H.I.S.-tory

by Vince Ciotti

Episode #90: GE Healthcare

Part 3© 2013 by H.I.S. Professionals, LLC, all rights reserved.

IDX Buys Into The Hospital Market• No, I didn’t screw up and place that graphic upside down – it was

as brilliant an ad as the firm IDX acquired to get into the HIS market• You may remember we left off last week with IDX going public in

1995, when they were primarily a physician billing company, with only a few hospital apps, like HPA (Hospital Patient Accounting).

• So with deep pockets from their IPO, IDX went looking for a hospital clinical system to make them a total HIS vendor. Who did they buy? Easily one of the most famous HIS vendors ever, and one whose product was the last word in clinical systems at the time, co-founded by two “doctors,” one an MD the other a Ph.D. and MD:– Dr. Mark F. Wheeler, MD, M.P.H., a practicing physician, and– Malcolm A. Gleser, MD, and with a Ph.D. in Biomathematics.

• They worked for the U.S. Public Health Service (USPHS) in Seattle, WA, which continue our trend of northern roots for so many HIS pioneers – not as cold as Vermont, but far more precipitation!

Sailors’ Charts• When Wheeler & Gleser joined USPHS in the

’70s, it was serving mainly American seamen and Department of Defense personnel.

• This highly mobile population provided the ideal venue for creating an electronic chart that would follow them around western ports.

• Strange how in their efforts to build an electronic chart for sailors, Wheeler and Gleser found two aircraft manufacturers in those early days who were also pioneering systems that automated charts:• Lockheed-Martin’s “MIS” – running on IBM 360 mainframes• Martin-Marietta – who were using Tandem “Non-Stop” systems

• Back in those DOS/MVS days when a system crash could take days to recover from, the appeal of having two CPUs, two disk drives, etc., working in tandem offered a far more reliable platform for an electronic chart whose reliability could adversely impact patient care

Working in Parallel• So the doctors decided to follow Martin-Marietta’s lead

and build their system on Tandem Non-Stop computers, as explained below by Dr. Wheeler in an early article:

“The NonStop platform was what allowed Martin to win. The total system life cost was lower, because we could add processors as needed. We really felt that the NonStop platform was optimal for our kind of work, and we still feel that way today.”

• Per the paper below, the USPHS operated 9 hospitals and 26 clinics, so the e-chart had to enable a given patient’s chart to be shared among many entities, much like the RHIO/HIE/interoperable world of today.

Famous Product Name• So what to call this new system? How about “Public Health

Automated Medical Information System” or PHAMIS for short. It was extremely robust, with modules that rival today’s HISes, viz:– Scheduling, ADT, Order Entry, Results Reporting, Medical Alerts,

Pharmacy, Laboratory, Radiologic reports, Problem Lists, etc.• In the early 80s, Wheeler & Gleser formed their own company

under the same PHAMIS name to offer the system to non-USPHS facilities. Thanks to their physician-friendly design, robust app portfolio and reliable Tandem platform, it sold well to sites like:– Mayo Clinic (Minn), Thomas Jefferson (PA), Montefiore (NY)…

• PHAMIS next came up with a name to separate the company from the product, which they felt was easily the last word in electronic medical records of the time:

Want ads from

Phamis20

years ago;

sadly, no $s were given. What were you

doing back

then?

Rapid Growth• PHAMIS rode the wave of the

tidal shift in the HIS industry from financial to clinical systems during the 80s & 90s.

• As the chart below shows, revenues grew well, and by 1995, PHAMIS had over 300 employees, 40+ large IDN clients, and had gone public.

Cross Country Acquisition• On a deal that benefitted airline stocks (both offices were kept

open), IDX from Burlington VT acquired PHAMIS in Seattle in a stock swap valued at $147M. The gory details of the 1997 deal:– “Under the agreement, Phamis shareholders would receive 0.73 share of

IDX common stock for each of their shares. Based on IDX's closing price yesterday of $31.75, the transaction is valued at $23.18 a share. Phamis had 6.35 million shares outstanding as of Dec. 31. Shares of Phamis, based in Seattle, were up $3.375, to $22.25, before trading was halted.”

• IDX re-named LastWord as “CareCast,” and started selling its “integrated” array of physician and other hospital systems, making them a target for the next big takeover themselves…

• Next week we’ll wrap up the GE saga, adding many more bars to this timeline!