I just attended the SIAA OnDemand Conference with our CEO and CFO. I actually didn't have high expectations, because the session summaries seemed to imply that the conference was aimed at client/server vendors that were considering migrating to SaaS. As it turned out, there was a broad variety of content, and we all walked away feeling like we had gained a lot.
I learned a new respect for Marc Benioff, Chairman and CEO of Salesforce.com; Josh James, CEO of Omniture; and Zach Nelson, CEO of NetSuite. These guys are true visionaries, and they "get" OnDemand software, even though their views conflict at times.
I was particularly impressed by Zach Nelson. His keynote was actually a "point/counterpoint" session with Anthony Lye, SVP of CRM at Oracle. Lye was obviously a smart guy, but he made a fair number of statements (minimizing the value of multi-tenancy, for example) that really didn't ring true.
The main impression that Lye left me with was how deeply entrenched senior executives at Oracle are in the anti-Microsoft mindset, and how arrogant they are about the superiority of Larry Ellison's vision of the enterprise.
Lye lamented the disastrous effects of Microsoft's "monopoly" on the OS, and said that it stifled innovation, and that it "didn't do any good for anyone." I would imagine that Microsoft stakeholders would dispute that assertion. So would hundreds of thousands of software developers that were suddenly able to administer their own database servers when SQL Server 7.0 was released. Or the millions of home users who could suddenly use a word processor to write letters when Word for Windows was released. And on and on and on.
Anyway, aside from the fact that Lye forgot that he wasn't at an Oracle Microsoft-bashing conference, he clearly didn't "get" SaaS and its value in the small and mid-market. (His primary argument against the value of multi-tenancy was that "none of the customers that we asked wanted to be in a multi-tenant environment." Well, duh! If you had a choice to fly in a private jet or a commercial airliner (for the same price), which would you choose? The point is that multi-tenancy lowers the cost of delivery and, hence, the overall cost of the solution.
But the conference was excellent, and very worthwhile. It was definitely targeted at C-level executives (the vast majority of attendees were CEOs or CFOs), so if you don't fall into that category I'd probably recommend the OpSource SaaS Conference next March (it was recommended to me by a Microsoft rep).
Speaking of Microsoft, they were conspicuously absent from this conference. I'm not sure why, unless they felt it was just too small. Or perhaps they find more value in talking to IT directors and engineers.
Thursday, November 20, 2008
Wednesday, October 29, 2008
Thursday, September 18, 2008
How many data centers do you really need?
Reliability and availability are areas of significant concern for any SaaS company, because a lot of people rely on the ability of a single, relatively small group to ensure that their software is working. A significant aspect of availability is disaster recovery (DR): What do you do if, in spite of your best efforts to eliminate single points of failure, something goes terribly, terribly wrong in your data center? How quickly can you get your customers back up and running?
For years, we've operated under the assumption that excellent DR requires two fully redundant data centers, with "flip of a switch" fail-over from one data center to the other. Toward that end, our DCO team has worked with our vendors to design a state-of-the-art replication system that ensures that both data centers are always in sync, and always ready to fill in for each other as needed.
Here's the problem: The cost of that kind of infrastructure is gigantic (essentially double the cost of a single data center). A small or mid-sized SaaS company may spend $1M per year to keep a single data center running. To maintain two data centers with enough capacity that one can take on the load of the other at a moments notice essentially increases the cost to $2M, or maybe a bit less. That can have a devastating on the company's Cost of Revenue (which, for a SaaS company, includes both DCO costs and Support/Help Desk expenses).
We learned recently that NetSuite, one of the leading on-demand ERP vendors (and one that we are intimately familiar with) has operated in a single data center since its inception. In mid-2007, they announced (as a prelude to their IPO in December 2007) that they would be expanding to a second data center in 2008. I can't find any evidence that they have done that and, in fact, the "Cautionary Note" in the press release announcing their record Q2 2008 results warns that, "unexpected disruptions of service at the Company's data center may occur".
Some key questions have to be answered to decide whether a second data center is necessary:
For years, we've operated under the assumption that excellent DR requires two fully redundant data centers, with "flip of a switch" fail-over from one data center to the other. Toward that end, our DCO team has worked with our vendors to design a state-of-the-art replication system that ensures that both data centers are always in sync, and always ready to fill in for each other as needed.
Here's the problem: The cost of that kind of infrastructure is gigantic (essentially double the cost of a single data center). A small or mid-sized SaaS company may spend $1M per year to keep a single data center running. To maintain two data centers with enough capacity that one can take on the load of the other at a moments notice essentially increases the cost to $2M, or maybe a bit less. That can have a devastating on the company's Cost of Revenue (which, for a SaaS company, includes both DCO costs and Support/Help Desk expenses).
We learned recently that NetSuite, one of the leading on-demand ERP vendors (and one that we are intimately familiar with) has operated in a single data center since its inception. In mid-2007, they announced (as a prelude to their IPO in December 2007) that they would be expanding to a second data center in 2008. I can't find any evidence that they have done that and, in fact, the "Cautionary Note" in the press release announcing their record Q2 2008 results warns that, "unexpected disruptions of service at the Company's data center may occur".
Some key questions have to be answered to decide whether a second data center is necessary:
- How redundant is the infrastructure in your data center? Have you eliminated, to the extent possible, any single points of failure? (That's not cheap--but it's a lot cheaper than a second data center.)
- How much do you trust the facility that you are in? Have they demonstrated the ability to absorb power failure without impacting you? Do they have strong bandwidth peering relationships?
- Do you have a comprehensive backup and validation process? Are you certain that your backups are good (i.e., do you restore and test each backup right after it's made)? Do you move your backups off-site frequently?
- In the case of a truly catastrophic event (major earthquake, fire, flood), how long can your customers wait to get back online? Would your customer base revolt if they were offline for 24-48 hours, or could that be absorbed? Do you have a documented and tested DR plan to recover within that time frame?
Monday, September 8, 2008
"Free" PMS and EMR software
Every few months, I get an e-mail or see a blog post about a new Open Source, "free" EMR or PMS. Usually, the e-mail is entitled something like, "We'd better keep our eyes on this..."
(By the way, I intentionally capitalize Open Source, because, as far as I'm concerned, it's a brand name. Or, if it's not a brand name, it's a movement. Or a religion. Or a political party. Whatever it is, it's a proper noun, and consequently requires capitalization.
For evidence of this, look at the Wikipedia entry for Open Source. As of this writing, it has the disclaimer, "The neutrality of this article is disputed" at the top. Of course it is! It's difficult to write about your religion and stay neutral.)
But I digress. I don't want to rehash the worn-out debate between Open Source and commercial software. That's about as interesting as Microsoft vs. Apple, Microsoft vs. Oracle, and Microsoft vs. Mozilla. The fact is, if Open Source works for your project, then you should use Open Source. If a commercial package meets your needs, use it.
Having spent most of the past 15 years of my career in the medical practice management software arena, I believe there are two broad categories of medical practices:
I honestly can't see where Open Source projects compete with commercial software like AdvancedMD. First of all, AdvancedMD and other SaaS-based software (is there any other kind?) are essentially free. The only up-front cost is for training and implementation. With commercial software, those services are available directly from the vendor, or from their authorized VAR. With Open Source, you'll have to find someone to provide those services, or you're working with a consultant. Either way, they're not free.
The real cost of software comes in the ongoing maintenance and support. With AdvancedMD, you pay a reasonable, fixed monthly cost. The software is maintained by the same team of IT professionals that maintain our other 3,000 customers. Help Desk support is provided by the same team of Support professionals that serve those same 3,000 customers.
If you choose Open Source, someone has to install and maintain the software, and provide end-user support. The software was free...these services are decidedly not.
That's not to say that there is no place for Open Source. There certainly is, and I'm certain that there are dozens if not hundreds of success stories.
The point is that it is very, very easy to determine whether you are a candidate for Open Source PMS and EMR software or not: If you fall in the left side of the above table, you should consider it. If you're one of "everyone else", well, welcome to AdvancedMD. (Sorry, that really was a shameless plug.)
(By the way, I intentionally capitalize Open Source, because, as far as I'm concerned, it's a brand name. Or, if it's not a brand name, it's a movement. Or a religion. Or a political party. Whatever it is, it's a proper noun, and consequently requires capitalization.
For evidence of this, look at the Wikipedia entry for Open Source. As of this writing, it has the disclaimer, "The neutrality of this article is disputed" at the top. Of course it is! It's difficult to write about your religion and stay neutral.)
But I digress. I don't want to rehash the worn-out debate between Open Source and commercial software. That's about as interesting as Microsoft vs. Apple, Microsoft vs. Oracle, and Microsoft vs. Mozilla. The fact is, if Open Source works for your project, then you should use Open Source. If a commercial package meets your needs, use it.
Having spent most of the past 15 years of my career in the medical practice management software arena, I believe there are two broad categories of medical practices:
| Open Source | Commercial Software | |
| Sophisticated internal IT staff | Everyone else | |
| Doctors = Technologists | ||
| High threshold of pain | ||
| Interest in or need for heavy customization | ||
| Equal/greater interest in tech innovation vs. treating patients |
I honestly can't see where Open Source projects compete with commercial software like AdvancedMD. First of all, AdvancedMD and other SaaS-based software (is there any other kind?) are essentially free. The only up-front cost is for training and implementation. With commercial software, those services are available directly from the vendor, or from their authorized VAR. With Open Source, you'll have to find someone to provide those services, or you're working with a consultant. Either way, they're not free.
The real cost of software comes in the ongoing maintenance and support. With AdvancedMD, you pay a reasonable, fixed monthly cost. The software is maintained by the same team of IT professionals that maintain our other 3,000 customers. Help Desk support is provided by the same team of Support professionals that serve those same 3,000 customers.
If you choose Open Source, someone has to install and maintain the software, and provide end-user support. The software was free...these services are decidedly not.
That's not to say that there is no place for Open Source. There certainly is, and I'm certain that there are dozens if not hundreds of success stories.
The point is that it is very, very easy to determine whether you are a candidate for Open Source PMS and EMR software or not: If you fall in the left side of the above table, you should consider it. If you're one of "everyone else", well, welcome to AdvancedMD. (Sorry, that really was a shameless plug.)
Saturday, September 6, 2008
IE8 compatibility looking good...so far
I downloaded the first beta of Microsoft Internet Explorer a couple of months ago to check out the new features and, while I was at it, find out how well AdvancedMD runs in it. (I blogged earlier about some of my fears about IE8.)
This is an important issue for us, because, historically, new versions of IE and (especially) Windows have caused us a few problems.
Most of the hurdles have come in the form of security enhancements. For example, we sometimes pop up dialogs outside the viewable area of the screen to test for the existence of controls, measure window title bars and borders, etc. Well, a couple of years ago (IE6 SP2), Microsoft decided to stop allowing windows to be opened outside the visible area of the screen (by default). Not a big deal--the only impact was that screens that used to be invisible suddenly started popping up on our users' screens. (Well, they would have if we hadn't identified and addressed the issue before SP2 was released to our customers.) But it was annoying.
Quite often, we see changes in behavior early in the beta process, and the behavior continues through the second beta, or even the release candidate, but the previous behavior returns in the final release. That happened in IE7, where the beta releases blocked pop-ups in the Trusted Sites zone (and we were scrambling to figure out what to do about it), but then the final release restored the previous behavior. (Pop-ups should not be blocked in the Trusted Sites zone by default.)
So, given this history, I was more than a little concerned when, after downloading and installing IE8 Beta 1, I couldn't run AdvancedMD. At all. I couldn't even log in. In fact, the user name, password, and office key text boxes didn't appear, just a scary-looking security alert of some kind.
Well, a few days ago I installed IE8 Beta 2, certain that I'd see the same behavior, and we would have to start exploring the problem and devising solutions.
To my astonishment, though, AdvancedMD runs perfectly under IE8 Beta 2, at least in all of the areas that I tested. Our QA team will continue to validate my findings, but at the moment, I'm very encouraged.
Perhaps the best explanation for this is that Microsoft invested extremely heavily in IE6 SP2 and IE7 to restrict javascript behavior to avoid the wide array of exploits that had become prevalent (and that seriously, perhaps permanently, damaged Microsoft's security credibility). That work is largely done, so they've begun to focus more on the feature set again. And javascript has been so severely restricted at this point that few further changes are required.
Whatever the reason, it looks like the upcoming release of IE8 will be uneventful for AdvancedMD and our users...unless they introduce something in the final release.
This is an important issue for us, because, historically, new versions of IE and (especially) Windows have caused us a few problems.
Most of the hurdles have come in the form of security enhancements. For example, we sometimes pop up dialogs outside the viewable area of the screen to test for the existence of controls, measure window title bars and borders, etc. Well, a couple of years ago (IE6 SP2), Microsoft decided to stop allowing windows to be opened outside the visible area of the screen (by default). Not a big deal--the only impact was that screens that used to be invisible suddenly started popping up on our users' screens. (Well, they would have if we hadn't identified and addressed the issue before SP2 was released to our customers.) But it was annoying.
Quite often, we see changes in behavior early in the beta process, and the behavior continues through the second beta, or even the release candidate, but the previous behavior returns in the final release. That happened in IE7, where the beta releases blocked pop-ups in the Trusted Sites zone (and we were scrambling to figure out what to do about it), but then the final release restored the previous behavior. (Pop-ups should not be blocked in the Trusted Sites zone by default.)
So, given this history, I was more than a little concerned when, after downloading and installing IE8 Beta 1, I couldn't run AdvancedMD. At all. I couldn't even log in. In fact, the user name, password, and office key text boxes didn't appear, just a scary-looking security alert of some kind.
Well, a few days ago I installed IE8 Beta 2, certain that I'd see the same behavior, and we would have to start exploring the problem and devising solutions.
To my astonishment, though, AdvancedMD runs perfectly under IE8 Beta 2, at least in all of the areas that I tested. Our QA team will continue to validate my findings, but at the moment, I'm very encouraged.
Perhaps the best explanation for this is that Microsoft invested extremely heavily in IE6 SP2 and IE7 to restrict javascript behavior to avoid the wide array of exploits that had become prevalent (and that seriously, perhaps permanently, damaged Microsoft's security credibility). That work is largely done, so they've begun to focus more on the feature set again. And javascript has been so severely restricted at this point that few further changes are required.
Whatever the reason, it looks like the upcoming release of IE8 will be uneventful for AdvancedMD and our users...unless they introduce something in the final release.
Wednesday, August 27, 2008
Microsoft HUG Tech Forum 2008 - Day 2
The Transformative Power of Technology, at the Intersection of Physicians and Patients (Opening Keynote)
Steve Shihadeh, VP, Health Solutions Group, Microsoft Corp.
Clyde Wesp, MD, FAAP, CMO, St. Joseph Health System
Today's Steve, like yesterday's Steve, compared HealthVault to PayPay, in the sense that "no one goes to the PayPal website...they go to eBay or Barnes and Noble..." I'm not sure that's quite accurate--PayPal was, in the early days, just a way to send money to send money to friends and family, and perhaps eBay sellers, instead of mailing a check. Once that business model was successful, online merchants jumped on the bandwagon.
In the case of HealthVault, Microsoft is hoping that vendors, hospitals, and insurance carriers jump on the bandwagon in a leap of faith that other vendors, hospitals and insurance carriers will follow suit.
As I've mentioned before, Google is taking more of a consumer-focused approach, much closer to PayPal's approach than HealthVault's.
Also, PayPal generates its revenue from transation fees. Microsoft claims that theirs is an advertising-based revenue model.
Another difference is that, for the most part, PayPal isn't a central storage facility for...well, anything. They do offer the ability to store cash in a money market account and then use that cash for future transactions, but many PayPal users (myself included) never store any cash in their PayPal accounts. Transactions pull money directly from the user's checking account or credit card to the merchant's account.
But I see what the Steves are saying. There is a need for a central clearinghouse for healthcare information, and it makes perfect sense that the patient should have control over the distribution of his/her information...even if (or especially if) they aren't fully aware of the control that they have (like they would if they were carrying around a PHR on a smart card or flash drive).
Great Healthcare via Unified Communications: A Developer's Perspective (Developer Track)
Chris D. Mayo, Technology Evangelist for the Unified Communications Platform, Microsoft Corp.
It should be news to no one that Microsoft would like to have all of their products fully entrenched in every company in the world. That's obviously not going to happen, since different IT shops have different platform expertise. But for companies that are already on the Microsoft bandwagon, it makes sense to at least explore Microsoft's offerings and, in the case of communications, consider Microsoft's Unified Communications platform as a replacement for traditional PBXs (or even newer IP-based telephony systems).
From a software engineering perspective, Microsoft has provided a wealth of tools (Web services, drag-and-drop WFC controls, etc.) to make it really easy to build UC features into apps.
Cross Enterprise Document Sharing (XDS.b) Reference Implementation (Developer Track)
Mark Simmons, Health Consultant, SIMPL
Wagner Silveira, Microsoft Technical Architect, Microsoft Corp.
This was an interesting discussion of the SIMPL/Microsoft approach to IHE...not highly relevant to AdvancedMD right now, because we're not pursuing IHE implementation at this point. Another opportunity to catch up on e-mails.
Better User Experience in Clinical Applications (Developer Track)
Anand Gaddum, Director, Healthcare Practice, iLink Systems
William Hughes, Director, Product Innovation, GE Heatlhcare Enterprise IT Solutions Division
Anand and William demo'd a prototype application built on Silverlight. It was very impressive, and only took a team of 5 full- and part-time engineers about 2 1/2 months to build...but it clearly wasn't ready for prime-time.
Still, it reinforces my believe that Silverlight will be a powerful development platform as it matures, and as the runtime becomes more ubiquitous.
In particular, as we try to encourage doctors to adopt new technology, Silverlight provides UI "eye candy" that might help pique their interest.
Building Safer Healthcare Applications in WPF and Silverlight with the Microsoft Health Common User Interface (Developer Track)
Andrew Kirby, Director in Microsoft Services UK, Microsoft Corp.
MSCUI was launched a year ago at the last Tech Forum in Redmond. This session was an overview of MSCUI and a view into how it's been adopted over the past year.
This is a really interesting project, because it isn't a sellable product, or even an initiative that directly results in the sale of Microsoft technology. It's a collection of design guidelines that are totally platform agnostic, as well as a collection of free controls that illustrate the principles of the guidelines using Microsoft technology.
Obviously, one of Microsoft's objectives is to provide enough free controls and other shortcuts using their technology that healthcare organizations will be encouranged to use Microsoft tools to create solutions, so it isn't a purely altruistic endeavor, but it's pretty cool, anyway.
There is a ton of information available at http://www.mscui.net/, so I won't dive in any deeper here.
Surface Technology in Healthcare (Closing Keynote)
Randy Fusco, CTO & Strategist, Microsoft U.S. Healthcare Provider Solutions, Microsoft Corp.
This was a pretty exciting session. Surface started out as an informal collaboration between a couple of departments at Microsoft back in 2001. A few years ago, it was officially funded as a research project by Microsoft, and now it is an actual product.
It's difficult to describe how cool this stuff is without actually seeing it. If you're interested, check out the Microsoft Surface website.
Steve Shihadeh, VP, Health Solutions Group, Microsoft Corp.
Clyde Wesp, MD, FAAP, CMO, St. Joseph Health System
Today's Steve, like yesterday's Steve, compared HealthVault to PayPay, in the sense that "no one goes to the PayPal website...they go to eBay or Barnes and Noble..." I'm not sure that's quite accurate--PayPal was, in the early days, just a way to send money to send money to friends and family, and perhaps eBay sellers, instead of mailing a check. Once that business model was successful, online merchants jumped on the bandwagon.
In the case of HealthVault, Microsoft is hoping that vendors, hospitals, and insurance carriers jump on the bandwagon in a leap of faith that other vendors, hospitals and insurance carriers will follow suit.
As I've mentioned before, Google is taking more of a consumer-focused approach, much closer to PayPal's approach than HealthVault's.
Also, PayPal generates its revenue from transation fees. Microsoft claims that theirs is an advertising-based revenue model.
Another difference is that, for the most part, PayPal isn't a central storage facility for...well, anything. They do offer the ability to store cash in a money market account and then use that cash for future transactions, but many PayPal users (myself included) never store any cash in their PayPal accounts. Transactions pull money directly from the user's checking account or credit card to the merchant's account.
But I see what the Steves are saying. There is a need for a central clearinghouse for healthcare information, and it makes perfect sense that the patient should have control over the distribution of his/her information...even if (or especially if) they aren't fully aware of the control that they have (like they would if they were carrying around a PHR on a smart card or flash drive).
Click here for full presentation
Great Healthcare via Unified Communications: A Developer's Perspective (Developer Track)
Chris D. Mayo, Technology Evangelist for the Unified Communications Platform, Microsoft Corp.
It should be news to no one that Microsoft would like to have all of their products fully entrenched in every company in the world. That's obviously not going to happen, since different IT shops have different platform expertise. But for companies that are already on the Microsoft bandwagon, it makes sense to at least explore Microsoft's offerings and, in the case of communications, consider Microsoft's Unified Communications platform as a replacement for traditional PBXs (or even newer IP-based telephony systems).
From a software engineering perspective, Microsoft has provided a wealth of tools (Web services, drag-and-drop WFC controls, etc.) to make it really easy to build UC features into apps.
Cross Enterprise Document Sharing (XDS.b) Reference Implementation (Developer Track)
Mark Simmons, Health Consultant, SIMPL
Wagner Silveira, Microsoft Technical Architect, Microsoft Corp.
This was an interesting discussion of the SIMPL/Microsoft approach to IHE...not highly relevant to AdvancedMD right now, because we're not pursuing IHE implementation at this point. Another opportunity to catch up on e-mails.
Better User Experience in Clinical Applications (Developer Track)
Anand Gaddum, Director, Healthcare Practice, iLink Systems
William Hughes, Director, Product Innovation, GE Heatlhcare Enterprise IT Solutions Division
Anand and William demo'd a prototype application built on Silverlight. It was very impressive, and only took a team of 5 full- and part-time engineers about 2 1/2 months to build...but it clearly wasn't ready for prime-time.
Still, it reinforces my believe that Silverlight will be a powerful development platform as it matures, and as the runtime becomes more ubiquitous.
In particular, as we try to encourage doctors to adopt new technology, Silverlight provides UI "eye candy" that might help pique their interest.
Building Safer Healthcare Applications in WPF and Silverlight with the Microsoft Health Common User Interface (Developer Track)
Andrew Kirby, Director in Microsoft Services UK, Microsoft Corp.
MSCUI was launched a year ago at the last Tech Forum in Redmond. This session was an overview of MSCUI and a view into how it's been adopted over the past year.
This is a really interesting project, because it isn't a sellable product, or even an initiative that directly results in the sale of Microsoft technology. It's a collection of design guidelines that are totally platform agnostic, as well as a collection of free controls that illustrate the principles of the guidelines using Microsoft technology.
Obviously, one of Microsoft's objectives is to provide enough free controls and other shortcuts using their technology that healthcare organizations will be encouranged to use Microsoft tools to create solutions, so it isn't a purely altruistic endeavor, but it's pretty cool, anyway.
There is a ton of information available at http://www.mscui.net/, so I won't dive in any deeper here.
Surface Technology in Healthcare (Closing Keynote)
Randy Fusco, CTO & Strategist, Microsoft U.S. Healthcare Provider Solutions, Microsoft Corp.
This was a pretty exciting session. Surface started out as an informal collaboration between a couple of departments at Microsoft back in 2001. A few years ago, it was officially funded as a research project by Microsoft, and now it is an actual product.
It's difficult to describe how cool this stuff is without actually seeing it. If you're interested, check out the Microsoft Surface website.
Tuesday, August 26, 2008
Microsoft HUG Tech Forum 2008 - Day 1
I'm at the Microsoft HUG (not "MS-HUG" any more, according to Michael Clifford's opening remarks) Tech Forum in Redmond today and tomorrow. My primary objective is to gain more exposure to HealthVault so that I can bring that knowledge back to my colleagues, but I'll be posting highlights from all of the sessions that I attend.
Opening KeynoteSteve Aylward, General Manager, Health & Life Sciences, Microsoft
I skate to where the puck is going to be, not where it's been.
- Wayne Gretzky
Steve started his presentation with Microsoft's Health Future Vision video (direct link).
The video has a lot of cool, visionary ideas, but I was especially impressed by the sweet TV in the patient's living room. Being a Tucson native, I liked her low-care landscaping (in contrast to the huge lawns in the Salt Lake City area). I was also happy to see that shopping carts wouldn't change.
Microsoft's growth in healthcare market:
2000
63 employees
< $100 million in sales in healthcare market 2008
> 700 dedicated employee
> $1.2 billion in US
> $2 billion in sales world-wide
In 2008, Microsoft invested $8B in R&D. Steve couldn't say how much of that was invested in healthcare, but indicated that it was a large percentage.
Aside from core initiatives like Office, Windows, BizTalk, etc., healthcare is among Microsoft's largest areas of investments.
Other notes:
- Amalga HIS is for emerging markets, where there isn't already a lot of infrastructure in place.
- Amalga Unified Intelligence System: I don't know what this is.
- HealthRamp: "Internet health platform that enables third-parties to create valuable health-related services." That description (pulled from one of Steve's slides) confirms my earlier assessment that Microsoft is taking a more vendor-based approach than Google.
Dr. Albert R. R. Kooiman
Bill Crounse, MD
Unification (via Office 2007) of:
- E-mail and unified messaging
- Instant messaging
- Enterprise telephony
- Conferencing
Dr. Kooiman opened with a demo of Outlook: He selected an e-mail message, then clicked a button to open an IM window with the sender. With another click, he called the sender on the phone. Presumably, another click or two would allow him to conference in another participant to the conversation.
The "Call to Action" for this session was to encourage developers to use Office 2007 as a platform to integrate unified communications into their applications.
Dr. Crouse introduced this video on unified communications on his HealthBlog, and showed it during this presentation. To be honest, I find UC to be more applicable to hospitals than ambulatory clinics, but perhaps there is a more relevant application for larger clinics.
Solving the Difficult Problems of Healthcare and Life Sciences with the Latest Generation of Microsoft Technologies (Developer Track)
Tim Huckaby, CEO, InterKnowlogy
Tim was invited to present because his company has done a lot of cool projects for healthcare organizations using Microsoft technologies. Also, Microsoft is IngerKnowlogy's largest client.
Tim demo'd a WPF application built on top of SharePoint Web services for Scripps research. Visually, the data is represented as complex, hyperlinked, rotatable 3D images, but they're stored as large text files in SharePoint. The graphical performance of WPF is impressive, and the rendering code was written by one developer in one week (although InterKnowlogy had invested heavily in WPF prior to embarking on this project).
Why hasn't WPF been widely adopted?
- It is huge: Larger than ASP and WinForms combined.
- It's a thick client, and thin clients are the current rage.
WPF is built on top of DirectX, and it makes sophisticated graphics much easier to deal with.
Silverlight only contains about 18-20% of the classes available in the full WPF framework.
InterKnowlogy has some some cool Silverlight demo apps.
Microsoft HealthVault Architecture Overview (Developer Track)
Sean Nolan, Chief Architect, Microsoft Corp.
Our bet: Patients as the hub of of communication.
- Sean Nolan's HealthVault presentation
Reasons to Integrate with HealthVault
- Private and Secure Storage
- Authenticate Users, Manage People Relationships
- Share Securely, Authorize Data Access
- Application Interoperability
- Device Connectivity
- Application and Device Discovery
- Developer Assistance
How does Microsoft monetize HealthRamp? (There are no fees or charges to use the platform.) They see healthcare being like travel - opportunities for advertising in the future.
HealthVault can be used in "Native" or "Copy" model:
- Native: Healthvault replaces traditional database and authentication mechanisms
- Copy: HealthVault is an external repository, you can pull data out of it or push data into it (import/export, merge, sync)
HealthVault supports both Windows Live ID and Open ID.
Interesting: All access to HV goes through the XML API (Basic XML over -HTTP interface, POST a request and receive a response)...NOT SOAP! (Although SOAP and WSDL will probably come in the future.)
This is interesting to me because we took the same approach with our core (XMLRPC) API 9 years ago. (In our case, SOAP wasn't fully baked, but we continue to believe that our lightweight version of SOAP is better suited for our application.)
Security, authentication, and access control are very important in HealthVault.
HL7 Based Data Warehousing: Fast Build to Data Use (IT Pro Track)
Eric V. Washburn, CTO, Athena Advanced Technologies/HVHS
This was a great opportunity to catch up on e-mail. (Eric did a good job, but his audience was pretty small--few organizations need to do what he did.)
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