MUMPS users had a sense of humor: the shirt pictured on the cover of this special issue of Computers in Healthcare reads, “MUMPS means never having to say you’re sorting.” (RG035, Institute for Biomedical Computing Records)
If you’ve ever accessed your electronic health records (EHR), there’s a good chance you’ve encountered MUMPS—the Massachusetts General Hospital Utility Multi-Programming System, that is, not the vaccine-preventable disease. Originally designed in the late 1960s specifically for building medical databases, MUMPS and its descendants continue to form the basis of the EHR software used by many hospital systems today.
MUMPS was developed in the context of heightened attention to, and federal support for, the potential uses of computers in medicine. By the 1970s, some institutions had begun to create MUMPS applications suited to their specific needs. These applications were implemented on increasingly affordable minicomputers—including the Artronix PC-1200, a version of the Programmed Console (PC) developed by Biomedical Computer Laboratory (BCL) researchers at the Washington University School of Medicine in 1965. This is just one of many connections WashU Medicine has to the history and evolution of MUMPS—from coordinating the users’ group, to contributing to a standard language, to providing database services to the campus community.
What is MUMPS?
Neil Pappalardo, Robert Greenes, and Curt Marble first developed MUMPS in 1966-1967 in G. Octo Barnett’s Laboratory of Computer Science at Massachusetts General Hospital. MUMPS is both a computer language and an operating system. As historian of computing Joseph November puts it, “MUMPS is not so much a general-purpose programming language as it is a hierarchical database construction kit with a built-in programming language.”1
Click the images to read, “What is MUMPS?” (FC157-S09-B049-F09)
MUMPS Users’ Group
The first gathering of the MUMPS Users’ Group (MUG) took place at Massachusetts General Hospital in 1972. When MUG next met in St. Louis, Missouri, in 1973, the organization’s structure and mission had begun to take shape: it would serve as a hub of information for people interested in the use of MUMPS, particularly in health care and medical computing. MUG facilitated the sharing of knowledge and promoted the use of MUMPS in myriad ways, such as annual meetings, newsletter distribution, maintaining a library of applications, offering continuing education opportunities, and soliciting regular feedback from members. They developed by-laws, established membership criteria, and selected leadership roles—including BCL research associate Joan Zimmerman as Executive Secretary.
BCL housed the Office of the Executive Secretary of MUG from 1973 until 1977 (later documents refer to the position as executive director), and with Zimmerman’s leadership, the international MUG mailing list grew from 830 to more than 4,200 individuals during that time. Much of her own work focused on ensuring that MUMPS applications were transferable, that is, designed in ways that were not institution-specific and that allowed for adaptation. She contributed to BCL projects in medical information systems and health care technology, taught programming courses, and wrote or edited numerous publications, including Computers for the Physician’s Office, an early book on the burgeoning field of computerized medical record-keeping. After her term as executive director ended in September 1977, Zimmerman went on to serve as an interim member of the MUG Board of Directors and as chair of the MUG Education Committee.
BCL director Jerome R. Cox Jr. recommended Joan Zimmerman for the role of Executive Secretary of MUG (FC157-S06-B015-F07), and her appointment was later announced in the Washington University Record. The Bylaws of the MUMPS Users’ Group (1974) can be found in the Cox Papers (FC157-S09-B049-F09)
Excerpt from Washington University Record, September 14, 1978
MUMPS Development Committee
In 1973, a sibling organization to MUG, the MUMPS Development Committee (MDC), was established to produce a MUMPS language standard. Like MUG, MDC formed with support from the National Center for Health Services Research (NCHSR), part of the Health Resources Administration within the Department of Health, Education and Welfare, and from the National Bureau of Standards (NBS) within the Department of Commerce. BCL was an institutional member of the MDC and contributed to the first language standard released in 1975. In the decades since, the MUMPS language standard and subsequent revisions have been approved by the American National Standards Institute (ANSI) and the International Organization for Standardization (ISO).
By 1978, major federal funding of MUG had ended, and the group moved toward becoming a self-sufficient organization. This included expanding its newsletter to a controlled circulation magazine format, MUG Quarterly, which continued to broaden the reach of the group in subsequent decades. (RG035, Institute for Biomedical Computing Records)
Using MUMPS at WashU Medicine
In addition to participating in MUG and MDC, BCL staff collaborated with colleagues throughout the School of Medicine to respond to the computing needs of both clinicians and researchers. Many of these projects involved implementation of MUMPS on the growing number of minicomputers on the Medical Campus. Just some of these projects are outlined below, and you can read about more in BCL’s annual progress reports.
Washington University Medical Care Group
Excerpt from BCL Progress Report No. 9
In the early 1970s, a successor to the BCL-developed Programmed Console (PC) became commercially available through local St. Louis company, Artronix, when it released a minicomputer, the PC-1200. BCL implemented MUMPS on the PC-1200, and this “MUMPS-PC” was subsequently used in many activities throughout WashU Medicine. For instance, BCL worked with the Washington University Medical Care Group (MCG) to develop an automated patient encounter form and a database of patients who obtained ambulatory medical care with MCG.
Mallinckrodt Institute of Radiology
A MUMPS-PC was also installed in the Mallinckrodt Institute for Radiology in 1973. It was used to help computerize clinical operations, such as scheduling and billing, and an existing tumor registry was also transferred to the system in 1974. BCL also worked to develop a Multi-User Radiotherapy Department System on the PC-1200, in which data entered in the system could be made available to other user terminals via telecommunications.
Image from “The Computer Story at MIR,” Focal Spot Vol. 5, No. 6 (Spring 1976)
Medical Computing Facility and Medical Computing Services Group
Image from Washington University Record, July 4, 1985, p. 6
In 1975, the Medical Computing Facility (MCF) was established to serve the Medical Campus. Initially located at BCL, MCF was staffed and administered by the University Computing Facilities, and it charged users on a fee-for-service basis. The director of the facility, Simon Igielnik, saw MCF as filling a gap in the School of Medicine by providing “a low-cost reliable MUMPS service,” which would provide data processing and database management services. It would also provide “a high-performance data transmission link between the School of Medicine and the Hilltop [Danforth] campus,” which would help to make data processed with MUMPS accessible across campuses.2 As the need for computing services continued to grow, BCL collaborated with MCF, the Division of Biostatistics, and the University Computing Facilities to create the Medical Computing Services Group (MCSG) in 1980. MCSG offered general database services to the university medical community.
- Joseph November, “Ask Your Doctor… About Computers,” ed. Bradley Fidler, IEEE Annals of the History of Computing 38, no. 1 (March 2016): 3, https://doi.org/10.1109/MAHC.2016.5. ↩︎
- Proposal, 1975, VF04908-B143-F04908-i01, Bernard Becker Medical Library Archives, Washington University in St. Louis. ↩︎