38. micro revolution
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8/3/2019 38. Micro Revolution
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H.I.S.-tory by Vince Ciotti
2011 H.I.S. Professionals, LLC
Episode # 38:
The MicroRevolution
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Micros Go Macro
Hope you remember this picture from our introduction last year,
about how the 4 epochs of computing in healthcare overlapped:
None totally replacedthe other, they just rose & fell in terms
of popularity (the new thing) and market share over time.
60s 70s 80s 90s
Mainframes(eg: IBM, BUNCH)
++++ +++ ++ +
Shared(eg: Blues, State Assoc,
Commercial Firms)
++ ++++ +++ ++
Minicomputers(eg: DEC, DG, HP)
+ +++ ++++ +++
Microcomputers(eg: Apple, IBM)
+ ++ +++
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Early Microcomputer Development
The roots of microcomputers go back surprisingly far in the 1970s:
1971 = first ads for Intel 4004 chip
1972 =MITS offers Altair 8800 kit
1973 = Xeroxs PARC Alto project
1974 = Simonyis Word Processing 1975 =Microsofts BASIC for the Altair
1976 = Apple introduces the Apple 1
1979 = VisiCalc spreadsheet for Apple II
1981 = IBM legitimizesthe PC
TI 99-4 Tandy Radio ShackTRS 80
Altair 8800
IMSAI 8080
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Very PersonalComputers!
Micros were verypersonal, as these shots of my first one shows:
1981= Our Texas Instruments 994A
Used an old TV as a CRT
Stored data on an audio cassette
Started my sons game addiction!
- 1984 =My brother Dave got hooked too, and
showed how rapidly PCs became a business:
He later programmed an Apple II PC,
To weigh eggs for farmers in the Midwest,
That sorted eggs into grade A, B & C,
Which they used for about 15 years!
Hes a PC maven at Trenton State today.
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PCs in Hospitals PC spread into healthcare started in the late 70s & early 80s:
Individuals in Finance and ancillary departments startedusing them topersonalize the data they could only obtain
from an HIS system in a fixed green bar paper printout.
Using breakthrough software like VisiCalc, the worlds first
spreadsheet, written for the Apple II in 1979
(Microsofts Excel came much later 1985 for the
AppleMacintosh, 1987 for Windows on IBMPCs)
HIS Vendors jumped on the PC bandwagon early too:
George Weinberger enthralled my sales team at HIS Inc. in
early 1982, taking an IBMPC apart in front of our eyes.
We then bought one for each salesman to show demo
screens of our non-existent IBMmainframe HIS system.
The ultimate way to sell vision-ware: See!
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Pioneering HospitalPC Product The first pure PC-based product I remember for hospitals was
written by an ex-SMS salesman named Tom Boyle circa 1980. Tom was a super-bright sales rep (as all SMS reps were!), who
targeted the dreaded SSA 2552 cost report step-down,
Which you may remember was handled by a terribly user-
unfriendly SHAS module called CAP (Cost Allocation Program). It required labyrinthine calculations to allocate the costs from
non-revenue producing departments to revenue depts, based
on such statistics as square footage, # of employees, etc.
T
om left SM
S to develop & sell a cost report system that ran on aPC and did this horrendous math for CFOs in the blink of an eye.
I tried to talk McAuto into buying it in 1980, but they balked,
so Tom sold it to Coopers & Lybrand who sold hundreds!
But what about PCs and mainstream HIS systems? Read on
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The Hardware Market
A major thing holding back PCs from the HIS
world was unknown names like Apple
IBMs 1981 introduction of their PC openedthe door now PCs were legitimate, and
hundreds of companies jumped on the Big
Blue bandwagon besides pioneers like Tom.
How quickly did IBMdominate the market?
Check out this next slide from SIDAs Guide
You should remember by now how much IBM
dominated the HIS hardware market back inthe 70s & 80s, when PCs were introduced.
On the left is a a chart based on figures from
Sheldon Dorenfests Guide, the bible for
HIS market statistics back then, which
showed how IBM totally trumped the BUNCH
group.
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Taking a Byte out of Apple This graph illustrates how quickly IBM took over the PCmarket
from early leaders like Apple & Radio Shack, based on a survey ofSheldon Dorenfests 250 sample hospitals in his 1986 Guide
0
10
20
30
40
50
60
70
1981 1982 1983 1984
% ofPCs in 250 Sample Hospitals by Brand
IBM
Apple
Burroughs
DEC
Wang
Radio Shack
Compaq
HP
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Sweet Revenge! Just in case youre an avid Apple fan like me, however, the chart
below shows how over time the computer market reversed itself: IBMeventually faltered to where in 1993 they posted their first
quarterly loss in the 100-year history of this computing giant.
They have since shifted much of their revenue from hardware
to services (read: software, outsourcing & consulting). Apple too faltered after both Steves (Jobs & Wozniak) left in the
80s, losing its consumer-centric focus until Jobs returned and
started the i-Revolution.
Per the chart on the right, by
2011 Apples stock marketcapitalization not only
exceeded Microsoft, but even
overtook its old rival IBM. For
a while in 2011, its cap evenexceeded Exxon-Mobils!
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EarlyMicros in HIS Systems
Total HIS
A vendor with a complete
HIS on embryonic IBMPCs
in the 80s running on DOS!
Bedside
-Micro systems broke down
the doors to patient rooms,
paving the way for E.H.R.s
During the 80s, literally hundreds of companies developed PC-
based systems, mainly for ancillary department systems such as:- Duponts Trinity RIS - Citations DOS/Novell-based LIS.
In the next episodes on micros, were going to dig deeper into
two uses of PCs that heavily impacted the HIS industry:
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