MUMPS, the Programming Language For Healthcare

citadrianne writes: An ICU patient is monitored and assessed according to 12 different variables. These include such measurements as body temperature, heart rate, blood oxygenation, blood pH, and others. Together, they're used to formulate a quantitative answer to the question, "How bad is it, doc?" Many of these physiological signs are measured in real-time via electrodes and like a billion different varieties of catheter. Add to it barrages of lab tests done multiple times per day per patient and the need for 20 or so clinicians (per patient) to have access to all of this data, and the result is very a deep data problem. Multiply that data problem by hundreds of thousands of patients.

This is the fundamental problem that the programming language MUMPS (sometimes called just "M"), or the Massachusetts General Hospital Utility Multi-Programming System, aims to solve. To its proponents, MUMPS allows for a one of a kind synthesis of programming and database management, while to to its detractors, it's a bizarre anachronism with little connection to the evolution and innovation taking place elsewhere in programming. Probably to most people that do things with computers, MUMPS/M is poorly understood, at best, and more likely to be completely unknown.

Comments

MUMPS: are you kidding?

[iTrawl]

O M G

Re:MUMPS: are you kidding?

[jthill]

I'm used to anti-{language,tool,method} screeds being ignorant braying in lieu of effort, but this . . . This isn't even remotely the worst of it, it's only that it's soundbite-able. That first link deserves the word "mindboggling". The list here starts out slow, easing you in to it gently. No, seriously..

• CASE SENSITIVITY: Commands and intrinsic functions are case-insensitive. Variable names and labels are case-sensitive.
• COMMANDS: may be abbreviated to one letter, case-insensitive. Includes commands such as IF, ELSE, GOTO, WRITE, and XECUTE [which is my personal favorite, it allows arbitrary execution of code contained in a variable]
• OPERATORS: No precedence, executed left to right, parenthesize as desired. 2+3*10 yields 50.
• DATA TYPES: one universal datatype, interpreted/converted to string, integer, or floating-point number as context requires.
• DECLARATIONS: NONE. Everything dynamically created on first reference.
• LINES: important syntactic entities. Multiple statements per line are idiomatic. Scope of IF and FOR is "remainder of current line."
• LOCAL ARRAYS: created dynamically, any number of subscripts, subscripts can be strings or integers. Stored in process space and expire when process terminates.
• GLOBAL ARRAYS: arrays that start with a caret symbol. Stored on disk, available to all processes, persist when process terminates. This is M's main "database" mechanism.

Re:Why?

[Anonymous Coward]

MUMPS originally had a sort of in-memory database layer (map > >). They then abstracted that so it could load chunks of the database on the fly from disk. Later, that became a separate product (forked?) known as Intersystems Caché, which billed itself as a post-relational database (read: pre-relational, hierarchical database). Caché at least added SQL-like language to the product so it could pretend to be an RDBMS... so it's not necessarily no-SQL, because they added SQL later, but it is non-relational, yes.

Re:MUMPS, ancient and rarely used

[angel'o'sphere]

That is not really correct. Cache is an objecy oriented database, Mumps is a programming language/programming system which happens to use Cache.

https://en.wikipedia.org/wiki/...é ... I wonder if that link works :)

Mumps usage

[kcokane]

/. comments seem to be a contest to see who can demonstrate the least knowledge of the subject. While Mumps is largely unknown to many, it is widely used in health care and finance. Epic Systems controls about 40% of the US market (http://medicaleconomics.modernmedicine.com/medical-economics/content/tags/electronic-health-records/why-epics-market-dominance-could-stifle-ehr?page=full) and is written in Mumps as is the world's largest clinical information system, VISTA (http://worldvista.org/AboutVistA).

Mumps is a simple, string oriented scripting language for a builtin multi-dimensional and hierarchical database (http://www.cs.uni.edu/~okane/source/MUMPS-MDH/stonehill.pdf). It is especially well suited for applications such as medicine where knowledge is often as varying depth hierarchies that are not well suited for relational systems.

The commercial vendors are Intersystems (http://www.intersystems.com - their version is called Cache') and GT.M (http://www.fisglobal.com/products-technologyplatforms-gtm) whose version is open source / GPL. My own version (http://www.cs.uni.edu/~okane/) is also open source / GPL and can map the Mumps global arrays (the sparse array trees) to PostgreSQL.

Comments from a former MUMPS programmer

[lurker412]

I used MUMPS (and MIIS) extensively while working in healthcare in the 80s and 90s. It was an efficient programming and database environment for mini-computers which combined a hierarchical database and interpreted language with sparse arrays and extensive pattern-matching capabilities baked in. It was widely used in hospitals for clinical operations and that legacy is still present in healthcare. The language itself would scare the shit out of anybody using modern technologies (self-modifying code, anyone?), but used with discipline it ran many applications that were literally a matter of life or death for patients. Some variants (MIIS, DEC) were also stand-alone operating systems running on the bare metal. It gave you lots of bang for the buck, even if the code itself looked like a printer test. There used to be a small but active community of vendors and users. Today, there is one large player, Epic Systems, which dominates the applications market, especially in the electronic medical records area. They use Intersystems MUMPS (now known as M) as the underlying language; it has an extensive application building environment on top of the basic language to provide relational, Web and object-oriented abstractions. You can build applications in this environment without ever touching MUMPS code, though commercial applications will generally drop down into MUMPS for special purpose routines.