iPad Causes Flashback – My Early Days In Tech And Medical Information Systems

by Randy Murray on May 4, 2010

In late 1985 I was hired by AT&T Technical Training Services fresh out of grad school (and with my freshly minted MFA in playwrighting) and assigned to a project at Bell Labs. I took a couple of quick UNIX courses and showed up at the massive facility out on Columbus’s East Broad Street and joined the team that was developing a revolutionary medical information system.

What? You’ve never heard of AT&T’s medical information systems? There are several good reasons for it.  Perhaps the biggest obstacle was that it was far too early and the laws at the time REQUIRED paper records. We did get it up and running in a few big hospitals and clinics, but it never lived up to its potential.

Using the iPad for the past couple of weeks has brought it all back to me. One of the big selling features of the AT&T system was something they called the “Bed Side Monitor”, a touch screen device that would allow healthcare workers to see all of the patient’s records, order medications, check lab results, and generally replace paper all around. The records would be stored on servers (AT&T 3B2s, to be exact), and available throughout the hospital, clinic, and even in enabled doctors’ offices. The presentation video was impressive.

The prototype of the Bed Side Monitor was very nifty by mid 1980’s standards. It was custom designed in gray plastic and shaped in a modern hockey stick fashion so it could rest over one arm and be controlled by touch. But the prototypes were pure design fiction. The technology at the time meant that they had to have a full PC bolted to the wall and a long cable tethering the monitor to it.  By the time we had functioning units, we were calling them “Bed SIZED Monitors”.

The prototype also didn’t account for the heat that the monitor generated and the first production units actually melted. Being on the documentation and training side, we jokingly classified this as a feature, saying the Bed Side Monitor would “conform to the shape of your arm”.  The heat problem was mitigated by drilling multiple holes in the backs of the units.

The system did have many terrific features. One was a text system and medical dictionary called “Pick From Thousands” that allowed a physician to start typing in a field and as they typed the system would present them with a narrowing list of matching medical and diagnostic terms. This may seem familiar to Google searchers today, but it was innovative at the time. The system’s reporting feature was also first class. A physician could specify high and low ranges for every possible test result and the system would automatically notify them if a patient’s results were out of range. That way a physician didn’t have to examine each record, but could know instantly if there were any problems.

I left the project in 1987 and it eventually folded (not because I left, I assume). It was a terrific introduction to the software and hardware business. It also showed me the value of human interface design, strong documentation and training, and professional software development, including code reviews (and these guys were primarily PhDs). And I became an Internet user. That’s right: I’ve been on the net longer than some of you reading this have been alive.

The iPad is what the designers at AT&T had wanted, but couldn’t get to with the tech available at the time. I’m already seeing hospitals and doctors buying them and I expect to see a real advance in online medical records and information systems. I’m not suggesting that the iPad will be the only device used in the health care industry, but simply that it is the first device that really achieves what we dreamed of back at Bell Labs. It is not a clunky, reconfigured PC - those have been tried and rejected over the years. The iPad and the devices that come after will let the hardware disappear and the user focus on what’s important: the patient and the patient’s information.

It only took twenty-five years longer than we thought.

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{ 6 comments… read them below or add one }

1 Hal Brown May 4, 2010 at 8:56 am

I worked for AT&T, but didn’t know about the medical information systems. Remember the Itron? In the mid-eighties I had my first email account on the AT&T UNIX system. The Itron had a three in screen, and was the smallest computer I have ever used. All command line of course.

After the breakup in 1983, AT&T became a lean, mean company. I wonder how many companies they bought, chewed up and destroyed over the years.

The irony is, AT&T is almost back to where it was pre-monopoly.

Great post Randy. You just sent me down memory lane.

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2 Randy Murray May 4, 2010 at 9:05 am

I enjoyed my time at Bell Labs. My first computer there was an AT&T branded PC. At the time they were the #2 manufacturer and seller of PCs, but the reason was they were buying most of them for internal use!

I also worked with an Sun 360 workstation, which gave me my first taste of working with a GUI. For my next job, I immediately bought a Mac SE and never looked back.

You mention command line. All of the documentation and training we developed there we wrote using VI. Loads of fun.

Randy

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3 Hal Brown May 4, 2010 at 9:18 am

I believe VI was invented by a Sadomasochist who has for years now had great pleasure watching others use it. :)

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4 Mari May 4, 2010 at 9:33 am

Some fascinating revelations here, Randy, about innovation and timing. I’d be interested to hear about something you glanced over: why AT&T Technical Training Services hired an MFA in playwriting? :0)

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5 Randy Murray May 4, 2010 at 3:42 pm

I got the job because one thing an education in the theater teaches you: how to audition. I shaped my interview for that job around writing, skills at listening, probing, and organizing (directing). I also knew how to relax, conform my body language to the interviewers, and ask probing questions. I had also been a long time technology and science fan, although becoming a gadget hound was still in it’s early stages.

And a friend’s mother worked there and was able to get me the interview. Once I had my foot in the door it was all I needed to turn it into a career.

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6 Mari May 5, 2010 at 12:51 am

A likely story. Kidding. Your explanation sounds like the skeleton of an intriguing play…something relevant about the many careers we’re projected to have within a lifetime, made more possible based on educational background.

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