Healthcare is a mobile profession -- nurses visit patient rooms, doctors move among examining rooms and from office to hospital, EMTs race to the scene, home health aides travel to homes. So it's no wonder that healthcare is embracing mobile computing.
Healthcare is also where the money is flowing. A combination of stimulus dollars, increasing safety regulations and the need to become more efficient are driving healthcare to play technology catch-up. Mobility is the answer to many of these challenges, and healthcare is becoming a major adopter of mobile solutions. More than 80 percent of global information technology decision-makers within the healthcare industry feel mobile technologies are more important to their organizations today than they were in 2008, according to the Motorola Enterprise Mobility
But getting into healthcare takes time, and with the domination of mostly-closed hospital information systems in the clinical arena of large healthcare organizations, ISVs and VARs must choose markets with care. The good news is that that leaves plenty of opportunity across the wide range of healthcare provider types.
Opening a Closed World
In the hospital setting, clinical care technology is synonymous with the big HIS firms including Cerner, CPSI, Eclipsys, Epic, GE Healthcare, McKesson, Meditech and Siemens. These developers are steadily expanding their footprints in healthcare, including mobile technology. Some align with a select few ISVs and VARs to fill functional gaps' McKesson, for example, opened its audit logs to FairWarning, a patient records auditing application, to provide auditing and snooping alerts to its customers, and seeks VAR help with some implementations. But those alliances are few and far between. For a new installation, "The first 12 to 18 months we'll work with a VAR on implementation services, then as the business grows we'll get our engineering staff to do it internally," says Greg Tartaglia, manager, technology inside sales for McKesson, an HIS provider and Motorola VAR.
"Don't waste your time," advises Vivian Funkhouser, principal, Motorola Global Healthcare Solutions. "Beyond the big eight there are so many other opportunities in the healthcare environment."
There is some desire among healthcare organizations for open platforms and standards, but those appear to be a long time coming; hopes are pinned on electronic healthcare records to trigger software standards. "They're going to have to go to open systems to communicate back and forth with each other," says Brenda McCurry, ScanSource POS & Barcoding
"People from other verticals are coming in as change agents," says Sandeep Bhanote, co-founder and CEO of Global Bay Mobile Technologies
, a mobile applications ISV; new technologies such as Web services will also help. Some software companies use screen scraping or other basic methods to extract data from these systems.
Healthcare has a lot of segments, including hospitals, clinics, physician offices, labs and testing facilities, nursing homes, emergency services and home healthcare. HIS companies are into mobile apps. such as point of care, lab/pharma/materials tracking, but, "There are a lot of white space opportunities that are not obvious," says Global Bay's Bhanote. "You can create your own market." Some of these areas include:
- Asset Tracking: Healthcare organizations need to prevent shrink by efficiently tracking their high-value equipment; many see high potential for RFID here. Asset management jumped from 12th to 3rd in healthcare IT priorities between the 2008 and 2009 Motorola Barometer.
- Materials Management: A great fit for auto ID VARs.
- Forms Reduction: Where there is a form, there is opportunity for automation. "Forms reduction may also offer collateral benefits, such as how to push out interfaces with insurers and get paid faster," says Harry Lerner, CEO of Janam Technologies. Automating manual processes can also help facilities prepare for JCAHO (The Joint Commission), a healthcare certification organization, says Global Bay's Bhanote.
- Patient ID: Creating barcoded or RFID wristbands and verifying them for procedures; opportunity depends on whether applications are integrated with clinical systems.
- Pharma/Med/Lab Tracking: Auto ID intensive, but could touch clinical; HIS companies offer these.
- Admissions/ Discharge/Transfer.
- Customer Relationship Management: As facilities compete, personalizing the experience will become more important.
- Wireless/wired networks: Not all facilities are fully wireless, or may need a/b/g/n migration.
- VoIP: Some facilities are adding voice to their mobile data devices; others use separate telephony.
- Time and Attendance.
- Safety Equipment Inspections.
- Electronic Medical Records: This is the hot app thanks to stimulus funding, and there are already
- about 400 ISVs, but a lack of standards is constraining adoption.
- Forms Reduction/Administrative Apps.
- General IT Consulting: Docs need a trusted adviser.
- ePrescribing: Secure prescriptions reduce handwriting errors and decrease the cost to serve.
In the Field
Form Factors Feed Functions
- EMS Response Systems: Global Bay's GBMobile First Responder Suite, for example, includes Field Patient Triage Tracking to dispatch qualified EMTs, collect patient ID to send ahead to hospitals and create patient incident reports.
- Lab Systems/Specimen Chain of Custody: for outside laboratory services.
- Home Health/Telehealth Apps: Administrative or data collection.
- Durable Medical Equipment Asset Tracking.
- Long-term Care Facilities: Require administrative apps and wireless for patient access. Consolidation means these facilities "have money and understand the value of efficiency and productivity," says Greg Davidson, healthcare senior business development manager at Panasonic.
Mobile hardware manufacturers are responding to these varied needs with a range of form factors and features; increasingly users want to run multiple applications on a single device.
One trend is antimicrobial plastics, so mobile devices resist germ growth. But devices must also be frequently disinfected to enhance infection protection. Healthcare workers "are wiping down devices multiple times a day with harsh chemicals, and this was breaking down the plastics," says Mark Bunney, director of global alliances for Honeywell Scanning & Mobility
. "We announced this year the Dolphin 9900hc with disinfectant-ready housing, built to withstand the harsh chemicals used to clean the devices."
Mobile hardware manufacturers are also including more radio options. "The ability to communicate via PAN, WLAN, WWAN and the capability to do wireless broadband means caregivers have communications ability they didn't have before," says Bob Laclede, VP business development at Ingram Micro
. "They can be available regardless of network availability."
For some applications, healthcare organizations are transitioning to small, lightweight mobile computers that enable users to take data collection and display closer to the patient. "They need it to be rugged, yet light," says Janam's Lerner. "They also need viewability, which is why we are using a 3.5-inch display rather than 2.7 inches or 2.8 inches. Healthcare buyers are also focusing on long battery life and easy battery swaps and charging systems.
But for other applications, larger screens, full keyboards and more robust processors drive adoption of healthcare-ready notebook and tablet form factors, held with straps or sitting on a cart. "Hand-helds are limited in screen size, computing powerââ¬â‚¬they'll never serve as the primary device," says Panasonic's Davidson. Larger screens and more robust processing are needed for displaying medical images, he says. "There is so much data in an electronic medical record on one screen."
Growing use of 2-D symbologies for marking wristbands, drugs and other materials is driving use of imagers integrated into mobile hardware, and healthcare is still expected to embrace RFID. Some are requiring biometric readers as part of their authentication process. Touch screens are also helpful for data collection and software navigation.
Another early trend is the merging of data collection/computing equipment with medical equipment such as blood glucometers and blood pressure cuffs, to automate data gathering; these can be through wireless integration or hybrid devices.
ISVs and the Channel
Like other markets, healthcare organizations are looking to decrease the number of vendors they use. That, together with the challenges of meeting growing demand, has healthcare ISVs increasingly seeking VAR relationships to present complete solutions and single-call accountability to healthcare customers.
When it comes to working with a VAR channel, "I don't see how you wouldn't do this model," says Global Bay's Bhanote. "As a software company, there are only so many sales guys you can have. As long as you make it simple to sell, understand and price you can be successful in any channel."
Several vendors and distributors offer guidance and matchmaking to ISVs and VARs. ScanSource POS & Barcoding recently unveiled its Healthcare VAR Source, for example, while Ingram's IMStimulus helps VARs targeting healthcare, among other verticals.
Succeeding in Healthcare
Selling solutions into healthcare demands learning the lingo, and talking about solutions instead of technology. ISVs may need application-specific certifications. "The sell cycle is long, and you will talk not only to IT leaders, but clinical leaders as well," says ScanSource's McCurry. Recognize that healthcare facilities are often made up of individual departments with distinct needs.
It also helps to be able to point to funding sources. "Be able to tell the end user, 'I can help solve this problem and find money',"advises Ingram Micro's Laclede.
"There is a completely different set of regulations and certifications for software companies such as the Certification Commission for Health Information Technology (CCHIT), that they need to meet in order to offer their software in the healthcare market,"says Honeywell's Bunney.
While safety and efficiency still lead healthcare's drive to mobile, healthcare executives are increasingly talking about consumer choice in healthcare. Savvy ISVs can tap into that trend. "Service is going to matter," says Janam's Lerner. "Smooth operations or customer service or operating efficiency equals an enormous need for our technology, hardware and software."