In 1998 the concept of "middleware" for the web was just getting started.

Created bid, set deliverables and timeline, persuaded a key decision maker about feasibility of the emerging technology of web-based information management despite incredulity from hospital IT staff.

At the first meeting with the director of IT and Orthogroup spearheading the group, a lead hospital IT staff member walked out of first meeting in 1998 saying that the project “couldn’t be done with that timeline.” We shrugged and got to work using a fast-paced model that later became known in popular culture as "the Sprint." 

Led team in a one week Sprint with a successful demo that persuaded client that the system would work, despite objections from that key IT person and the bid I created was accepted.  Was the lead programmer, client contact, and DBA. Hired extra programmers for project and taught them HTML, PHP and open-source secure programming techniques. Client was overwhelmingly happy with project they used the successful first year as the basis for writing and winning a 5-year, multi-million dollar grant. 

Set up secure system that de-identified patients even before HIPAA standards were enacted.

Project grew to run over five years and span multiple hospitals for an orthopaedic study on tibial-plafond fractures.  Program integrated, in real-time, patient records from 6 Hospitals (Univ. of Iowa, Univ. of New Mexico, Univ. of Virginia, Wake Medical Center, Univ. of Tennessee - Knoxville, OHSU). Had to convert all relevant medical forms (SF36, MFA, SMFA, Pain Scale, Xray data, etc.) to HTML or PDF. Website created detailed, real-time project management reports and color-coded reports including reports by hospital, by forms completion, and by which follow up visits/forms were done at proper times.

Managed upgrades from PHP2 to PHP3 to PHP4, from mSQL to MySQL3 to MySQL4 to MySQL5, and numerous Linux OS upgrades.
 
Program requirements grew to require statistical analysis and reporting. I self-taught/researched relevant medical conditions to create medical-statistical analysis package for real-time data analysis, but no PHP statistical plotting software existed, so I  created and released as open source <a href="/1998_phplot.htm">PHPLOT</a>, one of the world's first web-based graphing libraries which eventually became the world's 6th most popular opensource download (as measured on Sourceforge)