16. mini meditech

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  • 1. Turnkey Mini Pioneers Yes, Virginia,thatearly!

2. Earliest Mini Vendors

  • If youve been following our HIS-tory, youll remember how shared systems dated from the swinging 60s:
    • IBMs SHASwritten in the mid-60s to share 360 mainframes,
    • McAutosHFC also from the mid-60s, right after Medicare, and
    • SDK the oldest of them all, started by S. D. Kaufman in 1959.
  • Amazingly, the earliest turnkey mini vendors date from the 1960s as well, only they took many,manyyears to mature and grow anywhere as big as SMS or McAuto:
  • There were basically two flavors:
    • Departmental systems , vendors with standalone clinicals that interfaced to shared financials like HBOs Med-Pro.
    • Total HIS vendors , offering both clinical and financial apps that completely replaced shared systems.

3. Early Departmental Mini Vendor

  • Well start with one of the earliest departmental system vendors, that grew over time into a total HIS system.
  • To appreciate its roots, we have to go back to one of the earliest mini hardware/software development projects:
    • Massachusetts General Hospital , where Octo Barnetts Lab of Computer Science (LCS) used the first DEC PDP minicomputers to develop one of the very first time-sharing systems (ironic?)
      • LCS software was called MUMPS , short forM assachusetts General HospitalU tilityMu lti- P rogrammingS ystem.
  • Among Octos hard-working team were:
    • -Dr. Robert Greenes who went on to form American Health Systems, and
    • -Neil Pappalardo a long-haired (who wasnt in the 60s?) chain-smoking (ditto) project engineer on the right, who went on to form

4. M edicalI nformationT echnology

  • Odd name: was Neil thinking of his alma mater - MIT?
  • Anyway, the firms nickname became not MIT but Meditech , and its current mega-size makes it easy to forget its very humble roots as adepartmentalsystem:
    • At first, Meditech was a software programming shop, writing MUMPS code to automate phone directories, Sheraton hotels, and even the NYC prison system! First hospital client was:
  • Cape Cod Hospitalwhose daringPathologist elected to go with fledgling Meditech to write a Lab system running via a teletype machine over a dial-up phone line via an acoustic coupler, time-sharing on a DEC PDP-15 running at the Meditech facility in nearby Cambridge.
  • (Cape Cod stayed with Meditech til 2010)

5. MeditechEvolution

  • Cape Cods saga outlines much of Meditechs HIS-tory:
    • 1971= CCH converted to Meditechs MIIS, their proprietary variant of MUMPS, and added four Infoton Vistar CRTs and two slaved character printers (UNIVAC DCT-500). It took a full minute to print a single patient summary report (but far shorter than a clerk could ever {mis}type one!)
    • 1979= CCH converted to another generation of the LIS and Meditechs new MIIS (Standard) operating system which ran on a DG Eclipse C330 mini.
    • 1984= CCH replaced their shared financial system with Meditechs complete MAGIC HCIS system running on five DG MV6000 minicomputers, with 300 devices and five gigabytes of storage. Plans were to move to DGs new RISC machines in the future (MV10000 series).
  • I first encounteredMeditechin the early 80s when a NYC mainframe vendor I was working with partnered with Meditech to proposetheirclinicals (by then, an LIS, RX, RIS, and Orders & Results) withourfinancials. Luckily, the hospital didnt buy this odd couple, but I noticed how quickly Meditech added their own financial a bit later

6. Other Medi-techies

  • Like the troika of Jim, Harvey & Clyde at SMS, and Walt, Bruce, & David at HBO, there were 3 notables who made Meditech magic:
    • Neil Pappalardo still deserves the most credit, personally guiding their technical evolution through MIIS, $T, NPR, C/S and now Focus/Release 6.
    • Larry Polimeno one of the first employees (remember Jim Pesces GE Medinet story?), who eventually rose to become Vice-Chairman.
    • Howard Messing- who has risen today to the position of president and chief executive officer.
  • Other early heroes/heroines include:
    • Ed Pisinski early Sales VP, had the sense to recruit his successor, Stu Lefthes, from McAuto!
    • Barbara Manzolillo an early hire who rose through the ranks to become CFO.
    • Roberta Grigg- who eventually served as senior vice-president ofMEDITECH'sinternational operations before retiring in 2001.
    • John Dolan retired Northeast VP, who put up with some of the nastiest contract negotiations Bob Pagnotta & I ever put anyone through!

7. MoreMeditechMausoleum Myths

  • Meditech started several trends copied by later vendors:
    • Corporate OfficeOnlyeveryoneis based in Boston, Mass. there are no regional offices for sales or implementation.
      • Well, actually, in the early 70s there were 2 field offices in the West and one in the Midwest but they were closed as a cost-cutting measure after a bad year. Imagine the (your?) air bills to California!
      • (a model since followed by such notable vendors as CPSI and Epic)
    • SoftwareOnly buy your hardware from someone else: JJ Wild, Perot, Dell
      • In the early days, MIIS required modifications to the firmware in early DEC and DG minis CRTs, so gearhadto be configured in Westwood.
        • (anyone know the origins of JJ Wilds early hardware monopoly? Please email me)
      • Imagine how large Meditechs (and Epics) annual revenue would bewithhardware!

8. MeditechsAmazing Growth

  • The graph below illustrates Meditechs incredible success since:
    • In 1981, 70-odd (sic) clients convened at their first user group meeting
      • Much smaller than SMS & McAuto, with over 1,000 shared system clients then.
    • By 2011, there are about 2,000 hospitals worldwide using Meditech:
      • Several hundred international, hundreds still using clinicals only (eg: HCA), and well over a thousand US using one of their three flavors of full HIS: Magic, Client Server or Release 6.
    • Their MUSE user group has grown so big it rivals HIMSS in size and hype