Archive for the 'history of computers' Category

Dec 09 2011

My original design notes for the Security system for VistA and CHCS

Today is the 33rd anniversary of the 1978 Oklahoma City kickoff meeting for what was then called the CASS (Computer Assisted Systems Support Staff), later to be called Decentralized Hospital Computer Program, which today is called the VistA EHR.  We had groups from the VA, DoD, Indian Health Service, and other academia.  This is where we laid out the basic structure of the metadata (Data Dictionary), File Manager, the basic utilities (a common date routine, for example, that was Y2K compatible.).

I have lots of stuff to scan and post, but I’ll start with my my original notes for the design of the security system.  This explained the process by which we would control access to patient data through a system of privilege codes.  Our first two files were Patient (#2), and User (#3).  File #1 was supposed to be the Data Dictionary, as a meta-level description of the other files, but that idea (which today might be called Meta-Circular Evaluation of a Homoiconic Language but that was a bridge too far for the times.   So, we spun the data dictionary spun off as it’s own metadata world.  The lesson to learned is that VistA at its core is closer to an LISP-like, artificial intelligence approach than the standard COBOL/SQL “modern model” of the times.  This is the hardest thing for me to communicate to newcomers to the architecture – they look only at the code, not the metadata.

We programmed this security model into the VA’s system, and it was reviewed by the federal Computer Security Center (using what was called the Rainbow security guidelines.)  I remember flying to San Francisco to spend two days with men in black suits who wouldn’t identify the agency they worked for… The system passed with flying colors, and they were very complimentary about the design.   Then, about 7 years later, as we were porting the system to the DoD as the CHCS system, I repeated the validation process, only with a larger group of DoD, GAO, and more mysterious men.  They didn’t bring thumbscrews to test me with, but it was quite a nerve-wracking experience.  We passed that  inquisition, too.

So, these scribbles ended up controlling the access to nearly all federal electronic health record access for the past 3 decades.  (The Indian Health Service also used it for their RPMS system, as well).  As far as I know, they have never been breached technically.  The breaches have always been authorized users doing bad things with the data, such as a VA employee with access to doctors’s records selling a list of their SSNs and home information to some nefarious buyers.

It’s fun to go back to retrace my design steps in the early days.  I drew the original onion diagram on a placemat in June, 1978 at Coffee Dan’s restaurant in Loma Linda, CA. over dinner with George Timson, which delineated the initial core of 19 commands, 22 functions and one data type.  This was before I was hired by the VA; I started in September, 1978.  I think we started with the Patient and User file right off the bat, and this security logic linking the two was probably the first code I wrote.  Then I moved on to writing some of the early data dictionary logic.

I know that Richard Davis from Lexington was also quite active in this area, and one of my primary intellectual sparring partners for wrangling with some of the more abstract issues of the architecture.

This idea has certainly stood the test of time, and I think it could be updated to carry through to an updated approach – coupling the access metadata to the data as it is queried and shared.  I suspect that it could be integrated into an RDF Schema which could be used for generalized connection the Linked Data model.


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Oct 06 2011

How I introduced Steve Jobs to a vision of an “Intelligent Telephone” in 1977

Published by under history of computers

The passing of Steve Jobs has motivated me to dig out my material from the era that I met him. I was quite excited about microcomputers, and bought a Motorola 6800 Mikbug development kit that still sits out in my lab, encased in a 30 lb monstrous metal case.

I wrote a book called The Friendly Computer, which I ended up publishing with the Hofacker Verlag in Germany in 1980 as “Der Freundliche Computer.”  I talked to anyone and everyone I could about my idea, including the president of Commodore Computers, who liked the name so much that he named the Amiga computer after my suggestion of “Amigo.”
Bill Gates 1979 Consumer Electronics Show, Las Vegas
I talked (rather argued) with Bill Gates just after he dropped out of Harvard to live in Albuquerque to start Micro-Soft, and Steve Jobs the day he announced the Apple II.

I was working up an idea for a company called “The Friendly Computer Company” – a radical shift from the notion of computers-locked-in-massive-computer-rooms. Here is a scan of my original notes, written some time in 1975-1976.

I met Steve Jobs and Steve Wozniak the day they announced the Apple II at the First West Coast Computer Faire in San Francisco in April, 1977.  Steve Jobs and and I wandered off to the bleachers in the auditorium and spent an intense 30-60 minutes talking about the future of microcomputers.  L ooking back, I’m amazed at some of my ideas – that I was pitching the idea of an “Intelligent telephone” to him:

“The company will offer an array of low cost packages which will be designed to create additional demand for themselves.”  I thought of selling software for home use, including dieting, children’s stories, games, energy simulation, geneology, and personal finance.   It would start by selling on floppy disks, but then move to an electronic subscription model.  In Phase III of the evolution of the company, I spoke of the “Intelligent Telephone”:

“As electronics continues its progression, a microcomputer with memory, operating system, and interfaces will be placed on a single integrated circuit.  This dramatically increases the areas of use of what is now known as the microcomputer, but most significantly it would create the”intelligent telephone”, a computer linked to the phone network, capable of recording messages, interfacing to the electronic funds transfer systems, electronic mail and telegrams, and interfacing to larger, commercial computers. This concept represents the ultimate convergence of the IBM-ATT markets. IBM has been moving more and more into what it calls “teleprocessing” with more communications oriented products, such as satellite systems, considering it an extension of the central computer processing function.  ATT has been moving towards a more sophisticated “data communication” capability, with its dataspeed (?) products. The two giants will eventually converge on the telephone handset as the basic link in the data communication/teleprocessing controversy. Needless to say, the effects of this will be awesome and very political. The market for these units will be in the hundreds of milllons of units.  Software distribution will be over the phone network, obsoleting older distribution techniques.”

This paragraph amazed me.  I got most everything right except for the part about IBM being the company to converge with ATT.  It was Apple.

Looking back, I don’t think I had the killer instincts of the entrepreneur to pull the idea off.  I had a family with two young daughters to support, and a steady paycheck meant a lot to me back then.  And, of course, this was a silly idea – no one had ever done anything like this before.

This is a lesson I teach in my classroom visits today as a NASA/JPL Solar Systems Ambassador: I tell kids that if they ever invent something new, expect folks around them to say, “That’s crazy, no one has ever thought of that before.  And, of course, that’s exactly what we need to focus on.”

P.S.  I went on to another vision – of creating an open-source health care information system for the VA – now called VistA.  I didn’t make a fortune like Gates or Jobs, but I can go to sleep, thinking that I created something that has saved people’s lives.  I don’t know who they are, and they don’t know that a computer prevented a medical error from happening to them.  But I know I contributed a bit to making it happen.


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Jun 12 2011

Some of my original notes on the design of VistA

Here are some my Original Notes on the design of what would become the VistA system.  These were jotted on transparencies, which were then placed on overhead projectors – the powerpoint of the day.

As a VA employee (Loma Linda VA Hospital in California) I attended the December, 1978 Oklahoma City meeting at which the original design for a government wide, decentralized hospital information system was planned.  We had representatives from VA, DoD, Indian Health Service, and academia.  The foundations set at this meeting went on to become VA’s VistA, the Department of Defense’s Composite Health Care System, and the Indian Health Service’s Resource and Patient Management System (RPMS), which represents around 10-12% of the electronic records systems in existence today.

For fans of simplicity in the face of complexity, I might point out that we settled on a design that consisted of a single language (ANS MUMPS), using a single data type (string), database storage (globals of string-subscripted arrays), and 19 commands and 22 functions.  A large portion of the data base consisted of the null string, indicating that the information conveyed was the name of the object, not the value itself.  There are many subtleties to this approach which are invisible to standard IT thinking of a “place for every datum and a datum for every place.”

Note that this discussion was all about meta data – a higher level description of the information to be contained.   The inner core of the “onion model” of VistA architecture was all about a simple, portable centrality of software that supported a data dictionary, which supported the kernel utilities, then the patient data base, then the applications.  In today’s terminology, this would be called a semantic web.

This is an interesting precursor to the 2010 Presidents PCAST Health IT report – and a little ironic that they should be calling for “tagged metadata” and a “health exchange language” when the government has been supporting this approach for 35 years through NIH and NIST (then NBS) for the development of the ANS MUMPS language, which then successfully propagated to VA, DoD, and Indian Health Service.


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Apr 09 2011

Tribute to Ted O’Neill

Ths is a tribute to Ted O’Neill, who played a key role in the development of health informatics technology today.  At the National Bureau of Standards, he helped bring the American National Standard MUMPS to reality.  Moving on the the Veterans Administration, he started the office that became the Decentralized Hospital Computer Program, that is now called VistA.

I shot this video at an Underground Railroad Banquet in 2009, and pulled together some of the interviews to talk about Ted’s contributions.

Contact me if you are interested in helping out to build a larger collection of oral histories…


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