SaaS is a very cost-effective model that is still evolving in healthcare domain. Especially due to the nature of healthcare/medical products that has to meet FDA/ PHI/ HIPAA/ Security/ High Availability/ Stability type of regulations, policies and requirements, it becomes challenging to offer software product services using SaaS model to the customers. But good news is, healthcare product vendors can leverage recent changes that occurred in the recent decade in terms of federal regulations that streamlined healthcare IT/electronic infrastructure to be in compliance with a set of standards and guidelines for offering their software products as Software as a Service to customers without having to worrying too much about compatibility of their product services with the customers infrastructure. For instance, a product vendor might be able to offer some type of insurance claim validator as SaaS to make sure all the claims being submitted by a healthcare provider to the payers/insurance companies are valid and well formed, knowing that providers are federally required to transmit all of their electronic claims in X12 format to Insurance companies. So, there are lots of opportunities that we can continue exploiting on in healthcare domain to make quality healthcare cost-effective and affordable.

If you need more information on this topic, please feel free to email me at venkat.madip@sidglobal.net or post your questions or comments here.

What is an EMR? An EMR is a record that is composed of Electronic Health Records (EHR) of the patients and other administrative and financial information like appointment schedules, billing details etc.

There are primarily two types of HIS systems.

1. HIS for Hospitals
2. HIS for Clinics (Group or Single Physician Practices) – They are also called Medical Practice Management Systems

There are comprehensive and matured HIS solutions that support large enterprise multi-chain hospitals of varying sizes right now. But, there are hardly any reliable, proven and comprehensive HIS solutions for Clinics and small/mid size healthcare organizations.

Ok, enough of technology talks, this should have given you decent idea of HIS. To explain the HIS and EMR in detail, it’s going to take a whole big article for itself. So, let’s go straight to our primary question “What’s in it for me as a healthcare provider?”.

Ok, let’s start at the pain points or actual issues that you face in today’s world, while trying to provide quality health services.

• You practice out of multiple clinics, it’s a good way to reach out and provide your services to broader communities, but ever experienced trouble sharing patient records across these clinics. Sounds like a very familiar issue that you experience? Yes, it’s a big issue today for the practices with multiple clinics, especially when patients schedule their appointments across these multiple clinics randomly due to the convenience, doctor’s availability, patient’s schedule etc.
• You are a busy healthcare provider and you are having issues managing your time efficiently? Are you over-booked or under-booked significant amount of hours a week? Again, this is one of the most common issues, today’s medical practitioners are facing.
• You are a dedicated and quality healthcare provider and you want to provide best medical services possible for your patients at lower costs? But, you are not able to make enough justice to your patients and your profession because of bulky, unorganized health records of the patients charted and filed using paper based systems? You feel, it takes forever to find the patient health history/information while browsing through all that paper work in the patient’s file? Have you ever experienced the issue of not being able to get to the critical healthcare information of your patients on-time, the information that is hidden deep in that bulky paper work filed in the patient’s files? Studies show that, this is a common and high patient risk issue which needs to be addressed for better quality and legal issues.
• Malpractice issues
• HIPAA compliancy issues

Following are some of the many reasons why you need this type of solution. These are the answers for what’s it in me question. These are the solutions for the above listed issues that you face on daily basis.

• Ability to access patient records across multiple clinics of your practice. This will help you access patient records from any location. It doesn’t matter where you are, working out of one of your clinics, on-call at home or at a friend’s place; the records are at your fingertips for you to access in a secured environment.
• Scheduling process becomes easier and efficient by using HIS systems. You can plan your time in advance and record your plans (e.g. your weekly availability fluctuations, vacations, holidays, extra available time etc) so that registration clerk can schedule patients to efficiently utilize your time. Your practice will have better control on patient cancellations, delays, no-showups etc for more effective utilization of your time. This also gives ability to manage your schedule from any location and time.
• Ability to quickly review patient’s critical health records like allergies, medication, major health issues; a patient dashboard for quick and comprehensive snapshot of patient’s health. This feature really helps you by emphasizing some of this critical patient information during the treatment and thereby cutting down length of your sessions with each patient.
• Many malpractice issues can be avoided using HIS systems as they will help you make sure to follow all the approved clinical workflows and record all the events and data during the process.
• HIS systems keep your practice or healthcare organization compliant with Health Insurance Portability and Accountability Act (HIPAA) and Protected Health Information (PHI).

Right HIS solution should help you operate more efficiently and effectively which translates into 20% to 40% increase in revenues through cost savings and being able to handle higher patient volume.

As explained in this article, it’s most important for medical practices to adopt a suitable HIS solution to provide cost-effective quality services in this era. If you need more information on this topic, please feel free to email me at venkat.madip@sidglobal.net or post your questions or comments here.

“Thick clients are tough to maintain/deploy” is just a myth anymore in various perspectives, especially for java apps, ofcourse with some exceptions. With the introduction of Java webstart, it has become much easier to deploy and manage thick clients. This solution brings good from both worlds, web UI & thick client. Using this technology, you can deploy your thick client application in a centralized location (server) and access the application to serve HTTP/TCP requests from your workstation as if it’s a web app (atleast from the end-user perspective, there is lot of technical things that go under-covers to make that happen, which would be out of scope for this discussion). So, basically to visualize it better, you click a url link to the application from a web page as if you are launching a web page but launch the thick client instead, with all those rich UI features that come with workstation based clients. I recommend this solution for any application that need to meet following combination of requirements:
1. Access local workstation resources (e.g. Serial ports, RFID readers, USB ports, Local file system etc.)
2. Need quick UI response
3. Need easy deployment, upgrade and maintenance of application from a centralized location without needing to install on each and every end-user workstations/computers (e.g. application hosted by IIS on Windows server)
4. Need rich UI look & Feel
5. Need to server both HTTP and/or TCP requests
6. Need the reliability of thick client application
7. Need to work off-line

Note 1: Even though this technology is designed for Java applications, it can be used for non-java applications with some intelligent design.
Note 2: This technology currently have some limitations like, being able to handle dynamic data as an input to launch your application, but again with some intelligent design, we can over come most of the deficiencies Webstart possess.

It’s already that time where we are getting close to see another version of Windows operating system. It feels like we got there pretty soon this time, as many organizations are still at XP and some using Vista, some more in the process of migration to Vista accross the enterprise or small groups within the enterprise for various reasons. So, as always it’s going to be a challenge for the organizations to migrate to Win 7 from whatever Win release they are on currently. But, it’s even bigger challenge for the entities who are dealing with IT security. Some of them would be IT enterprise security groups within the organizations, secuirty & anti-virus software vendors etc. Most of the security software vendors collaborate with Microsoft during development of Win 7 to design their security products to be suitable for the new variations and features of the OS. In security software’s perspective most concerend areas with this new release of OS are Networking features, Caching mechanisms, Internet Browsers, Kernel & Registry. This translates to various efforts for enterprises that use Win 7 & software vendors that create security products. For organizations who use Win 7, it means new/modfied/enhanced security policies, and for security product vendors, it is significant changes/updates/enhancements to the security products (e.g. anti-virus) and lotz and lotz of teting testing & testing (Q & Q).

   Author: Venkat Madipadaga, Chief Architect – SIDGS

Integrated Development Platform (IDP) is a common integrated solution to support development process across multiple technology technology platforms like J2EE and System z (Mainframe). The solution is a combination of tools, connectors and processes. The solution is composed of various tools that support different phases of Software Life Cycle (SLC). SID Global Solutions (SIDGS) Enterprise Architecture Practice proposes this solution using IBM Rational tools and Unified Change Management (UCM) process. Following is the tooling strategy for the individual areas of Software Life Cycle (SLC).

Requirements Management: Rational RequisitePro
Application Life Cycle & Defect Management: Rational ClearQuest
Revision Management: Rational ClearCase
Development: Rational Software Architect (RSA)/Rational Developer for System z (RDz)
Test Management: Rational Test Manager (RTM)/ClearQuest Test Manager (CQTM)/Rational Quality Manager (RQM)
Build Management: Rational Build Forge

The above tooling is integrated to form the base platform for the solution. The following is the workflow using this solution. Requirements & Usecases are created and maintained in RePro. These requirements can be assigned to the developers in the project by the Team Lead or Project Manager. The Developer logs into RSA/RDz and opens ReqPro perspective in which he will see all of the requirements assigned to him and implements those requirements in the application code. He updates the code using RSA/RDz IDE/features after checking out all the source code modules required to make that change from Revision Management repository ClearCase. During check out of source code from ClearCase (CC), it prompts the developer for ClearQuest (CQ) Activity ID that has to be recorded for that specific checkout transaction  to capture the change record/history. So, developer chooses CQ activity ID of the activity that was assigned to him which suggested implementing that specific requriement or change. After making changes to the source code, developer delivers the changes from his own private development stream to project common workspace integration stream (Common work area for the project). Here, out of integration stream, software application is built using Build Forge and the built software is deployed in the appropriate server environment and at that point the built application can be turned over to Quality Assurance team for testing. The QA team will use ClearQuest Test Manager to execute the test procedures/cases using the test scripts that are created using Rational Functional Tester (RFT) for automated testing & Rational Manual Tester (RMT) for manual testing, which are stored in ClearCase repository.

 This solution solves the universal industry wide problem of keeping up with upto-date reliable traceability during Software Development Life Cycle (SDLC) by providing the end-to-end traceability, right from Requirements thru Test cases & built software. It helps in managing dynamically changing product/project artifacts during various phases of SLC while managing the relationships between these various artifacts.