2. H.I.S.-tory Outline
Overview of this H.I.S.-tory of Hospital Information Systems:
1. Four key epochs and the dominant platform during each
2. What I was driving then, symbolic of the computer hardware
3. Key vendors whose inside stories will be told in detail
1960s: Mainframes
1. Platform: Mainframes like IBM’s ground-breaking
Model 360, that filled a large room with their iron
core memory CPUs, noisy card sorters and tape
drives, huge disks - the reason so many hospital DP
shops were located in the basement back then!
2. Vehicle: 1966 427 Corvette – ideal symbol of a
mainframe: 425 horse monster I drove to my first
job at SMS in King of Prussia in 1969 – only got 10
MPG but sure impressed the lady programmers!
3. Vendors: - IBM which totally dominated their
“BUNCH” GRoup of competitors: Burroughs,
Univac, NCR, Control Data, Honeywell, GE and RCA.
3. 1970s – Shared Systems
• What do you do when you’ve sold all the large hospitals their own 360?
• Share a mainframe among many small to mid-size community hospitals!
1. Platform: 1 or 2 large mainframes in
a shared data center connected by
1200 baud (whew!) phone lines to
(eventually) hundreds of clients
nationwide. I/O devices: keypunch
cards & readers, green-bar paper.
2. Vehicle: 1967 Austin Healey 3000 –
I had to share it with my new bride
as we couldn’t afford both the big
‘vette and a mortgage in the 70s…
3. Vendors: GE was the first dominant
shared player with their Medinet
system, rapidly followed by upstart
SMS, aero giant McAuto, and
Tymshare from Cupertino, CA.
4. 1980s – Minicomputers
• As Moore’s law predicted, pioneering minicomputers soon grew enough power
to cut the cords between hospitals and their shared system vendors:
1. Platform: a fraction of the size (and
cost!) of a mainframe, early minis
first computerized clinical areas in
most community hospitals
2. Vehicle: 1974 Porsche 911 – very
fast for such a small engine (only
2.7 liters – less than half the 427
‘vette), I rolled it racing on my
commute to McAuto in 1981
3. Vendors: dozens of companies
offering HIS & ancillary systems
took over the market from shared
systems in the 80s, most notably
upstarts like HBO and Meditech
5. 1990s – Microcomputers
• PC-based systems offered amazing breakthroughs in the 90s, taking
automation beyond core financial and clinical systems and to the bedside!
1. Platform: we laugh today at the
floppy disks and main memories
measured in mere kilobytes (K) in
early PCs of the 80s and 90s…
2. Vehicle: 1969 Honda CB750 –
Japan’s breakthrough motorcycle
that conquered the 2-wheeled
world, started my bike collecting
fetish. Only 67 horsepower, but
faster than any of my cars!
3. Vendors: dozens of companies
introduced PC systems, with two
standouts being HMDS’ total HIS
(on DOS!), and Medtake offering
one of the first bedside terminals.
6. 1990s – Microcomputers
• PC-based systems offered amazing breakthroughs in the 90s, taking
automation beyond core financial and clinical systems and to the bedside!
1. Platform: we laugh today at the
floppy disks and main memories
measured in mere kilobytes (K) in
early PCs of the 80s and 90s…
2. Vehicle: 1969 Honda CB750 –
Japan’s breakthrough motorcycle
that conquered the 2-wheeled
world, started my bike collecting
fetish. Only 67 horsepower, but
faster than any of my cars!
3. Vendors: dozens of companies
introduced PC systems, with two
standouts being HMDS’ total HIS
(on DOS!), and Medtake offering
one of the first bedside terminals.
