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Aug 20 2010

1979 paper by Epic Systems CEO Judith Faulkner

Published by at 10:08 am under AHLTA

I’m researching a op-ed piece on federal health care software, and am browsing through my old proceedings from the early days of the MUMPS Users Group meetings.  These meetings were quite an entrepreneurial incubator: Judy Faulkner was starting Epic Systems,  Paul Egerman, founded Interpretive Data Systems, which then became  IDX and sold to GE HealthCare systems for $1.2 billion, Terry Ragon started Intersystems, and I had just started working for the VA to work on what was to become VistA, and spread to the Department of Defense as CHCS and the Indian Health Service as RPMS.

Here is scan of Judy Faulkner’s 1979 paper called PISAR: A Time-Oriented Data Management System.  Judy’s Epic Systems went on to become a powerhouse in the Electronic Medical Record space.  It is remarkably similar to the architecture I was developing for the VA VistA’s system with George Timson and others called the File Manager.

It’s interesting to look at these systems 30 years later.  Judy’s company, Epic, has become a giant in the electronic medical record world.  VistA has gone on to power the transformation of the VA documented in Phil Longman’s Best Care Anywhere.

Rumors abound that EPIC is the lead contender for replacing AHLTA.  An alternative is the Open Vista Initiative.

I have great respect for what Judy has accomplished over the years, but at the same time, I think it would be a travesty for the government to turn to a closed, proprietary system instead of a roughly equivalent open source, publicly available one.

Isaac Newton said, “If I have seen farther than others, it is because I have stood on the shoulders of giants.”  In today’s Federal health care IT world, it’s getting hard to see anywhere, because everyone is standing on each other’s toes.  The VA’s VistA system has been in constant evolution since 1978 – and continues to thrive today.  The DoD’s uses a “break and replace” model, running one system into the ground until it breaks, only to replace it wholesale with another, more expensive system.  (It spent $250 million on TRIMIS until it threw it away to spend $1.6 billion for CHCS, which it tried to replace for $5 billion with AHLTA, which it is now throwing away to be replaced by something else.)

How will DOD pull itself out of this bureaucratic disaster area?  Will it spend billions more on a closed, proprietary system, or will it join the VA to create an evolutionary open source approach that benefits all?

Stay tuned.

P.S. I’m digging out all my old papers from the era and will be posting them in an archive Real Soon Now.

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