Automated Multiphasic Health Testing Question Cards and Sort Box

Description:

Shallow wooden box divided into three equal-size horizontal compartments. Each compartment has an engraved black/white plastic label along its bottom edge providing instructions: TOP: "Please take out one card ay a time. Answer each question as correctly as you can by placing the card in the Yes section or the No section below"; MIDDLE: "Drop the card into this section if your answer to the question is YES or TRUE"; BOTTOM: "Drop the card into this section if your answer to the question is NO or FALSE" Each compartment holds a stack of computer punch cards with a question printed on the top side. A number is stamped on the bottom side of the card which appears to identify a set of cards. There appear to be parts of 3 different sets of questionnaire cards present: those stamped on the back with "29", those stamped with "108", and those stamped with "65." Set 108 has handwritten Chinese characters on the back - the questions appear to have been translated for Chinese-speaking patients. The questions in set 65 are printed in a different type face and appear to be concerned with mental or psychological health assessment.

These question cards and sorting box were used in the Patient Questionnaire portion of the Automated Multiphasic Health Screenings (Health Checkups) administered to Kaiser Permanente health plan subscribers from 1964-1973.

Multiphasic Health Screenings were developed by Dr. Morris F. Collen (1913-2014), one of the founding partners of The Permanente Medical Group and a pioneer in the field of medical informatics. Collen was committed to a holistic and systematic approach to providing medical care and treatment to large populations. During the 1950s, with a postwar shortage of physicians, Dr. Collen developed the multiphasic health checkup, a series of procedures and tests given to thousands of Kaiser Permanente subscribers that screened for conditions such as heart disease, diabetes, and cancer. In the early 1960s Dr. Collen and his team set out to automate the health-screening exam, developing a prototype electronic health record.

One part of the test was the patient questionnaire: a set of several hundred questions that elicited information about a host of symptoms and behaviors that where valuable in screening for disease. Each of the questions was printed on a pre-punched IBM card, for example, "Do you sweat a lot more now than you used to?" or “Have you worked or been in a place, in the past year, where you often or daily breathed in dust from sand blasting rock, grinding or rock drilling dust, silica, sand or coal?” The patient would sort the cards into “Yes” and “No” compartments, and those answers would be entered into an IBM 1440 mainframe computer. The patient questionnaire was just one part of a battery of tests that each patient would go through station-by-station including physical examination, laboratory tests, electrophysiology tests, and radiographs (x-rays). Results from many of these tests were fed immediately into the computer and in about two hours the computer would deliver a printout and preliminary diagnosis based on a statistical analysis of the data.

By the end of the 1960s, the automated screening program had accumulated health data from well over a million subjects. This information was available to help doctors make informed decisions. The information continues to be used in large-scale population studies, helping researchers identify trends that can improve health care.

Reference:

Collen, M F et al. “Automated Multiphasic Screening and Diagnosis.” American journal of public health and the nation's health vol. 54,5 (1964): 741-50.

Lindberg, D A B, and M J Ball. “Morris F. Collen at 100: a tribute to "the father of medical informatics".” Methods of information in medicine vol. 52,5 (2013): 371-3.