How is EHR technology used for managing Real-World Data?

In the previous blog post I covered a little bit of the history of EHR data. You may be wondering - how were the early EHR systems implemented? The key technology for EHR was called MUMPS (yes, a little unfortunate), which stands for Massachusetts General Hospital Utility Multi-Programming System. 

It was developed in the late 1960s at Massachusetts General Hospital. It was designed as a programming language and database system optimized for the healthcare environment, capable of handling medical records, billing information, patient tracking, and more. Over the years, MUMPS has been known simply as 'M'.

Key Role in EHR Development

One of the main reasons MUMPS played a critical role in developing EHR systems is its capacity for rapid development and customization. This was essential in the early days of EHRs when there were no one-size-fits-all solutions, and systems needed to be tailored to the specific needs of different healthcare practices.

MUMPS is unique because it integrates a programming language with a database, allowing for seamless data manipulation and retrieval. This was crucial for EHR systems that required efficient, real-time access to large volumes of patient data.

The MUMPS environment proved to be highly scalable, a necessary feature for hospital environments where the amount of data can grow exponentially. This scalability allowed EHR systems based on MUMPS to expand alongside growing healthcare institutions.

Several of today's leading EHR vendors, including Epic and Meditech, originally built their systems using MUMPS. These systems have evolved over time, but the core MUMPS infrastructure allowed them to establish a strong foothold in the healthcare industry early on.

Given the importance of reliability in healthcare settings, where system failure can result in life-or-death situations, MUMPS provided a secure and fault-tolerant environment for EHR data. Its simplicity and robustness made it an appealing choice for hospitals and clinics transitioning from paper to digital records.

Continuing Influence

Despite its age, MUMPS continues to influence the EHR landscape due to its presence in the underlying infrastructure of major EHR systems. While newer technologies are being integrated into EHR solutions, the principles of efficiency, reliability, and customization that drove the adoption of MUMPS remain central to EHR development. One commercial company that supports a large percentage of the proprietary EHR storage systems is InterSystems, for example. Their InterSystems IRIS Data Platform is utilized by Epic internally.

Conclusion

The MUMPS programming environment played a foundational role in the development of EHR systems by offering a combination of rapid development capabilities, integrated database functionality, scalability, resilience, and reliability. Its legacy endures in the architecture of several leading EHR systems, demonstrating its enduring impact on healthcare technology.

Please refer to my previous blog post to learn more about EHR data and its history.