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154-551: MUMPS technology has since expanded as the predominant database for health information systems and electronic health records in the United States. MUMPS-based information systems, such as Epic Systems ', provide health information services for over 78% of patients across the U.S. A unique feature of the MUMPS technology is its integrated database language , allowing direct, high-speed read-write access to permanent disk storage. MUMPS

308-426: A 19-inch rack . The backplanes allowed 25 modules in a single 5-1/4 inch section of rack, and allowed the high densities needed to build a computer. The original laboratory and system module lines were offered in 500 kilocycle, 5 megacycle and 10 megacycle versions. In all cases, the supply voltages were -15 and +10 volts, with logic levels of -3 volts (passive pull-down) and 0 volts (active pull-up). DEC used

462-405: A DEC PDP-7 . Octo Barnett and Neil Pappalardo obtained a backward compatible PDP-9 , and began using MUMPS in the admissions cycle and laboratory test reporting. MUMPS was then an interpreted language , yet even then, incorporated a hierarchical database file system to standardize interaction with the data and abstract disk operations so they were only done by the MUMPS language itself. MUMPS

616-593: A VAX CPU was the VAX-11/780 , announced in October 1977, which DEC referred to as a superminicomputer . Although it was not the first 32-bit minicomputer, the VAX-11/780's combination of features, price, and marketing almost immediately propelled it to a leadership position in the market after it was released in 1978. VAX systems were so successful that in 1983, DEC canceled its Jupiter project , which had been intended to build

770-661: A combination of a convolutional neural network and a heterogenous graph model. When a health facility has documented their workflow and chosen their software solution they must then consider the hardware and supporting device infrastructure for the end users. Staff and patients will need to engage with various devices throughout a patient's stay and charting workflow. Computers, laptops, all-in-one computers, tablets, mouse, keyboards and monitors are all hardware devices that may be utilized. Other considerations will include supporting work surfaces and equipment, wall desks or articulating arms for end users to work on. Another important factor

924-523: A comprehensive technology system and may involve errors of either commission or omission. These unintended adverse events typically stem from human-machine interfaces or organization/system design." The Joint Commission cites as an example the United States Pharmacopeia MEDMARX database where of 176,409 medication error records for 2006, approximately 25 percent (43,372) involved some aspect of computer technology as at least one cause of

1078-518: A delimited string (e.g., comma-separated values ) as an array. Early MUMPS programmers would often store a structure of related information as a delimited string, parsing it after it was read in; this saved disk access time and offered considerable speed advantages on some hardware. MUMPS has no data types. Numbers can be treated as strings of digits, or strings can be treated as numbers by numeric operators ( coerced , in MUMPS terminology). Coercion can have some odd side effects, however. For example, when

1232-410: A few years until Unix was developed. The lack of memory management hardware also meant that all multi-processing was fraught with the possibility that a memory pointer could change some other process. MUMPS programs do not have a standard way to refer to memory directly at all, in contrast to C language , so since the multitasking was enforced by the language, not by any program written in the language it

1386-500: A large pool, and uses this information to assist with the creation of "new treatments or innovation in healthcare delivery" which overall improves the goals in healthcare. Combining multiple types of clinical data from the system's health records has helped clinicians identify and stratify chronically ill patients. EHR can improve quality care by using the data and analytics to prevent hospitalizations among high-risk patients. EHR systems are designed to store data accurately and to capture

1540-447: A machine name in a variable (as in SET ^|"DENVER"|A(1000)="Foo" ), which can allow you to access data on remote machines. Some aspects of MUMPS syntax differ strongly from that of more modern languages, which can cause confusion, although those aspects vary between different versions of the language. On some versions, whitespace is not allowed within expressions, as it ends a statement: 2 + 3

1694-409: A much quicker rate. Natural language processing is increasingly used to search EMRs, especially through searching and analyzing notes and text that would otherwise be inaccessible for study when seeking to improve care. One study found that several machine learning methods could be used to predict the rate of a patient's mortality with moderate success, with the most successful approach including using

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1848-581: A nested child node of ^Car . In MUMPS terms, "Color" is the 2nd subscript of the variable ^Car (both the names of the child-nodes and the child-nodes themselves are likewise called subscripts). Hierarchical variables are similar to objects with properties in many object-oriented languages. Additionally, the MUMPS language design requires that all subscripts of variables are automatically kept in sorted order. Numeric subscripts (including floating-point numbers) are stored from lowest to highest. All non-numeric subscripts are stored in alphabetical order following

2002-576: A new virtual memory system, and would also improve performance by processing twice as much data at a time. The system would, however, maintain compatibility with the PDP-11, by operating in a second mode that sent its 16-bit words into the 32-bit internals, while mapping the PDP-11's 16-bit memory space into the larger virtual 32-bit space. The result was the VAX architecture, where VAX stands for Virtual Address eXtension (from 16 to 32 bits). The first computer to use

2156-476: A new device to be added easily, generally only requiring plugging a hardware interface board into the backplane and possibly adding a jumper to the wire wrapped backplane, and then installing software that read and wrote to the mapped memory to control it. The relative ease of interfacing spawned a huge market of third party add-ons for the PDP-11, which made the machine even more useful. The combination of architectural innovations proved superior to competitors and

2310-429: A page of code to see its function but would have to analyze it line by line. Database interaction is transparently built into the language. The MUMPS language provides a hierarchical database made up of persistent sparse arrays , which is implicitly "opened" for every MUMPS application. All variable names prefixed with the caret character ( ^ ) use permanent (instead of RAM) storage, will maintain their values after

2464-787: A patient's record is not only possible through a workstation but, depending on the type of system and health care settings, may also be possible through mobile devices that are handwriting capable, tablets and smartphones. Electronic Medical Records may include access to Personal Health Records (PHR) which makes individual notes from an EMR readily visible and accessible for consumers. Some EMR systems automatically monitor clinical events, by analyzing patient data from an electronic health record to predict, detect and potentially prevent adverse events. This can include discharge/transfer orders, pharmacy orders, radiology results, laboratory results and any other data from ancillary services or provider notes. This type of event monitoring has been implemented using

2618-482: A person's status from stable to unstable very quickly. With paper documentation it is very easy to not properly document the administration of medication, the time given, or errors such as giving the "wrong drug, dose, form, or not checking for allergies" and could affect the patient negatively. It has been reported that these errors have been reduced by "55-83%" because records are now online and require certain steps to avoid these errors. Electronic records may help with

2772-547: A physician performs tests in the office, it might reduce his or her income. Doubts have been raised about cost saving from EHRs by researchers at Harvard University , the Wharton School of the University of Pennsylvania , Stanford University , and others. In 2022 the chief executive of Guy's and St Thomas' NHS Foundation Trust , one of the biggest NHS organisations, said that the £450 million cost over 15 years to install

2926-462: A profit at the end of its first year. The original Laboratory Modules were soon supplemented with the "Digital System Module " line, which were identical internally but packaged differently. The Systems Modules were designed with all of the connections at the back of the module using 22-pin Amphenol connectors, and were attached to each other by plugging them into a backplane that could be mounted in

3080-444: A rapid pace. According to a 2012 survey by Physicians Practice , 62.6 percent of respondents (1,369 physicians, practice managers, and other healthcare providers) say they use mobile devices in the performance of their job. Mobile devices are increasingly able to sync up with electronic health record systems thus allowing physicians to access patient records from remote locations. Most devices are extensions of desk-top EHR systems, using

3234-459: A relative decrease in time by 65% has been recorded (from 130 to 46 hours). The Healthcare Information and Management Systems Society , a very large U.S. healthcare IT industry trade group, observed in 2009 that EHR adoption rates "have been slower than expected in the United States, especially in comparison to other industry sectors and other developed countries. A key reason, aside from initial costs and lost productivity during EMR implementation,

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3388-462: A result of initial demonstration of capabilities, Dr. Barnett's proposal to NIH in 1967 for renewal of the hospital computer project grant took the bold step of proposing that the system be built in MUMPS going forward, rather than relying on the BBN approach. The project was funded, and serious implementation of the system in MUMPS began. The original MUMPS system was, like Unix a few years later, built on

3542-556: A result, many have conducted studies like the one discussed in the Journal of the American Medical Informatics Association , "The Extent And Importance of Unintended Consequences Related To Computerized Provider Order Entry," which seeks to understand the degree and significance of unplanned adverse consequences related to computerized physician order entry and understand how to interpret adverse events and understand

3696-438: A selection of System Building Blocks to implement a small 12-bit machine, and attached it to a variety of analog-to-digital (A to D) input/output (I/O) devices that made it easy to interface with various analog lab equipment. The LINC proved to attract intense interest in the scientific community, and has since been referred to as the first real minicomputer , a machine that was small and inexpensive enough to be dedicated to

3850-480: A self-sustaining business, the company would be free to use them to develop a complete computer in their Phase II. The newly christened "Digital Equipment Corporation" received $ 70,000 from AR&D for a 70% share of the company, and began operations in a Civil War -era textile mill in Maynard, Massachusetts , where plenty of inexpensive manufacturing space was available. In early 1958, DEC shipped its first products,

4004-504: A separate input/output processor for further performance gains. Over 400 PDP-15's were ordered in the first eight months of production, and production eventually amounted to 790 examples in 12 basic models. However, by this time other machines in DEC's lineup could fill the same niche at even lower price points, and the PDP-15 would be the last of the 18-bit series. In 1962, Lincoln Laboratory used

4158-452: A single job, thus they are called "locals". Both "globals" and "locals" can have child nodes (called subscripts in MUMPS terminology). Subscripts are not limited to numerals—any ASCII character or group of characters can be a subscript identifier. While this is not uncommon for modern languages such as Perl or JavaScript, it was a highly unusual feature in the late 1970s. This capability was not universally implemented in MUMPS systems before

4312-481: A single large mainframe case, with a hexagonal control panel containing switches and lights mounted to lie at table-top height at one end of the mainframe. Above the control panel was the system's standard input/output solution, a punched tape reader and writer. Most systems were purchased with two peripherals , the Type 30 vector graphics display, and a Soroban Engineering modified IBM Model B Electric typewriter that

4466-549: A single line of program code could express, with few characters, an idea for which other programming languages could require 5 to 10 times as many characters. Abbreviation was a common feature of languages designed in this period (e.g., FOCAL-69 , early BASICs such as Tiny BASIC , etc.). An unfortunate side effect of this, coupled with the early need to write minimalist code, was that MUMPS programmers routinely did not comment code and used extensive abbreviations. This meant that even an expert MUMPS programmer could not just skim through

4620-643: A single task even in a small lab. Seeing the success of the LINC, in 1963 DEC took the basic logic design but stripped away the extensive A to D systems to produce the PDP-5 . The new machine, the first outside the PDP-1 mould, was introduced at WESTCON on August 11, 1963. A 1964 ad expressed the main advantage of the PDP-5, "Now you can own the PDP-5 computer for what a core memory alone used to cost: $ 27,000". 116 PDP-5s were produced until

4774-440: A standard was complete by 1974, and was approved, on September 15, 1977, as ANSI standard, X11.1-1977. At about the same time DEC launched DSM-11 (Digital Standard MUMPS) for the PDP-11. This quickly dominated the market, and became the reference implementation of the time. Also, InterSystems sold ISM-11 for the PDP-11 (which was identical to DSM-11). During the early 1980s several vendors brought MUMPS-based platforms that met

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4928-506: A string is coerced, the parser turns as much of the string (starting from the left) into a number as it can, then discards the rest. Thus the statement IF 20<"30 DUCKS" is evaluated as TRUE in MUMPS. Other features of the language are intended to help MUMPS applications interact with each other in a multi-user environment. Database locks, process identifiers, and atomicity of database update transactions are all required of standard MUMPS implementations. In contrast to languages in

5082-634: A successor to the PDP-10 mainframe, and instead focused on promoting the VAX as the single computer architecture for the company. Supporting the VAX's success was the VT52 , one of the most successful smart terminals . Building on earlier less successful models, the VT05 and VT50 , the VT52 was the first terminal that did everything one might want in a single inexpensive chassis. The VT52

5236-512: A trade journal suggests that since anyone using an EMR can view the patient's full chart, it cuts down on guessing histories, seeing multiple specialists, smooths transitions between care settings, and may allow better care in emergency situations. EHRs may also improve prevention by providing doctors and patients better access to test results, identifying missing patient information, and offering evidence-based recommendations for preventive services. The steep price and provider uncertainty regarding

5390-812: A trademark with the USPTO on November 28, 1971, and renewed it on November 16, 1992, but let it expire on August 30, 2003. ‹The template Manual is being considered for merging .›   MUMPS is a language intended for and designed to build database applications. Secondary language features were included to help programmers make applications using minimal computing resources. The original implementations were interpreted , though modern implementations may be fully or partially compiled . Individual "programs" run in memory "partitions" . Early MUMPS memory partitions were limited to 2048 bytes so aggressive abbreviation greatly aided multi-programming on severely resource limited hardware, because more than one MUMPS job could fit into

5544-440: A turn to use the stripped-down TX-0, while largely ignoring a faster IBM machine that was also available. The two decided that the draw of interactive computing was so strong that they felt there was a market for a small machine dedicated to this role, essentially a commercialized TX-0. They could sell this to users where the graphical output or real-time operation would be more important than outright performance. Additionally, as

5698-418: A variety of software to communicate and access files remotely. The advantages of instant access to patient records at any time and any place are clear, but bring a host of security concerns. As mobile systems become more prevalent, practices will need comprehensive policies that govern security measures and patient privacy regulations. Other advanced computational techniques have allowed EHRs to be evaluated at

5852-408: Is a way of helping people understand their own health condition and involving them actively in its management. Challenges with sharing the electronic health record with patients includes a risk of increased confusion or anxiety if a person does not understand or cannot contextualize the testing results. In addition, many EHRs are not designed for people of all educational levels and do not consider

6006-434: Is an electronic application for recording personal medical data that the individual patient controls and may make available to health providers. While there is still a considerable amount of debate around the superiority of electronic health records over paper records, the research literature paints a more realistic picture of the benefits and downsides. The increased transparency, portability, and accessibility acquired by

6160-527: Is an error, and must be written 2+3 . All operators have the same precedence and are left-associative ( 2+3*10 evaluates to 50). The operators for "less than or equal to" and "greater than or equal to" are '> and '< (that is, the Boolean negation operator ' plus a strict comparison operator in the opposite direction), although some versions allow the use of the more standard <= and >= respectively. Periods ( . ) are used to indent

6314-478: Is cost efficient. Due to the digital information being searchable and in a single file, EMRs (electronic medical records) are more effective when extracting medical data for the examination of possible trends and long term changes in a patient. Population-based studies of medical records may also be facilitated by the widespread adoption of EHRs and EMRs. The terms EHR, electronic patient record (EPR) and EMR have often been used interchangeably, but differences between

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6468-592: Is difficult to remove data from its context. Providing patients with information is central to patient-centered health care and this has been shown to have some positive effects on health outcomes. Providing patients with access to their health records including medical histories and test results via an electronic health record is a legal right in some parts of the world. There is some evidence that patient access may help outcomes. Sharing their electronic health records with people who have type 2 diabetes may help these people to reduce their blood sugar levels . It

6622-630: Is how all these devices will be physically secured and how they will be charged that staff can always utilize the devices for EHR charting when needed. The success of eHealth interventions is largely dependent on the ability of the adopter to fully understand workflow and anticipate potential clinical processes prior to implementations. Failure to do so can create costly and time-consuming interruptions to service delivery. Per empirical research in social informatics , information and communications technology (ICT) use can lead to both intended and unintended consequences . A 2008 Sentinel Event Alert from

6776-595: Is lack of efficiency and usability of EMRs currently available." The U.S. National Institute of Standards and Technology of the Department of Commerce studied usability in 2011 and lists a number of specific issues that have been reported by health care workers. The U.S. military's EHR, AHLTA , was reported to have significant usability issues. Furthermore, studies such as the one conducted in BMC Medical Informatics and Decision Making, also showed that although

6930-603: Is maintained even if data breaches occur. There are concerns about the efficacy of some currently applied pseudonymization and data protection techniques, including the applied encryption. Documentation burden : While such records could enable avoiding duplication of work via records-sharing, documentation burdens for medical facility personnel can be a further issue with EHRs. This burden could be reduced via voice recognition , optical character recognition , other technologies, involvement of physicians in changes to software, and other means which could possibly reduce

7084-656: Is most famous as the machine for which the Unix operating system was originally written. Unix ran only on DEC systems until the Interdata 8/32 . A more dramatic upgrade to the PDP-1 series was introduced in August 1966, the PDP-9 . The PDP-9 was instruction-compatible with the PDP-4 and −7, but ran about twice as fast as the −7 and was intended to be used in larger deployments. At only $ 19,900 in 1968,

7238-512: Is no reason for any individual to have a computer in his home." Unsurprisingly, DEC did not put much effort into the microcomputer area in the early days of the market. In 1977, the Heathkit H11 was announced; a PDP-11 in kit form. At the beginning of the 1980s, DEC built the VT180 (codenamed "Robin"), which was a VT100 terminal with an added Z80 -based microcomputer running CP/M , but this product

7392-428: Is possible for an EHR to increase physician productivity by providing a fast and intuitive interface for viewing and understanding patient clinical data and minimizing the number of clinically irrelevant questions, but that is almost never the case. The other way to mitigate the detriment to physician productivity is to hire scribes to work alongside medical practitioners, which is almost never financially viable. As

7546-931: Is the systematized collection of patient and population electronically stored health information in a digital format. These records can be shared across different health care settings. Records are shared through network-connected, enterprise-wide information systems or other information networks and exchanges. EHRs may include a range of data, including demographics , medical history, medication and allergies , immunization status, laboratory test results, radiology images, vital signs , personal statistics like age and weight, and billing information. For several decades, electronic health records (EHRs) have been touted as key to increasing of quality care. Electronic health records are used for other reasons than charting for patients; today, providers are using data from patient records to improve quality outcomes through their care management programs. EHR combines all patients demographics into

7700-556: The Epic Systems electronic patient record across its six hospitals, which will reduce more than 100 different IT systems down to just a handful, was "chicken feed" when compared to the NHS's overall budget. The implementation of EMR can potentially decrease identification time of patients upon hospital admission. A research from the Annals of Internal Medicine showed that since the adoption of EMR

7854-566: The InterSystems Caché database to support the Gaia mission. This mission aims to map the Milky Way with unprecedented precision. InterSystems is in the process of phasing out Caché in favor of Iris. Other current implementations include: Electronic health record An electronic health record ( EHR ) also known as an electronic medical record (EMR) or personal health record (PHR)

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8008-704: The SAGE system for the US Air Force , which used large screens and light guns to allow operators to interact with radar data stored in the computer. When the Air Force project wound down, the Lab turned their attention to an effort to build a version of the Whirlwind using transistors in place of vacuum tubes . In order to test their new circuitry, they first built a small 18-bit machine known as TX-0 , which first ran in 1956. When

8162-513: The minicomputer market starting in the early 1960s. The company produced a series of machines known as the PDP line, with the PDP-8 and PDP-11 being among the most successful minis in history. Their success was only surpassed by another DEC product, the late-1970s VAX "supermini" systems that were designed to replace the PDP-11. Although a number of competitors had successfully competed with Digital through

8316-399: The trademark Digital , was a major American company in the computer industry from the 1960s to the 1990s. The company was co-founded by Ken Olsen and Harlan Anderson in 1957. Olsen was president until he was forced to resign in 1992, after the company had gone into precipitous decline. The company produced many different product lines over its history. It is best known for the work in

8470-802: The "11" architecture was soon the industry leader, propelling DEC back to a strong market position. The design was later expanded to allow paged physical memory and memory protection features, useful for multitasking and time-sharing . Some models supported separate instruction and data spaces for an effective virtual address size of 128 KB within a physical address size of up to 4 MB. Smaller PDP-11s, implemented as single-chip CPUs, continued to be produced until 1996, by which time over 600,000 had been sold. The PDP-11 supported several operating systems, including Bell Labs ' new Unix operating system as well as DEC's DOS-11 , RSX-11 , IAS, RT-11 , DSM-11, and RSTS/E . Many early PDP-11 applications were developed using standalone paper-tape utilities. DOS-11

8624-539: The "Digital Laboratory Module" line. The Modules consisted of a number of individual electronic components and germanium transistors mounted to a circuit board , the actual circuits being based on those from the TX-2. The Laboratory Modules were packaged in an extruded aluminum housing, intended to sit on an engineer's workbench, although a rack-mount bay was sold that held nine laboratory modules. They were then connected together using banana plug patch cords inserted at

8778-699: The "absence of mandatory reporting enforcement of H-IT safety issues limits the numbers of medical device reports (MDRs) and impedes a more comprehensive understanding of the actual problems and implications." A 2010 Board Position Paper by the American Medical Informatics Association (AMIA) contains recommendations on EHR-related patient safety, transparency, ethics education for purchasers and users, adoption of best practices, and re-examination of regulation of electronic health applications. Beyond concrete issues such as conflicts of interest and privacy concerns, questions have been raised about

8932-477: The "argument" from the next command. Newlines are also significant; an IF , ELSE or FOR command processes (or skips) everything else till the end-of-line. To make those statements control multiple lines, you must use the DO command to create a code block. A simple "Hello, World!" program in MUMPS might be: and would be run with the command do ^hello after it has been saved to disk. For direct execution of

9086-439: The "sandbox" for a rising generation of engineers and computer scientists. Large numbers of PDP-11/70s were deployed in telecommunications and industrial control applications. AT&T Corporation became DEC's largest customer. RT-11 provided a practical real-time operating system in minimal memory, allowing the PDP-11 to continue DEC's critical role as a computer supplier for embedded systems . Historically, RT-11 also served as

9240-433: The 1950s, wiped out when new technical developments rendered their platforms obsolete, and even large companies like RCA and General Electric were failing to make a profit in the market. The only serious expression of interest came from Georges Doriot and his American Research and Development Corporation (AR&D). Worried that a new computer company would find it difficult to arrange further financing, Doriot suggested

9394-399: The 1970s, the VAX cemented the company's place as a leading vendor in the computer space. As microcomputers improved in the late 1980s, especially with the introduction of RISC -based workstation machines, the performance niche of the minicomputer was rapidly eroded. By the early 1990s, the company was in turmoil as their mini sales collapsed and their attempts to address this by entering

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9548-562: The 1980s, culminating in the NVAX microprocessor implementation and VAX 7000/10000 series in the early 1990s. When a DEC research group demonstrated two prototype microcomputers in 1974—before the debut of the MITS Altair —Olsen chose to not proceed with the project. The company similarly rejected another personal computer proposal in 1977. At the time these systems were of limited utility, and Olsen famously derided them in 1977, stating "There

9702-402: The 1984 ANSI standard, as only canonically numeric subscripts were required by the standard to be allowed. Thus, the variable named 'Car' can have subscripts "Door", "Steering Wheel", and "Engine", each of which can contain a value and have subscripts of their own. The variable ^Car("Door") could have a nested variable subscript of "Color" for example. Thus, you could say to modify

9856-477: The ANSI standard to market. The most significant were: This period also saw considerable MDC activity. The second revision of the ANSI standard for MUMPS (X11.1-1984) was approved on November 15, 1984. The chief executive of InterSystems disliked the name MUMPS and felt that it represented a serious marketing obstacle. Thus, favoring M to some extent became identified as alignment with InterSystems. The 1990 ANSI Standard

10010-853: The Ash Institute of the John F. Kennedy School of Government at Harvard University for its extension of DHCP into the Veterans Health Information Systems and Technology Architecture ( VistA ). Nearly the entire VA hospital system in the United States, the Indian Health Service , and major parts of the Department of Defense CHCS hospital system use MUMPS databases for clinical data tracking. Other healthcare IT companies using MUMPS include: Many reference laboratories, such as DASA, Quest Diagnostics , and Dynacare, use MUMPS software written by or based on Antrim Corporation code. Antrim

10164-406: The C or Wirth traditions, some space characters between MUMPS statements are significant. A single space separates a command from its argument, and a space, or newline, separates each argument from the next MUMPS token. Commands which take no arguments (e.g., ELSE ) require two following spaces. The concept is that one space separates the command from the (nonexistent) argument, the next separates

10318-447: The CPU which allowed one to easily see the logic modules plugged into the wire-wrapped backplane of the CPU. Sold standard with 4 kWords of 12-bit core memory and a Teletype Model 33 ASR for basic input/output, the machine listed for only $ 18,000. The PDP-8 is referred to as the first real minicomputer because of its sub-$ 25,000 price. Sales were, unsurprisingly, very strong, and helped by

10472-615: The EHR as a tool supporting particular work. Several possible advantages to EHRs over paper records have been proposed, but there is debate about the degree to which these are achieved in practice. Several studies call into question whether EHRs improve the quality of care. One 2011 study in diabetes care, published in the New England Journal of Medicine , found evidence that practices with EHR provided better quality care. EMRs may eventually help improve care coordination. An article in

10626-469: The EHR exist. The health information systems literature has seen the EHR as a container holding information about the patient, and a tool for aggregating clinical data for secondary uses (billing, audit, etc.). However, other research traditions see the EHR as a contextualised artifact within a socio-technical system. For example, actor-network theory would see the EHR as an actant in a network, and research in computer supported cooperative work (CSCW) sees

10780-476: The Louisiana Public health information exchange linking statewide public health with electronic medical records. This system alerted medical providers when a patient with HIV/AIDS had not received care in over twelve months. This system greatly reduced the number of missed critical opportunities. Within a meta-narrative systematic review of research in the field, various different philosophical approaches to

10934-508: The PC, but was more expensive than, and completely incompatible with IBM PC hardware and software, offering far fewer options for customizing a system. Unlike CP/M and DOS microcomputers, every copy of every program for the Professional had to be provided with a unique key for the particular machine and CPU for which it was bought. At that time this was mainstream policy, because most computer software

11088-612: The PDP-8, all in software. Although not a huge seller, 142 LINC-8s were sold starting at $ 38,500. Like the original LINC to PDP-5 evolution, the LINC-8 was then modified into the single-processor PDP-12 , adding another 1000 machines to the 12-bit family. Newer circuitry designs led to the PDP-8/I and PDP-8/L in 1968. In 1975, one year after an agreement between DEC and Intersil , the Intersil 6100 chip

11242-455: The PDP-9 was a big seller, eventually selling 445 machines, more than all of the earlier models combined. Even while the PDP-9 was being introduced, its replacement was being designed, and was introduced as 1969's PDP-15 , which re-implemented the PDP-9 using integrated circuits in place of modules. Much faster than the PDP-9 even in basic form, the PDP-15 also included a floating point unit and

11396-688: The Professional was a superior machine, running inferior software. In addition, a new user would have to learn an awkward, slow, and inflexible menu-based user interface which appeared to be radically different from PC DOS or CP/M , which were more commonly used on the 8080- and 8088-based microcomputers of the time. A second offering, the DECmate II was the latest version of the PDP-8-based word processors, but not really suited to general computing, nor competitive with Wang Laboratories ' popular word processing equipment. The most popular early DEC microcomputer

11550-506: The Rainbow, and in its standard form was the first widely marketed diskless workstation . In 1984, DEC launched its first 10 Mbit/s Ethernet . Ethernet allowed scalable networking, and VAXcluster allowed scalable computing. Combined with DECnet and Ethernet-based terminal servers ( LAT ), DEC had produced a networked storage architecture which allowed them to compete directly with IBM. Ethernet replaced Token Ring , and went on to become

11704-485: The System Modules to build their "Memory Test" machine for testing core memory systems, selling about 50 of these pre-packaged units over the next eight years. The PDP-1 and LINC computers were also built using System Modules (see below). Modules were part of DEC's product line into the 1970s, although they went through several evolutions during this time as technology changed. The same circuits were then packaged as

11858-465: The TX-0 successfully proved the basic concepts, attention turned to a much larger system, the 36-bit TX-2 with a then-enormous 64 kWords of core memory . Core was so expensive that parts of TX-0's memory were stripped for the TX-2, and what remained of the TX-0 was then given to MIT on permanent loan. At MIT, Ken Olsen and Harlan Anderson noticed something odd: students would line up for hours to get

12012-499: The U.S. Joint Commission , the organization that accredits American hospitals to provide healthcare services, states, 'As health information technology (HIT) and 'converging technologies'—the interrelationship between medical devices and HIT—are increasingly adopted by health care organizations, users must be mindful of the safety risks and preventable adverse events that these implementations can create or perpetuate. Technology-related adverse events can be associated with all components of

12166-731: The United States and the United Kingdom have introduced the use of EMR systems. EMS Encounters in the United States are recorded using various platforms and vendors in compliance with the NEMSIS (National EMS Information System) standard. The benefits of electronic records in ambulances include: patient data sharing, injury/illness prevention, better training for paramedics, review of clinical standards, better research options for pre-hospital care and design of future treatment options, data based outcome improvement, and clinical decision support. Health Information Exchange Using an EMR to read and write

12320-759: The Veterans Affairs' patient Admission/Tracking/Discharge system, Decentralized Hospital Computer Program (DHCP) was the recipient of the Computerworld Smithsonian Award for best use of Information Technology in Medicine. In July 2006, the Department of Veterans Affairs (VA) / Veterans Health Administration (VHA) was the recipient of the Innovations in American Government Award presented by

12474-436: The ability to address more memory, often by extending the address format to 18 or 24-bits in machines were otherwise similar to their earlier 16-bit designs. In contrast, DEC decided to make a more radical departure. In 1976, they began the design of a machine whose entire architecture was expanded from the 16-bit PDP-11 to a new 32-bit basis. This would allow the addressing of very large memories, which were to be controlled by

12628-422: The ability to exchange records between different EMR systems were perfected ("interoperability" ), it would facilitate the coordination of health care delivery in nonaffiliated health care facilities. In addition, data from an electronic system can be used anonymously for statistical reporting in matters such as quality improvement, resource management, and public health communicable disease surveillance. However, it

12782-505: The adoption of "\" for pathnames in MS-DOS and Microsoft Windows as opposed to "/" in Unix . The evolution of the PDP-11 followed earlier systems, eventually including a single-user deskside personal computer form, the MicroPDP-11. In total, around 600,000 PDP-11s of all models were sold, and a wide variety of third-party peripheral vendors had also entered the computer product ecosystem. It

12936-575: The adoption of electronic medical records may increase the ease with which they can be accessed by healthcare professionals, but also can increase the amount of stolen information by unauthorized persons or unscrupulous users versus paper medical records, as acknowledged by the increased security requirements for electronic medical records included in the Health Information and Accessibility Act and by large-scale breaches in confidential records reported by EMR users. Concerns about security contribute to

13090-485: The application exits, and will be visible to (and modifiable by) other running applications. Variables using this shared and permanent storage are called Globals in MUMPS, because the scoping of these variables is "globally available" to all jobs on the system. The more recent and more common use of the name "global variables" in other languages is a more limited scoping of names, coming from the fact that unscoped variables are "globally" available to any programs running in

13244-508: The basis for the new design, although when they first viewed the proposal, management was not impressed and almost cancelled it. The result was the PDP-11 , released in 1970. It differed from earlier designs considerably. In particular, the new design did not include many of the addressing modes that were intended to make programs smaller in memory, a technique that was widely used on other DEC machines and CISC designs in general. This would mean

13398-447: The better-established vendors like IBM or Honeywell , in spite of its low cost around $ 300,000. Only 23 were sold, or 26 depending on the source, and unlike other models the low sales meant the PDP-6 was not improved with successor versions. However, the PDP-6 is historically important as the platform that introduced "Monitor", an early time-sharing operating system that would evolve into

13552-442: The caller manually creates a new stack level ( do ) and aliases each of the variables they wish to protect ( . new x,y ) before calling any child routines. By contrast, undeclared variables (variables created by using them, rather than declaration) are in scope for all routines running in the same process, and remain in scope until the program exits. Because MUMPS database references differ from internal variable references only in

13706-475: The caret prefix, it is dangerously easy to unintentionally edit the database, or even to delete a database "table". The US Department of Veterans Affairs (formerly the Veterans Administration) was one of the earliest major adopters of the MUMPS language. Their development work (and subsequent contributions to the free MUMPS application codebase) was an influence on many medical users worldwide. In 1995,

13860-405: The code a kind of "label" (any alphanumeric string) on the first position of the program line is needed to tell the mumps interpreter where to start execution. Since MUMPS allows commands to be strung together on the same line, and since commands can be abbreviated to a single letter, this routine could be made more compact: The ' ,! ' after the text generates a newline. This code would return to

14014-745: The company's first computer, the PDP-1 . In keeping with Doriot's instructions, the name was an initialism for " Programmable Data Processor ", leaving off the term "computer". As Gurley put it, "We aren't building computers, we're building 'Programmable Data Processors'." The prototype was first shown publicly at the Joint Computer Conference in Boston in December 1959. The first PDP-1 was delivered to Bolt, Beranek and Newman in November 1960, and formally accepted

14168-411: The compatible DECSYSTEM-20 , along with a TOPS-20 operating system that included virtual memory support. The Jupiter Project was supposed to continue the mainframe product line into the future by using gate arrays with an innovative Air Mover Cooling System, coupled with a built-in floating point processing engine called "FBOX". The design was intended for a top tier scientific computing niche, yet

14322-560: The council, was passed in 2016 to go into effect in 2018 to protect the processing of personal data, including that for purposes of health care, the General Data Protection Regulation . Threats to health care information can be categorized under three headings: These threats can either be internal, external, intentional and unintentional. Therefore, one will find health information systems professionals having these particular threats in mind when discussing ways to protect

14476-479: The critical performance measurement was based upon COBOL compilation which did not fully utilize the primary design features of Jupiter technology. When the Jupiter Project was cancelled in 1983, some of the engineers adapted aspects of the 36-bit design into a forthcoming 32-bit design, releasing the high-end VAX8600 in 1985. DEC's successful entry into the computer market took place during a fundamental shift in

14630-505: The documentation burden to below paper-based records documentation and low-level documentation. Theoretically, free software such as GNU Health and other open source health software could be used or modified for various purposes that use electronic medical records i.a. via securely sharing anonymized patient treatments, medical history and individual outcomes (including by common primary care physicians). Ambulance services in Australia,

14784-544: The early 1970s, there were many and varied implementations of MUMPS on a range of hardware platforms. Another noteworthy platform was Paul Stylos' DEC MUMPS-11 on the PDP-11, and MEDITECH 's MIIS . In the Fall of 1972, many MUMPS users attended a conference in Boston which standardized the then-fractured language, and created the MUMPS Users Group and MUMPS Development Committee (MDC) to do so. These efforts proved successful;

14938-400: The era was multitasking . Although time-sharing on mainframe computers was increasingly common in systems such as Multics , most mini-computers did not run parallel programs and threading was not available at all. Even on mainframes, the variant of batch processing where a program was run to completion was the most common implementation for an operating system of multi-programming. It was

15092-658: The error. The British National Health Service (NHS) reports specific examples of potential and actual EHR-caused unintended consequences in its 2009 document on the management of clinical risk relating to the deployment and use of health software. In a February 2010, an American Food and Drug Administration (FDA) memorandum noted that EHR unintended consequences include EHR-related medical errors from (1) errors of commission (EOC), (2) errors of omission or transmission (EOT), (3) errors in data analysis (EDA), and (4) incompatibility between multi-vendor software applications or systems (ISMA), examples were cited. The FDA also noted that

15246-468: The fact that several competitors had just entered the market with machines aimed directly at the PDP-5's market space, which the PDP-8 trounced. This gave the company two years of unrestricted leadership, and eventually 1450 "straight eight" machines were produced before it was replaced by newer implementations of the same basic design. DEC hit an even lower price-point with the PDP-8/S, the S for "serial". As

15400-475: The first "R" (red) series " Flip-Chip " modules. Later, other Flip-Chip module series provided additional speed, much higher logic density, and industrial I/O capabilities. DEC published extensive data about the modules in free catalogs that became very popular. With the company established and a successful product on the market, DEC turned its attention to the computer market once again as part of its planned "Phase II". In August 1959, Ben Gurley started design of

15554-487: The fledgling company change its business plan to focus less on computers, and even change their name from "Digital Computer Corporation". The pair returned with an updated business plan that outlined two phases for the company's development. They would start by selling computer modules as stand-alone devices that could be purchased separately and wired together to produce a number of different digital systems for lab use. Then, if these "digital modules" were able to build

15708-411: The front of the modules. Three versions were offered, running at 5 MHz (1957), 500 kHz (1959), or 10 MHz (1960). The Modules proved to be in high demand by other computer companies, who used them to build equipment to test their own systems. Despite the recession of the late 1950s, the company sold $ 94,000 worth of these modules during 1958 alone (equivalent to $ 992,700 in 2023), turning

15862-431: The health information of patients. It has been found that there is a lack of security awareness among health care professionals in countries such as Spain. The Health Insurance Portability and Accountability Act (HIPAA) has developed a framework to mitigate the harm of these threats that is comprehensive but not so specific as to limit the options of healthcare professionals who may have access to different technology. With

16016-503: The high-end market with machines like the VAX 9000 were market failures. After several attempts to enter the workstation and file server market, the DEC Alpha product line began to make successful inroads in the mid-1990s, but was too late to save the company. DEC was acquired in June 1998 by Compaq in what was at that time the largest merger in the history of the computer industry. During

16170-428: The implementation of electronic medical records systems has been a great assistance to general practitioners there is still much room for revision in the overall framework and the amount of training provided. It was observed that the efforts to improve EHR usability should be placed in the context of physician-patient communication. However, physicians are embracing mobile technologies such as smartphones and tablets at

16324-544: The importance of its management for the overall success of computer physician order entry. In the United States, Great Britain, and Germany, the concept of a national centralized server model of healthcare data has been poorly received. Issues of privacy and security in such a model have been of concern. In the European Union (EU), a new directly binding instrument, a regulation of the European Parliament and of

16478-475: The increase of clinical notes being shared electronically as a result of the 21st Century Cures Act , an increase in sensitive terms used across the records of all patients, including minors, are increasingly shared amongst care teams, complicating efforts to maintain privacy. Personal Information Protection and Electronic Documents Act (PIPEDA) was given Royal Assent in Canada on 13 April 2000 to establish rules on

16632-413: The inspiration for many microcomputer OS's, as these were generally being written by programmers who cut their teeth on one of the many PDP-11 models. For example, CP/M used a command syntax similar to RT-11's, and even retained the awkward PIP program used to copy data from one computer device to another. As another historical footnote, DEC's use of "/" for "switches" (command-line options) would lead to

16786-485: The lab's various computer projects. The Lab is best known for their work on what would today be known as "interactivity", and their machines were among the first where operators had direct control over programs running in real-time. These had started in 1944 with the famed Whirlwind , which was originally developed to make a flight simulator for the US Navy , although this was never completed. Instead, this effort evolved into

16940-537: The limited information available, they used it to process radar cross section data for the Lockheed A-12 reconnaissance aircraft . Gordon Bell remembered that it was being used in Oregon some time later, but could not recall who was using it. In November 1962, DEC introduced the $ 65,000 PDP-4 . The PDP-4 was similar to the PDP-1 and used a similar instruction set, but used slower memory and different packaging to lower

17094-482: The lines in a DO block, not whitespace. The ELSE command does not need a corresponding IF, as it operates by inspecting the value in the built-in system variable $ test . MUMPS scoping rules are more permissive than other modern languages. Declared local variables are scoped using the stack. A routine can normally see all declared locals of the routines below it on the call stack, and routines cannot prevent routines they call from modifying their declared locals, unless

17248-441: The lines were shut down in early 1967. Like the PDP-1 before it, the PDP-5 inspired a series of newer models based on the same basic design that would go on to be more famous than its parent. On March 22, 1965, DEC introduced the PDP-8 , which replaced the PDP-5's modules with the new R-series modules using Flip Chips. The machine was re-packaged into a small tabletop case, which remains distinctive for its use of smoked plastic over

17402-491: The machine would cost much less than the larger systems then available, it would also be able to serve users that needed a lower-cost solution dedicated to a specific task, where a larger 36-bit machine would not be needed. In 1957, when the pair and Ken's brother Stan sought capital, they found that the American business community was hostile to investing in computer companies. Many smaller computer companies had come and gone in

17556-438: The machine would spend more time accessing memory, which would slow it down. However, the machine also extended the idea of multiple "General Purpose Registers" (GPRs), which gave the programmer flexibility to use these high-speed memory caches as they needed, potentially addressing the performance issues. A major advance in the PDP-11 design was DEC's Unibus , which supported all peripherals through memory mapping . This allowed

17710-401: The models are now being defined. The electronic health record (EHR) is a more longitudinal collection of the electronic health information of individual patients or populations. The EMR, in contrast, is the patient record created by providers for specific encounters in hospitals and ambulatory environments and can serve as a data source for an EHR. In contrast, a personal health record (PHR)

17864-425: The name implies the /S used a serial arithmetic unit, which was much slower but reduced costs so much that the system sold for under $ 10,000. DEC then used the new PDP-8 design as the basis for a new LINC, the two-processor LINC-8 . The LINC-8 used one PDP-8 CPU and a separate LINC CPU, and included instructions to switch from one to the other. This allowed customers to run their existing LINC programs, or "upgrade" to

18018-514: The need to increase information technology staff to maintain the system. The U.S. Congressional Budget Office concluded that the cost savings may occur only in large integrated institutions like Kaiser Permanente, and not in small physician offices. They challenged the Rand Corporation 's estimates of savings. "Office-based physicians in particular may see no benefit if they purchase such a product—and may even suffer financial harm. Even though

18172-416: The needs of those with a lower level of education or those who are not fluent in the language. Accessing the EHR requires a level of proficiency with electronic devices which adds in a disparity for those without access or for those who have a mental or physical illness that restricts their access to the electronic system. Electronic medical records could also be studied to quantify disease burdens – such as

18326-458: The next April. The PDP-1 sold in basic form for $ 120,000 (equivalent to $ 9,269,291 in 2023). By the time production ended in 1969, 53 PDP-1s had been delivered. The PDP-1 was supplied standard with 4096 words of core memory , 18-bits per word, and ran at a basic speed of 100,000 operations per second. It was constructed using many System Building Blocks that were packaged into several 19-inch racks . The racks were themselves packaged into

18480-718: The number of deaths from antimicrobial resistance – or help identify causes of, factors of, links between and contributors to diseases, especially when combined with genome-wide association studies . This may enable increased flexibility, improved disease surveillance , better medical product safety surveillance, better public health monitoring (such as for evaluation of health policy effectiveness), increased quality of care (via guidelines and improved medical history sharing ), and novel life-saving treatments. Privacy : For such purposes, electronic medical records could potentially be made available in securely anonymized or pseudonymized forms to ensure patients' privacy

18634-486: The numbers. In MUMPS terminology, this is canonical order . By using only non-negative integer subscripts, the MUMPS programmer can emulate the arrays data type from other languages. Although MUMPS does not natively offer a full set of DBMS features such as mandatory schemas, several DBMS systems have been built on top of it that provide application developers with flat-file, relational, and network database features. Additionally, there are built-in operators which treat

18788-568: The price. Like the PDP-1, about 54 PDP-4s were eventually sold, most to a customer base similar to the original PDP-1. In 1964, DEC introduced its new Flip Chip module design, and used it to re-implement the PDP-4 as the PDP-7 . The PDP-7 was introduced in December 1964, and about 120 were eventually produced. An upgrade to the Flip Chip led to the R series, which in turn led to the PDP-7A in 1965. The PDP-7

18942-399: The prompt. ANSI X11.1-1995 gives a complete, formal description of the language; an annotated version of this standard is available online. Language features include: MUMPS supports multiple simultaneous users and processes even when the underlying operating system does not (e.g., MS-DOS ). Additionally, there is the ability to specify an environment for a variable, such as by specifying

19096-705: The purchase, some parts of DEC were sold to other companies; the compiler business and the Hudson Fab were sold to Intel . At the time, Compaq was focused on the enterprise market and had recently purchased several other large vendors. DEC was a major player overseas where Compaq had less presence. However, Compaq had little idea what to do with its acquisitions, and soon found itself in financial difficulty of its own. Compaq subsequently merged with Hewlett-Packard (HP) in May 2002. Ken Olsen and Harlan Anderson were two engineers who had been working at MIT Lincoln Laboratory on

19250-411: The resistance shown to their adoption. Handwritten paper medical records may be poorly legible, which can contribute to medical errors . Pre-printed forms, standardization of abbreviations and standards for penmanship were encouraged to improve the reliability of paper medical records. An example of possible medical errors is the administration of medication. Medication is an intervention that can turn

19404-591: The same design. During construction of the prototype PDP-1, some design work was carried out on a 24-bit PDP-2, and the 36-bit PDP-3. Although the PDP-2 never proceeded beyond the initial design, the PDP-3 found some interest and was designed in full. Only one PDP-3 appears to have been built, in 1960, by the CIA's Scientific Engineering Institute (SEI) in Waltham, Massachusetts . According to

19558-416: The same process, but not shared among multiple processes. The MUMPS Storage mode (i.e. globals stored as persistent sparse arrays), gives the MUMPS database the characteristics of a document-oriented database . All variable names which are not prefixed with caret character ( ^ ) are temporary and private. Like global variables, they also have a hierarchical storage model, but are only "locally available" to

19712-483: The standardization of forms, terminology, and data input. Digitization of forms facilitates the collection of data for epidemiology and clinical studies. However, standardization may create challenges for local practice. Overall, those with EMRs that have automated notes and records, order entry, and clinical decision support had fewer complications, lower mortality rates, and lower costs. EMRs can be continuously updated (within certain legal limitations: see below). If

19866-462: The state of a patient across time. It eliminates the need to track down a patient's previous paper medical records and assists in ensuring data is up-to-date, accurate and legible. It also allows open communication between the patient and the provider, while providing "privacy and security." It can reduce risk of data replication as there is only one modifiable file, which means the file is more likely up to date and decreases risk of lost paperwork and

20020-485: The underlying organization of the machines from word lengths based on 6-bit characters to those based on 8-bit words needed to support ASCII . DEC began studies of such a machine, the PDP-X, but Ken Olsen did not support it as he could not see how it offered anything their existing 12-bit or 18-bit machines didn't. This led the leaders of the PDP-X project to leave DEC and start Data General , whose 16-bit Data General Nova

20174-466: The use of health IT could generate cost savings for the health system at large that might offset the EHR's cost, many physicians might not be able to reduce their office expenses or increase their revenue sufficiently to pay for it. For example, the use of health IT could reduce the number of duplicated diagnostic tests. However, that improvement in efficiency would be unlikely to increase the income of many physicians." One CEO of an EHR company has argued if

20328-548: The use, disclosure and collection of personal information. The personal information includes both non-digital and electronic form. In 2002, PIPEDA extended to the health sector in Stage 2 of the law's implementation. There are four provinces where this law does not apply because its privacy law was considered similar to PIPEDA: Alberta, British Columbia, Ontario and Quebec. Digital Equipment Corporation Digital Equipment Corporation ( DEC / d ɛ k / ), using

20482-521: The value they will derive from adoption in the form of return on investment has a significant influence on EHR adoption. In a project initiated by the Office of the National Coordinator for Health Information , surveyors found that hospital administrators and physicians who had adopted EHR noted that any gains in efficiency were offset by reduced productivity as the technology was implemented, as well as

20636-555: The very small memories extant in hardware at the time. The ability to provide multi-user systems was another language design feature. The word " M ulti- P rogramming" in the acronym points to this. Even the earliest machines running MUMPS supported multiple jobs running at the same time. With the change from mini-computers to micro-computers a few years later, even a "single user PC" with a single 8-bit CPU and 16K or 64K of memory could support multiple users, who could connect to it from (non- graphical ) video display terminals . Since memory

20790-408: The ways in which the physician-patient relationship would be affected by an electronic intermediary. During the implementation phase, cognitive workload for healthcare professionals may be significantly increased as they become familiar with a new system. EHRs are almost invariably detrimental to physician productivity, whether the data is entered during the encounter or sometime thereafter. It

20944-463: The widely used TOPS-10 . When newer Flip Chip packaging allowed the PDP-6 to be re-implemented at a much lower cost, DEC took the opportunity to refine their 36-bit design, introducing the PDP-10 in 1968. The PDP-10 was as much a success as the PDP-6 was a commercial failure; about 700 mainframe PDP-10s were sold before production ended in 1984. The PDP-10 was widely used in university settings, and thus

21098-438: Was also used in its earliest days in an experimental clinical progress note entry system and a radiology report entry system. Some aspects of MUMPS can be traced from RAND Corporation 's JOSS through BBN 's TELCOMP and STRINGCOMP . The MUMPS team chose to include portability between machines as a design goal. An advanced feature of the MUMPS language not widely supported in operating systems or in computer hardware of

21252-794: Was developed by Neil Pappalardo , Robert A. Greenes , and Curt Marble in Dr. Octo Barnett's lab at the Massachusetts General Hospital (MGH) in Boston during 1966 and 1967. It grew out of frustration, during a National Institutes of Health (NIH)-support hospital information systems project at the MGH, with the development in assembly language on a time-shared PDP-1 by primary contractor Bolt Beranek & Newman, Inc. (BBN). MUMPS came out of an internal " skunkworks " project at MGH by Pappalardo, Greenes, and Marble to create an alternative development environment. As

21406-469: Was either bought from the company that built the computer or custom-constructed for one client. However, the emerging third-party software industry disregarded the PDP-11/Professional line and concentrated on other microcomputers where distribution was easier. At DEC itself, creating better programs for the Professional was not a priority, perhaps from fear of cannibalizing the PDP-11 line. As a result,

21560-507: Was even sold in kit form as the Heathkit H11 , although it proved too expensive for Heathkit 's traditional hobbyist market. The introduction of semiconductor memory in the early 1970s, and especially dynamic RAM shortly thereafter, led to dramatic reductions in the price of memory as the effects of Moore's Law were felt. Within years, it was common to equip a machine with all the memory it could address, typically 64 KB on 16-bit machines. This led vendors to introduce new designs with

21714-618: Was eventually ported along with MS-DOS 2.0 and introduced in late 1983. Although the Rainbow generated some press, it was unsuccessful due to its high price and lack of marketing and sales support. By late 1983 IBM was outselling DEC's personal computers by more than ten to one. A further system was introduced in 1986 as the VAXmate , which included Microsoft Windows 1.0 and used VAX/VMS-based file and print servers along with integration into DEC's own DECnet -family, providing LAN/WAN connection from PC to mainframe or supermini. The VAXmate replaced

21868-628: Was followed by the even more successful VT100 and its follow-ons, making DEC one of the largest terminal vendors in the industry. This was supported by a line of inexpensive computer printers , the DECwriter line. With the VT and DECwriter series, DEC could now offer a complete top-to-bottom system from computer to all peripherals, which formerly required collecting the required devices from different suppliers. The VAX processor architecture and family of systems evolved and expanded through several generations during

22022-415: Was impossible to have the risk that existed for other systems. Dan Brevik's DEC MUMPS-15 system was adapted to a DEC PDP-15 , where it lived for some time. It was first installed at Health Data Management Systems of Denver in May 1971. The portability proved to be useful and MUMPS was awarded a government research grant, and so MUMPS was released to the public domain which was a requirement for grants. MUMPS

22176-709: Was initially available only to DEC employees. It was only after IBM had successfully launched the IBM PC in 1981 that DEC responded with their own systems. In 1982, DEC introduced not one, but three incompatible machines which were each tied to different proprietary architectures. The first, the DEC Professional , was based on the PDP-11/23 (and later, the 11/73) running the RSX-11M+ derived, but menu-driven, P/OS ("Professional Operating System"). This DEC machine easily outperformed

22330-493: Was launched, effectively a PDP-8 on a chip. This was a way to allow PDP-8 software to be run even after the official end-of-life announcement for the DEC PDP-8 product line. While the PDP-5 introduced a lower-cost line, 1963's PDP-6 was intended to take DEC into the mainframe market with a 36-bit machine. However, the PDP-6 proved to be a "hard sell" with customers, as it offered few obvious advantages over similar machines from

22484-663: Was open to both M and MUMPS and after a "world-wide" discussion in 1992 the Mumps User Groups officially changed the name to M. The dispute also reflected rivalry between organizations (the M Technology Association, the MUMPS Development Committee, the ANSI and ISO Standards Committees) as to who determines the "official" name of the language. As of 2020, the ISO still mentions both M and MUMPS as officially accepted names. Massachusetts General Hospital registered "MUMPS" as

22638-597: Was purchased by Misys Healthcare (now Sunquest Information Systems ) in 2001. MUMPS is also widely used in financial applications. MUMPS gained an early following in the financial sector and is in use at many banks and credit unions. It is used by the Bank of England and Barclays Bank . Since 2005, the most popular implementations of MUMPS have been Greystone Technology MUMPS (GT.M) from Fidelity National Information Services, and Caché, from Intersystems Corporation. The European Space Agency announced on May 13, 2010, that it will use

22792-535: Was released in 1969 and was a huge success. The success of the Nova finally prompted DEC to take the switch seriously, and they began a crash program to introduce a 16-bit machine of their own. The new system was designed primarily by Harold McFarland, Gordon Bell , Roger Cady, and others. The project was able to leap forward in design with the arrival of Harold McFarland, who had been researching 16-bit designs at Carnegie Mellon University . One of his simpler designs became

22946-549: Was soon ported to a number of other systems including the popular DEC PDP-8 , the Data General Nova and on DEC PDP-11 and the Artronix PC12 minicomputer . Word about MUMPS spread mostly through the medical community, and was in widespread use, often being locally modified for their own needs. Versions of the MUMPS system were rewritten by technical leaders Dennis "Dan" Brevik and Paul Stylos of DEC in 1970 and 1971. By

23100-404: Was the PDP-11's first disk operating system, but was soon supplanted by more capable systems. RSX provided a general-purpose multitasking environment and supported a wide variety of programming languages . IAS was a time-sharing version of RSX-11D. Both RSTS and Unix were time-sharing systems available to educational institutions at little or no cost, and these PDP-11 systems were destined to be

23254-454: Was the basis of many advances in computing and operating system design during the 1970s. DEC later re-branded all of the models in the 36-bit series as the "DECsystem-10", and PDP-10s are generally referred to by the model of their CPU, starting with the "KA10", soon upgraded to the "KI10" (I:Integrated circuit); then to "KL10" (L:Large-scale integration ECL logic ); also the "KS10" (S: Small form factor ). Unified product line upgrades produced

23408-528: Was the dual-processor (Z80 and 8088) Rainbow 100 , which ran the 8-bit CP/M operating system on the Z80 and the 16-bit CP/M-86 operating system on the Intel 8088 processor. It could also run a UNIX System III implementation called VENIX . Applications from standard CP/M could be re-compiled for the Rainbow, but by this time users were expecting custom-built (pre-compiled binary) applications such as Lotus 1-2-3 , which

23562-427: Was tight originally, the language design for MUMPS valued very terse code. Thus, every MUMPS command or function name could be abbreviated from one to three letters in length, e.g. Quit (exit program) as Q , $ P = $ Piece function, R = Read command, $ TR = $ Translate function. Spaces and end-of-line markers are significant in MUMPS because line scope promoted the same terse language design. Thus,

23716-441: Was used as a printer . The Soroban system was notoriously unreliable, and often replaced with a modified Friden Flexowriter , which also contained its own punched tape system. A variety of more-expensive add-ons followed, including magnetic tape systems, punched card readers and punches, and faster punched tape and printer systems. When DEC introduced the PDP-1, they also mentioned larger machines at 24, 30 and 36 bits, based on

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