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Dollars and Sense

March 30, 2009
by Vince Ciotti
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Large organizations bought into order entry, and HIS vendor competition meant low prices 20 years ago

A look back to April 1989 for what was “new” in HIT 20 years ago:

Featured Ad: IBM - A 2-page advertisement graced the inside cover of Computers in Healthcare, describing IBM's Patient Care System (PCS) orders application, through which “diagnostic tests can be ordered from a terminal at a nursing station, results reported back, charges automatically captured and the patient's record updated.” Wow, now that's automation! In fact, HBOC had popularized order entry systems back in the '70s with its pioneering Medpro system running on four-phase minis; IBM was simply upscaling the concept for large hospitals that could afford its 4,381 mainframes. PCS sold well, thanks to IBM's staggering marketing clout, and morphed into PCS/ADS (Application Development System), a forerunner of the “tools” so many systems offer today. Only then, PCS/ADS used hard-coded COBOL tools requiring a huge programming staff. Whatever happened to PCS/ADS? Like many systems, it was bought by HBOC in the '90s along with Medipac, and morphed into the HealthQuest RCM line still running today.

1989 HIS Prices - Our firm started consulting more than 20 years ago. Digging back into our 1989 files, I found this fascinating price comparison among three leading vendors in a system selection for a 300-bed hospital in New Jersey:

  • Baxter - the drug giant had acquired the Dynamic Control system running on IBM System 38 minicomputers, known today as McKesson's Series.

  • HCS - Hospital Computer Systems of Wall, N.J., which also offered an HIS on IBM System 38, and has morphed into a LTC system vendor today.

  • Unisys - the result of a merger between Univac and Burroughs, which offered a turnkey HIS system running on their mainframes.
















Misc. (eg: travel)




Total Capital:




Software Mtn./Lease




Hardware Mtn.




Total Operating:




Compare that to prices for a 300-bed hospital from today's HIS vendors and you'll get heartburn. To be fair, there's a lot more applications in today's systems, but this particular hospital chose Baxter and is still running Series some 20 years later.

Want Ads - In light of our economic downturn, some interesting job opportunities:

  • HIS Project Manager - for Queens Hospital in Honolulu! No salary was mentioned, but who would have cared?

  • European Career Opportunity - for someone who knows IBM's PCS/ADS Orders, an opening for a project manager. Again, salary was irrelevant!

  • Systems Analysis Corporation - an LIS vendor looking for Fortran programmers who know DEC's VMS operating system and database (not Windows 3.1!?)

  • Coopers and Lybrand - the “Big Eight” giant was looking for HIS consultants in the Dallas area. Great opportunity with a firm so big it will never go under…

  • Hersher - yes, Betsy was around then! I first ran across her at McAuto in 1980, looking for a “Director of Information Systems” - no CIO title then.

Healthcare Informatics 2009 April;26(4):88