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Alone at the Top

May 29, 2009
by Vince Ciotti
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Twenty years ago, IBM came near the $1 billion mark with a line that featured software and hardware, while the rest of the pack looked on

Since June is the “Top 100” issue for Healthcare Informatics, let's look back at who dominated the HIT industry 20 years ago. Here they are, ranked by 1989 annual revenue:

IBM - $925M - We all watched with bated breath as IBM neared the impossible billion dollar mark back then. “Big Blue” offered software as well as hardware: 37xx mainframes running PCS/ADS, System 38 minis running HPMS, and their PS/2 line of PCs running DOS. So much more efficient than Apple's GUI…

SMS - $375M - Shared Medical Systems, which was founded 40 years ago (big reunion in King of Prussia this fall!), was also heavily IBM: its three founders were ex-IBMers who shared an IBM 360 running SHAS software, source of the TCEs (Transmission Control and Error Reports) still found in Invision today.

MCAUTO - $185M - The airplane giant had a huge General Services Division (GSD) offering time-sharing IBM mainframes, with a smaller Health Services Division (HSD) offering HFC (Hospital Financial Control). McAuto was gobbled up by American Express, then HBOC, then McKesson, who still runs some HFC clients today …

DEC - $175M - Digital Equipment Corporation was a huge pioneer of minicomputers with their PDP line, featuring the amazing ability to process 16 bits of data! Later came the VAX line, with 32 bit processors, and eventually the Alpha series, handling 64 bits.

HBO - $145M - No “C” on the end of their name yet, but Huff, Barrington and Owens left McAuto to form HBO, and rode the mini-revolution to success with their MedPro order/results system replacing charge tickets at hundreds of hospitals, and IFAS (Integrated Financial and Administrative System) automating patient accounting (we had no “Revenue Cycle” back then!).

DG - $140M - Another minicomputer company, Data General easily offered the most powerful minis ever based on their product names. Whereas DEC offered puny little PDP 11, and IBM their 37xx mainframes, DG called their minis the MV 10,000 and MV 20,000 line. That's several orders of magnitude more powerful!

UNISYS - $125M - formed by the merger of Sperry-Univac and Burroughs, Unisys offered a number of product lines to hospitals in the '80s, but eventually gave up the healthcare ghost. Old hardware mavens still swear Burroughs mainframes offered superior price/performance over IBM …

BAXTER - $115M - The supply giant bought up a number of smaller turnkey mini-firms like Dynamic Control (running on IBM SYS38 minis), JS Data (IBM SYS34 minis), and Compucare (running on DGs). Dynamic and JS Data live on today as McKesson's Series, while Compucare was acquired by QuadraMed.

NCR - $75M - National Cash Register struggled valiantly to carve a healthcare niche with its “Care” suite of clinical apps, but the register ran dry.

TDS - $40M - The original CPOE system, Technicon Data Systems started out as a Lockheed experiment at El Camino hospital in California in 1970, pioneering direct physician order entry into “Video Matrix Terminals” with customized order sets created by matrix coding. Acquired so many times it could make a separate article (even Revlon owned them once), eventually bought by Harvey Wilson to form Eclipsys (yes, the Harvey Wilson from SMS!).

Vince Ciotti is founder and principal at HIS Professionals, LLC. His blog can be found at
Healthcare Informatics 2009 June;26(6):96