Docs are Tired of PCs that run on Vacuum Tubes

Posted on November 1, 2010 I Written By

Dr. Michael J. Koriwchak received his medical degree from Duke University School of Medicine in 1988. He completed both his Internship in General Surgery and Residency in Otolaryngology-Head and Neck Surgery at Vanderbilt University Medical Center. Dr. Koriwchak continued at Vanderbilt for a fellowship in Laryngology and Care of the Professional Voice. He is board certified by the American Board of Otolaryngology-Head and Neck Surgery. After training Dr. Koriwchak moved to Atlanta in 1995 to become one of the original physicians in Ear, Nose and Throat of Georgia. He has built a thriving practice in Laryngology, Care of the Professional Voice, Thyroid/Parathyroid Surgery, Endoscopic Sinus Surgery and General Otolaryngology. A singer himself, many of his patients are people who depend on their voice for their careers, including some well-known entertainers. Dr. Koriwchak has also performed thousands of thyroid, parathyroid and head and neck cancer operations. Dr. Koriwchak has been working with information technology since 1977. While an undergraduate at Bucknell University he taught a computer-programming course. In medical school he wrote his own software for his laboratory research. In the 1990’s he adapted generic forms software to create one the first electronic prescription applications. Soon afterward he wrote his own chart note templates using visual BASIC script. In 2003 he became the physician champion for ENT of Georgia’s EMR implementation project. This included not only design and implementation strategy but also writing code. In 2008 the EMR implementation earned the e-Technology award from the Medical Association of Georgia. With 7 years EMR experience, 18 years in private medical practice and over 35 years of IT experience, Dr. Koriwchak seeks opportunities to merge the information technology and medical communities, bringing information technology to health care.

Those of you less than 50 years old may not even understand that title.  I promise I will explain what vacuum tubes are and show their relevance to our current IT state of the art as it applies to health care.

Go back in time about 60 years, to the period 1950-1970.  This era was the latter part of the “Golden Age” of television, when TVs in the home went from rare to commonplace.  Back then televisions and radios ran on an eccentric piece of technology called the vacuum tube.  “Tubes” are almost nonexistent today, but I’ll bet your favorite rock star still uses a vacuum tube amplifier to give his/her electric guitar just the right sound.

Tubes made TVs of the day unreliable and difficult to operate.  Turning the TV on required getting up off the couch, walking over to the TV, turning a switch and waiting about 30 seconds for the tubes to warm up before anything happened.  Then you chose the channel – there were usually only 3 to choose from – by turning a large clunky mechanical knob, adjusting the antenna on top of the TV (or on the roof of your house) for best reception, and finally tweaking at least 2 more adjustments on the TV to get a good picture.  As the TV got hotter the picture would drift out of tune and you had to get off the couch again to make further adjustments to maintain a decent picture and sound.

Vacuum tubes by nature destroy themselves in order to function.  TVs of the day rarely ran for more than a few weeks before some of the tubes needed replacing.  This was not easily done by regular folks, so back then there was a TV repair shop on every corner.

To make up for their technological shortcomings televisions were packaged in many imaginative ways to appeal to consumers.  There was furniture of all sizes and shapes with TVs built in.  TVs were also combined with record players and radios into so-called “console” systems.  Portable TVs weighed over 20 pounds; “portable” just meant the thing had a handle on top.

A whole industry devoted to TV accessories thrived.  Most of Radio Shack’s product line at the time supported the shortcomings of TV sets.  Available were dozens of different antennas, cables, cleaners, and of course replacement vacuum tubes.

Then from about 1970 to 1980 all this disappeared.  Several factors conspired to make this happen.  The biggest single factor was the replacement of vacuum tubes with “solid state” technology – transistors, for those of you who remember.  TVs and radios overnight became smaller, lighter, and more reliable.   They could run for years without any service.  Furniture-based console TVs disappeared, as did TV repair shops.  Portable units could actually be carried around.  Radio Shack had to revamp its product line since all those TV accessories were no longer necessary.

The modern flat panel TV lacks the character of its older counterparts because it is a simple flat box just big enough to hold the display itself and the plugs on the back.  It just does its job and doesn’t get nearly as much attention as it did decades ago.

Nice to know we have come such a long way since the 1950’s…or have we? Today’s  PCs behave much like the old vacuum tube TV sets:

  • Over the last 20 years computers in the home have gone from rare to commonplace
  • Turning on a computer takes about a minute, to load the operating system.
  • Computers are available in dozens of different forms including desktops, laptops, netbooks, tablets, and cell phones.  It seems like a new form is introduced every week.
  • Between system crashes, network failures, viruses, worms etc. our computers require frequent attention during normal operation to keep them running.
  • Computers rarely run trouble free for more than a few weeks at a time.  Much of the tinkering required to keep them running is beyond the reach of the average user.
  • There are lots of computer repair shops and IT consultants.
  • Thousands of computer accessories are available, many of which attempt to compensate for the computer’s intrinsic shortcomings.

If history repeats itself then we eagerly await the end of the “Vacuum Tube Era” for computers. We are at least one major technological advancement away from making computers fully mature for the patient care environment.  Physicians need PCs that work like modern TV sets – plug them in, turn them on and get back to work.