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A mainframe is a large powerful computer that serves many users (hundreds) simultaneously and is sued by large companies for bulk data processing, running several programs simultaneously and sharing of resources amongst the organisations various computer users.

The term ‘mainframe’ was coined in the 1970s when the smaller minicomputers began available. In those days mainframes were huge and could occupy a whole room or take out an entire floor. Today mainframes have decreased in size nut with in an increase in computing power and are sometimes referred to as large servers.

In the 1960s and the 1970s, mainframes were popular, with quite a number of manufacturers, but the arrival of the cheaper microcomputers and the concept of distributed computing reduced the demand for mainframes and a lot of the companies went under.


However the in the 1990, things started looking up for the mainframe manufacturers as they had not only slashed down the prices of mainframes to half of that they predecessors were going for but had adopted new technologies such HTTP, Java and TCP/IP. This meant that mainframes could now be deployed in creating networks and most importantly embraced the Internet. Mainframes are now used as web servers and form the backbone for corporate intranets and extranets.

Mainframes like the z series produced by IBM, now run on the free Linux operating system further reducing their cost of production and opening up mainframes to take advantage of the software and development skills already available for the PC market.

Mainframes because of their larger internal memory and high capacity external storage with fast throughput are ideal for data warehousing (Large quantities of information stored from various sources with the aim of returning high quality results when queried).

All these factors coupled with the fact that mainframes are highly reliable, they can run for years without any interruption and continue to do so even when repairs are being carried out thus making it easier to maintain, have helped lead the resurgence of the mainframe.

A major drawback is cost, they are expensive to purchase and upgrade. System and application software often have to be custom written, tying organisations into a fixed computing environment, and those who decide to develop their own software will find it is more expensive and more difficult than that of PC development as the programming tools are less developed.

Healthcare has had a long relationship with the mainframe computer. In the early days of computing, all software applications ran from a mainframe from which were connected dumb terminals. Mainframes then were used to process patient financial data and maintain an organisations inventory. Later electronic medical records and patient and staff scheduling were just some of the additional functionality that mainframes offered.

In the 1980s, despite the widespread use of client/server technology, and the fact that many of the client/server applications ignored the mainframe, a lot of healthcare organisations still continued their love affair with the mainframe computer probably due to the fact that mainframes had proven to be reliable and the organisations had already made a significant amount of investments in that area of computing.

The cost of migrating mainframe applications to the client server architecture could also have been inhibitive but healthcare organisations have addressed this issue by creating multi-tier architectures that make use of middleware components that access data from whatever computer servers were available.

Thus is not uncommon to find organisations that have both the mainframe and client/server architecture running side by side, as they are not willing to let go of the large computers, at least not yet.

The resurgence of the mainframe has also sparked interest in its use in areas of healthcare such as knowledge management and telemedicine where they can be used as large repositories of data.



International Medical Informatics Association
American Medical Informatics Association
UK Health Informatics Society
Healthcare Information and Management Systems Society

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Last Updated: 10 August 2006.

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