Fribourg, at a Jesuit School called College of Saint. Michel, and followed the ... schema that is the DIOGENE wheel; that is, the middle of the wheel is the patient ...
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JAMIA
Special Features
Presentation of the Morris F. Collen Award to Jean-Raoul Scherrer, MD CHARLES SAFRAN, MD
The American College of Medical Informatics is an honorary society established to recognize those who have made sustained contributions to the field. Its highest award, for lifetime achievement and contributions to the discipline of medical informatics, is the Morris F. Collen Award. Dr. Collen’s own efforts as a pioneer in the field stand as the embodiment of creativity, intellectual rigor, perseverance, and personal integrity. At most once a year, the College gives its highest recognition to those whose attainments have, throughout their careers, substantially advanced the science and art of medical informatics. In 2000, the College was proud to present the Collen Award to Professor Jean-Raoul Scherrer. It is especially appropriate that we draw attention to the work of a distinguished European informatician, because ideas in Europe are somewhat different from ours and complementary. In the early days of the field, a lot of experiments were really essential, and Professor Scherrer was one of the pioneers. Jean-Rauol Scherrer was born in the Canton of Jura, Switzerland, in October 1932 but has lived most of his life in Geneva, Switzerland. He went to college in Affiliation of the author: Harvard Medical School, Boston, Massachusetts. Correspondence and reprints: Charles Safran, MD, MS, Chief Executive Officer, Clinician Support Technology, Associate Professor of Medicine, Harvard Medical School, 3 Speen Street, Suite 340, Framingham, MA 01701; e-mail: .
Fribourg, at a Jesuit School called College of Saint Michel, and followed the classical pathway—ancient Greek, Latin, and strong mathematics studies. In 1959, he graduated from the Medical School of the University of Geneva, where he studied physiology and internal medicine. Professor Scherrer: My first interest was to become a writer. Since I was not particularly convinced I was right, because I was too young, I decided to visit a famous author who was living quite close to where I was. And I asked him the question. And he said, “Well, as I see you, I would recommend that you become a doctor instead of becoming a writer.” So, I did it!
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SAFRAN, Morris F. Collen Award
standard hospital system, but starting with whatever tools were available to him. I think Jean-Rauol has played the role of bridging between the fields of physics, mathematics, and medical applications. He’s always, as he’s said many times, placed the top priority on developments leading to improvements in medical care. But his starting point really is physics and math. He bridges those fields very nicely. Actually, NIH now has a form of research grant award called the GLUE Award, which is meant to facilitate conversations between physicists, mathematicians, medical informaticians, and medical practitioners. I guess, really, the GLUE Award would permit Jean-Raoul to have a conversation with himself, because he represents all those fields at once.
From 1967 until 1969, Professor Scherrer did postgraduate work in medical physics at Brookhaven National Laboratory, on Long Island, and then returned to Geneva and the Cantonal Hospital of the University of Geneva, where he began to design and build what was to become DIOGENE, the hospital’s patient information system. Scherrer: The idea was to have a system that would be patient-centric. So, we have done in these years a schema that is the DIOGENE wheel; that is, the middle of the wheel is the patient. So the problem was that it was impossible to disarm so many wards that had stand-alones—those are PCs now—and we had to find a trick between the maximum terminals that we could manage (that was 48) and the 120 wards that had to be disarmed. So the trick was the pool operators who were handling the 48 terminals and serving the 120 ward units equipped with what we have called the telestation. They were also handling fast printers for all the documents to be printed locally in all the wards.
You put orders in through the telephone. You could immediately see on the screen what you had ordered. And behind this fantastic outward façade was a bank of individuals who were keying in the information for orders, for medications, for laboratory work, and for radiology. Professor Scherrer addressed the needs of the physician, and not only that, he did not encumber the physician with the need to learn the computer. But his objective was to see how the computer could be an enabling tool, to assist the health care provider in doing what he or she needed to do to be giving the best possible care for the patient. Donald Lindberg, MD: Professor Scherrer’s work on the hospital information system called DIOGENE is very interesting because, basically, it’s a big physics experiment. He undertook—was not afraid, I should say—to undertake a big, general, working, reliable,
In 1990, Professor Scherrer asked me to spend a sabbatical in Geneva with his group. When my family and I arrived there, we were amazed at the breadth of applications and the teams that Professor Scherrer had assembled around him. Not only was a hospital information system team in place, but he had groups working on natural language processing and image processing and manipulation in the OSIRIS system. Another of his groups was determining protein constellations in human patients by the use of bi-dimensional electrophoresis of human sera, and correlating these patterns with the identification of genes, using several scattered remote data bases. This Web-based system is called ExPASy. To my knowledge, this was one of the first bioinformatics groups assembled any place in the world. I was impressed that it was almost like a Renaissance of medical informatics. In Geneva in 1992, researchers at CERN, which is a high-energy physics laboratory, invented the World Wide Web. As luck would have it, the director of CERN was a neighbor of Professor Scherrer, and because of this neighborhood collaboration, the group at Geneva Hospital was really the first to apply World Wide Web technology in health care. They made their protein research databases available to colleagues around the world via the Web and were really the first to do this. Robert Baud, PhD: He was promoting a new technology—new ideas. And it was a chance for many of us, being with him, because he was pushing in a new direction.
Jean-Raoul has been very important in the utilization of medical computing in Switzerland but also in the affairs of IMIA, the International Medical Informatics Association. Scherrer: I was quite well acquainted with IFIP (International Federation for Information Processing), because IFIP was created in Geneva for
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computer science in general. And, of course, we need ed to have something special for computer science in medicine. Then I discovered the existence of IMIA, and understood that we should create a Swiss society for medical informatics. It’s a necessary step for becoming a member of IMIA. So, I had to create it … I became the founder of the Swiss Society for Medical Informatics. Marion Ball, EdD: Jean-Raoul was … could really be considered … one of the founders of this organization. He was very much involved early on with IFIP when IMIA was nothing more than a subgroup or a working group at TC4. There was also a very fun-loving and jovial side to Jean-Raoul’s contribution to medical informatics. As chairman of the organizing committee for the 1992 MedInfo meeting in Geneva, he organized a huge circus performance for all of us to attend. Well, if anybody wants to remember Jean-Raoul, or feels they might not know who he is, all you need to say is, “Jean-Rauol was the gentleman who rode into that marvelous circus arena on top of a huge, huge elephant.” The man riding the elephant was our friend, Jean-Raoul Scherrer!
A true renaissance man, Professor Scherrer is as comfortable and knowledgeable talking about acetyl cholinesterase activity of human erythrocytes as he is talking about 16th century painting techniques of the Italian masters. During my time in Geneva, I had a weekly meeting scheduled with him. I would be prepared every week to talk about database design, the design of hospital information systems, the functioning of the operator pool and its value in the DIOGENE system. To my surprise, Professor Scherrer would rather talk about the Reformation, the silk route followed by Marco Polo, or a variety of other historical topics or topics of art and poetry. Lindberg: One inevitably pictures Jean-Raoul Scherrer in Geneva, the city he grew up in and loves. He has an incredible knowledge of histories and humanities and literature, which seemingly is an endless store for him. I recall one day asking, Wasn’t it true that Julius Caesar actually marched through Geneva in olden times? (Julius Caesar, of course, would have called it Transalpine Gaul, not Geneva or Switzerland.) And Jean-Raoul said, “Of course. He stood right here at that corner and reviewed his troops.” I have not found anyone else in Geneva or elsewhere who knows where Julius really was, but I trust Jean-Rauol: Julius Caesar was on that corner. I’m certain of it!
Ball: … I was in the Holy Land with him at one time, when he followed the steps of Jesus Christ into Jerusalem as Jesus had come in on the donkey. JeanRaoul knew every step of the way. He knows his Bible intimately.
According to the practices of the University, JeanRaoul is now in retirement. In reality, of course, he is still very productive. With the help of the Ministry of Health of Geneva, he set up a new foundation— charged to collect and guarantee as far as possible the quality of health care information on the World Wide Web—called H-O-N, Health-on-the-Net. Professor Scherrer is president of the foundation whose logo and principles are widely adopted by health Web sites. Ball: I can truly say, for me and for many of my colleagues, Jean-Raoul has provided a lifetime of inspiration, which is not equaled by anyone I can even think of.
