Let’s Stop Using the Term “Data Lakes” in Healthcare, Since I Coined The Term “Clinical Data Repository”

I’ve been sitting on this one for a while because I didn’t want to seem rude. A number of folks have been asking for my opinion about the Oracle acquisition of Cerner and a lot of “woulda, coulda, shoulda” stuff. There’s a lot of real Digital Health OG’s out there that weren’t working for Boeing and actually crawled around IT basements in hundreds of hospitals trying to find the right RS232 cable or LAN connection to link up with a PDP 1184.

I remember when Cerner was a shitty little lab platform and Sunquest was kicking its ass in Clinical data representation. Back in the day, even Antrim and Rubicon did better than Cerner at presenting longitudinal lab values. A very strong argument could be made that Cerner wouldn’t exist today if they didn’t cash in on their $200 million+ investment in CareInsite. Cerner sold shares on the public market and received $84.7 million as part of a stock buyback.
Before AthenaHealth was a twinkle in Jonathan Bush’s eye, CareInsite was directing the creation of an internet based laboratory order entry and results reporting system at a hospital in NYC. Cerner staff like Scott Stuewe had pagers with direct connections to Neal Patterson, the late Founder and CEO of Cerner. The connection speeds to just login to the system were so slow that physicians couldn’t even use the product as intended. Cerner actually believed that this was the time that eHealth was born according to their 1999 annual report.

I say bullsh@t. The beginnings of eHealth stated earlier. I was recruited by CareInsight (that Morphed into WebMD) to help build this type of system. Twelve years earlier, my company Bukstel & Halfpenny, Inc. designed and implemented systems that were the very first to utilize open standards such as ASTM 1238 (HL7).

At the time, we built systems that allowed physicians to track information longitudinally. This type of tracking would be critical to identifying individual patient outcomes and many physicians and hospital systems utilized these types of application interfaces and clinical data exchanges as 20+ year precursors to Health Information Exchanges (HIEs).
I’ve recently talked with a lot of folks including my old partner Charles Halfpenny. There’s definitely an evolving story here and the implications and involvement of patients is the most important development to watch going forward. I am currently working on a product that will revolutionize interoperability in the workers compensation, medical malpractice, and personal injury domains of litigation.
Edward Bukstel
