This document summarizes healthcare IT news from November 1987 and discusses how the industry has changed. It provides ads and articles from that time period about leading vendors like Cerner, Sunquest, and NCR. It also discusses the evolution of technologies like mainframes, minicomputers, microcomputers, and today's cloud-based systems. Additionally, it accurately predicts that the number of hospitals and beds in the US would decrease by 2000. The document highlights how healthcare IT has progressed over the last 30 years.

1. 30 Years Ago In
H.I.S.-tory
by Vince Ciotti
© 2017 H.I.S. Professionals, LLC, all rights reserved
News from
November
1987 and
relevance for
today

2. Ads From November 1987
• We’re starting this month with a couple of interesting ads from
Bill Child’s Healthcare Computing & Communications magazine.
• First, a stunning 2-page ad for one of the leading LIS systems at
the time – do you recognize the name “PathNet?” Amazing to
think today’s #1 HIS vendor with over $5B in annual revenue
started out as “only” an LIS vendor during the 80s, not releasing
their Millennium HNA clinical system until the early 1990s…
• Cerner’s major competitor
back then was Sunquest -
the two duked it out in
several LIS selection our
firm ran in the ‘90s.
• Amazing that Sunquest is
still around 30 years later
too, though not quite as big

3. A Four-Page Ad!
• This vendor spent quite a lot of dough on a 4-full-page series of
ads, that alternated with 4 pages of content, inviting the reader
to guess just who it was that they were talking about…
• My guess after the first 2 ads was either SMS, McAuto or HBO,
the three HIS giants back then, but then the 3rd page had me
stumped: $5 Billion! Maybe it was Cerner projecting their
revenue in 30 years time? Who would you guess it was??

4. Who’d A Thunk It!?
• NCR (National Cash Register)!
I’d have never guessed…
• NCR was headquartered in
Dayton OH at the time, with
62K employees most of whom
worked on… guess what?
• They were one of the BUNCH
group battling IBM in the
mainframe market, with
MEDNET as their main HIS
that ran on their 9300 IP box,
featuring 32-bit system
architecture and VLSI tech.
• They claimed 77 MEDNET
hospital clients back then.

5. Fast FAX Facts
• Interesting story on Delta
Medical Center in MS that
installed a FAX system to send
STAT orders from nurse
stations to ancillaries, and
then get the results back.
• Reminds me of a similar one
called “TeleVideo” I saw on my
second SMS installation at
Good Samaritan Hospital up in
Suffren, NY, way back in 1970.
• Ironically, we helped Delta
replace the FAX system
around Y2K with Meditech’s
order entry & results
reporting.

6. Brilliant Forecast
• Art Randall wrote fascinating
columns in HCC, and his November
one described how the healthcare
industry is rapidly changing in 1987:
• Art predicted: “the 7,000 plus hospitals will
decrease to perhaps 5,000 by the year
2000… and the 1.2 million acute-care beds
will decrease to perhaps 75% of that size.”
• I worked for Art for 2 years at McAuto
where he was in charge of Sales & Marketing
– such a bright, witty and charming guy it’s a
shame that he passed away far too early…
• So how did his above statistical predictions
work out? Check the stats on the next page
to see just how smart this man was:

7. 2017 Hospital Stats
• Recent studies by the AHA, CDC, etc., sure bear Art’s forecast out:
• Anyone dare to predict what the
#s will be like in 30 more years?

8. Self-Developed
• In the 1960s, only the largest hospitals could afford an inhouse
mainframe and dozens of programmers to write HIS software,
which in those days were mainly financial systems: AR, BL, GL, etc.
• By the 1970s, shared systems like SMS & McAuto started to
blossom, selling hundreds of hospitals each their financial systems.
• In the 80s, mini-computer vendors like HBO, DCC, JS Data, etc.,
sold thousands of hospitals their highly affordable HIS systems,
which by then included early clinicals like Orders and Results.
• A feature article by the CIO of
Baptist Memorial Hospital in
TN, a 3-hospital IDN with over
2,000 beds, on their self-
developed approach for an HIS.
Interesting to review how IT
platforms evolved over time:

9. - The vendor has all your data,
- They charge as much as they can,
- Slow response-times are on your end,
- You trust their security & back-ups,
- You’re at the mercy of telecom (web),
- Hard to get data when you convert.
Yeah, I am a bit of a Luddite but these parallels are cute...
Today’s Platforms
• In the 90s, micro-computer (PC) systems took off, starting with
bedside systems, growing into most ancillary departments.
• In the 2000s, server-based systems ruled, with VM-ware devices
whose tiny physical size was the opposite of their Terra capacity.
• Where is hardware technology going today? Why, in the cloud,
which might be where some people’s heads are when they think
it’s different than the shared system approach of the 1970s:

10. PCs Back Then
• To end on a more positive note, check
out the growth of PCs from 1977 in
this article on device integration.
• The author goes on to describe 1987
PCs with “minicomputer levels of
processing capacity (32-bit processors,
a megabyte of memory, and up to four
gigabytes of hard disk storage).”
• I remember well buying my first Mac
SE back in 1987 – cost about $2K ( a lot
of $s then), and ran on 400K diskettes.
• After running out of room for the
disks, I added a 1 Meg hard drive for
about $1K – it hurt, but as a new
entrant into HIS consulting, I was
writing an awful lot of proposals…

11. Flash!
• Just got my latest copy of
one of the few print HIT
magazines still being
published these days:
Health Data Management.
• When I got to this ad on
the back cover, I couldn’t
believe my eyes – have
they been snooping into
my emails with Mr. HIStalk
about this 1987 episode?!
• Anyway, cute to see how
someone else appreciates
how hot the Mac SE was
back in the 1980s…

12. Next Month
• Some interesting news & articles from December 1987:
– Pay phones – remember them? Ever wonder what they
cost?? Answers from the New York Telephone company.
– Meditech – a review of how this upstart LIS vendor from the
1970s was now becoming a major player in the HIS market.
– CyberSecurity – no, they didn’t use that term in 1987, but a
fascinating article on computer fraud digs deeply into it.
– Sunquest – interesting article by Dr. Sidney Goldblatt who
founded it way back in… can you guess how long ago?
Hope you enjoy jumping back to these early days of HIS-tory –
glad to hear any of your memories or negative feedback:
Vince Ciotti HIS Professionals, LLC
505.466.4958 vciotti@hispros.com