SynapticHealth Blog

There are a number of Information Technology trends, strategies and ideas that SynapticHealth has studied or been involved with over the past several years that are ripe for healthcare, healthcare information technology (HCIT), and healthcare information exchange (HIE).

1) Webs of Pages vs. Webs of Services

Simply put, the web, networks, information exchanges, and collaboration platforms have moved well beyond content, the limitations of html, and the desire to present information, and towards web services, software as a service (SaaS), even cloud computing.

We talk about "webs" not "The Web" for two reasons:

• In healthcare, we are not always talking about the Internet. But HCIT and HIE still need to leverage network technology that is scalable, etc.
• In healthcare, we are always talking about multiple networks.  For example, a hospital has their substantial internal networks and information exchange requirements to deal with, as well as their external trading partners that may consist of numerous networks. Even a service provider with a single web solution has to be prepared to deal with numerous publishing and consuming systems and networks. 

Regardless of the technical debates about what will win or stick, suffice to say that HCIT and HIE need to incorporate a "web(s) of services" strategy into their approach.

2) Web 2.0

We'll grossly over-simplify the somewhat silly debate of the silly migration from Web 1.0 to Web 2.0. SynapticHealth's take on all of this:  

If Web 1.0 was about email, web pages and content, search (searching for reference material, not everything search could be), and e-commerce, Web 2.0 has added to the mix a few key things: networking (social networking like Facebook and professional networking like LinkedIn and Plaxo), publishing (things like blogging and syndication), and web services (the ability to move apps and solutions from the enterprise to the network.  Here's the key point: Web 2.0 has helped the movement from a web of pages to a web of services (trend 1) via tools, an ability to enable collaboration whether end-users are commenting, subscribing, engaging, subscribing, etc., or (perhaps more importantly) developers are able to collaborate around information services.  Web 2.0 principles include the ability for anyone to easily get in the game.

3) Viral Expansion Loops

A key component of Web 2.0 tools and the ease with which one can get into the Web 2.0 realm of social and professional networking is the concept of end-users expanding the user base themselves, inviting other network participants and nodes onto a network, sponsoring certified or accredited members of network, etc.  The ability for networks and information services to go viral has been greatly expanded – and HCIT & HIE vendors, networks, sponsors and developers would do well to consider how the network’s own customers and end-users can expand the membership and even depth of use of the network.

4) Information Services Exchanges and Registries

The place to find the Web 2.0 tools, apps, solutions, web services, Software as a Service (SaaS), etc. are registries, information services exchanges, and web services directories.  Think Apple’s iPhone App Store, Salesforce.com’s Appexchange, Widgetbox, even Windows Vista and Apple Macintosh desk-tops where one can consume apps out of a directory.

There are numerous apps of this type, displaying the weather or stock quotes on web sites and desk-tops, or for use playing games on cell phones.  But healthcare, HCIT, and HIE need to consider listing apps on two dimensions:

1. Technically, apps need to cover the underlying technologies of current infrastructure as well as future networking services and even cloud computing or grid computing. 
2. The HCIT value chain is a good guide to consider the specific elements that healthcare, HICT and HIE information services need to address: integration and connectivity, then transaction processing and data governance, and on to value-added services like data quality management.  Eventually decision support, business intelligence, and data processing performance can be addressed.

5) Mass Collaboration

A key concept that is pushing various fronts in information technology in general is mass collaboration.  “Opening up” technical platforms like the iPhone via the App Store, APIs, and SDKs, has proved a strategic bonanza for Apple.  Numerous other apps, solutions and platforms like Google Health, Microsoft Healthvault, and others have made available to developers some tools to enable mass collaboration.   HCIT & HIE vendors will do well to follow this strategy.

6) Mash Ups and Bundles

Healthcare is a distributed network of disparate systems and as such, almost all apps, solutions, transactions, etc. have to “live” in numerous networks or on numerous grids of services, usually in combination with several other services.  Healthcare, HCIT and HIE should consider:

1. Technically, can your service  be mashed up or bundled – is it already – and is it adequate, scalable, replicable, etc.?  Otherwise, why not and what can we do about it?
2. Strategically, where can you lead the way in terms of being a mash-up or bundle “leader” or “sponsor” and where does it make sense to participate in other ways?

7) From Integration as a Service (IaaS) to Solutions as a Service (SaaS) to Platform as a Service (PaaS)

Adoption of updated technology for everything from integration to software distribution to development platforms is likely to include web services and service oriented architecture (SOA).  At the very least, consideration of updated ways to commoditize integration and information exchange in favor of several of these other trends (collaboration, better information services, better tools, mash-ups, viral loops, etc.) will require scalable technology, replicable code, markets and exchanges for these commoditized information services, and the establishment of company-, HIE-, solution-, and network-specific information services exchange capabilities (like SynapticHealth and the SynapticGrid).

8) From Grids to Smart Grids to Synaptic Grids

In other industries like power/energy, there is talk of moving from a grid to a smart – meaning, the integration of management applications (whether enterprise solutions or Software as a Service), so that nodes on the network or players on the grid can then engage in much “smarter” information or commodity exchange.   Consider that healthcare is a grid of grids – many disparate networks – in search of increasing the intelligence of the information exchange.  But it’s not just a matter of applications being certified as interoperable (able to connect to a particular grid) – it’s a matter of enabling a wide range of information services that are compatible with the many-to-many networks common in healthcare.  In order to have your application thrive in the eco-system of systems that is healthcare, you have to do more than just get certified as able to produce a HIPAA-compliant transaction, for example.  And again, where do you want to participate and where do you want to lead the effort of taking a particular grid from “smart” to “Synaptic”?

9) From HCIT to HIE to Synaptic Information Exchange

HCIT has significant challenges with HIE.  HIEs have issues dealing with all of the HCIT.  But SynapticHealth and the SynapticGrid are a means to start to address these challenges, specifically, enabling HCIT and HIE consumers, vendors, and developers to now discuss, list, publish, consume, mash-up, and distribute information services of several key tops (infrastructure, solutions, platforms).

SynapticHealth and SynapticGrid address all of these trends directly.

Get Synaptic.

healthcare ecosystem
Healthcare is a distributed network of disparate systems (the "healthcare ecosystem"). As publishers, consumers and sponsors of information services, Healthcare Information Technology (HCIT) andHealthcare Information Exchange (HIE) vendors, users and developerscan improve healthcare by getting Synaptic - by thriving in this sort of ecosystem and leading the development of smarter, stronger and more profitable information services.

 collaboration
Healthcare relies on information and collaboration, meaning, the HCITandHIE, and the "glue" and other information services that make collaboration possible. Numerous interoperability, replicability, and efficiency challenges abound.

service registries
Every single healthcare organization, vendor, solution, device, etc. needs to articulate it's HIE capabilities - interfaces, transaction formats, APIs, data governance requirements, etc. "This is how my organization or application publishes and/or consumes data." A registry of these information services is more than a directory - it's a place to list, publish, consume, test, sponsor, mash-up, etc. various types of information services.

an exchange of services registries
A registry like the SynapticGrid is a one-to-many place to publish your information services. The SynapticGrid is a place where mash-ups and other "glue" between apps and solutions can more rapidly move the market to "many-to-many" solutions - a necessary next stage of the evolution of the healthcare ecosystem.

commoditization vs. value-added services
Certain parts of the healthcare value chain need to be commoditized: integration and transaction processing, primarily. Value-added services and especially mash-ups need laboratories, incubators, and profit motives - places where developers can collaborate and have a reason to share and sell information services.

transparency
Consumers of applications need a real means to determine which solutions thrive in the healthcare ecosystem. "Certification" and "meningful use" need to be demonstrated via APIs, interfaces, connection points, mash-ups, etc. - vendors need to list these services - and consumers need to be able to easily compare which apps are the most "synaptic."