H.I.S.-tory - by Vince Ciotti

© 2013 by H.I.S. Professionals, LLC, all rights reserved.

Episode #123: Epic-ologue

HIS-tory Presentation• If you’ve been following this HIS-tory series over the past 2

years, you may remember the kind way Judy Faulkner reacted when I contacted her about the story of Epic (you can find all the gory details in episodes #95 through 98 at HISPros.com).

• As a rather harsh critic of most vendors, I expected a cold shoulder, but she surprised me with a warm invite and was quite the gracious host when I arrived in (warm) Verona last October.

• I’ve since been accused of “drinking the Kool-Aid,” but I now understand why so many large AMCs and IDNs have gone Epic – it’s the opposite of Verona’s climate!

• So I asked Judy if she’d like me to present a my 2011 HIMSS presentation that launched this whole series to her staff, she accepted, and I called my travel agent for a dog sled...

A Warm Audience!• Even more chilling than the weather was the fact that I would be

addressing Epic’s entire employee base of ≈6,000 people! The largest audience I ever addressed was about 200-300 at various HIMSS & HFMA meetings over the years – heck, the Metropolitan Opera House in Lincoln Center NY only seats about 4,000…

• As it turns out, this would be the first presentation in a brand new hall Epic just constructed that holds an amazing 11,000 people, for future growth as well as their annual User Group meetings.

• The room is called “Deep Space” and in typical Epic fashion it was built in a unique manner: all underground to not spoil the lovely view of surrounding farms.

Introduction• So I travelled through the “polar vortex” to Verona last week

where Judy’s staff did its usual excellent job of organizing for the presentation. You can imagine how much technology Deep Space employs coming from a leading IT vendor – their only challenge was to find an overhead projector which I like to begin with to make the visual point about just how far back the 1960s were! They found one, and we set it up as a brief “blast from the past.”

• Amazingly, all 6K people found their way into Deep Space in 15 minutes, another testament to Epic’s superb planning and organization. Judy gave a kind and flattering introduction (that I had written), and I swallowed hard as I climbed the steps to face those 12,000 eyes & ears…

Strip Tease!• I started out in my business suit just like

at HIMSS in 2011 and got a few giggles about how overhead projectors could do things PowerPoint can’t, like a “revelator” – a piece of paper slid under the foil to reveal only parts at a time - and writing with an erasable (one hopes!) pen…

• Then the fun began: I told the ladies to avert their eyes as I was going to show them just what we looked like in the 1960 by taking my pants off… I slowly revealed a hippie outfit under my suit that Mr. HIS-talk goaded me to buy for the HIMSS shtick in 2011. The ladies roared (while the men moaned…) as I slowly revealed a pair of (overly) tight & colorful bell-bottom pants under my suit.

Strip Tease, cont’d• Next came a flower shirt with 6-inch wide tie

that barely matched, highlighted by a gold chain. Actually, the one piece of clothing that really did come from the 1960s is the dark leather belt which I wore to “D’Scene,” the hot spot in Philly circa 1969 when I started at SMS. Of course, I have had to drill many more holes in it to let it out as I grew & prospered…

• To really set the stage, I then showed them some of dance steps we did at D’Scene way back then – amazing my tired old bones could still do those tricky steps, although probably with a little less gusto & flair than when I was in my peak in my twenties. I did win a dance contest back then, and didn’t do too bad with the hot chicks in Phila…

A Hairy Subject• Lastly I donned a thick curly

wig to cover my grey temples, and finally looked just like I did when Jim Macaleer interviewed me in King Of Prussia – I can never figure out why he ever hired me (nor I suspect can he…)

• In case you think I’m exaggerating our hirsute appearance back then, the picture on the left was taken in 1973 at our apartment near King of Prussia when I donned one of the early 3-piece business suits that swept IBM’s “white shirt & blue tie” uniform off the stage at SMS. The beard didn’t last as long quite as the suit did!

How Fears Can Fade away…• It’s funny how the absolute terror I first felt at the thought of

standing in front of 6,000 people evaporated almost instantly with their first laughter, and as I preceded into the content that I knew so well: 6K or 6, once you get going, it’s a moot point…

HIS-tory Histrionics• Just like we “green IDs” at SMS way back then, Epic hires mostly

bright, young folks and teaches them the “Epic” way. So the audience was pretty young – an average age of about 30. I then proceeded to regale them with tales from the HIS-tory crypt that occurred decades before many of them were even born, like:– Lockheed’s “MIS” pioneering CPOE & EMRs way back in 1967– Mike Mulhalls’ IBM “HIS” project introducing scribes in 1968– NadaCom’s “REACH” EMR system started in the late 1960s– Walt Huff’s “CRASH” system from 1963, and “SHIS” from 1970– Malcolm Gelser’s “PHAMIS” EMR system started in 1975– SMS’ “Unifile” pioneering data base system from the mid 70s– NCR’s PNUT bedside patient monitoring system from 1984– CliniCom’s hand-held, bedside BMV system from 1985…

Attentive Audience• To their credit, the youngsters

seemed to stay awake and paid attention – maybe our younger years really are our best years, and our minds are far less open to new info as we age?

• They enjoyed Epic-related stories the most, for example, how Neal Pappalardo was one of Judy’s mentors when she first started “Human Services Computing” in 1979, and out of respect for him, she only sold to large hospitals, AMCs and IDNs.

Surprise During Q & A Session• After an hour of these tales from HIS-tory, a Q&A session started

and I was stumped by a question raised by an “EPIC-curean:”– “This review of the past was very informative, thank you, but

tell us, what do you see for the future of HIS systems?”• Wow, I was stumped: after giving this session to ≈300 CIOs at

HIMSS, the IT staff of a large hospital and dozens of vendor reps at a sales kickoff meeting, let alone all these 122 episodes on HIS-talk with hundreds of resulting emails, no one ever looked forward. I actually had to stop and think for a minute (a rare event for those who know me…). Best I could come up with were some platitudes and generalities – I really had never thought about it myself. Maybe that’s the best point to leave a HIS-tory series with – where is all of this marvelous technology taking us? What will the HIS industry & systems look like in 5 or 10 years??

Gracious Hosts• Many of you will recognize Judy

Faulkner, but her President, Carl Dvorak, on the right deserves recognition too as not only a super-bright techie ( he showed me things PowerPoint can do that I hadn’t known about for 30 years!), but as a very pleasant and charming person to boot!

• They both joined us for dinner where we had a fascinating conversation comparing answers about the future of HIS systems: I wish I had it tape-recorded it to see how our prognostications will have fared by 2024…

Final Episodes• So thanks to Judy’s team at Epic, I’m gonna add a few last

episodes on the “take-aways” from HIS-tory: just what is it that all these stories about the roots of HIS systems tell a CIO today?

• Starting with tactical issues that hospitals face today like:– How long to stay with your “legacy” HIS, versus taking the

plunge with a modern but relatively untested replacement?– Am I safer with a larger vendor firm than with a start-up?– Who can you trust to give advice when planning/selecting?– Are the rewards worth the risks when being a pilot site?

• Strategic questions over 5-10 years are tougher, so I welcome thoughts from readers: I’ll give you all due credit (or blame!).

• And if you’d like to have my HIS-tory presentation (and costume) at your next staff meeting or regional HIMSS session, call or write– Vince Ciotti at: 505.466.4958 or vciott@hispros.com