Conference Chair
H. C. Moon Mullins, M.D.
Conference Co-Chair
Robert D. Price, Ph.D.
Conference Consultants and Facilitators
Nancy M. Lorenzi, Ph.D.
Robert T. Riley, Ph.D.
Organizing Committee
Robert M. Bernstein (Canada)
Nick S. Booth (U.K.)
Robert Elson (U.S.)
Michael Kidd (Australia)
H.C. Mullins (U.S.)
Robert D. Price (U.S.)
Consensus Panel
Robert Elson (U.S.)
Michael D. Hagen (U.S.)
Philip T. Hagen (U.S.)
Stephen Kay (U.K.)
Michael Kidd (Australia)
Telecommunications Officer
Rob Wilson
Transcriber
Suzanne Spiers
Moving Toward International Standards in Primary Care
Informatics: Clinical Vocabulary
AMIA Family Practice/Primary Care Working Group
IMIA Working Group V
New Orleans, November 1-2, 1995
November 1
3:30 p.m.
Introduction:
Henry C. Mullins, M.D.
Conference Overview:
Nancy M. Lorenzi, Ph.D., Conference Facilitator
Robert T. Riley, Ph.D.
Keynote Address
Christopher Chute, M.D., Dr.P.H.
4:30
Presentation on UMLS
General Overview: Charles A. Sneiderman, M.D.
Expert Comments: Stuart J. Nelson, M.D.
Application to Primary Care: Michael J. Lincoln, M.D.
5:15
Report on Successful Global Programs
Ian Purves, M.D.
Rob Wilson, B.Sc.
5:30
Light Meal
Coding Summary Panels
6:30
SNOMED
General Overview: Yves A. Lussier, M.D., P.Eng.
Expert Comments: David J. Rothwell, M.D.
Application to Primary Care: Yves A. Lussier, M.D., P.Eng.
7:10
ICPC
General Overview: Robert M. Bernstein,Ph.D., M.D.
Expert Comments : Maurice Wood, M.D.
Application to Primary Care: Michael S. Klinkman, M.D.,
M.S.
7:50
Read Codes
General Overview: Nick S. Booth, M.D.
Expert Comments: Charles Stuart-Buttle, M.D.
Application to Primary Care: Neill Jones, M.D.
8:30 Break
8:45
Participant Questions, Discussion, and Testimony
9:30
Adjournment and Social Hour
November 2 (Glyn M. Hayes, M.D., Moderator)
7:00 a.m.
Breakfast
7:30
Distribution and Overview of Consensus Report
Consensus Panel Members
7:45
Discussion Groups
9:00
Break
9:15
Development of Consensus
Nancy M. Lorenzi, Ph.D.
Robert T. Riley, Ph.D.
11:30
Planning for the Future
12:00
Adjournment
University of South Alabama
College of Medicine
Department of Family Practice and Community Medicine
1504 Springhill Avenue
Mobile, Alabama 36604-3273
Telephone: (334) 434-3480
Moving Toward International Standards in Primary Care Informatics: Clinical Vocabulary
The purpose of this conference was to begin a process of moving toward international standards in primary care informatics. It succeeded far beyond our expectations, and we believe it to be a "breakthrough" conference for shaping the future. The proceedings that follow were carefully recorded and developed to accurately reflect the conference process, discussions, and outcomes. We suggest that readers focus on the Report of Consensus, which documents the outcomes and is the most valuable and important section of these proceedings.
Among the papers included in this publication, we recommend A View From the Consensus Panel, by Stephen Kay, for an appreciation of the spirit and feel of the meeting. A list of the participants and Process Overview are also included.
The keynote address and the 12 intensive 15-minute presentations covering the International Classification of Primary Care (ICPC), the Read Codes, the Systematized Nomenclature of Human and Veterinary Medicine (SNOMED), and the Unified Medical Language System (UMLS) are not included in this summary but will be published elsewhere.
We would like to share some of our own thoughts on future actions and direction. To be effective, our efforts must be staged. We suggest the following:
Stage I:
Stage II:
Stage III:
It is essential to work with national agencies. We recommend that immediate steps be taken to establish an ongoing working relationship with the Agency for Health Care Policy and Research (AHCPR), the National Library of Medicine, the National Committee on Vital and Health Statistics, and other appropriate U.S. agencies as well as agencies in other countries.
We express our appreciation to the 80 attendees who traveled from 9 countries to contribute to the deliberations, to the 12 presenters who provided key information, to Nancy Lorenzi for developing and then facilitating the process, and to the American Medical Informatics Association (AMIA) and AHCPR for financial support.
This conference was a beginning. A followup conference will be held in Washington, D.C., in October 1996 immediately after the Symposium of Computer Applications in Medical Care (SCAMC), and we invite you and others who are interested to attend and participate as we move closer to the goal of international standards.
H. C. Mullins, M.D.
Conference Chair
Past Chair, Family Practice/
Primary Care Working Group of AMIA
R. D. Price, Ph.D.
Conference Co-Chair
Chair, Family Practice/
Primary Care Working Group of AMIA
Primary Health Care Specialist Group
3 Beech Avenue North
Worcester
United Kingdom
WR3 8PX
Telephone: (+44)(0) 905 454705 (home)
Fax: (+44)(0)905 456817
International Medical Informatics Association
(IMIA)
Working Group 5
Combined Coding Standards Workshop, New Orleans, November
1995
Conducted with the American Medical Informatics Association
(AMIA)
Family Practice/Primary Care Working Group
IMIA Working Group 5 is responsible for information dissemination and collaboration among workers in primary care computing around the world. Part of its specific remit is the development of coding standards for the effective recording of medical conditions in the electronic medical record in such a way as to allow international communication of medical information. It is therefore with great pleasure that the IMIA Working Group acts as cosponsor to this seminal workshop held in collaboration with the AMIA Family Practice/Primary Care Working Group.
Electronic medical records are beginning to become effective vehicles for the delivery of patient care. They are also providing the data for better understanding of medicine and the delivery of health care services. These benefits will be realized only if the data stored within the electronic medical record are in a consistent and transportable form. This requires effective coding systems to provide the standardization required. These coding systems must not only be standardized but must be usable by clinicians when recording medical data.
There have been many attempts to develop medical coding systems in various parts of the world. Sometimes they have been tailored to meet local needs. Sometimes they have been tailored to meet the needs of particular groups of users. There has also been a divergence between those concentrated on a scientifically valid classification structure, which is needed for epidemiological purposes, and those concentrated on developing a nomenclature that suits the needs of the recording clinician. These divergent aims between local and broader requirements and between classification and nomenclature have led to many polarized views about the most appropriate types of coding system, and this argument has been continuing for quite some time.
In order to move the world forward, it is important to come to some overview of coding standards to see if there is such a thing as a potential international standard coding system and, if not, whether there can be some halfway house, some agreed collaboration and interchange between the protagonists of the various coding systems. This agreement would allow users and developers of the systems to know which coding systems are appropriate under which circumstances. It would also provide the basis for communication between the various coding systems in a scientifically valid manner, so that information can be communicated between the users of these various systems.
The conundrum has halted or slowed the development of international medical informatics. The New Orleans conference was indeed an excellent beginning, and the suggested actions and directions reported in these proceedings provide useful material that workers around the world can use to move forward toward international standards.
Dr. Glyn Hayes
Chair
IMIA Working Group 5
Adams, Bill, M.D.
Assistant Professor of Pediatrics
Boston University School of Medicine
Boston City Hospital
Maternity 412
818 Harrison Avenue
Boston, MA 02118
Phone: 617-534-4233
badams@bu.edu
Bainbridge, Mike, M.D.
Telematics Officer
Primary Health Care Specialist Group
of the British Computer Society
49 Bondgate
Castle Doninaton
Derby DE74 2NS
U.K.
Fax: 44-1332-812609
mikebain@phcsg.demon.co.uk
Bernstein, Robert M., Ph.D., M.D., CM, CCFP
Assistant Professor, Department of Family Medicine
University of Ottawa
75 Bruyere Street
Ottawa, Ontario K1N 5C8
Canada
Phone: 613-241-3344
Fax: 613-241-1971
rmbernst@aix1.uottawa.ca
Bird, David
Legal/Commercial Director
Computer Aided Medical Systems
Tannery Buildings
58 Woodgate
Loughborough
Leicestershire LE11 2TQ
U.K.
Phone: 44-1509-611006
Fax: 44-1509-235560
Bolinger, Robert E., M.D.
Professor Emeritus
Kansas University Medical Center
3901 Rainbow Boulevard
Kansas City, KS 66160
Phone: 913-588-6063
Booth, Nick S., M.D.
General Practitioner and Research Fellow
The Sowerby Unit
University of Newcastle Upon Tyne
20 Springfield, Ovington
Northumberland NE42 6EH
U.K.
Phone: 44-1661-835526
Fax: 44-1661-830316
n.s.booth@newcastle.ac.uk
Bormel, Joseph I., M.D, M.P.H..
Physician Executive
Cerner Corporation
11121 Lakespray Way
Reston, VA 22091
Phone: 703-904-1867, ext. 6479
Fax: 703-904-9575
jbormel@cerner.com
Bouhaddou, Omar, Ph.D.
Vice President, Knowledge Engineering
Applied Medical Informatics
2681 Parleys Way, Suite 101
Salt Lake City, UT 84109
Phone: 801-464-6209 (work)
801-582-6632 (home)
Fax: 801-464-6201
omar@ami-med.com
URL: http://www.ami-med.com
Bourque, Michael
Director of Operations
CUNIDATA
Canada
Phone: 514-392-1592
Brantley, Mikel S., M.D.
Project Coordinator
Clinical Integrated Workstation
Computer Data Systems, Inc.
375 Medical Group/SGSI
310 West Losey Street
Scott Air Force Base, IL 62225-5252
Buvig, Hakon, M.D.
Consultant
INFODOC
Lifaret 7
N-1410 Kolbotn
Norway
Phone: 47-55-12-1990
Fax: 47-55-12-3329
Cheong, Ian R., B.Med.Sc., MBBS, AACS
Information Management Fellow
The Royal Australia College of General Practitioners
49 Christie Street
Canungra QLD 4275
Australia
Phone: 61-7-5543-5688
Fax: 61-7-5543-5660
cheongi@acslink.net.au
Chute, Christopher, M.D., Dr.P.H.
Assistant Professor of Epidemiology
Department of Health Sciences Research
Mayo Clinic
Harwick 670
Rochester, MN 55905
Phone: 507-284-5506
Fax: 507-284-1516
chute@mayo.edu
Nancy B. Clark, M.Ed.
University of South Alabama
College of Medicine
1504 Springhill Avenue
Mobile, AL 36604
Phone: 334-434-3480
Fax: 334-928-0106
nclark@jaguar1.usouthal.edu
Deshazer, Charles R., M.D.
Vice President, Health Care Informatics
Prudential Insurance Company
250 Gibraltar Road, 1 South
Horsham, PA 19044
Phone: 215-443-2221
deshazer@aol.com
Elson, Robert, M.D.
Informatics Fellow
National Library of Medicine
Division of Health Computer Sciences
University of Minnesota
Box 511 UMHC
420 Delaware Street, SE
Minneapolis, MN 55455
Phone: 612-625-3246
Fax: 612-625-7166
relson@medinfo.labmed.umn.edu
Gnassi, John Angelo, M.D.
Consultant, Laboratory of Computer Science
Massachusetts General Hospital
50 Staniford Street, 5th Floor
Boston, MA 02114-2517
Phone: 617-724-3543
Fax: 617-726-8481
jgnassi@lcs.mgh.harvard.edu
Grayson, Rebecca R.
Kaiser Permanente Medical Care Program
Clinical Information System Group
1800 Harrison Street, 10th Floor
Oakland, CA 94612-2998
Phone: 510-267-5629
Gremp, Jennifer
Associate Editor
Medi-Span
8425 Woodfield Crossing
P.O. Box 40930
Indianapolis, IN 46240
Hagen, Michael D., M.D., FAACP
Professor, Department of Family Practice
University of Kentucky
Kentucky Clinic K-322
Lexington, KY 40536-0284
Phone: 606-323-6711
Fax: 606-323-6661
hagen@ukcc.uky.edu
Hagen, Philip T., M.D.
Assistant Professor of Preventive Medicine
Mayo Clinic
Ba5a
Rochester, MN 55905
Phone: 507-284-9203
Fax: 507-284-4251
phagen@mayo.edu
Hannah, Kathryn J., Ph.D., R.N.
Partner and Leader
Health Informatics Group
Sierra Systems Consultants, Inc.
Suite 660
202-6th Avenue, SW
Calgary, Alberta T2P 2R9
Canada
Phone: 403-264-0955
Fax: 403-233-2108
khannah@sierrasys.com
Harmon, Bart J., M.D.
Fellow
Laboratory of Computer Science
Massachusetts General Hospital
8 Hudson Street
Quincy, MA 02169
Hausam, Robert, M.D.
Postdoctoral Fellow
Department of Family and Preventative
Medicine Hospital and Clinical
Medical Informatics
University of Utah School of Medicine
1138 East Wilmington Avenue
Salt Lake City, UT 84106
Phone: 801-581-2000
Fax: 801-463-0313
robert.hausam@hsc.utah.edu
Hayes, Glyn M., M.D.
Primary Health Care Specialist Group
British Computer Society
3 Beech Avenue North
Worcester WR3 8PX
U.K.
Phone: 44-1527-579414
Fax: 44-1905-456817
glyn@conline.demon.co.uk
Hollingworth, Gary R., M.D.
Assistant Professor
Department of Family Medicine
University of Ottawa
75 Bruyere Street
Ottawa, Ontario K1N 5C8
Canada
Phone: 613-241-3344
Fax: 613-241-1971
grholl@aix1.uottawa.ca
Jenkins, Rolland, M.D.
Senior Staff Internist and Clinical Instructor
Long Beach VA Medical Center Hospital (111-GM)
5901 East Seventh Street
Long Beach, CA 90822
Phone: 310-494-5748
Fax: 310-494-5155
jenkins.rolland@forum.va.gov
Jernigan, Clarence A., M.D., M.Ph.
Associate Professor, Family Medicine
University of Texas Medical Branch
301 University Boulevard
Galveston, TX 77555-0853
Phone: 409-772-9859
Fax: 409-772-5820
cjerniga%utmbgalv@mhost.utmb.edu
Jones, Neill, M.D.
Clinical Consultant
2 Saxon Close
Cleadon Village, Sunderland S46 7SD
U.K.
Phone: 44-191-519-0136
Fax: 44-191-519-3798
Kay, Stephen, Ph.D.
Senior Lecturer
Department of Computer Science
The University of Manchester
Oxford Road
Manchester M13 9PL
U.K.
Phone: 44-161-275-5719
Fax: 44-161-275-6932
sky@cs.man.ac.uk
Kern, Valerie C., R.N., M.S.
Senior Editor
Oceania
3145 Porter Drive, Suite 103
Palo Alto, CA 94304
Phone: 415-812-3038
Fax: 415-493-2202
vkern@oceania.com
Ketchell, Debra, M.L.S.
Deputy Director, Health Sciences Libraries
University of Washington
Box 357155
Seattle, WA 98195-7155
Phone: 206-543-3409
Fax: 206-543-8066
ketchell@u.washington.edu
Kidd, Michael, M.D., FRACGP
Professor of General Practice
Central Clinical School
The University of Sydney
37A Booth Street
Balmain 2041
Australia
Phone: 02-9818-1400
Fax: 02-9818-1343
michael@sugp.bal.cs.nsw.gov.au
Klinkman, Michael S., M.D., M.S.
University of Michigan
Assistant Professor, Department of Family Practice
1818 Fuller Street
Ann Arbor, MI 48109-0708
Phone: 313-998-7120, ext. 309
Fax: 313-998-7335
mklinkma@umich.edu
Kokiko, Elaine
South Tower, Suite 1105
4340 East-West Highway
Bethesda, MD 20814
Phone: 301-229-3000
Fax: 301-654-6940
Legler, James D., M.D.
Associate Professor, Family Practice
University of Texas Health Science Center
at San Antonio
7703 Floyd Curl Drive
San Antonio, TX 78284
Phone: 210-270-3911
Fax: 210-220-3763
legler@uthscsa.edu
Lincoln, Michael J., M.D.
Assistant Professor of Medicine
Department of Medical Informatics
University of Utah School of Medicine
Room AB-193, Medical Center
Salt Lake City, UT 84132
Phone: 801-581-4080
Fax: 801-581-4297
mlincoln@cmed.utah.edu
Lorenzi, Nancy M., Ph.D.
Associate Senior Vice President and Provost
Health Education
University of Cincinnati
Medical Center
250 Health Professions Building
P.O. Box 70663
Cincinnati, OH 45267-0663
Phone: 513-558-3024
Fax: 513-558-2962
lorenzi@uc.edu
Lussier, Yves A., M.D., P.Eng.
Accurate Informatics and Medicine,
Consultants
250 King
Sherbrooke, Quebec J1G 1A9
Canada
Phone: 819-563-0510
Fax: 819-564-6889
ylussier@multi-medias.ca
McCallie, David P., Jr., M.D.
Cerner Corporation
Director, Core Technologies
Community Products and Services
2800 Rockcreek Parkway
Kansas City, MO 64117-2551
Phone: 816-221-1024
Fax: 816-474-1742
dmccallie@cerner.com
McCormick, Kathleen A., Ph.D., R.N.
Senior Science Advisor
Agency for Health Care Policy
and Research
2101 East Jefferson, Suite 602
Rockville, MD 20852
Phone: 301-594-1483
Fax: 301-594-2333
kmccormi@ahrq.gov
McDaniel, Mary
AMI
Salt Lake City, UT
McGuire, Sam A., M.D.
Family and Community Medicine
University of Arkansas
Medical Sciences
Slot 530
4301 West Markham
Little Rock, AR 72205
Phone: 501-686-6632
Fax: 501-686-8421
samcguire@dfcm.uams.edu
Milholland, Kathy, Ph.D., R.N.
Senior Policy Fellow
Practice, Economics and Policy
American Nurses Association
600 Maryland Avenue, SW
Suite 100 West
Washington, DC 20024-2520
Phone: 202-651-7060
Fax: 202-651-7001
milholl@ana.org
Morrison, Patricia
Manager, Group Systems
Prudential
250 Gibraltar Road, 1 South
Horsham, PA 19044
Moshman, John
Moshman Associates, Inc.
Suite 1105
South Tower
4340 East-West Highway
Bethesda, MD 20814
Phone: 301-229-3000
Fax: 301-654-6940
Mullins, Henry C., M.D.
Professor, Family Practice
University of South Alabama
College of Medicine
1504 Springhill Avenue
Mobile, AL 36604
Phone: 334-434-3480
Fax: 334-928-0106
hmullins@jaguar1.usouthal.edu
Nelsen, David A., M.D.
Assistant Director
Family and Community Medicine
University of Arkansas
4301 West Markham, Slot 530
Little Rock, AR 72205
Phone: 501-686-6608
Fax: 501-686-8421
dnelsen@dfcm.uams.edu
Nelson, Brent D., Ph.D.
Senior Computer Scientist
Ameritech Health Connections
801 East Campbell Road, Suite 450
Richardson, TX 75081
Phone: 214-301-5503
Fax: 214-301-6161
brent.nelson@ameritech.com
Nelson, Stuart J., M.D.
Head, Medical Subject Headings
National Library of Medicine
8600 Rockville Pike
Bethesda, MD 20894
Phone: 301-496-1495
Fax: 301-402-2002
Oates, Randall, M.D.
Family Physician
President and Chief Executive Officer
SOAPware
803 Quandt Street
Springdale, AR 72764
Phone: 501-751-9236
Fax: 501-751-7013
Ojala, Matti, M.D.
National Agency, Welfare and Health
Box 220
Siitasaarenkatu 118
00530 Helsinki
Finland
Phone: 358-0-39672103
Fax: 358-0-714469
URL: http://www.stakes.fi
Olenick, Jeffrey S., M.D.
Pacific Medical Group
4510 Southwest Hall Boulevard
Beaverton, OR 97005
Olson, Kenneth P., M.D.
Family Physician
Park Nicollet Medical Center
1885 Plaza Drive
Eagan, MN 55122-2612
Phone: 612-993-4000/4046
Fax: 612-993-4075
olson174@maroon.tc.umn.edu
olsonkp@ergan.hsmnet.com
Pace, Wilson D., M.D.
Associate Professor, Director of Information
Services
University of Colorado
Department of Family Medicine
Center for Studies in Family Medicine
University of Colorado Health Sciences Center
1180 Clermont Street
Denver, CO 80220
Phone: 303-270-5191
Fax: 303-270-3210
wilson.pace@uchsc.edu
Pedigo, Thurman L., M.D.,
Vanderbilt University
Oxford House, Suite 405
Nashville, TN 37232-4335
Phone: 615-936-1341
Fax: 615-936-0320
pedigotl@ctrvax.vanderbilt.edu
Price, Robert D., Ph.D.
Professor, Family Medicine
Director, Division of Medical Informatics
University of Arkansas
Department of Family and Community Medicine
4301 West Markham, Slot 530
Little Rock, AR 72205
Phone: 501-686-6608
Fax: 501-686-8421
rdprice@dfcm.uams.edu
Purves, Ian, MBBS, MRCGP
Director, Department of Primary Health
Care Informatics
Sowerby Unit for Primary Care Informatics
University of Newcastle
Newcastle Upon Tyne NE2 4HH
U.K.
Phone: 44-91-222-7884
Fax: 44-91-222-6043
ian.purves@ncl.ac.uk
Reynoso, Guillermo A., M.D.
Chief, Medical Informatics Section
CEMIC-Buenos Aires
Argentinean Biomedical Informatics Society
Sanchez de Bustamante 2560
Buenos Aires 1425
Argentina
Phone: 54-1-788-2201
Fax: 54-1-780-2000
greynoso@pinos.com
Richmond, Robin, Ph.D.
Healthcare Information
United HealthCare Corporation
MNO6-6130
P.O. Box 1459
Minneapolis, MN 55440-1459
Phone: 612-945-6152
Fax: 612-945-6502
rrichmo@uhc.com
Riley, Robert T., Ph.D.
President
Riley Associates
221 Hilltop Lane
Cincinnati, OH 45215
Phone: 513-521-3125
Fax: 513-521-9319
rileyrt@uc.edu
Rothwell, David J., M.D.
Editor
SNOMED
College of American Pathologists
14515 Woodbridge Circle
Brookfield, WI 53005
Russler, Daniel C., M.D.
MEDICALdesk
P.O. Box 47
Lodi, WI 53555-0047
Shoulders, Harrison H.
Tracy Clinic
P.O. Box 623
Monteagle, TN 37356
Slager, J.N.
HIS User Group
c/o Achtergracht 25
The Netherlands
Sneiderman, Charles A., M.D., Ph.D.
Research Medical Officer
National Library of Medicine
B 1 N 28 L
8600 Rockville Pike
Bethesda, MD 20894
Phone: 301-496-6280
Fax: 301-480-3035
charlie@nlm.nih.gov
Spiers, Suzanne
Court Reporter/Transcriber
5060 Longview Road
Elmore, AL 36025
Phone: 205-251-4200
Voice: 205-350-7895
Fax: 205-252-5644
Stuart-Buttle, Charles
National Health Service Center
for Coding and Classification
Info. Mat. Group
Executive Headquarters
Woodgate
Loughborough
Leicestershire LE11 2TG
U.K.
Phone: 44-1509-211411
Fax: 44-1509-211611
Takeda, Hiroshi, M.D., D.Sc.
Associate Professor
Department of Medical Information Science
Osaka University Hospital
2-15, Yamada-oka
Suita 565
Japan
Phone: 81-6-879-5900
Fax: 81-6-879-5903
takeda@hp-info.med.osaka-.u.ac.jp
Teasdale, Sheila
MAAG Manager
Lincolnshire MAAG
P.O. Box 206
Lincoln LN4 2JE
U.K.
Phone: 44-1522-569814
Fax: 44-1522-569874
sheila@informat.demon.co.uk
Thornton, Thomas C., M.D.
Family Health Care
P.O. Box 314
Upper Sandusky, OH 43351
Phone and Fax: 419-294-5711
Timka, Toomas, M.D., Ph.D.
Head Physician and Associate Professor
of Medical Informatics and Social Medicine
Departments of Community Medicine
and Computer Science
Linkopina University
S-581 85 Linkopina
Sweden
Phone: 46-13-221037
tooti@da.liu.se
Viner, Gary, M.D.
Assistant Professor
University of Ottawa
Department of Family Medicine
770 Broadview Avenue, Suite 105
Ottawa, Ontario K2A 3Z3
Canada
Phone: 613-728-7700
Fax: 613-722-6214
gviner@uottawa.ca
Williams, David, R.N.
U.S. Army
902 130th Street East
Tacoma, WA 98445-2967
Phone: 206-968-1605
Fax: 206-968-0974
david.williams@xmail1.ha.osd.mil
Wilson, Rob, B.Sc.
Research Assistant
Sowerby Unit for Primary Care Informatics
University of Newcastle
21 Claremont Place
Newcastle Upon Tyne NE 24AA
U.K.
Phone: 44-191-222-5415
Fax: 44-191-222-6043
rob.wilson@newcastle.ac.uk
Wood, Maurice, M.D.
Emeritus Professor, Family Practice
Medical College of Virginia
Route 1, Box 672
Roseland, VA 22967
Phone and Fax: 804-325-1383
wood150@aol.com
Zee, G.N., M.D.
HIS-User-Group
Hoofdwal 23-25
4207 EA Gorinchem
The Netherlands