American health care UI: snapshot


BB reader Taylor says,

Some friends of mine who were working at a call center at the Minnesota Dept. of Human Services told me they were working on a "throwback" system that hasn't really been overhauled for a few years.

Here's how "throwback" it looks.

But you know what? I bet it works perfectly.


  1. Such UIs aren’t actually that uncommon in the corporate world either.

    It’s dangerous and expensive to transition systems. It might be old software, but all the humans know how to use it by now.

  2. Being old might mean that users have had some time to learn to work around its quirks, but age does not guarantee that it works perfectly.

  3. They use the same system at my mom’s office. I cringe everytime I see it. From what I heard its only kept on because of doctors’ technophobia.

  4. Some older stuff just works well, staff is familiar with it, best of all, it’s paid for.
    Sometimes it makes sense to stick with what’s working, and not get caught up in the pursuit of the newest stuff. There’s probably a “Peter Principle” kind of thing that applies to technology in the work place.
    Oops, gotta’ run, the Linotype is hot!

  5. In the early 90s I worked at a company that sold text books to schools. Massive orders every one of which was slightly different. New owners brought in suggested that the computer system be changed from the AS/400’s that were being used. After being told how many files were needed they went away did some research and came back recommending that they stay with the same system. A few years later I worked in a record store that was part of a global chain. They used terminals and AS/400s. I’m sure things have changed now. My city is about to have a new system for public transport tickets. The costs have blown out to ridiculous levels. We still miss the people who used to just sell you the tickets on the trams and don’t get me started on electronic voting machines.

  6. Know what? I used to work there between ’96 and ’98. Bet you that system doesn’t work perfectly. Bet you that system is the bane of all who use it and anyone with half a brain works around it.
    Yeah, I bet you.

  7. Santa’s Knee here.


    The old CICS Cobol information management system!

    How I do miss thee, now that we have “upgraded” to DB2…

  8. A few years? If nothing else it looks like the interface hasn’t been updated in a few decades. But so what? I agree with @1 and @2: Age is not as important as reliability, familiarity and functionality. That being said, I’d still bet the system is fraught with inefficiencies.

  9. Eh. I’ve worked for a bank (which may or not be the largest corporation in the world) and it had a similar looking system for a lot of tasks. Some other tasks had a different interface which was pretty much just a prettier overlay which actually worked a lot slower–if you knew how to use the ‘throwback’ you’d be using the same database and it worked faster.

    I’ve worked for a number of other companies with similar GUIs. It’s not uncommon in corporate America.

    Not that I like to defend insurance companies but I’d prefer it to crying wolf.

  10. There’s really very little difference between the 3270 model of screen updating (where you fill in a bunch of form fields and then press Enter to generate an interrupt and send your data to the computer) and an HTML form (in fact, h3270 makes excellent use of this fact).

    It’s certainly a lot closer than the difference between a webform and a character-addressible each-key-interrupts-the-processor screen, and much, much closer than a model in which the GUI is being generated on the same host that the computation is being done.

    If they wanted to, they could have this looking much spiffier in a couple weeks with h3270 and some CSS. It wouldn’t change the interface in any way except cosmetically, and from a reliability standpoint, then you’d have to worry about a Tomcat (or equivalent) framework too.


  11. It may “work” perfectly if you know exactly what you’re doing, but the trade-off is less familiarity, having a small set of people who know how to do everything on it, and longer training time for new hires. Also probably lots of inefficiencies in terms of paging through menus after menus — the computer version of phone menu systems.

  12. A few years ago my local public library spent a considerable sum switching its electronic card catalog from an ancient terminal-style UI to a pretty new web UI, which is worse in almost every way. Its search results are worse, it’s bandwidth intensive and thus slower. But it sure looks cool!

    So I’m inclined to agree. “Updating” a UI used for serious work just because it looks old is like painting a hammer just to make the hammer prettier; the very best thing that can happen is that the hammer will drive nails exactly as well as before.

    That said, though, I wonder what they have against lower-case.

  13. Looks like a mainframe CICS system. I programmed CICS in health insurance companies for almost 20 years. A magnificent technology. Done right, they’re absolutely bullet proof as only a serious business computer system with decades of development will be. I could tell stories…

  14. Xeni, it probably works perfectly because the MN Dept of Human Services has molded all their SOP’s to the capabilities and peculiarities of the software. Throwbacks like this might get to be rock solid after a long while, but they do it at the price of organizational adaptability and procedural flexibility.

  15. Looks like a Mainframe Interface, I’d bet it was written in RPG400 or a similar interface.

    Very bullet-proof. You’d be hardpressed to match that performance on a GUI type system.

    The only downside is I bet updating that system requires a sacrifice to the Mainframe gods.

  16. I work at a hospital in Toronto and we have a similar system that we use. It’s dead simple once you learn to use it and all the information is right there and easy to read.

  17. Some of the reasons that UI’s like that are still around are that not only is the system functional and paid for, but there’s often a huge amount of business process that has been designed around or grown up with those systems. So when you start to think about “upgrading” you end up with the problem of having to uproot titanic amounts of your organization’s culture along with the system which often makes the task impossible.

    Also, many organizations are terrified of messing with the heart of their business. they’ve seen too many of their corporate and government brethren become totally quagmired in similar upgrades that failed completely, and left the organization crippled and stuck in court trying to get their IT contractors (like EDS and Accenture) to fix the system or cough up the huge amount of money they took.

  18. I work at a hospital that uses a similar decades old system. Sure it works as it it doesn’t crash, but it’s also really inefficient to use and doesn’t interface with any of our other half dozen similarly old databases. Is missing a bunch of fields that we need so every department/division has their own unconnected shadow database.

    If you want to point at a real quality and working hospital database system look to the VA hospitals. They use a opensource system that is supposedly awesome. I wish we could use it here.

  19. Hey that looks like the systems I work with on a daily basis. Data entry users don’t need a fancy UI, they need a place to type in data…. thats it. As much as I endlessly harass our terminal based apps, they are some of the most stable applications I support.

  20. It use to be green, but then the Hercules card died and they couldn’t find another at the MIT Flea.

    But hey, my Kaypro worked like a charm for years (used it to store recipes!) so maybe this ol’ warhorse will do fine.

    Wonder if they have ZORK on that thing…

  21. Dead ringer for the ancient system I use every day at a major university. It does what it does well, but the platform does not provide the functionality that people need today. As a result, its use is cripplingly inefficient.

  22. Back then user interfaces were handcrafted with the application in mind. Today you often have “Cargo Cult” UIs, where things are done in a way, because others do it, too. Often this will result in user interfaces where one has to switch between multiple forms of input, even though it’s not really nessesary.

    Programmers often don’t understand why it’s vital that user interfaces can be used efficiently.

  23. The DB for credit card accounts at Citi is the same way. There’s a Windows interface over the top of a legacy system. For someone who is unafraid of a terminal window, the legacy system is faster, more efficient, and gives access to commands and features which are not even implemented in the Windows layer.

  24. Yeah, when I was a student, my university library was in the process of replacing their search terminals (actual terminals – DEC VT terminals with orange screens), with Windows boxes that automatically opened up IE on the library’s search page.

    The problem was exactly what Lagged2Death describes – the results were (in this case) exactly the same, but flexibility was reduced, the whole thing was slower. Also whenever you wanted to look for a book, there were always people reading their webmail hogging all the web search terminals.

    It usually made your search quicker to go across to the other wing of the library and up a flight or two of stairs, and find an unused orange-screen terminal – even if you had to go back to the main wing to get your books.

    To give them credit – the new system let you search for interlibrary loan materials, which I don’t think the old one did.

  25. I work for a healthcare software company, and I can tell you firsthand that newer is not better. And keyboard-only data entry is vastly superior to click-happy windowing interfaces, for many purposes. Of course that’s not universally true, and the interface that finds the happy medium (which I have not yet seen) would be amazing.

    Also, I see an NPI (National Provider Identifier) field in that screenshot–those were not really implemented until the last few years, so I’d imagine this system gets updated even if not “overhauled”.

  26. I think systems like this will be in use for years to come. As others have stated, these text user interfaces are still commonly used. These systems were bought a long time ago and became entrenched in the business. Trying to migrate to something new turns out to be difficult because the software often uses proprietary and/or old storage technology that makes it difficult or impossible to migrate data out of. A lot of “updates” with web interfaces are grafts onto this old system that perform poorly, making the original text interface “easier” to use.

    I worked for a university that used a text interface based student information system that I think dated back to 1980. Once you learned the commands, it worked well, though you couldn’t call it elegant. I think the software was still supported by a company that bought the company that bought the original company that made the software, but there wasn’t really an upgrade path.

    If you have propriety software that you have been running for 20+ years with database storage just as old, what is your upgrade path?

  27. Legacy computer systems with archaic interfaces are the locomotives of the business world. Not as flashy as the latest hybrid car, but behind the scenes they’re carrying most of the load.

  28. I often see people complaining about “text interfaces” and how a “GUI” would be better, but they don’t seem to have thought this through. Consider: what would a “GUI” version of this look like?

    Well, you’d have all the same fields, and they’d work the same way, except that now they would be white boxes with a black outline surrounded by grey, instead of black boxes with no outline surrounded by black, and you could move between them with the mouse as well as the keyboard.

    And that would be the only difference. Colour scheme and mouse support. It’s not “easier” and it’s not “more friendly” – these are lies which have been sold to you by consultants who want to charge you a great deal of money for that colour scheme.

    (You think some of the fields are useless or should be changed? Well, that can be changed just fine on the existing system…)

  29. Not only are these type of systems often incredibly robust, but people who enter data for a living _love_ them. I used to do accounting software, and users would revolt if we added ANYTHING that slowed them down (ie, a box you had to tab past). Clicky-clicky GUIs _suck_ for repetitive text entry and I can promise you no one is wasting time on this computer surfing the web.

    Long live the ugly black and white texty screen!

  30. I work with a “large ticketing system” that is all command line driven and I am completely happy with it’s performance. When I first started it was all dumb terminals and tractor feed printers. Now there are all sorts of slick web and windows based interfaces for it, but the core remains the same. I can do the commands in my sleep at this point and it is very robust! But, alas, I am a dinosaur and as more folks go with the web based versions they’ll be less and less of us folks who can hack the database. I am fighting progress tooth and nail because I can accomplish things much faster than any windows point and click user can.

  31. I think at some point, that exclusive cabal known as “everyone” decreed from their ivory tower that anything with a mouse pointer was “easier” than anything without a mouse pointer.

    Since then, the notorious underground counterculture known as “everyone else” conspired that anything without a mouse pointer, already being “harder” than anything without a mouse pointer, should be given a steep learning curve. So that little cheat sheet that tells you what all the F1 through F10 keys do at the bottom of the screen, that went away, superceded by a list of keystroke commands that can be forever expanded with the use of meta keys and extended command line options, and if you can’t figure that out, then you don’t deserve to edit text files with vi, or play nethack.

    The war continues within my own Mac. You can use Terminal to go to one world, or Aqua to go into the other. People who use X11 are mouse traitors, and are thus denied the use of the all-important “meta” key that so many useful apps seem to demand. People who want to use function keys must first make a burnt offering to System Preferences, explaining that F2 means F2, and not “volume down”.

    And in the meantime, way too many of the things I have to do at work are done through a web browser.

  32. @coltraneofmars

    You called it on the upgrade path. I worked for a Canadian telco as a contractor when they wanted to migrate from a legacy system to a newer and more widely adopted system – it was difficult, time-consuming, expensive, and fraught with peril.

    When no one has ever migrated from system A to system B, there are a lot of unknowns, and the people who are experts with system A have a lot of disincentives to cooperation (i.e. you’re killing the only system they have twenty years of experience with and what are they going to work at when the migration is done?)

    In our case, the telco got bought by another telco, and the buyer was also the maker of system A, so the whole migration thing got called off anyway, which was okay by me.

  33. Looks substantially like the IBM System i most of the insurance industry has been using for at least the past two decades.

    Something many people don’t realize about these programs is that they’re insanely customizable and customized. Upgrading any part of this involves a massive duct-tape job.

    I’d agree with Patrick Austin though: though most of the people in my company who work with AS400 regularly wouldn’t mind an updated appearance which was easier on the eyes, they’d probably pitch an unholy fit if the interface changed much.

  34. CRS’es (Computer Reservation Systems) for airlines in the travelindustry work similar. Jus a blank screen and a cursor. Just type ‘a10sepjfklax8a’ and the system responds with an availability of all the flights on sep. 10 around 8 am from New York JFk to Los Angeles.
    Eat your heart out pull-downs!

  35. When I worked at Kaiser, we had a system like this. Every time I wanted to order something for a patient, I had to go down four levels to order it, then up four levels to go to the next task, then down four levels again, etc. It took me twenty minutes to do a list of tasks that I could do in 30 seconds with drop-down menus.

  36. Yeah, its ugly on the eyes but I agree with Xeni: I’m sure it works perfectly. Its almost certainly a mainframe application which has been used for decades, survived Y2K in-tact and runs on expensive but hyper-reliable mainframe hardware.

    Users have, no doubt, memorized all the key-commands and probably fly through the menus with a speed that’ll make a Window’s user’s head spin.

    I’m sure its a steep learning-curve for new users but its probably also true that the annual down-time is measured in minutes rather than days.

    And lest we forget, In the beginning, there was the command line.


  37. Having worked with and made applications replacing this kind of technology, I have to say that ‘works perfectly’ is usually matched with a mindset that can’t see the forest for the trees.

    Since then, there are great strides in GUI and data relationships that can make things better. This can happen when the interface is created with the help of the personal whom the interface is designed for. It’s not enough to just create a wish list of features. You need to know how the data is used.

    With some of the project I was involved in at Emerson College (StageDoor & Housing Selection), we treated our projects like video games and conducted playtests. Sessions where we invite the people whom the application is for to ‘play’ with the interface. This isn’t a bug hunting exhibition, but a way to see how people interact with the data.

    So it can be done right, but only with proper study in how people use data. That requires a lot of discipline and care in the process that is sadly rare in these sorts of applications.

  38. ASA-400? Standard Character interface, only difference is the company I consulted for displayed it on the IBM terminal program for Windows.

    The data screen actually isn’t too different from the one State Farm uses for their Auto Insurance in my local Agent’s office. It’s not flash, but it sure is quick!

  39. i don’t think there’s a single person i’ve talked to here that prefers our new Peoplesoft system over the rock-solid (and much more flexible) CICS system we used to have, neither programmers nor functional users.

  40. Oh, please

    It might be good; it might be lousy… that’s got nothing to do with how “modern” it looks.

    Bill and Steve will just love you guys for this item.

    Many character-based systems are more efficient than WIMPS-based stuff, especially for pro data-entry staff. That mouse really slows people down. Some old systems are better at type-ahead too.

    If it’s lousy, and needs updating, fair enough, but if not, hey, leave it alone!

  41. Believe me, it’s not just health care that uses old AS/400 tech. Much of what I do is integration between old AS/400 apps and newer slicker LoB apps. You would not believe how far integration has come these days. Companies never have to transition because they can just integrate it.

  42. Why not have updated systems without fancy GUI interfaces? I’m sure quite a few programmers would be HAPPY to throw black console screens at users.

  43. i don’t work in healthcare, but for a sales organization. they have been telling us we will be switching from our antiquated AS400 order entry system to a new system with a “better, more versatile” UI. we all feel that they will give us back AS400 once they see the sales numbers plummet like crazy when we are all forced to use this new system.

  44. I’ve shared this link with my girlfriend who works for the MN Department of Human Services. Her reply: “We keep in real in MN– who needs new fangled systems ;)You can tell him his bet is wrong.”

  45. I work on a system like this, but running on a Tandem Non-Stop (main difference: Fuction keys are numbered 1 – 16 instead of 1 – 12). Our Development department has been trying to rewrite our system to run on a series of SQL servers, using middleware communications software & GUI based clients for 20 years now and they’ve almost gotten the functionality up to where it is running on the Tandem, but they can never touch the availability of the Tandem (I think our production system passed 7 9s last year. That’s 99.99999% up time).

  46. My college “upgraded” to a GUI based student management system a couple of years back. The woman in charge of operating the system said it takes about twice as long to do anything in it.

    You see, the old system wasn’t pretty, but was very easy to work with once you knew the keys to press. The new system with it’s constant dependence on the mouse for input makes things slow and clunky. Even though anyone can use the new system, only one woman needs to and now her work got twice as hard.

  47. I like it. It looks like it is possible to do everything you need to do without ever having to touch a mouse, so it would be more efficient and easier on the wrist. I hated using GUI based software that wasn’t keyboard usable. It slowed everything down and made my wrist hurt.

  48. heh, I just can’t get the image out of my head of interns or trainees walking up to a desk with an attached keyboard 2 a dumb terminal and their eyes glaze over while their right hand sort of reflexively gropes for a mouse.
    Oh lord, and the function key?
    It seems that in the public perspective, ease of use within any scale is ‘micro$.’ Which means whatever it means. Does GUI = bucks?
    As a library user at several universities, I loved and learned on, the old command line stuff. It was fast and functional. The new stuff is like eating hard serve ice cream with a colonel sanders circa 1987 spork. I can do it, but I don’t like, and it pisses me off. Doesn’t that defeat the purpose?

  49. I worked in the billing department of a medium sized hospital in New Hampshire one summer. It was hell on earth.

    We had a ‘paperless’ system, which involved every day beginning with the arrival of ream boxes of dot matrix triplcate forms. As the temp assistant girl, my first job every day was to rip off all the sides of the sheets, rip apart the sheets, and staple each claim together. Then, later in the morning, we would, armed with those roll on wite out things, manually go through the forms and correct codes. Then we would go into the computer system and correct more codes. Then they’d go off to the insurance company, half would get paid, and the other half would come back for another batch of tweeking.

    Most claims the hospital would end up ‘writing off’ 20-60% of the charges. The hospital jacks up prices because they know the insurance won’t pay it all, the apparent cost of health care goes up, the insurance company increases rates, it’s terrible.

    Did I say it was hell on earth? It was. I made the most money I had made to date- $11/hour, but refused to go back the next summer. I took a job at the mall for $8 instead.

  50. guysmiley: from your link: “I will discuss how the … addition of user-friendly features … contributed to the radiation accidents.”

    It seems that unnecessary improvements in that case, made things worse (or at least didn’t improve the things that were wrong). I don’t see how this supports your implied position.

  51. I work at a chiropractic office and we run an old dos based system – looks lots like the capture above. We have tried a new system and learning and transering information has causes such a headeach that we have gone back to the old dos system. not to mention both the dr.s here are older and simply cannot figure out how to work the scanned in forms – not worth it!

  52. Looks similar to the UI for the NJ Child Support system they just turned off permanently two weeks ago. It was replaced by a GUI-based system that looks pretty but is so buggy, it makes a beta version of (Microsoft/Apple/Insert Your Preferred Software Maker of Hate here)’s software.

    A beta version of a program designed for a child.

    Designed for a child and coded by monkeys.

    Who are high on crack.

    People’s support payments have gone missing, been overpaid, warrants erroneously issued/rescinded, and other life-changing events for our litigants because of the new, bug-filled (but pretty!!!!!) system.

    I miss my old system — and I say that as an employee, a proponant of (necessary) change, and a techno-junkie.


  53. Our hospital uses several different electronic health record systems (one of which resembles that UI). The old “solid as rocks” program works, yes, but it’s such a mystery that no one in the company that owns it knows what the acronym title stands for (seriously).
    Sure, if left alone, it would be a powerhouse, but as electronic records are being used in more areas, the old programs all but puke when trying to move data in and out – they just weren’t designed for that. Any new users are left stranded for months until they figure out the multitude of secret codes and keystrokes. And system updates risk the whole thing crashing down and possibly never recovering.
    All medical software needs to be updated on a regular basis to be current (procedures, billing, etc). If it cannot achieve this goal, it does not matter how solidly it runs.

  54. AS/400 would not have PF keys – that is more like CICS or something from the old mainframes. I bought an i5 (AS/400) 2 years ago and implemented a character based ERP for our metal fab company. We use software still being developed in Canada which is awesome. The machine was about $70k and has 150 users in 4 plants. Barcode terminals and printers all over and lots of 5250 emulation windows open on lots of PC’s – all running character interfaces and everyone with two hands on the keys at all times.

    I should take a video of some of our better keyboarders flying around the screens – no one can click windows as fast as a properly caffeinated and experienced character based operator.

  55. Oh, come on. Graphical user interfaces are the most overrated, inefficient wastes of resources since the automobile. This operating system probably runs on a toaster, costs nuts and your slack ass employees can’t play facebooks and solatairs up on it.

    If the purpose of the operating system is text based, like 95% of what we do with computers is, it is only logical to operate in a text based environment. Instead we have to have 4gb of RAM and quad core CPUs and $300 video cards to read the onion and sned instant messages to our grannies.

    Don’t knock the text based UI, my friends. It’s the plugin hybrid of operating systems.

  56. No shame using COBOL, CICS, and IMS/DB – just the way your father used to code…

    Really though, the sight of a CUI (Character User Interface) is foreign/alien to many Boing Boing’ers? I guess I’m old-school…

    BTW, COBOL (at 50 Years Young!), CICS, and IMS/DB are all very capable transaction processing technologies, and in some ways are superiour to object-oriented, seven-layers of abstration code you young whipper-snappers pound out in your latte fueled coding fits (we old pharts prefer our caffine the old-fashioned way, black cofffe or Coke ;^)

  57. Ever look at the systems your bank tellers are using? Around here (NJ, USA) character-based interfaces are quite common, typically served up on modern, small form-factor PCs running trminal emulation programs back to the datacenter…

  58. I work on a Windows GUI app that uses an iSeries/AS-400/whatever-IBMs-calling-it-now for the back end. The back end system is popular in our market segment, and we’re producing lots of new screens that look very much like that. All in some flavor of RPG.

    The most important thing about it is bad analysis and crappy programmers can make just as huge a mess there as they can on the PC. We do our best to not be crappy programmers, and to admit it when we are so that we can fix it. Alas, the guys on the other side doing the green screen work tend to have a culture that is less proactive about producing good code. They are much more business-pragmatic (does it work? does it make money? good enough.).

  59. “Designing something” is easy.

    Designing well crafted, efficient tools, applications, appliances etc. that fit to task, guard against human shortcomings, and support sound, modular concept-based learning and skill development from novice level through to mastery is very, very hard.

    …OK, but not always *that* hard. C’mon. “OOPS”? Really? :P

  60. The system is not an AS400.

    The 400 had a name change to iSeries then i5 then Systemi etc but everyone including IBM still call it a 400. Stupid marketing department.

    Our 400 is primarily used for data entry and those greens screens (PC terminal emulation software) are FAST. The 400 runs Linux, html, ftp, C, Unix etc and more. If I want to do reporting then I write in html and interface to the database. Reporting is PDF and emailed. Horse for your course people.

    The core business software was written in the late seventies and there are NO bugs left (well not that anyone can find). The company owns the software. The business rules are all codified.

    Sales vendors for new systems are laughed at.

    The only problem is it is made by IBM.

  61. I’ve worked for four different health insurance companies. Not only did they all have systems that looked like this, they all had two to four different systems like this that didn’t interact with each other: billing, case management, provider database, preauth. Also lots of hospitals have stuff like this for lab data.

    At all of the four insurance companies, there was not one person who really understood how all the programs worked. For some of the programs, no one completely understood how they worked. There were plenty of lines that no one knew what it meant and what was supposed to go in it. Usually someone somewhere had a manual in a looseleaf notebook you could look at if you didn’t take it out of their office. Most of the time it’s missing pages or just doesn’t make sense.

  62. I work at a Board of Education that still uses an AS/400 in the finance department. Someone above was right: When I got there, I asked for training on navigating the system and all I got from the finance folks was a shrug of the shoulders…they didn’t want anyone in their “club”. When I asked for a command “cheat sheet” to get to certain functions and reports, they just looked at me and told me it was easy and that I would be able to figure it out!! Well, it isn’t so easy when you don’t know what functions are available…and I’m still figuring it out. But watch them do the keystrokes, and it’s like perlman on a stradivarious!

  63. I work for state disability and use that kind of system. I’m 23 years old and it only took a day to learn it. It may look very out-dated, but it works well.

  64. My city is about to have a new system for public transport tickets. The costs have blown out to ridiculous levels. We still miss the people who used to just sell you the tickets on the trams and don’t get me started on electronic voting machines.

    You from Melbourne?

  65. Comments that said what I was going to say, but better than I would have:

    Those are the standouts for me.

    My healthcare I.T. anecdote: Being hired to watch a giant bank of monitors, each running 6 terminal server sessions, with each session running between 6 and 10 clipper programs that moved claims information. My job was to flip through all the windows and watch for red dialog boxes, then press “alt/c” and “Y”.

    My wife’s CICS to Web App anecdote: working at a bookstore and no longer being able to ship special orders to Canada because the programmers “validated” the address field.

  66. Interesting. I am not familiar with this system. As a MUMPS programmer ( I am very familiar with this old roll and scroll style of UI. I’d say 90% of Hospital EMRs (Epic, Cerner, Meditech et al) have something like this under the hood.

    Like everyone else has stated, there’s nothing wrong with this. No doubt this “page” loads really, really fast. A key ingredient for heads-down data entry…

  67. I’m a tinkerer. I could develop a beautiful, complex geared system to get food from your plate to your mouth, but you’d use it once and go back to your fork.

    Simple UIs fit simple tasks. Or as experienced people like to say, “If it ain’t broke don’t fix it.”

  68. Here’s a mainframe story for you, out of a decade and a half of them. I worked for a large power utility, supervising the outage management system. IBM 360/CICS/VSAM. The app was a minor resource user until there was a bad storm and power lines went down, then attention turned to OAS to manage customer service restoration. We’d terminate all of the other apps on the machine and the outage system would just devour all of the CPU and IO for hours, or sometimes days with every resource running flat out in the red zone. No reboots, no reorgs, no reloads, just cranking hundreds of transactions a second. It never even stumbled. Once after a tornado went through Hamtramck and knocked hell out of the power grid for 2 weeks I looked at the specs on the app. The worst transaction response time the system hit was 1.25 sec, a delay you’d never notice, under a transation load 10,000 times heavier than normal.
    That, my friends, is engineering.

  69. You damned kids and your fancy Windows GUIs with their pop’m-ups and dropsy-downs can just take your toys and get off my damn LAN!!!

  70. When the insurance company that I worked for in 1995 first got a PC department the CFO was afraid that a network would allow people to steal data. The programmers had to copy everything onto floppies and walk it around on foot to share information. Wow. The memories.

  71. It’s not just about having boxes or a mouse. The text size on this old program is HUGE. As a result all the text has to be abbreviated and readability is tough. It’s also pretty ugly when characters are pretending to be borders.

  72. Would someone please inform these newbies that computers have been around for a long time before BoingBoing ever existed?

    Something to think about is that TRILLIONS of dollars worth of data for most of the largest companies in the U.S.A. – still reside on and are processed daily, on mainframes.

    To migrate away from a mainframe costs millions of dollars, is error prone, and usually doesn’t improve your workflow or reliability at all.

    Other comments have made other points too, about efficiency and whatnot.

  73. @Guysmiley #55, the THERAC-25 system had a number of problems that contributed to those deaths and other injuries, but the UI wasn’t one of them. No operator error was involved beyond continuing to use a system that was obviously cantankerous.

    If changing the treatment mode can reconfigure one part of the machine but not another, leading to a massive overdose, it doesn’t matter whether the treatment mode is specified as letters, text, drop-down, radio button or physical switch. The operator worked correctly, the machine didn’t. If there’s an error message of the form “malfunction 54, zero dose delivered, proceed / abort?” it doesn’t matter whether proceed is the “P” key on the keyboard or a button clicked by the mouse. Again, the operator worked correctly, the machine didn’t.

    The problems were caused mostly by a combination of crappy software (and crappy software engineering process) and the removal of interlocks between the Therac-20 and Therac-25 models.

    Operator error or the UI had nothing to do with it.

  74. I’d love to join the text-interface love-in as we have all sorts of old terminal stuff here in my corner of the NHS. But it’s not quite as simple as “if it ain’t broke, don’t fix it.”

    These old systems run on old OSes that run on old hardware. You try buying something that’ll run 3.0 or *shudder* old versions of Novell. Or getting parts for a 1980s VAX. It’s a fun hobby, but sourcing parts for ancient kit to keep it running is no game when the kit has to be high-uptime reliable.

    Worst of all, it’s so ancient and nichey that we can’t even virtualize it. All the medium-old stuff has been Ascended to the Cluster of Glory, but that singularity is denied the really crusty gear becuase, once again, the hardware layer isn’t supported.

    So we’re stuck with a system that works, but we have to offer prayers to the hardware gods every time it reboots in case the damn thing blows a gasket.

  75. For an authentic old style computer experience, just play some Fallout 3 – the in game computer hacking is a proper old school green screen delight, just like it was in the old days!

    Hats off to the Fallout 3 designers…

  76. I’m about to use this system and I love the fact that I *never* have to use a mouse. Also, I can change the text color/background on mine. :-) black/gray isn’t very kind to the eyes.

  77. It seems that unnecessary improvements in that case, made things worse (or at least didn’t improve the things that were wrong). I don’t see how this supports your implied position.

    A simple LOOKING text based UI can still be a disaster of muddled complexity.

  78. I couldn’t agree more with everyone’s post about how crappy GUIs are… though I couldn’t see the image on Lynx, how does it look? No need to use a fancy GUI tool to browse the web… or review a patient’s medical history…

    Crappy user-interfaces suck, always. But text only interfaces support simple-tasks, or people that are willing to learn complex (albeit, powerful) commands and scripting. Managing patient health is not a simple task, and I can guarantee you that healthcare professionals don’t have time to learn regular expressions to do their jobs (or learn what PF3 is, or what the “any” key is…) That’s not an excuse for poorly designed systems, but the lust here for page-after-page of menu based, green-screen, text only systems (regardless of the application) is, I guess, an only too predictable extension of the usual neo-Luddism (see Steam Punk)…

    “Rock Solid.” Sure, do you know what else is rock solid? A rock. Go carve your data on it. Never fails.

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