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Market Analysis, Circa 1990

June 25, 2010
by Vince Ciotti
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Leading vendors and personalities from HCI 20 years ago
Vince Ciotti
Vince Ciotti

Featured Ad: A stunning two-page, full-color ad announced “HealthQuest,” the company selling Medipac, a pioneering mainframe-based patient accounting system. Interesting HIS-tory of Medipac: developed at Evanston (Illinois) Hospital by Medicus, a pioneering HIT consulting firm in the late '70s, programmed in COBOL and using IBM's VSAM file structure. The system sold so well in those halcyon mainframe days that it was spun off as Mediflex, a separate company from Medicus, and sold to hundreds of hospitals in the '80s. Eventually bought by IBAX, then by American Express, eventually winding up in HBOC, where it lives to this day with several hundred clients.

Pharmacy System Market - Sheldon I. Dorenfest & Associates (SIDA) published a fascinating review of this niche market in 1990, with the leaders being:

Baxter - 169 hospital clients, mostly on Dynamic Control (Series 2000);

HBO - 120 sites, running their MedPro mini-based system;

Continental - 93 sites with this mainframe-based, high-end system;

SMS - 92 clients, mostly on their “ACTIon” mini-based system;

Digimedics - 60 hospital clients on this RX specialty system;

Amex/SAI - 58 on the old “Saint” system, with Point Four minis;

DOSE - 55 clients on their dedicated RX mini-based system;

TDS - 47 sites on Technicon Data System's mainframes;

McAuto - 41 sites on their HDC mini or PCS Tandem systems;

Meditech - 38 sites using their “Magic” DEC-based module.

SIDA (pre-cursor to HIMSS analytics) found only 30 percent of the nation's hospitals had automated pharmacies by 1990, amazingly low in light of today's eMAR, BMV, and Med-Rec mania.

David vs. Goliath - Title of an article written by Joe Smith, VP at American Healthware, another interesting HIS-tory. This firm started as HIS Inc., a purveyor of Quantel mini-based system, and yours truly became its marketing director in 1980 when it tried to morph onto mainframes and compete with the big boys: IBM's PCS/ADS, Medipac, DataCare, Nadacom, etc. Thanks to some of the best salesmen in HIS-tory (Dick Schopp, Don Trammell, Jud Foreman and Brian Fitzpatrick) we actually sold a dozen large medical centers, but the software was not delivered in time. HIS Inc. went bankrupt, and Amercian Healthware rose Phoenix-like from its ashes, finishing the product as “Eagle 2000.” Joe became the VP of Marketing, and led its 2nd successful sales campaign, eventually dominating the NYC market. SMS got so tired of losing to them it bought Eagle in the '90s, and it still runs today in dozens of Siemens NYC sites.

Hospital Systems Industry - HIS maven Ron Johnson wrote an analysis of the HIS industry in 1990, with his most salient observations being:

The merger of IBM and Baxter into IBAX was prompted by the steady decline of IBM's PCS/ADS software sales;

A definite trend was emerging in favor of UNIX- and Mumps-based products (e.g.: Meditech);

Vendors are developing systems that run on multiple brands of computers (heresy in the '80s when a vendor was either IBM, DEC, or DG, etc.);

Daily increasing nursing shortage may force hospitals to automate more clinical systems;

Network Micro- or PC-based systems will begin to challenge mini-based systems in the midsize hospital market.

RFP: Request For Prevarication? - HIS pioneer Frank Poggio contributed an article on RFPs, with some cute definitions of this time-honored paper chase:

Vendors referred to an RFP as a “Real Funny Process”;

Consultants define it as “Required Fruitful Process”;

Users call it a “Real Frustrating Process”;

Cynics call it a “Real Fraudulent Process.”

Ironically, Frank's company HMDS offered the first PC-based HIS (like Ron Johnson was talking about) and won one of our firm's earliest selection processes at Central Medical Center (CMC) in St. Louis in 1991, where we introduced our “Non-RFP Selection Process!” The CFO at CMC, Steve Berger, went on to form his own firm, Healthcare Insights, selling a superb EIS.

Healthcare Informatics 2010 July;27(7):48