Polish Society of Medical Informatics, Wroclaw, Poland
The development of medical informatics in Poland started first of all in the two academic centres, Warsaw and Wroclaw. Warsaw, the capital of Poland, is the main centre of Polish science, but Wroclaw was the centre of the computer industry from 1965 to 1989. In the mid-1970s the Medical Academy of Wroclaw bought its first computer, ODRA 1304, which was similar to the ICL 1904 computer. Then, other medical academies and institutions also installed ODRA 1304/1305 (ICL 1904/1905) and SM4 (PDP11) computers.
After the co-operation with ICL had been weakened and the computer company ELWRO at Wroclaw had developed production of the RIAD-series computers (IBM 360/370), the situation of medical informatics in Poland became critical. The following question emerged: what type of computers and information technology should be used in medicine? The deep recession in Poland, ranging from 1981 to 1985, was another problem, which resulted in a major emigration of Polish scientists to Western Europe and the USA.
The second step in the computerisation of the Polish Public Health Service began when IBM PC XT/AT computers became cheap and easy to access. Since 1984 this type of computer has been installed in medical academies and hospitals. Today, most hospitals, clinics and academies have computers, and some of them work in Novell or UNIX networks
At present, there are major difficulties in the areas of medical programming, standardisation and unification of medical data, communications, pricing hospital care, hospital epidemiology and statistics, and also in the effectiveness of the Polish Public Health Service. The Ministry of Health has taken these problems into consideration, but they have not been solved yet. We can expect that the new law against software piracy will stabilise programmers' groups and will improve the quality of medical programming.
Currently, medical systems have been created in institutions, academies or hospitals. Some of those systems were not finished because programmers had moved on to better salaries in private companies or had established their own computer companies. Since their products are not always good, there are many management, departmental, drug and other systems that are not compatible with each other. The only benefit of this is an increase of the level of awareness of medical staff, and a growing consciousness that it is very important to keep co-operation between different systems within the structure of the Polish Health Service.
The Polish Society of Medical Informatics, which was established in 1988, aspires to develop medical informatics in Poland by organising conferences, inviting specialists from Western Europe, and attending conferences, such as, for example, the HC94 conference. At present, the Society presents the problems of informatics only by articles in other medical journals; however, the Society is planning to publish a quarterly similar to the British journal Computers in Medicine.
We estimate that in the Polish Public Health Service there are:
The Military Clinic Hospital at Wroclaw is one of the most computerised hospitals in Poland. The development of medical informatics in the hospital began in 1984. At this hospital 20 information systems work in a Novell network and about 120 PC computers are used by about 250 users. Total HDD memory exceeds 3 GB. This Hospital has 600 beds, 20 departments and 2 clinics. The Medical Informatics Centre and the Biocybernetic Laboratory belonging to the Military Clinical Hospital have elaborated many medical systems, such as Registration, Departmental, Drug, Food, Library, Computerised Tonal and ERA Audiometry, Nystagmus, and other systems. The group of engineers, which collaborates with medical doctors, works in this Centre. All systems made in this Centre are used not only in the Military Clinical Hospital, but also in other hospitals in Poland, for example, in the Central Hospital at Warsaw, Plastic Surgery Hospital at Polanica, Municipal Hospital at Kamienna Gora and in other hospitals at Wroclaw. In the 'best computerised hospitals in Poland' one can also include the Polish Mother Health Centre at Lodz, municipal hospitals at Katowice, Radom and Szczecin. More hospitals use financial systems, but only a few of them exploit medical management and statistical systems as well as the following diagnostic systems: Laboratory, Radiology, and ECG Systems.
The Polish Ministry of Health in co-operation with The World Bank plans to computerise a few hospitals which have more than 200 beds. In these hospitals a statistical system and a system for pricing the treatment costs of patients will be installed. The Ministry has organised a competition for medical systems and chosen the best one, which will be preferred and its cost will be refunded by The Ministry and The World Bank.
I think the tempo of the development of medical informatics in Poland depends on the rate of reforms in the Polish Health Service as well as on collaboration with health services in Western Europe.