The Other Shared Systems, con’t

Blame Mr. HIS-talk!

The Other Shared Systems, con’t• If you’ve been following this HIS-tory series on HIS-talk, you

should remember the 3 epochs covered to date:– Pre-cursors – my sick pun for 1050’s cardboard posting cards and

other precursors to the computer age in hospitals.– Mainframes – IBM and the BUNCH Group in the 1960s– Shared Systems – led by SMS and McAuto in the 1970s

• This week was to be the first installment of the 1980s:– Minicomputers – that solved the problems of mainframes…

• But, blame Mr. HIS-talk who had the nerve to publish my email address, enlisting dozens of emails and two fascinating phone calls that led to this week’s step back into shared systems, thanks to Mike Kaufman and Jim Pesce,

• Who shared (sic) these 2 amazing stories…

Medinet, redux• Jim Pesce

– Who’s he, and what’s he got to do with the price of eggs? Well, read on:

– Back in D.P. Neanderthal days (circa 1964), Jim got his first job at an amazing start-up firm in Boston with a bunch of MIT and Harvard graduates (of which Jim was distinctly not a member!)

• The project was headed up by Ed Yourdan, 22-year-old MIT PhD, and father of “structured programming.”• Jim landed a job as the night shift supervisor at the data center for Yourdan’s project called “Medinet.”

“Massive” Shared Mainframes• Jim’s data center housed a monstrous mainframe of the

time: an IBM Model 7090, later upgraded to a 7094,

• With a then-staggering 128K (not meg or gig) memory!• One of Jim’s night-shift employees was a youngster

named Larry Polimeno (sound familiar Meditech-ers?)• Larry was passed over for a supervisor job, and quit to

join some other flaky start-up off of Route 128… dumb!• Medinet was funded initially by Bolt, Beranek and

Newman (BBN), a consulting brain-trust famous for:– ARPANET – a military redundant communication

system, forefather to the “www” Internet!– Acoustics – they were later hired by the feds to

analyze sound recordings of JFK’s assassination…

Early HIE/RHIO Vision!?• Medinet’s amazing vision according to Jim was to build a

network of IBM 7090s in major cities (Boston, NY, LA, etc.), connected to Honeywell computers in individual hospitals, linking patient information – sound familiar?

• Even worked on a program to allow MDs to write notes, but slow KSR teletype terminals killed response times…

• According to Jim, Medinet had a Hippie culture back in the swinging 60s, until one day a bunch of suits came in.

• GE – had acquired Medinet, and, in typical big-business fashion, they shifted the emphasis from clinicals (with little market back then) to financial systems, a huge market SMS and McAuto were devouring.

GE’s MedinetMedinet• Just as HFC was developed at OSF and SHAS pioneered

by Minnesota BC/BS, GE sought a hospital partner:– Ellis Hospital – in Schenectady, NY, was picked to help design

Medinet’s financial modules: Census, Billing, AR, etc.

• Retired GE executives led the project at vastly reduced salaries, but with deep financial system experience.

• After selling about 50 hospitals, GE folded its tents circa 1975, and sold Medinet to HCA in Nashville, Tenn., which, after many updates and releases, it still runs it at 150 HCA hospitals today!

• Of course, the Medinet project has nothing to do with the GE “Centricity” systems being sold today, which will take a whole chapter later on for where they were acquired from…

Jim’s Career Since Medinet• Jim left Medinet after it was sold to HCA, and began a

career that is easily remembered by we acronym geeks:– McAuto – which Jim joined in the mid 70s, and headed up

Client Services in their Florham Park office in NJ for 10 years.– Micro Healthsystems – which Jim joined in the mid-80s as

president, and led their pioneering bed-side systems called:– MMedTake – which he and Chairman Sal Caravetta sold to– McKesson – where Jim was given the task of shutting down

Paragon circa 2000, after its many years of delays and bugs. • After studying the system, he appealed to

McKesson to give it one more try, and the rest is HIS-tory – Paragon is one of the hottest selling HIS system in the small to mid-size hospital market today. (Just surprised he didn’t rename it Maragon!)

The Kaufmans, Père et Fils• The second shared system redux story is courtesy of Mike

Kaufman, whose father, S. David Kaufman, is famous for his acronym shared system, SDK, which may be the original shared system ever!! According to Mike:– Sam – was CFO at several large medical centers in the 1950s:

• Beth Israel in Boston, Mass, and Mt. Sinai in NY, NY.– Circa 1955, Sam formed his own CPA firm, and applied for a

federal grant to build a system to share data among hospitals.

• April 1, 1961 – Sam formed SDK as a shared system, beating SHAS and HFC by over 8 years! Sam took 8 of his accounting clients over to SDK’s financial system.

• Built by a CPA, SDK offered a very functional suite of financial apps, and the client base grew rapidly, processed through a GE data center in Lynn, Mass

End of SDK, Start of “MBK”• SDK granted a sub-license to Astradyne that

sales & marketing rights in the NY/NJ/PA area, although processing was done by SDK.

• In the mid-70s, Sam passed the baton to his son, who read the tea leaves about mini-computers, that were entering the market.

• Michael B. Kaufman re-wrote his Dad’s shared code in then-state-of-the-art Mumps, which was re-named Intersystem’s “M,” eventually Cache, which is still the underpinnings of many HIS systems today.

• Mike ran the new SDK on a DEC mini, and sold it to 50+ hospitals, even teaming with Cerner in the 90s (before they wrote ProFit).

• In 1997, Mike got an offer he couldn’t refuse from Harvey Wilson, who had left SMS to form a “NewCo,” eventually named Eclipsys.

• The DEC mini SDK became part of Sunrise, and still runs in over a hundred hospitals to this very day (now owned by Allscripts).