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Generation HL7

December 31, 2009
by Vince Ciotti
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Of the 15 founding fathers of HL7, just one remains today, leaving many to question whether interoperability is attainable

A look back 20 years ago to “U.S. Healthcare” magazine from January 1990:

Featured Ad: “HL7 and Open Systems Architecture” - a two-page ad graced the inside cover, touting this breakthrough in an era when interfaces were almost as difficult as an Act of Congress (well, almost). To quote HL7's claims: “It allows for multiple kinds of hardware and software to function together on one network without the restrictions of a central mainframe system architecture. This is particularly beneficial in the healthcare industry, because no single vendor solution can accommodate an entire hospital's functional requirements.” Couldn't have said it better myself in 2010! Fun part is the list of HL7 founders, which reads like a “who's who” of HIT 20 years ago:

  • Professional Hospital Systems - created by hospital chain American Medical International to market their DG-based turnkey mini system featuring a revenue cycle systems called “PatCom.” It's running today at Johns Hopkins, Massachusetts General, and other customers of Keane, Inc., who still sells it as part of “Optimum.”

  • Simborg Systems - formed by Donald Simborg to market “StatLAN,” his pioneering patient care system, later taken public as Oacis.

  • Digital Equipment Corporation - as big in minis as IBM was in mainframes, from their PDP line right through to 64-bit VAXes; eaten up by Compaq and later swallowed by HP.

  • Compucare - a Reston, Va.-based HIS vendor formed by Ron Apprahamian in the '70s, eventually bought by QuadraMed for its “Affinity” HIS.

  • Ernst & Young - hard to imagine how dominant these “Big Eight” firms were back then; E&Y itself was formed by the merger of Ernst & Whinney and Arthur Young.

  • MegaSource - a Michigan-based pharmacy system vendor running on PCs; acquired by Cerner, who eventually sunset it.

  • Arthur Andersen - amazing how the then-small consulting arm survived the Enron accounting debacle, thriving today as Accenture.

  • First Consulting Group - formed by Jim Reep and some ex-Andersen friends, FCG grew to over $100 million in revenue before being gobbled up by CSC.

  • Peat Marwick & Main - Main was eventually replaced by Mitchell; PM&M was another Big Eight back then, eventually gobbled up by KPMG and spun off to Bearing Point, which went defunct this year.

  • Enterprise Systems Inc. - offered one of the least-expensive and most functional ERP suites in HIS-tory, running on IBM PCs under DOS. Some say ESI is still better than its “Horizon” successor …

  • Digimedics - an early RX vendor eventually bought by Mediware along with competitors Continental and Pharmakon.

  • Community Health Computing - a leading LIS vendor back then, later bought by ADAC, which was eventually bought and sunset by Cerner.

  • Coopers & Lybrand - another Big Eight monster, merged with Price Waterhouse, nicknamed by insiders as “Pricey Coopers.” A dominant HIS consulting firm in the '80s and '90s, totally out of healthcare today.

  • Space Labs - literally started by monitoring early astronauts' vital signs, the firm dominated patient monitoring and cardiology markets back then.

  • Data General - another mini monster back then, DG had the largest product names in HIS-tory: the MV 10,000 and 20,000 series. Must have been a lot faster than IBM's puny 360 or 370 series, right?

Lesson for today: Only one of these 15 firms above survives (Ernst & Young). HL7 is still with us, but with so many founding firms defunct, we can only hope interoperability is not a fatal disease.

Healthcare Informatics 2010 January;27(1):48

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In early 1986, Dr. Simborg, Cumpucare and HL7 were alive and running at Moses Cone Hospital in Greensboro, NC. James Gabler, the CIO and I thought at the time, people at the University of PA. were also involved in the development of HL7. We were able to interface Compucare, Sunquest, SMS Invison and a number of other systems using StatLan. It was neat to answer inquiries from folks that told us we simply could not do what we were already doing...

Dave Davisson