Milestone-Proposal:Pioneering Medical Informatics, 1965-1974
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Docket #:2025-24
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To the proposer’s knowledge, is this achievement subject to litigation? No
Is the achievement you are proposing more than 25 years old? Yes
Is the achievement you are proposing within IEEE’s designated fields as defined by IEEE Bylaw I-104.11, namely: Engineering, Computer Sciences and Information Technology, Physical Sciences, Biological and Medical Sciences, Mathematics, Technical Communications, Education, Management, and Law and Policy. Yes
Did the achievement provide a meaningful benefit for humanity? Yes
Was it of at least regional importance? Yes
Has an IEEE Organizational Unit agreed to pay for the milestone plaque(s)? Yes
Has the IEEE Section(s) in which the plaque(s) will be located agreed to arrange the dedication ceremony? Yes
Has the IEEE Section in which the milestone is located agreed to take responsibility for the plaque after it is dedicated? Yes
Has the owner of the site agreed to have it designated as an IEEE Milestone? Yes
Year or range of years in which the achievement occurred:
1965-1974
Title of the proposed milestone:
Pioneering Medical Information System, 1965-1974
Plaque citation summarizing the achievement and its significance; if personal name(s) are included, such name(s) must follow the achievement itself in the citation wording: Text absolutely limited by plaque dimensions to 70 words; 60 is preferable for aesthetic reasons.
From 1965-1974, the first successful real-time medical information system for patient care was created by Lockheed Missiles and Space Company in partnership with El Camino Hospital. Its intuitive light pen interface allowed physicians, nurses, and staff to quickly access and update patient data, including ordering lab work, X-rays, and medications. This automated system enabled significant improvements in patient outcomes while reducing costs, and proved influential worldwide.
200-250 word abstract describing the significance of the technical achievement being proposed, the person(s) involved, historical context, humanitarian and social impact, as well as any possible controversies the advocate might need to review.
The evolution from early medical information systems to today's integrated medical informatics has fundamentally transformed how healthcare is delivered, making it more data-driven, coordinated, and patient-centered. This has resulted in improved patient care and a reduction in costs, and its global market size reached $313 billion in 2024.
Beginning in 1965, Lockheed Missiles and Space Company worked in partnership with El Camino Hospital to pioneer the first successful medical informatics system which was directly usable by all the care providers, especially the physicians. Its implementation began in 1968, a commercial contract was signed in 1971, and the system was fully accepted in 1974. Lockheed divested this business in 1971 as Technicon Medical Information Systems.
While Lockheed/Technicon succeeded in this effort, early attempts by companies including IBM, Burroughs, Honeywell, General Electric, Control Data, and NCR failed. The key to success was a systems engineering approach across the entire medical enterprise, with the hardware and software enabling the care providers and physicians to easily interact with the system. This was essential since human-computer interaction outside of computer labs in the 1960s and early 1970s was a totally new concept, and so there was a need to overcome the intimidation that care providers and physicians had regarding such interaction. In 1977 it was observed that:
- “Success is the word used most often to describe El Camino Hospital's computerized medical information system. Operational since 1972, the system has gained total support from virtually all hospital personnel.” [11, p. 3-14]
By 1993, Technicon’s technology was installed in over 200 systems in the US, Canada, and Europe, and several original installations were still operating in 2012. While the scope of present day integrated healthcare IT ecosystems has greatly expanded and improved, they all comport to Lockheed/El Camino Hospital’s concept of system-wide direct interaction with the computers of the ecosystem.
IEEE technical societies and technical councils within whose fields of interest the Milestone proposal resides.
Computer Society (CS)
Engineering in Medicine and Biology Society (EMBS)
Control Systems Society (CSS)
In what IEEE section(s) does it reside?
Santa Clara Valley Section
IEEE Organizational Unit(s) which have agreed to sponsor the Milestone:
IEEE Organizational Unit(s) paying for milestone plaque(s):
Unit: Santa Clara Valley Section
Senior Officer Name: Avery Lu
IEEE Organizational Unit(s) arranging the dedication ceremony:
Unit: Santa Clara Valley Section
Senior Officer Name: Avery Lu
IEEE section(s) monitoring the plaque(s):
IEEE Section: Santa Clara Valley Section
IEEE Section Chair name: Avery Lu
Milestone proposer(s):
Proposer name: Brian A. Berg
Proposer email: Proposer's email masked to public
Proposer name: Tom Gardner
Proposer email: Proposer's email masked to public
Please note: your email address and contact information will be masked on the website for privacy reasons. Only IEEE History Center Staff will be able to view the email address.
Street address(es) and GPS coordinates in decimal form of the intended milestone plaque site(s):
El Camino Health - Mountain View Hospital, 2500 Grant Rd, Mountain View, CA 94040 US (37.369445, -122.079605)
Describe briefly the intended site(s) of the milestone plaque(s). The intended site(s) must have a direct connection with the achievement (e.g. where developed, invented, tested, demonstrated, installed, or operated, etc.). A museum where a device or example of the technology is displayed, or the university where the inventor studied, are not, in themselves, sufficient connection for a milestone plaque.
Please give the details of the mounting, i.e. on the outside of the building, in the ground floor entrance hall, on a plinth on the grounds, etc. If visitors to the plaque site will need to go through security, or make an appointment, please give the contact information visitors will need. In the main lobby of the hospital (which is not an emergency care entrance).
Are the original buildings extant?
No, but the building proposed for the plaque is in the original overall site.
Details of the plaque mounting:
On a wall or in a special mounting in the main lobby.
How is the site protected/secured, and in what ways is it accessible to the public?
The main lobby is publicly accessible 8:00 am to 8:00 pm, and there is building security.
Who is the present owner of the site(s)?
The El Camino Healthcare District owns the land on which the hospital sits, and it leases it to El Camino Health which owns the building itself.
What is the historical significance of the work (its technological, scientific, or social importance)? If personal names are included in citation, include detailed support at the end of this section preceded by "Justification for Inclusion of Name(s)". (see section 6 of Milestone Guidelines)
The transformation of healthcare through information technology represents one of the most significant technological advances of the late 20th century. What we now call Medical Informatics began as Medical Information Systems (MIS) in the 1960s [28], when the marriage of computer technology and medical practice seemed both inevitable and impossible. The inevitability stemmed from the clear potential for computers to manage the vast amounts of data generated in modern hospitals. The impossibility lay in a fundamental human factor that confounded the best minds in technology: healthcare professionals, particularly physicians and nurses, were unable and unwilling to interact directly with computers.
Between 1965 and 1974, Lockheed Missiles and Space Company [29], in collaboration with El Camino Hospital [27 at 0:06] in Mountain View, California, solved this seemingly intractable problem. Lockheed's Medical Information System (MIS) represented not merely an incremental improvement over existing systems, but a fundamental breakthrough in human-computer interaction. Unlike other efforts of the era that focused on departmental solutions, Lockheed’s system-wide architecture established the foundation for all modern Medical Informatics (see Figure 1).
This collaboration represents one of the most significant technological achievements in modern healthcare. By solving the fundamental problem of caregiver-computer interaction, they together established the foundation for all subsequent developments in medical informatics. The key to their success lay not only in computing technology and system design (their competitors had access to similar hardware), but in their deep understanding of the human factors that had caused previous systems to fail.
The insight that physicians could not and would not learn to type, combined with the innovative solution of light pen interaction, transformed an impossible dream into practical reality. The incredible commitment of time, capital, and exceptional talent made a huge difference – as other projects stumbled and fell.
The lasting significance of this achievement is demonstrated by its continued relevance more than fifty years later. The principles of direct physician interaction, intuitive interfaces, and workflow integration that Lockheed pioneered remain fundamental to modern medical information systems. The $20 million investment ($151 million in 2025 dollars) by Lockheed has yielded returns measured not only in economic terms, but in improved patient outcomes and more efficient healthcare delivery worldwide.
This pioneering work represented not merely a successful engineering project, but a breakthrough in transforming healthcare delivery, and helping to establish the foundation for the modern medical informatics industry. The legacy of Lockheed's innovation continues to benefit patients and healthcare providers around the world, making this achievement truly worthy of lasting recognition.
What obstacles (technical, political, geographic) needed to be overcome?
A. Early Attempts at Hospital Information Systems (Pre-Lockheed Era)
The 1960s witnessed ambitious attempts by major technology companies to computerize hospital operations; all recognized the enormous potential market, and invested heavily in hospital information system development. [1] Most of the major computer companies at the time including IBM, Burroughs, Honeywell, General Electric, Control Data, and NCR saw the potential of significant sales in this market, and were active in support of MIS development. However, of all of these early systems, only the Lockheed-designed solution still existed in 1994. [1]
Academic institutions pursued a different approach with systems like MUMPS (Massachusetts General Hospital Utility Multi-Programming System), developed at Massachusetts General Hospital, and which began in the late 1960s as a time-sharing operating system and programming language for medical applications. MUMPS started earlier than Lockheed's efforts but remained primarily a departmental solution focused on laboratory functions rather than hospital-wide integration. This evolved into COSTAR, developed at Harvard's Laboratory for Computer Science. It achieved limited success in specialized environments, but lacked comprehensive, hospital-wide integration. Barnett et al. noted in 1979, "COSTAR 4 does not have the potential for use by other ambulatory practices, since it incorporated a number of characteristics which were specifically designed for HCHP [Harvard Community Health Plan] needs, and had only a limited set of functional capabilities." [5]
Most hospital/academic systems failed in their early implementations, although MUMPS/COSTAR ultimately succeeded much later than Lockheed's breakthrough, and illustrated the difference between academic research in specialized applications and the comprehensive integration and user-friendly interfaces that characterized Lockheed's commercial success. [20]
The root cause of these failures was identified decades later by Mel Hodge [2], author and head of the Lockheed MIS project: "A key characteristic of the decade of the 60's was that few professionals in any field ever needed to learn how to type. Instead, almost all depended upon stenographers in their offices capable of taking dictation or transcribe it from a Dictaphone." [3] This seemingly simple observation revealed a critical flaw in early system design.
Dr. Donald Lindberg, writing in 1968, captured the state of the field: "Computer processing of medical data has much to offer in rendering data readily available and in assuring the quality of the observations recorded... As a consequence of these heavy requirements, no total hospital system exists [in 1968] except for trivial billing functions." [4] The technological capability existed, but the human interface problem remained unsolved.
B. Problems Solved - Key Innovations and Technological Solutions
One fundamental problem that Lockheed solved was elegantly articulated in their internal memo of April 1, 1968: "The major problem in a hospital today is accuracy of information as it passes between multiple caregivers and ancillary servers. The design of this system automates the communication between all hospital disciplines and departments eliminating all communications errors. It totally eliminates the middleman in the communication process." [17] [27 at 0:07] (Emphasis added)
Achieving hospital-wide performance and reliability with 1960s technology was itself a formidable challenge. The Block Diagram of MIS-I illustrates the complexity of integrating multiple components into a dependable system (see Figure 3).
A few of the specific technological innovations that enabled this breakthrough included the following:
- 1. Video Matrix Terminals (VMT)
"Off the shelf" TV sets supplemented by light pens, keyboards, custom-designed stands with arm rests, and terminal interface boxes simplified communication between healthcare workers and the computer system, and this was optimized for medical workflow rather than general computing tasks. [17]
- 2. Light Pen Technology
As the revolutionary commercial application of light pen technology eliminated the need for most keyboard entry, this allowed physicians to interact with the computer by pointing and clicking on screen options. [15] Specified response time to a light pen button press was 0.4 seconds for most operations. This innovation directly addressed the typing skill barrier that had defeated previous systems. As Hodge explained, "The common central mistake by the companies who consequently failed was designing hospital systems requiring keyboard entry, a skill absent from medical professional training or experience [in the 1960s and 1970s.]" [3]
- 3. Matrix Coding and Standardized Order Sets
These features streamlined physician order entry by providing standardized options that could be selected via light pen, ensuring consistency while maintaining efficiency. Standardized order sets were predetermined order sets for medical specialties stored in the computer. These could be recalled by physicians, who selected needed orders by checking them off on the checklist format presentation on the VMT display. Personalized order sets, similar to standardized sets, were prepared by individual physicians for their specific use, allowing customized workflows while maintaining system integration. [9]
- 4. Multi-hospital Operation from Data Centers
Lockheed initially designed the system for remote data centers to serve multiple hospitals over high-speed telephone lines, assuming hospitals lacked computer expertise. While this approach proved successful for hospital systems with common ownership with up to 12 hospitals operated from a single center (e.g., the Third Order of St. Francis health system in Illinois), most independent hospitals preferred to maintain control of their patient data locally.
C. The Result of These Innovations and Technological Solutions
The integration of these technologies created a system that, as Hodge observed, "proved to be generally acceptable to physicians with negligible training." [3] This represented a fundamental shift from systems that required extensive user adaptation to technology that adapted to user needs.
This engineering rigor extended to detailed user benefits analysis. For physicians, the system would accomplish orders "more quickly and accurately" while providing "current test data on demand" and eliminating "duplicate record generation." For nurses, it would provide "legibility of orders" by eliminating "handwritten orders" and "substantially" reducing "order transcription." For patients, the system promised "reduced errors," "more timely emergency responses," and "expeditious record handling." [19] The MIS-I specifications also outlined an evolutionary path to MIS-II with 16 additional advanced functions including physiologic monitoring, diagnostic guides, and comprehensive scheduling systems. [19]
What features set this work apart from similar achievements?
A. Lockheed's Pioneering Work at El Camino Hospital (1965-1971)
The collaboration between El Camino Hospital and Lockheed Missiles and Space Company began in 1965, marking the start of what would become the most successful MIS development project of its era. El Camino Hospital, a 464-bed general acute care facility in Mountain View, California, provided the perfect partner for Lockheed's ambitious vision. [6 at p. 1]
The earliest public disclosure of Lockheed's revolutionary approach appeared in the San Jose Mercury News on January 18, 1966, describing a "high-level Lockheed brain trust" demonstration to Santa Clara County Supervisors. The article described a "video matrix input-output device" and noted that "Using a 'light pencil,' [a doctor] can prescribe... Rapidly, the system can give the doctor all laboratory, X-ray, medication and other facts regarding his patient, from such remote points as other hospitals and, ultimately, even his office." [7]
In 1966, Lockheed embarked upon a prototype design of what would be called the Medical Information System (MIS-I). [6 at p. 1] This was not an incremental improvement, but was instead a fundamental reconceptualization of human-computer interaction in healthcare. The key insight came from a Lockheed physician development team member which correctly perceived the necessarily interactive and simplified training required for physician acceptance. [3]
Lockheed's system architecture demonstrated total hospital integration through a centralized Regional Center that connected all hospital departments: Admissions, physician and nurse stations, Pharmacy, Food Service, Laboratory, Radiology, EKG/EEG, Physical Therapy, Inhalation Therapy, Central Supply, and Business Office. (See Figure 1.) Unlike the departmental silos that characterized failed systems, this comprehensive approach ensured that patient data flowed seamlessly between all caregivers and ancillary services. What would later be called Computerized Physician Order Entry (CPOE) was, in Lockheed's comprehensive vision, really computerized provider order entry encompassing all care providers in the hospital, from nurses to the clerks in accounting.
Lockheed's 1968 objectives encompassed everything from eliminating transcription errors and improving patient care, to reducing costs and enhancing hospital efficiency across all departments. [17] This approach revealed the key to Lockheed's eventual success: a direct interaction with the computer system using an intuitive interface requiring no typing skills. [26]
The progressive installation of terminals during 1968-1969 demonstrated Lockheed's systematic approach to functional integration. During 1968, to give hospital staff direct interaction with the system, on-line display and printer terminals were installed in the Doctors' Lounge and at one nursing station. By 1969, as system development expanded, more terminals were installed in Admissions, Laboratory, Radiology, EKG, Pharmacy, Food Service, and at additional nursing stations. [6 at p. 1]
Simultaneously, Lockheed was conducting crucial research at the Mayo Clinic in Rochester, MN. In October 1966, Business Week reported "Mayo asks Lockheed to train its sights on a total medical information system." [8] Beginning in November 1966, Lockheed started sending a number of personnel (including one physician) to the Mayo Clinic. They would stay for an extended period, with Hodge making monthly trips for status updates. [30] This collaboration was essential in developing the deep systems knowledge of medical workflow, and perfecting the hardware and software necessary for direct interaction between caregivers and computers. This was particularly important for the Video Matrix Terminals (VMT) and the Matrix coding technologies that would distinguish Lockheed's approach from its competitors.
B. Long-Term Impact and Modern Medical Informatics (1990s to 2025)
The influence of Lockheed's pioneering work extends far beyond the immediate success at El Camino Hospital. Edward Shortliffe, a leading figure in medical informatics, wrote in 2005: "Among the early experiments, the Lockheed/Technicon system at El Camino Hospital in Mt. View, California, is perhaps the best known and most influential of the 'hospital information systems.'" [14]
The transformation from standalone systems to integrated Electronic Health Records (EHR) built on the Lockheed model of direct physician interaction. Modern CPOE systems, now considered essential for patient safety, trace their lineage to the light pen interface pioneered at El Camino Hospital. [31] Its pioneering role in CPOE development continued to be recognized decades later, as noted for example in 2007: "Back in the 1970s, the hospital got together with space and defense contractor Lockheed Martin to create the very first computerized physician order entry system, or CPOE. By taking handwriting out of the process, CPOEs eliminate both transcription errors and manual order entry, thereby improving care and efficiency at one time." [18] Vince Ciotti, a medical informatics historian, noted that "While IBM's 'HIS' pilot at Monmouth was floundering, several other mainframe systems succeeded in making clinical software take flight, the most famous and long-lived: Lockheed." [20]
The significance of this early achievement becomes clear when viewed against the slow adoption of similar systems. As late as 2002, computerized order entry was not available to physicians at 83.7% of hospitals, with only 9.6% reporting complete availability. [22] Even by 2013, only 59% had implemented basic CPOE for drug administration [26], demonstrating that the fundamental challenges of physician-computer interaction that Lockheed solved in 1972 remained an obstacle for most hospitals for more than four decades.
The evolution from the original MIS system through various corporate transitions from Lockheed through Technicon, TDS, Revlon, Alltel, Eclipsys, Allscripts, and still today remnants at Veridgm [20] represents one of the longest evolutionary paths in medical informatics history. The fundamental principles of direct physician interaction and intuitive interface design remained constant as additional functions and capabilities were added throughout. However, the experience of early CPOE implementations demonstrated that failure stories often became antecedents of eventual successes, with analysis revealing that what is considered a failure is context dependent, and that it often is an antecedent to success. [21]
Modern Healthcare Informatics continues to grapple with many of the same challenges that Lockheed addressed in the 1960s and 1970s. User acceptance, system reliability, and workflow integration remain critical success factors for any healthcare information system implementation. The light pen technology that enabled breakthrough physician acceptance at El Camino Hospital has evolved into touch screens and voice recognition, but the underlying principle of minimizing the technical skills required for system interaction remains paramount.
The global market size of Medical Informatics reached $313 billion in 2024 [23], representing the enormous industry that grew from the foundations laid by pioneers such as Lockheed and El Camino Hospital. Every modern MIS incorporates the core principle established by Lockheed: direct interaction between healthcare providers and computer systems through intuitive interfaces.
Why was the achievement successful and impactful?
A. Full Implementation of Medical Information System at El Camino Hospital (1971-1974)
In April 1970, Lockheed submitted a fixed-price proposal for the complete installation of MIS-I, demonstrating confidence in their technical approach and willingness to assume financial risk. [6 at p. 2] The proposal was followed by a crucial validation phase beginning in August 1970. For one month, four physicians entered all orders for their patients' stay, and the nursing staff operated each of the nursing portions of MIS (except the nursing notes) in parallel with manual operation. [6 at p. 1]
The success of this parallel testing led to national recognition in 1971 when, in competition with the most promising similar projects in the United States, the MIS project was awarded a one-year $373,000 contract by the National Center for Health Services Research and Development to undertake system demonstration and evaluation. [6 at p. 2]
In the spring of 1971, El Camino Hospital and Lockheed entered into a multiyear agreement to install MIS operationally throughout the hospital. The agreement's terms reflected the innovative nature of the project: implementation costs would be borne by the vendor, and because of the "first of its kind" nature of the system, monthly payments by the hospital for service to Lockheed would be made only as cost benefits, as measured solely by the hospital, were actually realized until a stated monthly fixed level was reached. Thereafter, all additional savings would be retained by the hospital. This arrangement was unique in that Lockheed assumed the unprecedented risk of potentially receiving no payment if the system failed to deliver measurable benefits. [6 at p. 2]
B. Outside Evaluation
The Battelle Columbus Laboratories evaluation of El Camino Hospital showed remarkable results. It revealed that MIS allowed the nursing staff to reduce the amount of time spent on clerical tasks, helped to improve communications among nurses and with ancillary departments, and facilitated better planning of patient care by nurses. Additionally, the study found that more readily available, more complete, and more accurate information was being used for administering care, and for monitoring patient progress. [9 at p. 2-2]
The Video Matrix Terminal (VMT) user interface studies provided quantitative evidence of the system's effectiveness. Mayo Clinic research demonstrated that physicians wanted very rapid response from the video system so that their thought processes would not be interrupted. The studies showed that physicians would be able to enter patient history and physical-examination data at speeds comparable to normal handwriting. Most significantly, when surveyed about the VMT system, physicians showed overwhelming support with approval ratios of 29 to 0 and 26 to 5, depending on the specific question asked. [10]
The system became fully operational at El Camino Hospital in 1972. [9] By 1975, total investment in the development of the MIS system was estimated by the vendor to be roughly $20 million ($151 million in 2025 dollars). [6 at p. 3]
C. Ultimate Validation
The ultimate validation came in August 1974 when secret ballots were cast by El Camino Hospital's professional and administrative staffs to determine whether the hospital should retain the MIS. The results were overwhelmingly positive: 94% of the nursing staff, the administrative and technical staffs, and a majority of the 300 physicians, voted in favor of retention. [11]
The depth of user acceptance was captured in individual testimonials. As Plotnick documented, one El Camino Hospital internist told Hodge of the system: "It's just like breathing, I couldn't get along without it." [12] This level of integration where physicians viewed the technology to be as essential as a biological function demonstrated that Lockheed had achieved a level of human-machine harmony rather than mere user tolerance. [12]
A contemporary promotional video [32] from the early 1970s vividly demonstrates the comprehensive scope of Lockheed's MIS-I system, showing nurses entering observations directly into Video Matrix Terminals, physicians communicating orders without handwriting errors, automated pharmacy operations with medication labeling, and complete charge capture throughout the hospital workflow. The video emphasizes that "M.I.S. One reduces paperwork, ensures accuracy and enhances patient care" while eliminating manual charting and transcription errors across all departments.
Department of Health, Education, and Welfare-sponsored studies heralded the system for its impact on improving patient care and containing costs. [11] In 1974, the hospital board, after careful economic analysis, concluded that MIS was both medically practical and economically advantageous, approving a contract to pay Technicon $67,379 per month for the computerized service. [13] [27 at 0:08]
D. Technicon and Wider Adoption (1971-1980s)
In 1971, under pressure from a Federal bailout to prevent insolvency following problems with the Lockheed L-1011 commercial aircraft, Lockheed discontinued many activities. Lockheed sold the 100 member MIS Division to Technicon Corp, the successful pioneer and leader in clinical laboratory automation. MIS thereafter operated independently as a Technicon subsidiary (Technicon Medical Information Systems), recognizing that the specialized requirements of healthcare information systems required focused attention. This transition marked the beginning of the commercial expansion of the El Camino Hospital model.
Technicon's MIS achieved significant business success. By 1987, TMIS had been installed in more than 85 institutions [14], with an additional 32 hospitals choosing TDS in just the 18 months leading up to 1989. [15] By 1993, more than 200 systems had been installed in the US, Canada, and Europe [25], and several original installations were still operating in 2012. [20] This validated the scalability and adaptability of the Lockheed design as further demonstrated in continued successful installations. Technicon Corporation's sale to Alltel proved to be one of a series of mergers in the 21st century for TMIS, with its core principles remaining intact.
The influence of El Camino Hospital's system on future hospital-wide implementations was profound. As noted by W.E. Hammond, "The ultimate success of the system at El Camino led to the spread of this and other systems into other hospitals." [16] The El Camino Hospital model became the template for successful medical information system implementation.
Supporting texts and citations to establish the dates, location, and importance of the achievement: Minimum of five (5), but as many as needed to support the milestone, such as patents, contemporary newspaper articles, journal articles, or chapters in scholarly books. 'Scholarly' is defined as peer-reviewed, with references, and published. You must supply the texts or excerpts themselves, not just the references. At least one of the references must be from a scholarly book or journal article. All supporting materials must be in English, or accompanied by an English translation.
[1] Hammond, W.E. "Hospital Information Systems: A Review in Perspective." Duke University Medical Center, Yearbook of Medical Informatics, 1994, p. 156. PDF
[2] Hodge, Melville H. "Medical Information Systems: A Resource for Hospitals." Aspen Pub, 1978. ISBN 9780912862477.
[3] Hodge, Melville. Personal email message to Tom Gardner, May 12, 2025. PDF
[4] Lindberg, D. "The Computer and Medical Care." Charles C Thomas Publisher, Springfield, Illinois, 1968. VIII. Data Processing With an In-Hospital Computer, Summary, p. 89. Extract PDF
[5] Barnett, et al. "COSTAR—A Computer-Based Medical Information System for Ambulatory Care." Proceedings of the IEEE, Vol. 67, No. 9, September 1979, p. 1226. PDF
[6] Gall, Jr. et al. "Demonstration And Evaluation Of A Total Hospital Information System." Battelle, December 1975, 194 pages. Report PDF
[7] Choate, Jim. "Rx For The Doctor's Paperwork: Automation." The Mercury, January 18, 1966, p. 15Z. Article PDF
[8] "Mayo asks Lockheed to train its sights on a total medical information system." Business Week, October 29, 1966, p. 110. Article PDF
[9] Barrett, James P., Ronald A. Barnum, Benjamin B. Gordon, and Robert N. Pesut. "Evaluation of the Implementation of a Medical Information System in a General Community Hospital." Final Report, December 19, 1975. Report PDF
[10] Kiely, Joseph M., John L. Juergens, Bradner L. Hisey, and Paul E. Williams. "A Computer-Based Medical Record: Entry of Data From the History and Physical Examination by the Physician." JAMA 205, no. 8 (August 19, 1968): 571–576. Article PDF
[11] Watson, Ralph J. "A Large-Scale Professionally Oriented Medical Information System Five Years Later." Journal of Medical Systems, Vol. 1, No. 1, 1977, p. 3. Article PDF
[12] Plotnick, R. "Computers, Systems Theory, and the Making of a Wired Hospital: A History of Technicon." Journal of the American Society for Information Science and Technology, June 2010, pp. 1283, 1288. Article PDF
[13] Mead, Dale F. "Hospital OK's Computerized Data System." San Jose Mercury, August 10, 1974, p. 40. Article PDF
[14] Shortliffe, Edward H. "Strategic Action In Health Information Technology: Why The Obvious Has Taken So Long." HIT Policy, September/October 2005, pp. 1222–1223. Article PDF
[15] "TDS Two page Ad." U.S. Healthcare Magazine, September 1989, v6 #9. Ad PDF
[16] Hammond, W.E. "Patient Management Systems: The Early Years." ACM, Duke University Medical Center, 1987, p. 153. PDF
[17] Childs, Bill W. "25 Standards for Development of MIS." Lockheed internal memo, Medical Information Systems Division, LMSC, April 1, 1968. Memo PDF
[18] Santosus, M. & Venturo, T. "El Camino Hospital." Healthcare Digital, White Digital Media, UK, July 2007, p. 1. Article PDF
[19] Lockheed Missiles & Space Company. Analysis of Information Needs of Nursing Stations: Medical Information System Technical Report, LMSC-682684, Sunnyvale, California, May 1969. Report PDF
[20] Ciotti, Vince. "H.I.S.-tory." Healthcare Information Systems History Collection, 2011–2019. Extract PDF; full collection available at HISTalk
[21] Stavri, P. Zo, and Joan S. Ash. "Does failure breed success: narrative analysis of stories about computerized provider order entry." International Journal of Medical Informatics 72 (2003): 9–15, p. 14. PDF
[22] Ash, et al. "Computerized Physician Order Entry in U.S. Hospitals: Results of a 2002 Survey." Journal of the American Medical Informatics Association, v. 11, no. 2 (March 2004): 95–99, p. 95. PDF
[23] "Healthcare IT Market.," Fortune Business Insights, August 11, 2025. Online Link
[24] Lockheed Missiles & Space Company. Independent Development Report for 1970 and Program Plan for 1971. LMSC, March 1971, pp. 06–14. Report PDF
[25] ALLTEL Corp. "Form 10-K." SEC Filing, December 31, 1994, p. 1. Extract PDF
[26] Nuckols, Teryl K., et al. "Implementing Computerized Provider Order Entry in Acute Care Hospitals." Joint Commission Journal on Quality and Patient Safety, vol. 41, no. 8, August 2015, p. 342. PDF
[27] Melville Hodge, Oral History Interview, February 14, 2025. (Video to be published on IEEE.tv)
[28] The terms Medical Information Systems (MIS) and Hospital Information Systems (HIS) were initially used interchangeably, but both terms were gradually displaced by "Medical Informatics" (MI). Lockheed was potentially the first to use "MIS" when describing its product as "MIS-I."
[29] Lockheed Missiles and Space Company (LMSC) was a division of Lockheed Corporation, which later became part of Lockheed Martin Corporation following the 1995 merger with Martin Marietta. For consistency, this document refers to the company as "Lockheed" throughout, representing the corporate entity responsible for the Medical Information System development.
[30] Sources differ on the exact number of Lockheed personnel sent to the Mayo Clinic, with various sources suggesting numbers ranging from 4 to 14 total participants. However, Hodge, as head of the MIS project, confirms that only five personnel were sent to the Mayo Clinic. The team was stationed there for extended periods to conduct systems analysis, while Hodge made monthly trips from California for status updates. Bill Childs (in [17]) notes humorously that he was the "lucky one" who worked on the Business Office System in the warmth of California while his colleagues "endured Minnesota winters."
[31] The acronym CPOE has evolved over the years, initially "P" stood for Physician, although in Lockheed's view it really meant all the care providers in the hospital from nurses to clerks in accounting. “P” for Provider now appears common and Lockheed’s vision is being extended to Patients with some facilities providing tablets for patients to fill out forms rather than having the paper forms scanned in a back-office procedure.
[32] Promotional Video by El Camino Hospital, circa 1971
Supporting materials (supported formats: GIF, JPEG, PNG, PDF, DOC): All supporting materials must be in English, or if not in English, accompanied by an English translation. You must supply the texts or excerpts themselves, not just the references. For documents that are copyright-encumbered, or which you do not have rights to post, email the documents themselves to ieee-history@ieee.org. Please see the Milestone Program Guidelines for more information.
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