- AR/Medique was a mini computer-based hospital information system founded in the 1970s that grew to serve around 50 midwestern hospitals. It was originally called AR Medical Management and was based on IBM's HPMS software. The company struggled financially and was acquired multiple times before ultimately closing in the early 1990s. However, the software lived on through hospitals that formed a cooperative to continue its use and support.

1. “H.I.S.-tory” by Vince Ciotti
© 2011 H.I.S. Professionals, LLC, all rights reserved
Episode # 25:
AR/Medique
st – a “mini’
Mini

2. Mini Recap
• Over the past few months, HIS-tory episodes covered a
number of the “maxi” minicomputer vendors that ended
the dominance of shared systems in the 80s (just as they
had broken the mainframe system dominance in the 70s)
per this great chart from Shelly Dorenfest’s 1987 Guide:
– Meditech
– Compucare
– Dynamic Control
– Keane
– Saint
– Sentry Data
– Gerber-Alley
– IHC

3. Mini Minis!?
• Now we start covering some relatively less-known minicomputer-
based systems that still have some interesting lessons for today.
• This week, a lesser-known system that had a maxi impact on fifty
small (defined as under 100 bed) Midwest hospital clients:
– AR Mediquest, an IBM-based mini system
• In future episodes, we’ll cover a few more mini players that lead
us back into a re-visit of just how shared giants SMS & McAuto
fought the mini revolution, through the history of such firms as:
– Computer Synergy, Tom Culligan’s San Fran. firm
• Giving a perfect segue into a brief revisit of mainframe
systems, which hardly lay dormant in the 80s either,
with major clinical system players like:
– Datacare, Nadacom, CSC, NCR, PHAMIS, et al.

4. AR/Mediquest
• Another IBM-based mini system, this one on the System 34/36, that
was based in Lansing, MI, with some fascinating twists...
• Thanks to these 2 HIS-tory heroes for the AR/Mediquest details:
- Paul McVicker, Strategy & Planning
Analyst today at Hannibal Regional
Healthcare Systems in Missouri:
- “I was the Information Systems
manager for Ozarks Medical Center
(OMC) from 1985 to 1992 where I
managed an AR/Mediquest system.”
Paul sent in three lengthy emails on what it was like being an
AR/Mediquest client, and was kind enough introduced me to:
– Kalon Mitchell, President, MEDTranDirect, providers of Web
Based HIPAA Transaction Software today; Kalon worked for
AR/Mediquest back in the 80s, so knows it from the inside.

5. The “AR/Mediquest” Name?
• I always assumed “AR” in AR/Mediquest stood for “Accounts
Receivable,” but Kalon relayed this fascinating piece of trivia:
• The founders were named “Andy & Roger” and they formed the firm
as “AR Medical Management” sometime back in pre-HIStory…
- And the software is another fuzzy piece of
HIStory trivia that tested my memory:
- Seems IBM developed an early piece of
software for hospitals way back in the 70s
to spur sales of their System 34 minis,
- (something like their development of SHAS
in the 60s to spur 360 mainframe sales …)
- I remember that it was called HPMS
(Hospital Patient Management System), and
that IBM provided it with their minis…

6. So Who Wrote HPMS?
• So just to be sure, I called Dave Pomerance, of Dynamic Control
fame, who you should remember from episode 18 on DCC.
• Low and behold, it was Dave’s team who built HPMS for IBM!
– Installed User Program (IUP) was IBM’s name for such projects
– Like how Dave developed HPMS at Variety Children’s in FL,
– First on the System 3 mini, in RPG and a bit of Assembler,
– Then later, re-writing it for IBM in RPGII for their System 34.
– HPMS software was the licensed by IBM to hospitals who
bought system 34 minis, which Dave estimates ran easily into
hundreds of sites (independent of the hundreds sold by DCC)
• So Andy & Roger got their original software for AR Medical
Management from IBM (courtesy of Dave’s DCC programmers).
• (Amazingly, we helped a NY hospital replace HPMS just last year!)

7. AR Medical Management
• Andy & Roger eventually sold AR Medical Management to a
real lady entrepreneur named Jean Johnstone.
– Seems Jean owned a number of businesses, and was
interest in two areas that were new to HIS back then:
• Medical Records (HIM to you moderns), and
• MD clinics, not only software, but owning them!
(sound like another Midwestern entrepreneurial HIS lady?)
• Jean bought Andy & Roger’s firm, renaming it AR/Mediquest
– The “Mediquest” part to reflect her HIM and MD interests
• She also upgraded the HPMS software to run on System 36
minis, which were selling hotter than A & R’s System 34…
• Eventually, she sold over 50 hospitals, mostly in the Midwest.
• But now the story shifts to clients perspective, from Paul:

8. Running AR/Mediquest
• From Paul McVicker, IS Director at Ozark Medical Center today:
– “OMC was the first System/36 in southern MO to try twisted
pair wiring. IBM and AR/Mediquest tried to get us to stay
with their usual twin-axial cabling, even going over my
head.
– The hospital backed me and we switched to the twisted pair
wiring when we moved the data center and B.O. across the
street, which took two days over a long weekend.
– Everything went according to plan and the system came up
4 hours early. The CFO, head of maintenance and I were
staying outside discussing how well the move went. The guy
upstairs decided to remind us not to get a big head:
– A lightning strike hit a telephone pole up the street as we
watched. Within a minute, I had an operator at the door
telling me the system was down, and there was a funny

9. A Close Call!
• “The lightning took out the number 1 user
connection panel on the System/36.
• A quick visit from Sorbus (I was not an IBMer for
maintenance) and the number 2 panel was
swapped in for number 1.
• The twisted pair equipment was unaffected.
With the twisted pair, I was able to rearrange
the high priority users to the remaining panel.
• If I had been on the twinaxial, the temporary fix
would have been impossible due to the daisy
chain nature of twinaxial.
• It only took Sorbus two days to get the
replacement panel.”

10. Denouement
• So what happened to AR/Mediquest?
• Unlike almost every other mini system we’ve
looked at, they were not bought by some giant
firm, re-named, and live on to this day...
– E.g.: DCC, JS Data, Medseries4, etc., etc…
• Sadly, they met the undertaker, as Paul tells it:
• “We survived the December/January period (I think it
was in 1991) when the IRS locked the doors of the
company -
• due to failure to pay taxes on a real estate
investment Jean had made in Florida...
• AR/Mediquest staff operated from their homes to
support the hospitals during that time.”
(talk about HIS-tory heroes!)

11. The Survivors
• Paul’s finale ends the AR/Mediquest saga:
• “A group of 14 hospitals had the rights to the
source code and took it to form their own
cooperative in the late eighties.
• Kalon Mitchell formed a company named
‘Remote Support Services’ in Springfield Missouri
to support these hospitals.
• Remote Support Services has morphed into
MEDTran Direct, Kalon’s current firm.”
• Paul found a web site with a 1994 continuation of the AR/Mediquest
saga, sold to a firm named Churchill Technology Inc., whose Vice
Chairperson and Secretary was, you guessed it, Jean Johnstone!
- The web address is:
http://www.thefreelibrary.com/CHURCHILL+ACQUIRES+AR%2FMEDIQUEST,
+ENTERS+HEALTHCARE+INDUSTRY-a015130677

12. What’s Next?
• Next week, we’ll cover JS Data thanks to feedback from
these two HIS-tory heroes:
– Steve Kilgus – VP of Product Management at Emdeon -
Skilgus@emdeon.com
• You may remember Steve from the Gerber-Alley episode
– Tom Aikens – EVP at maxIT - tom.aikens@maxithc.com
• Tom’s digging through his old files for some treasures…
• Would really love to learn more about the founder of JS
Data a gentleman named John Sacco.
– Anyone remember John or can steer me to someone
who does?
• Please send any contributions to: vciott@hispros.com