13,000 BC: Pre-historic humans decorate their caves with images of herbal remedies used for their medicinal purposes. Unfortunately, these primitive clinical information systems are not CCHIT-certified, and reimbursement for shamanism drops dramatically. Neanderthals go extinct.
2600 BC: The Egyptian Imhotep describes the diagnosis and treatment of 200 diseases. ICD-10 soon expands this list by nearly three orders of magnitude.
460 BC: Hippocrates, the “father of modern medicine,” writes the first draft of his famous oath. After an extensive public comment period, Hippocrates tones down his commandment to “first, do no harm by taking an extensive medical history, including prior medications, allergies, and surgeries and accounting for the patient’s renal and hepatic function“ out of concern that this tough requirement may hamper widespread adoption.
150 AD: Galen of Pergamum, pioneering Roman surgeon, insists on using only papyrus. He refuses to implement parchment in his practice because he finds it so disruptive to his workflow.
1231: Theodoric, Barber of York, proposes standardized terminology for various forms of bloodletting, primarily so he can “upcode” to get increased reimbursement for using leaches.
1427: As the Black Plague sweeps through Europe, self-flagellation is lauded as a pioneering effort for health information exchange. Whole communities get into the act by burning sufferers alive, using the fiery glow as a novel public health reporting tool.
1601: James Lancaster proves that consumption of citrus fruits prevents scurvy in British sailors in the world’s first controlled clinical trial. Unfortunately, in a world without quality metrics for scurvy prevention, Lancaster fails to achieve his pay-for-performance bonus for the year.
1795: After a mere 194 years (and 1 million scurvy deaths), the British navy mandates lemon and lime juice as standard sailor’s rations. Next up, EHR adoption.
1816: Rene Laennec invents the stethoscope, which is subsequently rated “Best in KLAS” over the objections of the Open Source community.
1845: Surgical anesthesia is pioneered at Massachusetts General Hospital. The Federal government sets up “Regional Anesthesia Extension Centers” to assist in anesthesia implementations nationwide.
1854: Florence Nightingale begins a medication bar-coding initiative during the Crimean War, but then realizes it would be preferable to save lives by cleaning the army hospital’s sewage system.
1884: Robert Koch establishes his famous postulates to identify microorganisms responsible for various diseases. Privacy advocates successfully sue Koch, forcing him to go back and de-identify the pathogens.
1889: Sir William Osler creates the medical residency but completely fails to anticipate the headaches his other creation, the co-signature, will cause in 120 years.
1895: X-rays are discovered by Wilhelm Röngten, without the assistance of a PACS. Nevertheless, for years Röngten would claim that his images conform to DICOM standards.
1928: Alexander Fleming extracts penicillin from mold growing on a tablet PC he had forgotten to plug in for several days. He tries to e-prescribe the antibiotic for a patient, but the antibiotic is not in his “favorites” list, so he handwrites the prescription and gets the dosage wrong.
1967: Christiaan Barnard performs the first human heart transplant. No one ever hears about it because Twitter has not yet been invented.
2003: The human genome is completely sequenced. Instead of the expected ACTGs, the genome is apparently filled with strange acronyms like LOINC, CCD, CCR, and HL7.
2008: CCHIT is involuntarily dissolved for the first time.
2009: David Blumenthal, the National Coordinator for Healthcare Information Technology, delivers the government’s definition of “meaningful use” to an immense crowd of jubilant healthcare providers from the steps of the Lincoln Memorial, after an opening concert by U2. Healthcare in the US is saved! The rest of the industrialized world yawns while besting us on nearly every relevant quality measure for the tenth straight year.