Healthcare Software

Healthcare Technology Roundup: Cloud Computing

There is a lot of confusion in the industry around what “cloud computing” really means. Often, marketing communications that refer to a “cloud solution” actually mean an ASP offering with a SaaS business model.

True cloud computing is the use of virtualized servers that can be scaled on demand based on varying levels of resource requirements at run-time. For example, an application running on a cloud can programmatically turn on five servers in response to a spike in demand for computing resources. Several mature solutions include Microsoft Azure, Citrix, VMWare, Amazon Elastic Compute Cloud and Google App Engine.

What are the opportunities for healthcare innovation?

By making use of cloud computing, vendors can in theory enhance traditional ASP solutions by offering:

• Scalable hardware. Additional hardware can be turned on based on need.
• Efficiency and performance. Since servers are virtualized, different instances can reside on the same hardware. The instances can be moved around depending on need to make the best use of the hardware without compromising performance.
• Increased availability. Cloud hardware is distributed and fault tolerant. Cloud providers promise 99.95% availability. From a technical perspective, a cloud would be the best option for delivering a solution on scalable and fault tolerant hardware while still delivering on performance requirements.

What constraints does the technology face?

With ASPs, there is definite knowledge as to the location and ownership of the housed data thus satisfying privacy and data security laws. True cloud computing, on the other hand, is not in widespread use with EMRs since it is an issue of controversy due to privacy and security risks.

Some platforms such as Microsoft Azure offer private clouds to organizations facing trouble with compliance. At this time, however, this solution is intended for very large organizations who are working with at least 1000 servers, likely outside the scope of any major hospital. Microsoft has recently begun a push into the Healthcare IT space, so the time may be right to look to Microsoft for future innovations in cloud computing as it applies to EMR systems.

Until then, there are other ways for organizations to pump up their ASP offering – for example offering a client application with a richer user interface, more logic and even an “offline mode.” Technologies such as WPF and Adobe AIR represent a first step towards the creation of such rich clients.

Healthcare Technology Roundup: Mobile Home Care Devices

Mobile home care devices are pieces of hardware that allow patients to communicate the current state of their illness to a healthcare provider from home. Although still in the development stage, the potential for managing chronic illness is clear, and development of home care devices is moving quickly to meet the demand of our aging population.

Examples of existing mobile home care devices include blood pressure monitors, weight scales, glucose meters, pulse oximeters, and peak flow meters. One such device is Intel’s HealthGuide, which offers a variety of solutions to the patient in his own home.

What are the opportunities for healthcare innovation?

• Usability. Patients using these devices are often ill and/or elderly. The devices must be intuitive and robust, putting home care ethnographic study and other usability techniques at the forefront of innovation.
• Continuous data stream. Physicians can monitor patient activity and catch problems before they become severe. The EMR will become a meeting place for patient data.
• Access to CDS systems. A clinical decision support system can monitor patient readings and alert physicians to cases that need special attention. This can help physicians to be more efficient.
• Empowering patients. Inventive features could maximize the activities that can be taken on by the patient remotely, such as picking up prescriptions and scheduling interventional procedures.

How is this technology applied in healthcare today?

At the time of writing, Intel and GE Healthcare recently formed a new company in a joint effort to meet the future needs of telemedicine. In their vision, mobile home care devices will interact with EMRs to deliver the data to those in charge of the patient’s health. While this is the hot topic of the moment, most major Healthcare IT vendors (as well as many smaller organizations) have a telemedicine and home care product portfolio.

Many existing home care devices are standalone solutions that are used by the patient at home and then brought to the hospital or clinic during a scheduled visit. The data is then transferred into the EMR so that the physician can refer to the data in his interpretation and clinical notes. This process is often cumbersome, which has lead companies like Cardiac Science to offer a solution to bridge the gap between device and EMR so that integration is more automatic.

What constraints does the technology face?

Probably the biggest limitation to widespread mobile homecare device adoption is cost. Unless these devices can be cost effective, the average patient will not purchase one. In most cases, the devices are loaned out to patients who need special monitoring and reused by other patients down the road.

To counter this challenge, there is a growing push for home care software on consumer devices. The LifeScan Diabetes Monitor and Zume Life self-care service are both currently available on iPhone.

Vince Kuraitis, a thought leader in the growing home care industry, sums it up nicely:

“Think about your user experience when you get into your car into the morning. You are greeted by a dashboard of information about the vital processes in your car -- fuel availability, fluid levels, driving speed, etc. You know that if something goes wrong with a major system, you'll get a "check engine" notice.

Now think about your user experience with your body. What do you know about the vital processes going on in your body right now?

Remote patient technologies are beginning to provide the analogous dashboard to help people monitor vital processes and to take appropriate actions if something goes wrong.”