I am Systems Architect of Computer Services at the Veterinary Medical Teaching Hospital UC Davis. My primary responsibility is for the development advanced features of VMACS (Veterinary Medical and Administrative Computer System). VMACS is a comprehensive Hospital Information System (HIS). VMACS is used throughout the VMTH for case management, laboratory results reporting, billing, teaching, and research.
Some of the outstanding aspects of VMACS are the completeness and timeliness of medical records, the integration of communication and data for all services of the hospital, and the ease with which our users can search and retrieve case records and diagnostic reports by content, even when the content is textual rather than numbers or codes.
VMACS is now based almost entirely on Open Source software: the GNU/Linux operating system, the Apache Web Server, the Mozilla web browser, and GT.M (a high-performance implementation of MUMPS).
VMACS is in an active state of development and has been under continual development since 1981, originally as a medical records system based on MUMPS and CoSTAR.
A financial setback about six months into the initial project prevented us from acquiring the computer hardware to support whole-hospital operations. That forced us to put a hold on CoSTAR based development and focus for a few years on smaller projects. During that time we became familiar with the VA Fileman and used it to develop the first iterations of a reporting system for Pathology and record systems for various other hospital services. Significantly, this led us to wrestle with SNOMED and issues revolving around coding and retrieval of diagnoses that led us to advocate KWIC retrieval of natural language text.
Development really took off in 1984 when we committed to take on the cashiering and accounts receivable functions for the hospital. VMACS became operationally central to the VMTH in 1985 when we switched off the old accounting system. We brought up Point-of-Service billing in 1986 and Diagnostic reporting for Chemistry and Hematology in 1987, followed with Microbiology and Radiology Services, etc. -- many details to fill in here --
In 1990 we switched the foundation of the system from InterSystems M11+ on dual DEC 11/73 supporting 116 serial ports with VT102 terminals DEC LN03 printers to Datatree DTM on a cluster of five Intel 386 25Mhz supporting the same terminals and printers plus additional PC clients.
In 1993 we began experimenting with the World Wide Web, and in 1994 we began running our first MUMPS based web server, MHTTP, as part of VMACS. By 1995 we had almost all VMACS reports available on the web to our students, faculty, and staff.
-- many details to fill in here -- (Netscape, Javscript, Java, InterSystems' monopoly of MUMPS, Microsoft's monopoly of desktop computing, the fight with Microsoft over standards and security and everything, the anti-trust trial, the rise of Open Source, the Mozilla project, etc.)
In 2002 we switched the main data server over to GT.M, maintaining connection to a dozen DTM application servers via OMI (Open MUMPS Interconnect). In early 2003 we completed switching over all existing web applications to the new GT.M/Apache/Linux platform and turned off the old DTM web servers.
In converting VMACS over to run on GT.M/Linux, we found a truly excellent web server in Apache. Developing a CGI gateway from Apache to GT.M proved to be a better alternative than attempting to develop a complete new MUMPS based web server, at least for now. The combination of Apache CGI and GT.M seems to be quite robust and easily scalable far beyond our current needs. M2Web includes far more than a simple application gateway. There are many powerful utilities for developing sophisticated web applications. In the M2Web demo site I have linked it to the routines and data from the World VistA project.
We started developing a web interface for MUMPS applications back in 1994 while VMACS was based on Datatree MUMPS (DTM). We developed our own web server (MHTTP) entirely in MUMPS, except for a small bit of assembler at the heart of it for more efficient overall management of TCP sockets and connections. MHTTP was actively developed and used in VMACS up until Feb 2003 when we completed the conversion of all current web applications to M2Web on GT.M/Linux.
We are providing this software to the MUMPS community in the hopes of stimulating cooperative software development efforts and a more rapid growth of MUMPS based applications on the Web.