However, the goal of compiling patients' medical history so that it can be easily viewed and managed in one place has yet to be fully realized. The first EHR systems, around the 1960s, were known as clinical information systems. They influenced later systems because their processing speed and flexibility allowed multiple users to access the system at the same time. Around the same time, the University of Utah jointly developed Health Evaluation through Logical Processing (HELP), one of the first clinical decision support systems (Rosenthal, 2007). Subsequently, in 1968, the development of the Computer Stored Ambulatory Record (COSTAR) began at Massachusetts General Hospital, in collaboration with Harvard. It is designed to perform the data management functions necessary for an outpatient care practice. In the 1970s, the federal government began using an enterprise-wide information system built around the EHR called the Veterans Health Information Systems and Technology Architecture. Before the information age, medical records were all stored in folders within secure filing cabinets in doctors' offices, hospitals, or health departments (Rosenthal, 2007). The information contained in the records was confidential and shared exclusively between the patient and the doctor. Today these files are fragmented in multiple treatment centers due to the branching of specialized centers such as