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Pioneers of HMT Up from the basement

Three decades of evolution in healthcare IT, seen through the eyes of CIOs who led their organizations through some of healthcare’s most dramatic changes.

By Michael E. Hilts

Editor’s Note: This is part one of a two-part series. Part two will be featured in the October issue.

History. We’re told to know it, to remember it, or be “condemned to repeat it.”

The good news about healthcare IT’s history of the past 30 years: it’s not possible to repeat. The landscape has changed too much, on too many fronts. There will be no return to the era of green bar reports, green screens and dumb terminals. Even as all the software, hardware and IT architectures have changed, so has healthcare itself. America has gone through a roller coaster of changes, trying to fi nd the right model under which to deliver and pay for care, going from fee for service, to managed care, to patient-centric concepts.

Apple and Radio Shack started selling the fi rst personal computers in 1977, but the fi rst rudimentary PCs suitable for business were just entering the market in the 1980s, with 5-1/4-inch fl oppy disks the primary means of input and storage, replacing the relic IBM punch card.

Arguably, the past three decades have been among the most revolutionary periods in healthcare’s his- tory – with more changes just ahead as we prepare for healthcare reform.

Despite constant change and the tribulations of the past, healthcare IT leaders don’t seem worn down by the pace. Few we talk to seem ready to throw in the towel. Most chief information offi cers (CIOs), when looking back through their personal histories and those of their organizations, view their journeys with some nostalgia, as well as a sense of fulfi llment for what’s been accomplished. They seem to share a cautious optimism as they venture forth, with some trepidation, ready to help write the next chapter in healthcare IT.

14 September 2010 Early years

In the early 1980s, few – if any – healthcare organi- zations had formal IT departments. Instead, even the largest health organizations employed just handfuls of assorted personnel specifi cally allocated to computer technology. And they carried an odd assortment of titles, including project managers, programmer ana- lysts and a few other non-IT sounding titles. The fi rst department directors didn’t even begin taking “chief” titles as CIOs until the last few years of the 1980s. “In my fi rst IT leadership post, I was data processing manager, as were many others of the top IT leaders in their organizations,” says John Hummel, who later served as senior vice president and CIO of the 30-hospital Sutter Health Sys- tem and was a founding member on the Certifi cation Commission for Health Information Technol- ogy. “We spent much of our day printing out reports on green bar. At fi rst, our responsibilities didn’t even include overseeing the patient accounting systems, as most of that was outsourced. Sunquest lab and a few other systems were in use, but they were standalone systems. IT guys had a struggle to win acceptance from the ancillary departments. They didn’t want us to run their programs. “We did programming to get these lab systems installed and operating, but we were otherwise still kept down in the basement,” Hummel says. “Shadow groups were hired to keep the standalones going. In fact, when IT fi nally crawled out of the basement, these shadow groups were the bane of our existence. It was one of the tougher jobs to try to assimilate those groups into the IT department, or dispense with them.”

John Hummel JohnHummel Punch cards to fl oppy disks

Apple and Radio Shack started selling the fi rst personal computers in 1977, but the fi rst rudimen- tary PCs suitable for business were just entering the market in the 1980s, with 5-1/4-inch fl oppy disks the primary means of input and storage, replacing the

HEALTH MANAGEMENT TECHNOLOGY www.healthmgttech.com

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