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Posts Tagged ‘SaaS’

Yesterday, Microsoft announced a new joint venture with GE where both organizations would transfer significant healthcare software technology into a new company led by GE health care executive Michael Simpson. This new company will be based in the Redmond area and have more than 700 employees dedicated to HCIT solutions.

A few months back, Microsoft sold its EMR (Amalga HIS) to Orion and via this announcement,  is transferring two of its three remaining healthcare assets – Amalga and Sentillion – into the JV.. Curiously, Microsoft is hanging onto HealthVault, its personal health record (PHR) suite.

It is hard to grasp why Microsoft would jettison its “crown jewel” HCIT and clinical solutions into the JV and say goodbye to most of its healthcare team (including top exec Peter Neupert (retiring)), while apparently remaining content to simply sell its horizontal platform and servers into health care settings.  (We understand that many Microsoft employees will be transferred into the JV). Moreover, what will become of other HC initiatives underway at Microsoft such as their announced work in the insurance exchange marketplace?

A straight up comparison of Google’s complete retreat from health care to this move by Microsoft is a bit unfair, but yet another juggernaut exiting from an industry desperately in need of new ideas is puzzling.

Is this JV the type of new idea needed by the healthcare sector?  Nat McLemore, GM for Microsoft Health Solutions Group describes the GE / Microsoft JV as follows:

“… Microsoft and GE Healthcare have just announced an exciting new initiative aimed at improving healthcare quality and the patient experience. The two companies are creating a joint venture that will combine Microsoft’s deep expertise in building platforms and ecosystems with GE Healthcare’s experience in clinical and administrative workflow solutions. The new venture, which is pending regulatory approval and has yet to be named, will develop and market an open, interoperable technology platform and next-generation clinical applications that will help enable better population health management.

The joint venture’s foundational offering of an open technological platform will also enable application developers to build customized, differentiated solutions that interact to meet customers’ specific needs. By enabling independent software vendors, system integrators and healthcare IT pros to develop on a common platform, the joint venture aims to support a robust ecosystem of partners that offers customers real choice.”

For veteran watchers of technology centric alliances, it is easy to be skeptical.

The platform approach is exactly what Microsoft Amalga was about – a gigantic integration engine for healthcare. It is no surprise that Amalga will be a major foundational asset in the new company. The challenge with Amalga, and the reason why its adoption was limited in the US, is that giant footprint implementations are far from the ideal solution. Amalga required massive investments and a multi-year implementation to stand-up, and in a world where hospitals and other healthcare organizations don’t have the appetite or budget for monolithic systems and if they do…it likely orbits around an EMR.  The likes of Epic have taken up most of the bandwidth that hospitals can afford for big-iron IT projects and despite Microsoft attempt to buy market share, its ‘platform strategy’ had limited success.

If the JV platform vision is right (and what is needed for the industry) it will take a few years to get legs. Beyond integrating their HCIT suites (and apparently work has already been underway here for a few months) it will take considerable effort for the new company to ready its platform for app developers, a sometimes skeptical lot. Developers may opt to wait and see whether the JV successfully drives adoption for their platform vision given their traditionally limited resources and proclivity for aligning around the true vendor platforms where market share is known, versus jumping on board into the Microsoft/GE health care legacy.

Finally, is this big platform vision the right approach in today’s world of SaaS, Cloud, SOA, and modular app development? Healthcare already has many traditional stacks   – Epic, Cerner, McKesson, Allscrips…the list goes on. The new entrants like Aetna/Medicity, Optum/Axolotl, IBM, Oracle, and others are focused on integrating data and workflows. If the new company claims it is the ‘true path’ for data integration, the market could become confused with other mega HCIT vendor messages, given they acute need for nimble solutions that are quick to implement, solve an immediate pain point, and provide a near term ROI.

Big HCIT vendors must do more to help perpetuate a strong vision and direction for the healthcare industry and perhaps this is where this new venture can emerge as a leader. Microsoft and GE have both tried and neither was successful. Perhaps they have some new innovation and new capabilities that could create a truly differentiated solution. We’re watching closely and would like to know what you think.

Scott Donahue

Scott Donahue is a Vice President at TripleTree covering infrastructure and application technologies across numerous industries and specializes in assessing the “master brands” of IT and Healthcare. Follow Scott on Twitter or e-mail him at sdonahue@triple-tree.com

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Innovative and complex technologies are rapidly gaining market traction, but are far from ubiquitous across U.S. hospitals.  For instance, why can credit card companies proactively call, email, and text customers within minutes of potential fraud on their accounts, but hospitals don’t use the same types of analytics to provide patients with better, and in some cases life-saving care?

The answers to these questions are not simple, but we’ve grouped them into four themes:

  • The systems, or lack thereof, in place at hospitals historically did not provide adequate interoperability;
  • Hospitals have prioritized expensive electronic medical record (EMR) deployments and revenue cycle management solutions ahead of clinical analytics platforms and have not had budget dollars to allocate to additional projects given cost constraints;
  • Clinicians have not been educated and trained to use these type of tools and, aside from early adopters, are reluctant to change;
  • There are not enough incentives in place for hospitals to change how they operate in order to improve care.

Hopefully these excuses will dissipate as modern clinical and administrative systems are deployed, clinicians realize the power of analytics, and incentives change across the healthcare landscape.  Chart reviews and significant human intervention with patients will still be prevalent, but clinical surveillance analytics will be additive platforms for improving patient care.  As hospitals complete the initial phases of their EMR deployments and have time to focus on harnessing their data to improve care, the market for clinical analytics will grow quickly.

Last week, Wolters Kluwer acquired Pharmacy OneSource (Disclosure: TripleTree was the exclusive advisor to Pharmacy OneSource on the deal).  The flagship application provided by Pharmacy OneSource is Sentri7®, a unique solution in an emerging market for clinical surveillance.  Sentri7 is a software-as-a-service (SaaS) application that receives data feeds from various hospital systems, such as EMR, admissions and demographics, nursing, laboratory, radiology, and pharmacy.  The system analyzes data feeds real-time against business rules (configured by hospital clinicians) which identify opportunities for clinicians to intervene and improve patient care.  A harbinger of where this market will evolve, Sentri7 can:

  • Identify patients with complex medical conditions that are being overlooked,
  • Warn of early signs of sepsis,
  • Remind clinicians if evidence-based guidelines are not being followed,
  • And ensure the appropriate drugs are being administered to patients.

To be successful in this market, systems must be flexible, easy to use and seamlessly integrate into a clinicians’ workflow.  While EMR systems from the likes of Epic and Cerner can be programmed to mine data, they lack the architectural flexibility offered by clinical surveillance tools like Sentri7 which will become table stakes as the expectations of clinicians evolve.  Hospital IT departments are already over-burdened and adding development and maintenance of analytics business rules to their purview is not practical.

As the interoperability of healthcare data continues to expand, health information exchanges will enable analytics across regional hospital systems, surgery centers and standalone clinics.   We expect automated analytical tools to continue to proliferate across all areas of healthcare and related to clinical analytics within the hospital, surveillance is just the beginning.

Let us know what you think. Thanks and have a great week!

Jason Grais

Jason Grais is a Director at TripleTree covering the healthcare industry specializing in healthcare IT, population health management and emerging services in the life sciences sector. You can email him at jgrais@triple-tree.com

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This week, TripleTree hosted its fourth Principals Forum web cast of 2010 discussing the impact cloud computing is making across the healthcare landscape.

Our colleague Ryan Stewart facilitated our panel-centric discussion around the broad healthcare industry issues of improving access to, and care within the healthcare system.  After a few introductory remarks by Scott Donahue of TripleTree on the evolution of Software as a Service (SaaS) to cloud, our panel of four accomplished healthcare veterans took the helm, they were:

  • Dr. Giovanni Colella, President, CEO & Co-Founder – Castlight Health
  • John Holton, President, CEO & Founder – SCI Solutions
  • Nancy Brown, Chief Growth Officer – MedVentive, Inc.
  • Albert Prast, CIO/CTO – Connextions

The panel cited real world examples where cloud-based solutions are influencing how hospitals, doctors, and the patients consume information, primarily:

The impact of hCloud on healthcare workflows:  Cloud computing is weaving itself into both the clinical and administrative areas of healthcare and fundamentally changing the dynamic of “IT support” for healthcare workflows and care delivery. Impacts of cloud computing in healthcare can be seen in:

  • Anywhere, anytime access to accurate and usable information: hCloud is enabling the mobilization of data to the right constituent, through the right medium at the right time.  This is having a profound impact on how providers deliver care, patients access care, and consumers (i.e. patients) purchase healthcare coverage and connect with the care community.
  • Improved access to and utilization of information: One of the biggest challenges in healthcare is the fact that critical data (necessary for clinicians to make accurate decisions, or consumers to make informed choices) is spread out across multiple systems and points of care.  Healthcare IT’s data structures are based on encounters and events rather than on a holistic patient viewpoint making it very difficult to identify and collect the data, let alone analyze the information. Traditional “silioized” approaches to managing data are being challenged by solutions that leverage the cloud to more efficiently gather, integrate, and act upon critical information.
  • New levels of collaboration across the care continuum: Utilizing the Web as a platform provides a lower cost, more ubiquitous method of connecting provider communities as well as linking patients to providers appropriately.
  • Empowering consumers: With better access to information, more transparency, and the ability to retrieve information across a multitude of digital and physical mediums, consumers are more involved in identifying the right channels of care and types of coverage for their individual needs.
  • Cost efficiency: Cloud, the web, and SaaS have made developing the clinical and administrative systems to support healthcare more cost efficient. As these models become even more mainstream in healthcare, hospitals can focus less on building out massive IT infrastructure projects and more on supporting clinical workflows. Legacy systems can be gradually phased out and modern architectural standards will better support necessary integration across the enterprise.

Certainty there are complexities and information sensitivities within healthcare that are more acute than other industries, but as Dr. Collela eloquently stated that “Cloud computing is coming to healthcare… There is no way to stop it.”  With so many stakeholders standing to benefit from this computing paradigm, and with proven delivery points across industries and within healthcare, it is just a matter of time until the cloud moves away from these specialized discussions to become more accepted as mainstream within healthcare.

The evolution of hCloud is a core component to our research agenda for 2011, and will be influencing how our strategic advisory clients think through growth, financing and liquidity strategies in the months ahead. Click here to listen to the audio replay of the web cast; and here to read our most recent publication on hCloud.

We’d like to know what you think. Have a great week!

Scott Donahue

Scott Donahue is a Vice President at TripleTree covering infrastructure and application technologies across numerous industries and specializes in assessing the “master brands” of IT and Healthcare. Follow Scott on Twitter or e-mail him at sdonahue@triple-tree.com

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There has been much written by TripleTree and others on the influence of cloud technologies on healthcare, but what about open source as a transformative technology?

No doubt open source technologies will make their way into and have an impact on healthcare in some way, but we’re of the mindset that it will take a long time to get here, and the size of the impact could be minimal. Here are seven considerations for healthcare CIOs and their technology partners:

  1. Commercial open source vendors are small and unsophisticated in the ways of healthcare IT. So with little investment and large barriers to entry (slow buying cycles, antiquated architectures, compliance, etc.), healthcare will be a hard sell. There will probably be some experiments, trial runs, and partnerships with early stage ISV’s looking to triangulate around the trend of SaaS/Cloud/Open Source; but in reality it will take a few years to get efforts ramped up into large commercially viable solutions.
  2. Virtualization will have a bigger impact on HCIT operational efficiency than simply open source. Sure, where virtualization and open source intersect (specifically at the Xen hypervisor), there may be some impact, but I think open source gets overshadowed by virtualization investments.
  3. The IT “master brands” vendors with expressed interest in healthcare (MSFT, IBM, HP, etc) are pushing their proprietary stacks.  Deeper pockets will prevail and the only new entrant that can make an impact is probably Google (and their HC commitment is questionable). Will they push ChromeOS into HC and make a meaningful impact?  Not likely as ChromeOS is too new and Google Health is too consumer (rather than system) focused. Plus with Oracle taking out Sun, another open source proponent will move to a proprietary stack (Fusion)
  4. Workflow and process integration in HC systems are mostly manual. Before open source has a meaningful impact on data integration a process automation evolution within healthcare is needed…and process automation in healthcare is nascent.
  5. Open source has had a good seven year run of enterprise acceptance. Given that healthcare is lagging about 10 years behind in IT innovation, we likely have two plus years before HC starts thinking about open source more widely. In smaller pockets, we could see early open source efforts where a few innovative vendors expose limited/departmental use cases or in public sector instances where states try to be innovative with alternative procurement (e.g.  HIE may see open source experimentation).
  6. The mainstreaming of SaaS and other alternate delivery/licensing/outsourcing models from groups like Athena provide a better value proposition.  This is relevant to the likely adopters – small and mid-size doctor’s offices – who want to avoid on-premise open source systems and related complexities of specialized IT knowledge and a willingness to go-it-alone with limited vendor support.  SaaS wasn’t mainstream when enterprises began to embrace open source; but now that SaaS (and cloud) is prevalent the same drivers of open source adoption don’t exist.
  7. Open source will probably have more of an impact in research/government/university settings where a healthcare focus and established open source culture (around longer running projects) can coexist.  Within healthcare, open source will emerge more readily with health plans where large data centers and processing make it an interesting operating system.

The list of technology issues confronting healthcare is considerable, and it’s unclear that open source would have impact given other innovative tools.  We’re watching the likes of Citrix and RedHat as vendors that could step forward and we’ll continue to update this blog with our latest thinking.

Thanks and have a great week!

Scott Donahue

Scott Donahue is a Vice President at TripleTree covering infrastructure and application technologies across numerous industries and specializes in assessing the “master brands” of IT and Healthcare. Follow Scott on Twitter or e-mail him at sdonahue@triple-tree.com

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Trends in the many industry sectors are pointing toward another eventful year as the maturation of Outsourcing and Cloud-centric technologies impacts how organizations share, find and archive important content.

Back in early 2008, TripleTree published a report on SaaS Platforms report detailing some approaches being used by Software as a Service (SaaS) firms to broaden their application partner ecosystems, harness the power of developers and become more relevant.

By all accounts, these vendors have been busy and successful.  SaaS seems to have found a new, catchier term “Cloud” to replace the “as-a-service” label attached to nearly everything resembling an on demand solution, including new ways for outsourcing and managed services vendors to innovate.

In sectors like education, healthcare and logistics we’re predicting that outsourcing and managed services firms are entering a new era, one where clients will still look to them as a partner for cutting costs and driving efficiency.  But we also think this era will see outsourcers and service providers leveraging Cloud-centric solutions to address the growing need of organizations to homogenize their business applications and link disparate data sets.

Our team is actively advising outsourcing firms on strategic alternatives, visit our blog next week for more of our latest thoughts – until then, if you’re interested in learning more we’d like to hear from you.  Here are a few news items that caught our eye this week:

Have a great week!

Chris Hoffmann

Chris Hoffmann

Chris Hoffmann is Research Director at TripleTree covering Cloud, SaaS and enterprise applications and specializes in CRM, loyalty and collaboration solutions across numerous industries. Follow Chris on Twitter or e-mail him at choffmann@triple-tree.com.

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Following our co-hosting of last weeks’ fifth annual Wireless-Life Sciences Investor Day & Summit with our partners Qualcomm and Johnson & Johnson, we couldn’t be more bullish about the healthcare innovations on display.

The recurring theme of the event was improving healthcare access, quality and affordability – which was echoed by presenter Dr. Hyung Kim, MD; Vice President of Research for Ascension Health as he talked through Ascension’s key initiatives including:

  • Operating more effectively in terms of cost and quality
  • Remaining focused on serving the poorest and most vulnerable people in the communities they serve
  • Getting physicians closer their patients
  • Managing the uncertainty of reform

Here are some news stories we’re watching this week:

  • CMS awards $73.2mn web optimization contract to CGI Federal in effort to improve online communication channels:  more here
  • California Telemedine and eHealth Center launches telehealth initiative:  more here
  • Early peak at upcoming SaaS/Cloud earnings picture?  Salesforce.com reports early and disappoints:  more here
  • Economist Larry Kudlow likes the rising US Dollar as harbinger of price stability amid concerns about Euro:  more here

Read our most recent research on Healthcare Compliance and mHealth, and if your schedule aligns catch up with us next week at AHIP in Las Vegas.

To learn more, contact us at 952-253-5300…have a great week!

Chris Hoffmann

Chris Hoffmann is Research Director at TripleTree covering Cloud, SaaS and enterprise applications and specializes in CRM, loyalty and collaboration solutions across numerous industries. Follow Chris on Twitter or e-mail him at choffmann@triple-tree.com.

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