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Winners & Losers in HIT

I was recently asked to predict IT Winners and Losers in 2009. Rather than name individual companies, I’d like to highlight categories.

Winners1.  Electronic Health Record vendors, especially web-based applications – The Obama administration has promised  $50 billion for interoperable EHRs.

2.
Software as a Service providers – SaaS providers offer lower cost of
ownership and faster implementation than traditional software
installation approaches.

3. Open Source – I’m embracing Open
source operating systems, databases, and applications as long as they
can provide the reliability and supportability that I need.

4.
Green IT – Winners will be innovative techniques to adjust power draw,
such as idle drive management, cpu voltage adjustments, and high
efficiency power supplies.

5. Cloud Computing offerings – These
are remote infrastructure utilities such as storage and high
performance computing. Friday’s Cool Technology of the Week will
describe a new technology called Cloud Optimized Storage.

Losers

1.
Client Server applications – the cost of deploying, supporting, and
maintaining client server applications is no longer affordable.

2.  Proprietary operating systems – I’m eliminating Solaris, AIX, HP-UX from my data centers. 

3.
High end SAN storage – I find that 90% of my storage needs are met with
lower end SAN, NAS, and appliances which use low cost, high density
drives (SAS and SATA).

4.  Devices that do not offer energy efficient operations.

5.
Applications that require a specific operating system or a specific
browser on the client side. To be successful in 2009, applications
should be operating system neutral, browser neutral, and easily hosted
as a service accessible via the web.

I welcome your thoughts on your own winners and losers for 2009.

John D. Halamka, MD, MS, is CIO of the
CareGroup Health System, CIO and Dean for
Technology at Harvard Medical School, Chairman of the New England
Health Electronic Data Interchange Network (NEHEN), CEO of MA-SHARE, Chair of the US
Healthcare Information Technology Standards Panel (HITSP), and a
practicing emergency physician. He blogs regularly at Life as a Healthcare CEO, where this post first appeared.

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  1. As an IT analyst in healthcare, I applaud your list of winners and losers. However, one roadblock to promoting open source, is that open source is only being embraced by IT folks. IT depts see the future value of such systems, however, the users (docs, nurses, ancillary workers) and administration seem to prefer the older established systems that use antiquated platforms (MUMPS for heavens sakes) but have nice, intuitive user interface screens. The IT dept has but one voice when decisions are made about these enterprise-wide systems. Oh, and these systems require client-server deployment too.
    Our primary goal at our hospitals is for the “best patient experience” and all our IT goals must be aligned with that goal. For that I applaud our administrators because that is really the end-goal. However, other areas where we can increase efficiences and increase our bottom line (like real-time claim ejudication with third party payors) is overlooked furthermore, it is currently out in a prolonged development state because nation-wide reps have to all agree on a variety of complex standards. It would be nice to see President-elect Obama give the nation-wide reps a year timeline to get an agreement and get the standards in place (I know, I’m dreaming here).
    One “winner” that I do question is the System as a Service provider. In our shop we have a combination of both and although the SaaS’s cost less to install, we have been less than pleased with the customer service of quite a few. Its a good concept, but unless the companies have exceptional (and often 24/7) response and repair rate, its not worth the risk. As we are schooled, downtime equals patient risk and our bosses want to see fast results from workers who have a direct stake in the problem. I’m not sure from our experience that SaaS’s feel the same pain that we do when systems fail. And it IS that pain of hearing from our frustrated docs and nurses that make us work hard to correct problems.
    Overall, I like your list and agree with it, I just wish administrators in general would see the future value of the measures listed above. I also see that you are part of the EDI Network in New England — push those initiatives locally and nation-wide!! We need them in place faster.

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