morandi 21-20121 Milano, ITALYTel. 39-2-784970

r A. FERNANDEZ PEREZ DE TALENSFisiologia Clinica C.N.R. - Via Savi, 81-56100 Pisa, ITALYTel. 39-50-855695, Telex 1 500371BITNET PI0211-1 at CNUCEUM

JAPANs Japan Association for Medical Informaticsr Shigekoto KAIHARA Past President

Director of Hospital Computer CenterUniversity of Tokyo Hospital7 Hongo, Bunkyo-kuTokyo 113, JAPANTel. 038155411 ext 8126Telex 2723669 TODA1M JKAIHARA at SUMEX-AIM.FORSYTHE.STANFORD.EDU

KOREAc Chang-Soon KOH

Professor of Internal MedicineSeoul National University Hospital28 Yuk-kun Dong, Chogro-kuSeoul 110, KOREATel. (82-2) 7601-2200, Telex K25501

MALAYSIAc Chong Yok CHIN

Head, Information & DocumentationSystem Unit, Ministry of HealthJalan Cenderasari50590 Kuala Lumpur, MALAYSIA

MEXICOs Academia Mcxicana de Informatica, A.C.r Enzo MOLING

Edificio 1-701, Villa Olimpica14020 Mexico City, D.F., MEXICOTel. 568-2127

MOROCCOc El. ALJ

Derector E.M.I., Faculte des SciencesDept. des Mathematiques, B.P. 1014Rabat, MOROCCOTel. (7) 705-79, Telex 32939 M

NETHERLANDSs Vereniging voor Medische en

Biologische Informatie-Verwerkingr A.R. BAKKER Treasurer

Director of BAZISc/o University HospitalBuilding 50, Rijnsburgerweg 10NL-2333 AA Leiden, THE NETHERLANDSTel. 071-263261BITNET BAKKER at HLERUL54

14

LIST OF IMIA NATIONAL MEMBERS ANDREPRESENTATIVES

s = member society • r = representative • c = corresponding member (academic titles have been omitted)

NEW ZEALANDs The New Zealand Computer Society

National OfficeP.O.Box 12249Wellington, NEW ZEALAND

r I. H.SYMONDSMed. Laboratory WellingtonKelvin Chamners, 16 The TerraceWellington 1, NEW ZEALAND

NIGERIAc F. AGBALAJOBI

Department of Computer SciencesUniversity of LagosYaba, Lagos, NIGERIATel. 821111-821119 ext 593Telex 27238 APEXBD NO

NORWAYs Forum for Databehandling i

Helsesektoren PostuttakN-Oslo 1, NORWAYTel. 472 3560 20 ext 320

r B.G. SOLHEIMBlood CentreHolbergsgt. 1N-0160 Oslo 1, NORWAYTel. 472-202939

PEOPLES REPUBLIC OF CHINAs China Medical Informatics Association

(CMIA)55 Xueyuan Nanlu, Haidian DistrictBeijing, 10081, P. R. CHINA

r OUYANG Zhineng Trusteec/o China Computer Technical Corp.55 Xueyuan Nanlu, Haidian DistrictBeijing, 10081, P. R, CHINATel. 86-1-831-6539, 86-1-831-6549Telex 222337 iccst enMEDINFO office Tel. 892565, 898516

POLANDcJanDOROSZEWSKI

Head Dept. Biophysics and BiomathematicsMedical Center of Postgraduate EducationMarymoncka 9901-813 Warsaw, POLAND

PORTUGALs Associacao Portuguesa de Informatica (API)r M.J. Matos BARBOSA

Director of computer servicesUniversidade de CoimbraCentre de Informatica3000 Coimbra, PORTUGALTel. 39-20443Telex 52273

QATARc Robert J. HAGAN, Director

Management Systems DepartmentHamad General HospitalP.O.Box 3050Doha, QATARTel. 417595, Telex 4779 HAMHOS DH

ROMANIAcG.I. MIHALAS

Institute of MedicineDepartment of BiophysicsP-ta 23, August No. 2R-1900 Timisoara, ROMANIATel. 961 13058

SAUDI ARABIAc Khalide M. AL-SALAMAH

National University HospitalDirector, Computer CenterMinistry of HealthP.O.Box 88412Riyadh 11662KINGDOM OF SAUDI ARABIATel. 4029087

SINGAPOREc LUN Kwok Chan

National University HospitalDepartment of Community, Occupationaland Family Medicine / Public HealthLower Kent Ridge Road

Singapore 0511, SINGAPORETel. 7724296 or 7795555 ext 2252BITNET LUNKC at NUSVM

SOUTH AFRICAs South African Medical Informatics Groupr P. J. H. PANSEGROUW

Dept. of Computer ServicesPrivate Bag XI0Hennopsmeer 0046REPUBLIC OF SOUTH AFRICATel. 012-6622902

SPAINs Sociedad Espanola de Informatica Medica

(S.E.I.M.)Agustin de Foxa, 27 9-AE-28036 Madrid, SPAINTel. 34-13158241

r Juli BOU SANTOSHewlett PackardDivision de Informatica MedicaAv. Diasonal 605E-08021 Barcelona, SPAINTel. 34-3-4019100, Telex 52603

SWEDENs Swedish Society of Medical Information

ProcessingP.O.Box 558S-10127 Stockholm, SWEDEN

r H. E. PETERSONHalso-och SjukvardsnamndenP.O.Box 9099S-10272 Stockholm, SWEDENTel. 8-737-5060, home: 8-760-3628

SWITZERLANDs Swiss Society for Medical Informaticsr J. R. SCHERRER Trustee

Division d'Informatique, Hopital CantonalCH-1211 Geneve 4, SWITZERLANDTel. 41-22-22-6250BITNET SCHERRER at CGEHCU61,WISCVM.WISC.E

THAILANDc Narong KASITIPARDITH

Division of EpidemiologyMinistry of Public HealthBangkok, THAILAND

UNITED KINGDOMs British Computer Society

Medical Specialist Group13 Mansfield StreetLondon W1M OBPUNITED KINGDOM

r Barry BARBERNational Health ServiceInformation Management Centre19, Calthorpe Road, EdgbastonBirmingham, B15 1RP, UNITED KINGDOMTel. 021-454 1112, Fax 021-455 9340

URUGUAYc Mario TENZER

Vidal y Fuenfes 3184Montevideo, URUGUAYTel. 791968, Telex 23023 CLAP UY

U.S.A.r M.J. BALL Trustee

Association Vice PresidentInformation ResourcesaUniversity of MD at Baltimore610 W. Lombard Street, 3rd FloorBaltimore, MD 21201, U.S.A.Tel. 301-328-2004Fax 301-328-8459

U.S.S.R.c Boris LEONOV

President, Central Board of the All-UnionScientific Medical Eng. Soatkina, 3Moscow 129301, U.S.S.R.

YUGOSLAVIAcM. MARIC

Institute "Mihjlo Pupin"P.O.B. 906Beograd, YUGOSLAVIA

EUROPEAN FEDERATION FORMEDICAL INFORMATICS (IMIA-EUROPE)

John BRYANTCaer Gwent, St. Paul's Hospital,St. Paul's HillWinchester, S022 5AA, UNITED KINGDOMTel. 44-962-842506, Fax 44-962-842342

FEDERATION OF HEALTHINFORMATICS SOCIETIES INLATIN AMERICA (IMIA-LAC)

Valerio YACUBSOHNsee: Argentina

WORKING GROUP 1(Information Sciences and Medical Education)r Denis J. PROTTI

School of Health Information ScienceUniversity of Victoria, P.O.Box 1700Victoria, B.C., V8W 2Y2, CANADATel. (604)721-8575

WORKING GROUP 3(Testing and Validation for ECG Analysis Programmes)r Christoph ZYWIETZ

Medizinische Hochschule HannoverKonstanty-Gutschow-StrasseD-3000 Hannover, 61, F.R.G.Tel. 49-511-5324412

WORKING GROUP 4(Data Protection in Health Information Systems)r Barry BARBER

National Health ServiceInformation Management Centre19, Calthorpe Road, EdgbastonBirmingham, B15 1RP, UNITED KINGDOMTel. 021-454 1112, Fax 021-455 9340

WORKING GROUP 6(The Coding and Classification on Health Data)r Roger A. COTE

Faculty of Medicine, University of SherbrookeSherbrooke, Quebec, J1H 5H4, CANADA

WORKING GROUP 7(Biomedical Pattern Recognition)r Jan van BEMMEL

Department of Medical InformaticsMedical Faculty Erasmus UniversityP.O.Box 1738NL-3000 DR Rotterdam,THE NETHERLANDSTel. 0104087050BITNET U00070 at HASARA5

WORKING GROUP 8(Nursing Informatics)r KathrynJ . HANNAH

Director of NursingCalgary General Hospital841 Centre Avenue EastCalgary, Alberta, T2E OA1, CANADATel. 1247 5454 ext. 53BITNET HANNAH at UNCAMULT

WORKING GROUP 9(Health Informatics for Development)r Otto RIENHOFF

see: F.R.G.

WORKING GROUP 10(Hospital Information Systems)r A.R. BAKKER

Director of BAZISc/o University HospitalBuilding 50, Rijnsburgerweg 10NL-2333 AA Leiden, THE NETHERLANDSTel. 071-263261BITNET BAKKER at HLERUL54

WORKING GROUP 11(Dental Informatics)r John SALLEY

Medical College of VirginiaVirginia Commonwealth UniversityBox 566 MCV StationRichmond, VA, 23298/0560, U.S.A.Tel. 804-786-0779Fax 804-786-4913

15

DATE CITY

1990April 2-5

April 20-21

August 18

August 19

August 20-23

September 3-7

October 8- 10

October 22-26

November 19-22

1991January

April 14-17

June 17-21

June 18-21

August 19-22

November

1992September 4

September 5

September 6-10

Brighton

Tbilisi

Glasgow

Glasgow

Glasgow

Prague

Amsterdam

Montpellier

Rotterdam

Melbourne

Stockholm

Brussels

Vienna

Washington D.C.

Geneve

Geneva

Geneva

COUNTRY

United Kingdom

USSR

United Kingdom

United Kingdom

United Kingdom

Czechoslovakia

The Netherlands

France

The Netherlands

India

Australia

Sweden

Belgium

Austria

U.S.A.

Switzerland

Switzerland

Switzerland

TITLE

Working Conference:The State of the Art in PrimaryCare Computing

IMIA Board Meeting

IMIA Board Meeting

IMIA Annual General Meeting

Medical Informatics Europe Congress

Working Conference:Medical Informatics and MedicalEducation

Working Conference:Software Engineering in MedicalInformatics (SEMI)

Working Conference:Methodological Approaches of MedicalTechnology Assessment, with SpecialEmphasis on Informatics applied toMedicine and Health

Working Conference:Telematics in Medicine (TELMED)

Working Conference:Appropriate Medical InformaticsTechnology for Developing Countries

Working Conference:Nursing Informatics '91Fourth International Conference onNursing Use of Computers andInformation Science

Working Conference:Dental Informatics

EFMI Working Conference on DRG

Medical Informatics Europe Congress

IMIA Annual General Meeting

IMIA Board Meeting

IMIA Annual General Meeting

MEDINFO 92

16

IMIA-CALENDAR