30 Years Ago In H.I.S.-tory by Vince Ciotti

© 2018 H.I.S. Professionals, LLC, all rights reserved

News

from

January

1988 with

relevanc

e for

today

December 1987 Episode Feedback

• Last month I challenged readers to guess what this building at Cedar Hospital in Miami which was built way back in the 60s was built to look like. Several veteran HIStalk readers got it right:Stephanie Reel – SVP & CIO at Johns Hopkins:

- “Easy… punch card!”

Lynn Witherspoon – CMIO at Ochsner Health:

- “But of course! I get blank stares when I mention punched 80 column cards today…”

Mike Peterson – mike@rxpeterson.com

- “Your latest HIStory with the picture of the building in Florida reminded me of the new TD Ameritrade Headquarters building in Omaha. Occupied in 2012, the window design was to mimic a punch card. Dejavu!”

1988: SMS Goes Inhouse…• The January issue of Bill Child’s Healthcare

Computing & Communications gave the news of Shared Medical System forming a turnkey system division. Back then SMS & McAuto dominated the HIS market with their shared systems, but both acquired and/or developed turnkey systems to keep up with vendors like HBO, Meditech, IHC, etc., who were rapidly gaining market share with their inhouse minis.

• SMS’ turnkey division was comprised at first of the “Spirit” HIS, which they acquired from Computer Synergy in 1985, augmented by their ACTIon self-developed system. Spirit was later renamed as Allegra and was running in 175 hospitals before Y2K when it was sunset.

Today’s Vendors Are Going Back!• How ironic that today most leading vendors of what were

originally inhouse systems are now offering remote hosting (aka SaaS, cloud, etc. ), the modern equivalent of shared systems:

– Cerner – had the wise business sense to make the shift to remote processing of Millennium early in the 2000s due to the much larger ongoing revenue stream that hosting offers.

– Epic – just announced in 2016 the option of clients hosting their system remotely from a huge data center in Verona.

– Meditech – almost all clients ran inhouse at first; today there are a number of 3rd party hosters: Dell, Teknicor, Parallon…

– Allscripts – remote hosts through a large data center in NJ.

• “Cloud” may be where buyers’ heads are if they think it’s much different than a shared system where the vendor has the servers, charges the max, blames any outages on your local network/devices, and may give you the data when you convert…

BMV Pioneer• A feature story in the January 1988 of HC&C was this pioneering

hospital serving as a pilot for bar-code scanning for Bedside Medication Verification, or BMV. Today we take it for granted as key part of every vendors’ EMR and one of CMS’ key Meaningful Use criteria, but back then it was a daring new tech concept.

• The vendor was CliniCom whose founder Peter Gombrich had an amazing vision of how a modern technology that was becoming common in other industries (such as check-out counters at stores) could prevent drug mis-administration.

Bedside Pioneer• An interesting quote from St. Francis’ VP of Patient care Services

summed up why such a small hand-held device was attractive:

- “One thing I definitely did not want was a nurse working at a full-size PC in the room mainly because of the disruption to the patient. Nurses also disliked bottlenecking at the nurses’ station where there were too few terminals...”

• Instead of a bulky PC, CliniCom ran on the small hand-held device pictured on the right used to scan the nurse’s ID badge, the patient’s wrist-band, and the label on the drug unit dose. The data was sent via telecom to a large microcomputer in the data center which sent back a signal that the data was either correct or not. Pretty hot for 1988 when most PCs still ran DOS!

A Daring Move• The other leading print journal back in 1988 was Computers in

Healthcare (CHC), and their January issue contained a revolutionary offer by the LIS vendor Community Health Computing that was so daring one wishes they were still around! today! • In case you can’t read the small print on the

left, CHC was offering a 100% up-time warranty. For every hour its fault-tolerant hardware or LabCare software was down, CHC would pay 1% of its monthly service fees to a charity chosen by their client hospitals. Wow, some guts back then with early hardware!

• Sadly, most vendors today have almost as many lines of legal gobbledygook in their contracts protecting them from any downtime fault or penalties than their software has lines of code preventing it. Now that’s progress…

Name Change

• As this news clipping reveals, it turns out they originally named their firm Advanced Information Concepts (AIC), and in 1998 were renaming it as Healthcare Management Systems (HMS).

• Ever hear of AIC? Well, I never did either, even though I interviewed the two founders of the firm, Tom Givens and John Doss, a few years back when I was writing my HIS-tory series for HIStalk (you can find them on our web site hispros.com by clicking on the button for H.I.S.tory). Tom and John formed their firm back in 1984, the year DRGs went into effect, and did very well selling to hospital chains many of whom were also based in Nashville, TN.

What’s In A Name?• Surprisingly HMS happened to also be the acronym for a vendor

formed in 1974 in NYC that specialized in software for insurance companies, Medicaid agencies, HMOs, etc. They used the initials HMS for their NADAQ stock symbol, and today for their web site. So Givens & Doss’ HMS had a bit of an identity problem…

• Ironically the Nashville-based HMS re-named itself again just a few years back when they merged with MedHost, a leading EDIS vendor, whose name was adopted to eliminate any confusion with the other HMS in New York. Must have been an awful lot of business cards, brochures, stationary, signs, etc., to be re-printed!

• Have any of today’s leading vendors also changed their names? Can you recognize any these start-up firm’s acronyms/monikers:

PGI

HSC

BDPQSI

HSDNewCo

Ever-evolving Acronym-itis• PGI = the initials of the 3 founders of a 1980 start-up Lab vendor

based in in Kansas City: Patterson, Gorup and Illig. Not sure why they picked this order of letters since Illig was actually the #2!?

• HSC = Human Services Computing, the name for another 3-FTE start-up vendor, this one based in Madison WI, a truly Epic tale…

• BDP – Burlington Data Processing, a start-up formed by Rich Tarrant in VT, later renamed IDS, then IDX, later bought by GE.

• QSI - founded in 1973 by Sheldon Razin as Quality Systems Inc., their next generation name adopted in 2000 was… guess what?

• HSD – part of an IT firm started as KeaMed circa 1970, then split as an HIS division named Keane Health Services Division.

• NewCo – apparently a common acronym for many start-up firms, it’s what Harvey Wilson called his before coming up with Eclipsys.

Vendor Longevity• How long does the typical HIS vendor last? Here are the

advertiser indexes from the January 1988 issues of HC&C and IHC magazines – recognize any still in business 30 years later?

• Neal Patterson would be very proud…

Another 30th Anniversary

• Here’s a final 30-year-ago event that I forgot to mention last month; at the end of 1987, three professionals with decades of experience each in the HIS industry formed a start-up firm:– Bob Pagnotta – co-founder of Medical Data Systems, General Manager

of Tymshare Medical Systems, and President of Hosplex Systems.

– Karl Sydor – DP Manager at Perth Amboy Hospital, ID Manager and later Regional Manager at Shared Medical Systems.

– Vince Ciotti – who lost too many jobs in his career to be listed here…

Over the past 30 years, their firm called HIS Pros has provided consulting to 390 clients in 46 states, with nary a lawsuit.

• Hope you enjoy looking back to these early days of HIS-tory –glad to share any of your memories or suffer any feedback:

Vince Ciotti HIS Professionals, LLC

505.466.4958 vciotti@hispros.com