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Help! If you are old enough to remember Epic and Cerner both being founded in 1979, this thread is for you. I'm writing a timeline for EHR technology, starting in 1960, and would appreciate any notable memories from friends and acquaintances. I first tried to create an EMR in 1984 on an Osborne computer. Hah! They went bankrupt 6 months after I bought my Osborne for $3,500. (Still have it, it still runs.) Not a particularly important moment in EHR history, but you get the drift...
Introduced: April 1981. Price: US $1795. Weight: 24.5 pounds. CPU: Zilog Z80 @ 4.0 MHz. RAM: 64K RAM. Display: built-in 5" monitor. 53 X 24 text. Ports: parallel / IEEE-488. modem / serial port. ...
Margalit Gur-Arie's profile photoMark Frisse's profile photoSherry Reynolds's profile photoDavid C. Kibbe's profile photo
This sounds like an excellent project! I've looked around online for EHR timelines, and have not found much...
+Nate Osit So, Nate, can you come up with something for the timeline that you think marked an important step in the development of EHRs?
ca.1980: At Medical College of Pennsylvania in Philadelphia, Marc Salzman (?) and I implemented a short-lived Emergency Department registration system on a Radio Shack TRS-80 with dual high speed tape drives that captured demographics, treating emergency physician, vital signs, final diagnosis and patient disposition. It ran well for about 4 months until we ran out of the gumption to get out of bed and trouble shoot every time it went down.
1994 - Hippocrates on the Apple Newton Messagepad. $395

Yes - I had Newton ... even wrote software for it ... but never pulled the trigger on Hippocrates.

Fractional press release:

Lincoln, Neb. - A Newton can read your doctor's writing, even if you can't, with a new application from HealthCare Communications Inc.
Hippocrates, priced at $395, replaces many of the paper forms and quick notes used in medical, dental and chiropractic practices, as well as hospitals, nursing homes and home health-care environments.

The program manages a daily patient schedule, prescriptions, encounter tracking and patient records. It can exchange information with the company's MacHealth line of desktop practice-management …
I was reading Tim Benson's "Principles of Health Interoperability: HL7 and SNOMED" at the time, and came across some good info I'd include in a timeline.

1967-1982: Larry Weed implements PROMIS, a problem-oriented patient record system. Introduces SOAP acronym- Subjective, Objective, Assessment, Plan.

1971: El Camino Hospital Project- First hospital to implement comprehensive EHR. A detailed 6 year study was done.

I would also include the UK's GP2GP program, as well as the national adoption strategies of Australia, New Zealand, and Denmark.

There's also probably quite a bit of info on PubMed if you poke around!
Great idea! David, Bring Osborne at some Web 2.0 ore related meeting. When you want to create a ruckus, just put it up on the table and start tacking notes... Remember the pre-AMIA SCAMC meetings where that was the "platform of choice"?
Talk with Warner Slack at Beth Israel Deaconess. I believe Werner used a LINC computer to do a lot of medical survey and other early biomedical research. The LINC was the creation of Wes Clark and Charlie Molnar. Werner can tell that story as well as anyone. A 1967 video is to be found at:
+Nate Osit Interesting!! I have been reading up on Jan Shutlz and Larry Weed's PROMIS this afternoon. The link is and it's fascinating stuff. Among other things, I learned that they started out in Cleveland at the Metro General, where I did some of my training, before moving to Vermont in 1969. The really interesting things is that they were working on re-structuring of health information, at the same time as they were trying to bring the operator and the computer together. Touch pad stuff, no less!
+Mark Frisse I do not remember the SCAMC meetings you mention. Can you elaborate on the role Osborne played?
+David C. Kibbe Regarding Larry Weed, see my recent piece at the THCB
Also Lincoln Weed brought to my attention a new book he co-authored with Dr. Weed (his father) "Medicine in Denial"
I am reading it now and it is truly amazing. I don't agree with everything but since the Weeds have been gracious enough to invite me to comment, I fully intend to initiate a conversation to better understand Dr. Weed's views (I don't think they realized what they are getting into :-) )
All in all I find the man fascinating, a veritable giant.....
SCAMC - Symposium for Computer Applications in Medical Care and the AAMSI Congress were the precursors to the AMIA meetings. In the early 80s there were people demonstrating apps on Osborne computers.
Concerning the Collen book, I don't have a copy. I'm sure there's one somewhere at Vanderbilt. I'll get you can get one on loan from the National Library of Medicine. Shortliffe's textbook of medical informatics has a chapter on the history, I think.

Rob Kolodner (also former head of ONC) could add some insights along with those from the VA "underground railroad. " Some of their recent meetings are online (video) and they talk about the challenges they faced implementing the Vista system back 30 years. It is a powerful story of politics and technology and doing the right thing for providers and patients.

1965 - 1977: The Age of Cooperation: Birth of the VistA Strategy and Architecture 1977 - 1982: The Age of Struggle: Birth of the VistA Software 1982 - 1993: The Age of Expansion: Widespread Adoption and Improvement 1994 - 2004: The Modern Age: Achievements and Contradictions

Here is a link
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