This document summarizes the early history of Shared Medical Systems (SMS) from 1969-1981:
- SMS was founded in 1969 and grew from a small startup with 24 employees to become the largest healthcare IT vendor, developing early database and billing systems like UNIFILE to automate hospitals.
- In the early days, SMS employees worked long hours to develop the systems and support clients with little experience. Many early clients and implementations faced challenges common to new software.
- SMS developed innovative technologies that helped automate hospitals and deal with issues like the Year 2000 problem, but growth also caused performance issues that were later addressed.
- The story highlights both the challenges and rewards of working with innovative young companies versus established large vendors
GDG Cloud Southlake #33: Boule & Rebala: Effective AppSec in SDLC using Deplo...James Anderson
Effective Application Security in Software Delivery lifecycle using Deployment Firewall and DBOM
The modern software delivery process (or the CI/CD process) includes many tools, distributed teams, open-source code, and cloud platforms. Constant focus on speed to release software to market, along with the traditional slow and manual security checks has caused gaps in continuous security as an important piece in the software supply chain. Today organizations feel more susceptible to external and internal cyber threats due to the vast attack surface in their applications supply chain and the lack of end-to-end governance and risk management.
The software team must secure its software delivery process to avoid vulnerability and security breaches. This needs to be achieved with existing tool chains and without extensive rework of the delivery processes. This talk will present strategies and techniques for providing visibility into the true risk of the existing vulnerabilities, preventing the introduction of security issues in the software, resolving vulnerabilities in production environments quickly, and capturing the deployment bill of materials (DBOM).
Speakers:
Bob Boule
Robert Boule is a technology enthusiast with PASSION for technology and making things work along with a knack for helping others understand how things work. He comes with around 20 years of solution engineering experience in application security, software continuous delivery, and SaaS platforms. He is known for his dynamic presentations in CI/CD and application security integrated in software delivery lifecycle.
Gopinath Rebala
Gopinath Rebala is the CTO of OpsMx, where he has overall responsibility for the machine learning and data processing architectures for Secure Software Delivery. Gopi also has a strong connection with our customers, leading design and architecture for strategic implementations. Gopi is a frequent speaker and well-known leader in continuous delivery and integrating security into software delivery.
Let's dive deeper into the world of ODC! Ricardo Alves (OutSystems) will join us to tell all about the new Data Fabric. After that, Sezen de Bruijn (OutSystems) will get into the details on how to best design a sturdy architecture within ODC.
Search and Society: Reimagining Information Access for Radical FuturesBhaskar Mitra
The field of Information retrieval (IR) is currently undergoing a transformative shift, at least partly due to the emerging applications of generative AI to information access. In this talk, we will deliberate on the sociotechnical implications of generative AI for information access. We will argue that there is both a critical necessity and an exciting opportunity for the IR community to re-center our research agendas on societal needs while dismantling the artificial separation between the work on fairness, accountability, transparency, and ethics in IR and the rest of IR research. Instead of adopting a reactionary strategy of trying to mitigate potential social harms from emerging technologies, the community should aim to proactively set the research agenda for the kinds of systems we should build inspired by diverse explicitly stated sociotechnical imaginaries. The sociotechnical imaginaries that underpin the design and development of information access technologies needs to be explicitly articulated, and we need to develop theories of change in context of these diverse perspectives. Our guiding future imaginaries must be informed by other academic fields, such as democratic theory and critical theory, and should be co-developed with social science scholars, legal scholars, civil rights and social justice activists, and artists, among others.
Accelerate your Kubernetes clusters with Varnish CachingThijs Feryn
A presentation about the usage and availability of Varnish on Kubernetes. This talk explores the capabilities of Varnish caching and shows how to use the Varnish Helm chart to deploy it to Kubernetes.
This presentation was delivered at K8SUG Singapore. See https://feryn.eu/presentations/accelerate-your-kubernetes-clusters-with-varnish-caching-k8sug-singapore-28-2024 for more details.
Neuro-symbolic is not enough, we need neuro-*semantic*Frank van Harmelen
Neuro-symbolic (NeSy) AI is on the rise. However, simply machine learning on just any symbolic structure is not sufficient to really harvest the gains of NeSy. These will only be gained when the symbolic structures have an actual semantics. I give an operational definition of semantics as “predictable inference”.
All of this illustrated with link prediction over knowledge graphs, but the argument is general.
Transcript: Selling digital books in 2024: Insights from industry leaders - T...BookNet Canada
The publishing industry has been selling digital audiobooks and ebooks for over a decade and has found its groove. What’s changed? What has stayed the same? Where do we go from here? Join a group of leading sales peers from across the industry for a conversation about the lessons learned since the popularization of digital books, best practices, digital book supply chain management, and more.
Link to video recording: https://bnctechforum.ca/sessions/selling-digital-books-in-2024-insights-from-industry-leaders/
Presented by BookNet Canada on May 28, 2024, with support from the Department of Canadian Heritage.
JMeter webinar - integration with InfluxDB and GrafanaRTTS
Watch this recorded webinar about real-time monitoring of application performance. See how to integrate Apache JMeter, the open-source leader in performance testing, with InfluxDB, the open-source time-series database, and Grafana, the open-source analytics and visualization application.
In this webinar, we will review the benefits of leveraging InfluxDB and Grafana when executing load tests and demonstrate how these tools are used to visualize performance metrics.
Length: 30 minutes
Session Overview
-------------------------------------------
During this webinar, we will cover the following topics while demonstrating the integrations of JMeter, InfluxDB and Grafana:
- What out-of-the-box solutions are available for real-time monitoring JMeter tests?
- What are the benefits of integrating InfluxDB and Grafana into the load testing stack?
- Which features are provided by Grafana?
- Demonstration of InfluxDB and Grafana using a practice web application
To view the webinar recording, go to:
https://www.rttsweb.com/jmeter-integration-webinar
GraphRAG is All You need? LLM & Knowledge GraphGuy Korland
Guy Korland, CEO and Co-founder of FalkorDB, will review two articles on the integration of language models with knowledge graphs.
1. Unifying Large Language Models and Knowledge Graphs: A Roadmap.
https://arxiv.org/abs/2306.08302
2. Microsoft Research's GraphRAG paper and a review paper on various uses of knowledge graphs:
https://www.microsoft.com/en-us/research/blog/graphrag-unlocking-llm-discovery-on-narrative-private-data/
Essentials of Automations: Optimizing FME Workflows with ParametersSafe Software
Are you looking to streamline your workflows and boost your projects’ efficiency? Do you find yourself searching for ways to add flexibility and control over your FME workflows? If so, you’re in the right place.
Join us for an insightful dive into the world of FME parameters, a critical element in optimizing workflow efficiency. This webinar marks the beginning of our three-part “Essentials of Automation” series. This first webinar is designed to equip you with the knowledge and skills to utilize parameters effectively: enhancing the flexibility, maintainability, and user control of your FME projects.
Here’s what you’ll gain:
- Essentials of FME Parameters: Understand the pivotal role of parameters, including Reader/Writer, Transformer, User, and FME Flow categories. Discover how they are the key to unlocking automation and optimization within your workflows.
- Practical Applications in FME Form: Delve into key user parameter types including choice, connections, and file URLs. Allow users to control how a workflow runs, making your workflows more reusable. Learn to import values and deliver the best user experience for your workflows while enhancing accuracy.
- Optimization Strategies in FME Flow: Explore the creation and strategic deployment of parameters in FME Flow, including the use of deployment and geometry parameters, to maximize workflow efficiency.
- Pro Tips for Success: Gain insights on parameterizing connections and leveraging new features like Conditional Visibility for clarity and simplicity.
We’ll wrap up with a glimpse into future webinars, followed by a Q&A session to address your specific questions surrounding this topic.
Don’t miss this opportunity to elevate your FME expertise and drive your projects to new heights of efficiency.
2. It Was A Very Good Year!
• This week continues the HIS-tory of Siemens Healthcare, today’s #3 vendor in
annual revenue, whose HIS roots go back to the mid-1960s when IBM developed
SHAS, featured last week.
• Thanks to the many HIS veterans who contributed to the origins of SHAS, which
automated patient accounting in thousands of US hospitals who used it through
local Blue Cross, state hospital associations, and many proprietary firms like
Gamut & SMS.
• This week, we cover the early days of Shared Medical Systems for CIOs who may
not have been born when it was founded in 1969.
I was fortunate to be one of SMS’ early employees (#24, hired in October of
1969), so I’m going to relay the inside and human story of SMS’ amazing growth
to eventually being the #1 HIS vendor.
3. SHAS Was Not Perfect!
• SMS started running IBM’s SHAS soon after its release, and like all
new HIS products (Millennium, Paragon, Soarian, etc.) it had its
share of bugs, design flaws, missing features, etc., all to be
corrected in the 4th quarter per the vendor (but in what year?).
• We touched on one last week which was the Scalar Date routine
IBM came up with to minimize storage requirements back in the
days of their 360 mainframe, whose disk drive had one (1) meg!
• An early SMS programming maven, Glen Marshall, tells the tale
(he’s pictured on the right at our 2007 reunion in FL):
“In the mid-1980s I rewrote the old SHAS scalar date routine,
changing the base-date from 1/1/1900 to 1/1/1960. This
extended the range of dates until September 2049, well past my
100th birthday. For the geeks among us: The original scalar date
calculation was done in packed decimal arithmetic: year x 36525
/ 100 (by lopping-off 2decimal places) then calculations for
month, day, and leap-year adjustments.” (VC: simple, huh?)
4. Y2K Pre-Cursor (still love that
pun!)
“My rewrite was based on the date calculation formula used in satellites,
and that formula dealt with the Y2K problem as well. (I saw it coming
early...) In addition, the calculation was done in binary register arithmetic,
which cut the CPU time for date calculation by 90%. This time-savings was
significant.
The billing records were chock-full of dates that entered into the insurance
proration calculations. As I recall, the savings was nearly a net 10% savings
for the overnight billing program runs. That is a major savings for a
mainframe.
All the scalar-date using programs needed to be re-linked to pick-up the
new date calculation subroutine. A one-time conversion program was run
to change the date-base to 1960. Everything works like a charm. Only one
program was not re-linked, though, due to an oversight. And that was the
one that caused the headache and headline in 1989.” – Glen Marshall
5. Start-Up Ups & Downs
• There was an amazing esprit de corps at SMS in those early days –
as I’m sure there was at HIS new start-up: McAuto, HBO, SAI, etc.
Everyone knew we had to work hard just to survive, let alone ever
make the big times. The hours were long and hard too: I got up
one winter morning to a freezing rain at my home and couldn’t
get the door to my ‘vette to open – the lock was frozen solid! I
tried heating the key with matches, to no avail. Waiting an hour
for the sun to do its job, the phone rang around 9AM – it was Jim
Macaleer wondering why I wasn’t there yet: we started at 8:30!
• And I’ll never forget the “Saturday Club” – a
small group of fools like me who got their dull
admin stuff done on Saturday mornings: “Big
Jim,” Harvey Wilson (Sr. VP), Mike Mulhall (VP of
Installations), Phil Jackson (Terminals), Tony Sam
(CSC)… you could tell who was in by the cars in
the near-empty parking lot at 650 Park Avenue…
6. Inside Humor
• It wasn’t all just work during
those early 10-12 hour days
either – we goofed off a lot to
keep each other half sane...
• We IDs (Installation Directors)
received a stream of memos
from K of P telling us of bugs
that were fixed and new
features or modules.
• I was an ID at SMS’ NJ office,
and wrote this mock memo
to a hot chick in King of
Prussia HQ trying to impress
her with my puny humor (she
was an English Major too).
She laughed, but didn’t buy…
7. Outside Humor
• ID memos were re-written
in English (sort of…) for
clients to learn of new
enhancements by our
Customer Service Center.
• They were called CSC
Memos and #531 went out
that really didn’t do a good
job of explaining some
changes in 1977 to our
new Inventory system...
• The next day, Big Jim wrote
this cover memo to a re-
written version of the
memo apologizing to our
100-odd (sic) clients!
8. New Product Break-throughs
• SMS had an amazing team of programmers, and one of their
technological breakthroughs was called UNIFILE – Ken Shumaker’s
incredibly powerful & flexible early data base system in the 70s.
• Unlike SHAS’ batch processing, it processed transactions in real
time as soon as they were entered (like rival McAuto’s HFC did),
and then passed them on to an on-line data base for inquiries.
• Needless to say, it sold like proverbial hot cakes but as more and
more clients jumped on board, things started to slow down as the
water-cooled IBM 370s of that era had trouble handling the many
census transactions, report writer requests, and db inquiries…
• It was eventually toned down to less-powerful
but more reliable versions called Focus &
Command, but at one of SMS’ infamous Xmas
parties, I had a blast giving Bog Jim, Harvey and
Ken Shumaker T-shirts labeled Uni, Fi and Al!
9. Near Misses
• The earlier HIS-tory episode on SMS (#11 –see them all at
hispros.com) as a shared system pioneer covered two near misses
that might have put SMS out of business early in the 1970s:
– Regionalization that brought SHAS down for days on June 30
– Cash Flow – turning the corner from red to black circa 1971
• Another close call was when SMS moved from rented space at
Ross & Royal Roads in Bridgeport to 650 Park Avenue in King of
Prussia. Phil Jackson, who was assigned a number of challenging
tasks (like ACTIon and the NYCHHC install) headed up moving the
data center, and he asked we IDs to go to client hospitals on three
Saturdays, the first 2 to test the move, the 3rd for the real thing.
• We all went to clients and dumped in batches of cards for the two
tests, with only a few problems switching the hundreds of phone
lines, etc. When it came time for the 3rd test we got the word: the
2nd one was the real thing – no need for #3. Few complaints…
10. Green IDs
• Another down side to start-up firms is the lack of
experience with the system by their “green” staff.
• Most of we IDs at SMS in the early 70s were totally new
to computers, hospitals and even accounting basics:
- I was an English major from Temple, at my first “real” job
- Al College (eventual VP) was a former school teacher & coach
- Takis Petrakis (sadly deceased) set the record for ID novitiates:
he was the former captain of a submarine in the Greek navy!
• So what, you ask, doesn’t every vendor hire rookies and train
them? We had a 3-week class that tried to teach us every aspect of
SHAS (several million lines of code!), accounting (debits vs credits)
and hospitals (what’s the difference between an RN, LPN and
Aide?) – lots of luck! We learned as as much as we could during
those 3 weeks, then were sent out to the real world to learn in the
school of hard knocks, at our client hospitals’ time & expense.
11. Card Column 11 of the Header Card
• Al College & I were assigned to convert St. Vincent’s Hospital in
Staten Island, which had been totally manual on NCR posting
cards. We started with AR, showing them how to fill out coding
sheets for their thousands of ledger cards for keypunching:
• The cards were then sorted into batches of ≈50 each for ease of
handling, and SHAS required each one to have a header & footer
card. On the header card went the hospital’s code (St. V = “O”),
the batch type (new AR = 05), a batch number (001 to 999), etc.
• According to the SHAS OPS manual (our bible!), card column 11
indicated outpatients with a “6.” So Al & I dutifully sorted all the
hundreds of batches by IP & OP, entering a 6 in cc 11 for OP ones.
12. A Catastrophe!
• I squeezed all the boxes of 5081 cards into my car on Friday, drove
them down to K of P to load onto our mainframe. On Monday I
went back to get the TCEs (Transmission Control & Error report),
and was dismayed to have as many boxes of paper error printouts
as we had submitted keypunch cards! It seems what the SHAS
OPS Manual meant to say was that cc 11 separates OP vs IP
charges (batch type 03): new AR from cards was batch type 05.
• So I drove the boxes of error reports back to the poor folks at the
hospital, who started trying to correct the bewildering array of
duplicate errors that each batch had generated: some from the
AR program, some from the OP billing program. A nightmare!
• Precious days went flying by as all patient accounting activity
halted until we could correct all the errors and balance the AR –
we never did, and after a few weeks, the CFO just wrote off the
difference (6 figures…) before we proceed on to ADT & Billing…
13. Near-Death Experience
• We converted Census and Billing at St. V’s much better, and the
hospital eventually benefitted enormously from automation – it is
still an SMS (Siemens) client to this day! But I must admit, I still
avoid driving over the Goethals bridge thru Staten Island, afraid
the CFO might still be gunning for me somewhere out there…
• I probably almost got fired for the screw-up – I
remember trying to explain to Steve Macaleer my
ID Manager about the error in the SHAS OPS
manual, but he told me to not screw-up again…
• The real irony is that I learned from my mistakes, became one of
SMS’ better IDs (aced my 2nd and 3rd hospitals), and was
eventually promoted to be Education Manager, in charge of
teaching all new IDs the ropes. I told this story to every trainee!
• So is it better to get a rookie who’s very bright and hard-working,
or a stogy old veteran who just repeats the same formula over &
over? I’d look for both: a veteran who is smart & willing to learn!
14. The Takeaway?
• So what can one take away from this story of SMS’ early days –
should a CIO stick with large proven giants like McKesson, Cerner,
Siemens, and other “Top 10” HIS vendors, or take a risk with new
products from start-ups like CSS HealthTech, or RazorInisghts?
• Like so many HIS issues, the answer has both pros & cons. Pros:
– Giants forget their own past when they too were start-ups
themselves, viz: Huff, Barrington & Owen in Walt’s kitchen!
– Small start-ups generally give the best service as any of their
early clients can get the CEO on the phone & they’ll listen!
• And on the other side of the coin, there are cons, like:
– Who can remember hot new start-ups Bulldog IT, IntraNexus
and American Health Net, who rocked just a few years ago?
– An adage from the 60s had it that “No One Ever Got Fired For
Buying IBM” – dare take an unknown name to your Board?
The answer is different for every hospital and every HIS-tory epoch…