2. 4th of Today’s Leading Vendors
• This week we begin the 4th episode on
today’s HIS vendors: QuadraMed, whose
story encompasses Compucare and HDS.
- $3.2B = McKesson, née HBOC = Walt Huff, Bruce Barrington, & David Owens
- $2.2B = Cerner, still run by Neal Patterson, co-founded with Cliff Illig
- $1.7B (est) = Siemens, née SMS: Jim Macaleer, Harvey Wilson & Clyde Hyde
- $1.4B = Allscripts, née Eclipsys, also founded by Harvey Wilson of SMS.
- $1.2B = Epic. Gee, I have to wonder, just who was it who founded them?
- $900M (est) - GE Healthcare, née IDX/PHAMIS: created by Malcolm Gleser
- $545M = Meditech, still run after all these years by Antonino Papallardo
- $353M = NextGen: new Opus & old Sphere financials by Florian Weiland
- $174M = CPSI (Computer Products & Services Inc), founded by David Dye
- $170M = QuadraMed, née Compucare, founded by Sheldon Dorenfest
- $160M = Keane, parent giant by John Keane, but HIS div. built by Ray Paris
- $110M = HMS (Healthcare Management Systems), Tom Givens & John Doss
- $70M (est) = Healthland, formerly Dairyland, founded by Steve Klick
3. Triple Play!
• This series of 3 episodes actually covers 3 HIS vendors
(Techie Troika?) that we’ll review in chronological order:
– Compucare – home of Shelly Dorenfest, which we
first covered in an earlier episode (#17, which you
can find at hispros.com), only this time we get the
perspective of the man who took it (and other HIS
firms!) on to bigger & better things: Ron Aprahamian
– QuadraMed – formed by the acquisition of over a
dozen HIS firms over several decades of acquisitions,
then bought itself a few years back, and the surviving
name & vendor in hundreds of hospitals to this day.
– Health Data Sciences – Formed by Ralph Korpman,
yes, that same Dr. Korpman who was a Pathologist at
Technicon back in the days of MIS, and created
UltiCare, the pioneering bedside system.
4. Another HIS-tory Hero!
• Many thanks for this weeks inside story of the rise of Compucare
to David Pomerance, co-founder of Dynamic Control, who was
kind enough to introduce me to Ron Aprahamian, for the inside
story. Ron’s story begins way back in the 1969 mainframe era:
– Ron joined Compucare after it had grown to about 20 FTEs in
the 1970s, but he recalls it was first founded by Peter Marsh
and Richard Freibrun, then joined by Shelly from Abbot Lab.
– Shelly and Peter hardly need introductions, both having long
HIS-tories, but Dick Freibrun has a fascinating background:
• He was one of the 47 charter members of HIMSS in 1961!
• He developed a plastic overlay for clinicians entering data
onto IBM’s “clunky” old 1052 keyboards (which if you’ve
been a good student of HIS-tory, you’ll remember was Mike
Mulhall’s claim to fame at the IBM Monmouth Medical
Center in NJ “HIS” project in the late 60s {see episode #8}).
5. Rocky Start…
• Like so many start-ups, Compucare was challenged to
grow the business through sales (income), while at the
same time programming and installing their HIS
(expenses), and by 1975 the ratio of the 2 was not very
good, with only about $500K in revenue and 30-40 FTEs.
• Ron was the FM (Facilities Management) Director for
Compucare at Georgetown U. Hospital, which you may
remember was the idea behind Compucare: develop an
HIS through a series of FM clients writing various apps.
At that time, most of their clients were mainframe users.
• With the impending minicomputer revolution, Ron
got the idea to switch boxes and paid about $50K to
buy out Compucare’s stock. That would be between
a ¼ and 1/3 of a million in today’s dollars, a pretty
gutsy gamble for 29-year old Ron way back then!
6. Boston Connection!
• How Ron switched from mainframes to a
minicomputer platform is an incredible story that even
blew my mind after being in this crazy business for 40+
years:
– Rather than start from scratch, Ron turned to a
little start up in Boston that had developed a
rudimentary LIS on DG minis: Medical Information
Technology – ever heard of them? Try the acronym
in green they used for their overly lengthy name…
– Yes, Virginia, Compucare’s first HIS apps were
coded in MIIS, Meditech’s proprietary version of
MUMPS, long before it was eventually renamed as
Magic!
• Ron’s programmers built a full set of financial apps, patient and
general accounting (ERP for moderns), to add to Meditech’s suite
of ancillary systems, ADT and OE/RR. As you might imagine, Ron’s
Georgetown Hospital became the pilot, and they started to sell!
7. Rapid Growth & IPO
• Like so many turnkey mini vendors back then,
Compucare’s DG-based HIS sold well, and the firm
went public in 1983, for a total stock value of
≈$40M
– Not bad for a $50K investment by a 29-year old!
• As the stock grew in value, it caught the attention ofanother very successful healthcare company that was looking to
buy its has into the HIS market: Baxter-Travenol, who by then had
already acquired a number of mini and mainframe HIS vendors:
• John Sacco’s “JS Data” (featured in HIStory episodes #26 & 27)
• Mitch Lasky & Dave Pomerance’s Dynamic Control Corp. (#18)
• Frank Russo’s IBM mainframe system from Long Island Jewish
• As you might imagine, Ron & the other
stockholders got a pretty good price from the
supply giant: the total value of the
transaction being somewhere around
8. But Wait, There’s More!
• I’m sure some of you CIOs are ready to
leave your hospital job and start a vendor,
but believe it or not, Ron’s amazing
financial prowess was only just beginning!
• Travenol renamed
Compucare’s HIS the
“Sigma” series and tried to
sell it alongside DCC’s IBM
System 38-based HIS,
which sold much better…
• After several years of this
internecine warfare, and
after Baxter joined IBM to
create IBAX, they gave up!
9. Guess Who, and For How Much?
• So guess who IBAX sold the Sigma series back to? Our man Ron!
And for how much? So little, would you believe $7M! If you’re an
old friend, email Ron at raprahamia@aol.com to confirm…
• When Ron got his old firm back, he
started it in a new direction, that should
sound familiar after you read the last
few Keane episodes on Ray Paris’
Threshold and John Indrgio’s InfostatInfostat:
- An “open” system platform written
in UNIX so it could run an any mini:
- IBM, Hewlett-Packard, DG, etc.
- Under these “open” covers, the
programming language was still
MIIS, but UNIX opened many more
doors for this latest HIS: Affinity
10. ““Code Generator”Code Generator”
• Rom relayed a fascinating tech detail
about a “code generator” they wrote
to write the actual programming code
• He gives credit to a techie named Jim
Kline, the development Director who
created it (sounds like the “translator”
HIS Inc. tried to develop in Brooklyn
that was described in episode 30!).
• When Affinity first went live circa 1990,
response times were slow, and they
had to re-do a lot of the code to speed
things up. “Re-writing by hand would
have taken forever,” per Jim Kline, and
his code generator saved the day!
11. Ron’s Final Sale of Compucare
• By the late-90s, Compucare had sold
over 100 Affinity systems, and the
company was fast approaching the
$100M mark in annual revenue.
• Ron left in 1996, by which time
Compucare had become quite a hot
commodity, again! This time the
buyer was the star of our next HIS-
tory episode: QuadraMed, who
acquired many firms & runs Affinity in
scores of hospitals to this very day.
– Tune in next week for their story…
• And what happened to Ron after he
left Compucare? True to form, he
started looking for “green” pastures…
12. Retirement? This Guy??
• After he left Compucare, Ron was Chairman of the Board of
CHIME until 1999, and came a little close to retirement, serving
as a consultant to Sunrise Senior Living, Inc. for a few years.
• However, you can’t keep a good HIS man down, and in 2000, Ron
became Chairman of the Board of Superior Consulting Corp.,
during which time he organized a turnaround of this struggling
firm. In 2003, Superior was acquired by Affiliated Computer
Services (ACS), who were themselves later acquired by Xerox.
• After Superior, Rom took his expertise to another struggling
consulting firm: First Consulting Corp., turning its shares around
from $5 to $13, before they were eventually acquired by CSC.
• What’s he doing today? Besides golf 5 days a week, he is a
director at a healthcare firm named Hooper Holmes, Inc., along
with Larry Ferguson, another HIS pioneer from SAI (Saint).
– You just can’t keep these HIS-tory heroes down!
13. Most Proud Accomplishment
• Ron gives credit for the success of Compucare was given to al the
hard-working employees who did the day-to-day heavy lifting.
• But his most proud achievement is pictured below:
– Two sons and one daughter, all married, and with 8 grand
kids!
14. Next Week: QuadraMed
• Next week we continue the saga
of Affinity with its new owner
QuadraMed, who along the way
acquired over a dozen other HIS
firms, each its own fascinating
HIS-tory in themselves. Their
latest acquisition a few years
ago will lead us to UltiCare…
• And in case you missed any prior
episodes of our HIS-tory series
(or want to check out where
your HIS vendor originally got
their stuff), just hop on over to
our web site and enjoy any past
episode at: HISPros.com
