“Also Rans” - The Other Shared Systems• It wasn’t just SMS and McAuto selling the shared systems that

automated most US hospitals in the 70s. Some of the major “minor” shared systems included:– GE’s Medinet – a huge player nationwide through GE’s name– MDS – Bob Pagnotta’s Medical Data Systems in NJ, sold to:– Tymshare – from California, that made a run at SMS & McAuto– ISD – the Information Services Division of American Hospital Supply,

which was itself comprised of:

• Four regional shared systems AHS acquired around the country…

• Just as Bob Pagnotta built two shared systems, so did John DePierro, also of NJ, & one is still running!– Gamut – running SHAS in NYC in the late 60s– MDT – Medical Data Technology, sharing TDS

70s Shared Giant: General Electric• GE’s “Medinet” – Formed in 1966, right after Medicare• (just like IBM’s SHAS and OSF’s HFC!)

– Grew to over 100 employees, including:• Notables like Jim Pesce, VP for Paragon

– Hardware: • Processing on GE’s “485” mainframe• I/O via “KSR33” teletype terminals

• Products:– Announced with great fanfare at ‘67 AHA convention:• Full clinical suite: Laboratory, RX, CPOE, Medical Records…

– Only financials were delivered, however; RIP ≈1975

Bob Pagnotta’s Medical Data Systems• One of the most famous names and faces in the HIS

industry, Bob formed MDS in 1967 in Elmwood Park, NJ • Unlike SMS’ $5M in start-up capital, MDS started on a

shoe-string, with just a bunch of hard-working guys like:– Clark Hower, Steve Callas, Phil Nowicki, Bob Mathes…

• Unlike most others, they ran on Burroughs mainframes, that offered better price/performance than IBM’s 360s.

• Early NJ clients steered their product development:– Hackensack – had a large, complex ED, causing

MDS to concentrate on outpatient Reg. & Billing– Monmouth – hired them to build a Payroll

system, starting their general financials suite– Burlington County – where Bob started clinical

systems for CEO Dave Hunter & CFO Paul Long.

Tymshare• Building clinicals proved to be so costly, Bob sold MDS in 1976 to

Tymshare, a time-sharing giant from Cupertino.• Formed in 1964, Tymshare was a major player in generic industries, just

like McAuto’s GSD, its prime competitor.– Tymshare had the R&D capital to complete MDS’ clinicals.

• Heading up Tymshare, Bob grew it rapidly, acquiring:– Wisconsin Blue Cross, with about 30 hospitals on “MediStat”– Space Age Computers – in Washington, DC, an FM specialist– Medical Information (MI) – in Dallas, TX, giving a national base

• Clinical systems proved to take too much time and money, and in 1984, Tymshare and its 150 hospital clients were sold to McAuto in St. Louis.

AHS’ ISDISD• American Hospital Supply was battling with Baxter-

Travenol in the early 70s for hospital supply dominance, and created its Information Service Division (ISD) from:– Hospital Computer Center – which ran 2 separate data centers• Michigan – run by HIS gurus Gerry Mathis & Marv Cadwell• Georgia – run by Bill Brehm, of IFAS fame (w/ Irwin Gerber)

– CB2 – Central Bank Computer Bureau - from San Francisco, CA– NJHA – which ran a shared system in NJ, battling SMS and MDS

• ISD fought the good fight right up to the mid-70s, when:

• SMS cashed in some of its stock, which had done superbly well after its IPO, to acquire ISD and its personnel talent, who went on to make SMS even bigger and better. Marv Cadwell eventually became SMS’ CEO in the 90s, after Jim and Harvey retired…

John DePierro’s two NY/NJ Shared Systems• Like Bob Pagnotta, John DePierro is a famous figure in

NY/NJ HIS circles, and also start two shared systems: – Gamut – formed in 1968 and running IBM’s SHAS out of a data

center at 9 West 57th Street, early clients included:• Medical Arts Center in NYC & Caledonian Hospital in Brooklyn• Pascack Valley & St. Barnabas Hospitals across the Hudson in NJ

Competing with SMS on the same SHAS product proved too hard, so John’s next company was a truly innovative strategy:

• Medical Data Technology – John negotiated a license from TDS to offer its MIS clinical system on a shared basis to hospitals out of a data center in Mountain Lakes, NJ. MDT prospered for many years, and was eventually acquired by SMS’ Harvey Wilson when he formed Eclipsys. Several hospitals still run TDS from the Mountain Lakes data center to this very day!

End of an Era• Shared systems dominated the US hospital market through the

70s, as illustrated on this ancient chart from Sheldon Dorenfest & Associates, the HIS industry gurus (now HIMSS Analytics).

• What eclipsed shared systems? Starting in the early 1970s, hardware manufacturers were developing a new computer that solved the “main” problems with mainframes: costs and programming staff.

• What was it? Stay tuned for the next epoch in HIS-tory….