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Semantics Take Center Stage

April 26, 2009
by Vince Ciotti
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Bedside terminals, a giant acquisition and competing pharmacy systems made headlines in 1989

A look back at “U.S. Healthcare” for what was “new” two decades ago:

Bedside Terminals: HDS (Health Data Sciences) - a full page color ad touted “UltiCare,” and bedside terminals, a daring concept back then, when CRTs (Cathode Ray Tubes for you youngsters) were almost a yard long and weighed 50+ pounds. There were no “COWS” (Computers On Wheels) then, but end tables holding monstrous IBM 3270 terminals. UltiCare and other pioneers like Johnson and Johnson's “Critikon” broke new ground with devices at the bedside to facilitate nursing documentation and even physician viewing of test results. There were no laptops back in those days; PCs were equally large and bulky devices dominated by IBM's PS/2 line, or more compact Macintosh “SE” models with a black and white screen so small it would barely hold a single pop-up ad of today.

Not until laptops came into the fore in the early '90s did bedside terminals take off, overcoming the obstacles of size and price. What happened to HDS? UltiCare sold fairly well, with 30+ large clients until it was sold to Per Se in the late '90s. Per Se then sold it to Misys, who recently sold it to QuadraMed, who now markets it under the name QCPR (QuadraMed's Computerized Patient Record).

Huge Acquisition: Systems Associates Inc. (SAI), a unit of American Express, announced the acquisition of McDonnell-Douglas Health (McAuto), one of the earliest and largest HIT firms. This was a “shark eating a whale” story, as SAI was a tiny upstart turnkey mini-based system out of Florida in the '70s who sold its “Saint” system to small hospitals, at a time when McAuto and SMS dominated the market with shared mainframes. As these mini-mammals ate shared dinosaur eggs, McAuto reacted by offering mini systems too, including:

  • HDC - Hospital Data Control, a combination of Four Phase and DEC PDP minis that competed with HBO's MedPro clinical suite.

  • MHS - the “Mini-based Hospital System” McAuto acquired from Skip Shippee's MSA in NC, that ran on MicroData minis that, fortuitously, McDonnell-Douglas had acquired from their UK owners.

McAuto fought the good fight right through the '80s, trying to hold on to their shared system clients while selling minis, and their acquisition was a shocker in an industry dominated by shared mainframes. Today, of course, no one sells old-fashioned time-sharing, but rather far better “remote hosting” or ASP. Ah, the progress we have made in semantics and marketing…

RX Vendor Review: leading pharmacy systems included:

  • RXCOM - from American Express, who acquired this DEC-based system from McAuto, who had just acquired it themselves.

  • Kinetics - from Baxter Systems Inc., the giant supply company who was a major HIS player in the '80s acquiring Dynamic Control, JS Data, etc.

  • CPSI - a little-known upstart firm from Mobile, Ala., who had the nerve to think they could run entire hospitals on minis.

  • Continental - the “King Kong” of Pharmacy systems in the '80s, whose mainframe system dominated large (budget!) hospitals.

  • Digimedics - pharmacy specialists, bragging of a 4GL language and SQL report generator.

  • Dose - another pharmacy specialist who built a large client base out of Fort Worth, Texas.

  • Ferranti - international conglomerate that acquired several HIS firms, then sold them (sound familiar, Misys?).

  • GTE - the electronics giant acquired the I.H.S. mini-system from Intermountain Healthcare, eventually selling it to SMS as “MedSeries IV.”

  • Gerber Alley - another upcoming mini maven who started on HPs, but met its demise trying to switch to DEC with ALT (release) 4…

Correction: A sentence in March's Memory Lane column was open to misinterpretation due to an editing error. To clarify, William F. Andrew was humorously referred to as “infamous” only in regard to the “six-inch-thick RFPs” he issued; and he was never in sales. We apologize for any unflattering implications.

Healthcare Informatics 2009 May;26(5):56