Healthcare Pioneers

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 find the right model under which to deliver and pay for care, going from fee for service, to managed care, to patient-centric concepts.

At times, it feels as if I’ve made a career out of writing about the healthcare industry’s quest to rid itself of paper. It started back in the mid 1990s when I served a brief stint as editor of this magazine. I left the magazine in 1996 to create my company that focuses on writing about health information technology (IT), and I have been doing that ever since. On a fundamental level, the recurring theme in most of the topics that I’ve written about during the past 16 years entails some clinical, financial or operational component that focuses on using technology to reduce or eliminate paper-based processes.

Time really does fly when you’re having fun.

The story of how this magazine came to be actually begins in the 1960s. I was at Lockheed Missiles & Space Company in Sunnyvale, Calif., when a few adventurous entrepreneurs gathered to consider building a medical information system (MIS) and a business office system (BOS). At some point, I drew the short straw to head up the development of the financial information system. Actually, this set very well with me because our clinical team was sent off to the Mayo Clinic in Minnesota in the dead of winter in 1967 to study the possibilities of an electronic medical record (EMR) and computerized physician order entry (CPOE) system, along with work-flow design and clinical process optimization.

Although still three to five years away, digitized voice recognition and input may hold the key to a comprehensive electronic patient clinical record.

Editor’s Note: This is the 12th and final installment in our year-long 30th anniversary “Pioneers in Healthcare IT” celebration, featuring articles from past issues of Health Management Technology, formerly called Computers in Healthcare. This article appeared in the December 1991 issue. At the time, Tim Zinn was president of Zinn Enterprises Ltd., a Chicago-based hospital information system consulting organization. A graduate of Harvard, Zinn was a nationally known healthcare consultant and futurist specializing in healthcare trends.

Digitized voice recognition has far-reaching ramifications for healthcare information systems (HIS). It holds great promise in the hospital setting, where most professionals are working with their eyes and hands continually. This approach will allow doctors and nurses to enter information about their tasks while they are actually working, rather than relying on their memories to record accurate facts at a later time.

Documenting while doing is especially advantageous for those charged with making detailed and accurate records that are both timely and critical in nature, a situation physicians and nurses encounter regularly during the course of patient care. Further, information can subsequently be sorted into multiple data formats with only one handwritten copy of doctors’ orders. Clearly, this form of data entry will not only be more convenient, but will capture close to 100 percent of clinically necessary information, as opposed to the 40 percent that current HIS automation now captures.