Tom Munnecke is the inventor of Veterans Health Information Systems and Technology Architecture (VISTA), which is the core for half of the operational electronic health records in existence today.
From the VISTA monograph:
In 1996, the Chief Information Office introduced VISTA, which is the Veterans Health Information Systems and Technology Architecture. It is a rich, automated environment that supports day-to-day operations at local Department of Veterans Affairs (VA) health care facilities.
VISTA is built on a client-server architecture, which ties together workstations and personal computers with graphical user interfaces at Veterans Health Administration (VHA) facilities, as well as software developed by local medical facility staff. VISTA also includes the links that allow commercial off-the-shelf software and products to be used with existing and future technologies. The Decision Support System (DSS) and other national databases that might be derived from locally generated data lie outside the scope of VISTA.
When development began on the Decentralized Hospital Computer Program (DHCP) in the early 1980s, information systems were in their infancy in VA medical facilities and emphasized primarily hospital-based activities. DHCP grew rapidly and is used by many private and public health care facilities throughout the United States and the world. Although DHCP represented the total automation activity at most VA medical centers in 1985, DHCP is now only one part of the overall information resources at the local facility level. VISTA incorporates all of the benefits of DHCP as well as including the rich array of other information resources that are becoming vital to the day-to-day operations at VA medical facilities. It represents the culmination of DHCP’s evolution and metamorphosis into a new, open system, client-server based environment that takes full advantage of commercial solutions, including those provided by Internet technologies.
Yeah, you caught the alternative expansion of DHCP. Surprised me the first time I saw it.
A couple of other posts/resources on Munnecke to consider:
Some of my original notes on the design of VistA and Rehashing MUMPS/Data Dictionary vs. Relational Model.
From the MUMPS/Data Dictionary post:
This is another never-ending story, now going 35 years. It seems that there are these Mongolean hordes of people coming over the horizon, saying the same thing about treating medical informatics as just another transaction processing system. They know banking, insurance, or retail, so therefore they must understand medical informatics as well.
I looked very seriously at the relational model, and rejected it because I thought it was too rigid for the expression of medical informatics information. I made a “grand tour” of the leading medical informatics sites to look at what was working for them. I read and spoke extensively with Chris Date http://en.wikipedia.org/wiki/Christopher_J._Date , Stanford CS prof Gio Wiederhold http://infolab.stanford.edu/people/gio.html (who was later to become the major professor of PhD dropout Sergy Brin), and Wharton professor Richard Hackathorn. I presented papers at national conventions AFIPS and SCAMC, gave colloquia at Stanford, Harvard Medical School, Linkoping University in Sweden, Frankfurt University in Germany, and Chiba University in Japan.
So successful, widespread and mainstream NoSQL has been around for 35 years? 😉
[…] I did notice on thing that needs correcting in Sean’s blog entry. See: Munnecke, Heath Records and VistA (NoSQL 35 years old?) NoSQL is at least 35 years old, probably longer but I don’t have the citation at […]
Pingback by Someone Is Being Honest on the Internet? « Another Word For It — November 8, 2011 @ 7:45 pm
re: “So successful, widespread and mainstream NoSQL has been around for 35 years?”
well, I’m not sure sure its “mainstream” – there is an irresistable urge for folks to normalize VistA to make it buzzword compliant.
Yes, I took a very hard stance on avoiding the restrictions of the SQL model. My focus was really at a higher level, however – creating a “speech community” for folks to talk about health.
I think that this architecture had a number of other firsts: the notion of a portable virtual machine (VistA was based on tiny core interpreter of 19 commands, 22 functions, 1 data type), active metadata (today: Semantic Web) using a data dictionary-driven approach, Open source (all was public domain, designed for VA, DoD, Indian Health Service, with input from universities, and Finnish National Health Service), agile development (“generations, not specifications” of software), email (VistA had one of the first SMTP implementations), and more…
Comment by tom munnecke — November 21, 2011 @ 2:13 pm
Tom,
I didn’t mean to “normalize” VistA as much as I was tweaking the NoSQL community for thinking they were the first to escape the bounds of the SQL model. Apologies for not being clearer.
The NoSQLers also miss the pre-1970’s to about the 1890’s era when mechanized and other means were used with a variety of data models.
Can you say a bit more about why you think active metadata is today the Semantic Web?
Thanks!
Comment by Patrick Durusau — November 22, 2011 @ 6:45 am