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20 Years of H.I.S.tory

July 24, 2008
by root
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Up & Coming Vendor in 1988: HMDS

Although it's hard for us high-tech junkies to remember, PCs were a breakthrough idea 20 years ago. In 1988, Health Micro Data Systems (HMDS) was an up-and-coming vendor, founded by Frank Poggio.

Frank cut his IT teeth as a CFO at the University of Wisconsin, where he also acted as the “CIO” (the term hadn't been invented yet), responsible for Shared Medical System (SMS) there. When IBM entered the PC market in the mid-'80s, Frank had an idea to replicate the mainframe functionality he had from SMS on these more affordable devices.

It took the second generation of IBM PC-2 Model 80s running Intel's 80386 16-bit microprocessor before he could install a pilot site at 80-bed Neillsburg Hospital in Wisconsin. Networked via Novell, a group of PCs offered the same basic functionality as competitors' minicomputer-based systems, at a fraction of the price.

What happened to HMDS? After selling to over a hundred small hospitals, it was bought out by Citation, a PC-based Lab firm, who later sold out to Cerner, who eventually sunset it.

Were these early PCs able to handle the load of a full HIS? IBM's PS-2/80 featured an 800 megabyte hard drive, which could be expanded to over a gigabyte. Imagine — a full gig.

Updates were mailed out on floppy diskettes, and for emergencies, HMDS could dial into clients' PCs using blazing 9600-baud modems from their headquarters in Madison, Wis.

Does this architecture sound familiar? Today's “client/server” systems use basically the same approach, only with a modern GUI (graphical user interface) and far more powerful PCs. So the next time you see a demo of Paragon or Focus, remember those brave pioneers from the '80s who had the nerve to challenge the mainframe and minicomputer dinosaurs of their day.

Other Vendor News in 1988

Press releases announced sales by other leading HIS vendors:

  • Cerner — scored several big LIS contracts like HUP in Philadelphia

  • PHS — signed Paracelsus in California for their “PatCom” Patient Accounting (now Keane's)

  • TDS — signed Pacific Presbyterian (now Eclipsys')

  • TSI — signed 14 sites for its DSS/EIS (also Eclipsys')

  • Baxter —sold two of its “Omega” mainframe systems (now McKesson's “Healthquest”)

Hot Clinical System: ULTICARE

A fascinating ad graced the pages in June of 1988: Health Data Sciences' “ULTICARE.” Although not using the modern moniker of an EMR, the ad touted the availability of critical patient information to providers — anytime, anywhere via a “Computerized Patient Record.” Sound familiar? Yes, this is the same ULTICARE sold to MISYS, and most recently acquired by QuadraMed, now known as their “QCPR.”

1988 Rage: Bedside Terminals

The hot new concept in the late '80s was placing terminals at the bedside for nurses. Whether full-size CRT (cathode ray tube) computer terminals or equally bulky PCs, this idea seemed radical at the time due to the size and cost of these early devices. Remember, laptops did not take off until the '90s, so large bulky terminals in a patient's rooms was daring.

Three vendors started this trend:

  • Ulticare — from HDS, using large DG terminals.

  • MedTake — from N.J. start-up MicroHealthsystems, PC-based.

  • Clinicom — featuring a handheld bar-coding device for meds.

Ain't much new under the sun.

Another Crazy Idea

Buried in the back pages is an article claiming Georgetown University Hospital has the largest installed PACS (Picture Archiving Communication System). Based on AT&Ts' “CommView” network, the system linked the hospital to MRIs and CTs at an imaging center 13 miles away. What were these people thinking, replacing high-quality X-Ray film with fuzzy images on the low-pixel CRTs of the day? Crazy… it will never sell.


Vince Ciotti

Vince Ciotti

Very few companies in the HIS industry have lasted more than 20 years, and the consulting business has been particularly unforgiving — anybody remember the “Big Eight?” HIS Professionals, LLC, passed our 20th anniversary last year, and in honor of that milestone we created this column for HCI to remind today's CIOs of what went on 20 years ago.

Our sources are twofold: Dusty copies of “Computers in Healthcare” and “Healthcare Computing and Communications” and files from consulting engagements that we are still able to open despite their being in Works 1.0. Enjoy the following gems, and stay tuned to this column for monthly trips down memory lane.

Healthcare Informatics 2008 August;25(8):72


Some of us may have Vince's memory but very few of us have Vince's recall. It is amazing how far we've come in a few short years. Thanks to Vince for tracking, benchmarking, and understanding and sharing the journey.