ONDEMANDHEALTHCARE.net

SOWSIA’s Inpatient EHR Solution Gets 08 CCHIT Certification, SaaS company introduces browser based EHR for mass use.

Arvind Jain — Wed, 22 Jul 2009 10:00:00 -0700

SOWSIA’s Inpatient EHR Solution Gets '08 CCHIT Certification

SaaS company introduces browser based Electronic Health Record (EHR) for mass use

SAN FRANCISCO, July 22 /PRNewswire/ -- SOWSIA Healthcare Solutions Inc.’s product Ondemand Healthcare uHPM, 7Plus, M1 is now a pre-market conditional CCHIT Certified® 08 Inpatient EHR. The Certification Commission for Health Information Technology (CCHIT®) made this announcement today.

SOWSIA Healthcare Solutions Inc., a Software-as-a-Service (SaaS) healthcare IT company, has now also become the first SaaS company (one of only 3 vendors) to achieve the CCHIT 08 Inpatient Electronic Health Record (EHR) Certification. EHR Certification, currently being defined by the U.S. Department of Health and Human Services, is one requirement for qualifying for the Federal Stimulus funding in FY2011.

Until now, hospitals wanting to purchase EHR’s could either choose a proprietary client-server solution or a hosted ASP solution. SOWSIA provides a new choice of SaaS solutions that only need a browser to use healthcare applications. No hardware to purchase. No software to license. No upgrade costs. SOWSIA's EHR is based on a fixed monthly subscription fee that contrasts with the large upfront IT expenditure, lengthy implementation cycles, and ongoing high maintenance fees of traditional software.

Expanding on SaaS in healthcare, Sandeep Jain, MD, co-founder of SOWSIA, added, “SOWSIA’s applications delivered on the Healthcare Operating System (HCOS) also allows hospitals to leverage their current investments in legacy systems so they could preserve their best of breed solutions and still be able to bridge the information gaps these antiquated solutions leave behind. We’ve always had IT within the hospitals walls. Yet, we see medical errors causing in excess of 98,000 deaths a year. SOWSIA’s HCOS helps bridge process gaps amongst disparate solutions, integrates multiple applications and at the same time will be capable of seamlessly connecting information residing in hospital systems to available health information exchanges such as the emerging Nationwide Health Information Network (NHIN). SOWSIA does this without the use of any middleware.”

SOWSIA Enterprise Software Solutions are based on the paradigm of the network being the computer for patients, payers and health enterprises. SOWSIA guarantees a 100% available, HIPAA and SAS-70 Certified, highly secure, scalable and reliable network. SOWSIA’s solutions meet stringent security requirements for Web access and sharing of Protected Health Information.

Arvind Jain, Founder and CEO of SOWSIA, believes that “Health IT ought to be an enabler of business, not a resource drain. In the current environment this becomes more important than ever before. Paying for IT procurement during times when the reimbursements are only going down is a serious challenge facing every Hospital CEO and CIO as they make decisions about purchasing complexly priced on-premise software. The American Recovery and Reinvestment Act (ARRA) provides hospitals with financial incentives for EHR procurement. However, in the long run, CFO’s will face unsustainable IT budgets with licensing and maintenance fees running into millions of dollars because unlike SaaS, traditional software is costly to manage. For such discerning buyers, SaaS provides an option that leverages the benefits of cloud computing – this model is what makes SOWSIA's solutions an attractive option.”

About SOWSIA Healthcare Solutions Inc.

SOWSIA Healthcare Solutions Inc., an innovative and specialist health IT Company offers J2EE, XML, SOA-based Enterprise Solutions for Inpatient, Ambulatory and Urgent Care settings delivered on a Healthcare Operating System (HCOS) and accessible via devices like iPhones. SOWSIA’s multi-tenant SaaS solutions are fully scalable with guaranteed 100% availability globally. No hardware to purchase. No software to license. All upgrades included. A browser is all the customer needs - true SaaS with all its benefits. For more information, visit www.sowsia.com

20/20 Hindsight: What Obama’s billion dollar health prescription can learn, and is there a better recipe for New Year?

Arvind Jain — Tue, 13 Jan 2009 13:48:12 -0800

SATimes, Vol.1 No.37 January 3-9, 2009: 2008 is on its way out and I will have to remind myself to fill the right date on my prescriptions. Apart from this nuance, nothing else will have changed in my world. Or yours. Let’s not therefore confuse motion of a clock’s hand with change. Looking in the rear view mirror, 2008 has been a year many of us would want to forget. That would actually be a tragedy. Because, it is a year we all need to remember. In it lies a lifetime of learning that we must absorb, lessons that validate what we South Asians all grew up with but thought less valuable in today’s Kalyug (Dark Ages).

2008’s typhoid tainted tomatoes brought to life verses in Manusmriti that implore us to wash hands before we touch food. Wall Street is not the only one that needs to take a cue from Jainism’s Ratnatreya (three gems): Bisphenol contamination in plastic baby bottles personify how following the principles of Right Vision, Right Knowledge and Right Conduct would have prevented us raising our children on toxic milk. It is not for nothing that our founding fathers built this great nation on principles, not rules! How we’ve deteriorated into a country that follows rules within its borders and breaks them beyond those boundaries! No surprise, then; that its citizenry in Board Rooms chose to behave so recklessly that my elderly patients now need notes for utility companies begging them to continue supplying electricity to their homes so that they may breathe life from their nebulizer and oxygen machines.

As we look at 2009, let’s use these principles to analyze the core of Obama’s prescription for health and score it:

1. Right vision:

The way it is now, I can't get access to my own patient's previous records when they end up in a hospital at midnight. The cardiac catheterization images were on an older type of machine that is no longer supported. Older records were archived and sent for storage to Pennsylvania. Records of hepatitis test results were destroyed because the law allows destruction of old records regardless of their importance to a patient or a doctor. When a new lab system was brought in, it did not port any of the previous lab history - there were issues with integrating two different proprietary systems that stored information differently. The Cardiologist and the Neurologists have their pieces of my patient's records in their offices which my patient's family is trying to obtain. One of the children is standing for hours trying to get MRI films from another facility - this is his third trip: first, he forgot to get the 'facility specific' consent signed while they figured out which of the same name records was his mothers; the next time around he did not carry enough money on him to pay and sign out the films and they were still sorting out the duplicate visit records that had not been merged!

My patient is a 72 year old mother of four and grandmother of fifteen who suffered a stroke from an irregular heart beat. She can't speak or swallow food leave alone walk on her paralyzed limb. I have already had to get the MRI repeated because the Insurer wants to know why I cannot send this woman home. The hospital informed me the Insurer was refusing to authorize payments for her days in hospital - I spoke to their medical director yesterday and he approved 'one more day' for a woman that clearly needs five more days; something that the Medical Director at the other end understands but is not authorized to approve by his employer.

My team is chasing their tails to wrap things up and have all the information so that the specialists can make the right decisions for my patient. Any copies of tests results that I had in my office were a result of my staff and my patient's efforts in trying to consolidate information over the years. Any tests that the Urologist sent out went to a different lab that would not send me a copy of the results even if they were asked to. The pharmacy never tells me what new medicines got started by any of those consultants or which refills my patient forgot to pick up. I have relied on my patient to remember Greek and Latin derived names of diagnoses and drugs that graduate students cannot pronounce. As a primary care physician I coordinate care - I spend 80% of my time trying to collate information, call pharmacies, check and reconcile bottles, discard duplicate medications whose doses were changed months ago - the list of chores doesn't end. My patients hug me and bring me Christmas cards and home baked cakes because they value my input- I keep them safe. That is not why I went to medical school. I can do much more for them if I could only get past this asinine system that encourages fragmentation of information and gives birth to medical errors.

Obama wants this to end. I cannot agree more. Electronic health records is the central theme of Obama's health prescription. Every hospital will be paid to ‘upgrade’ their technology. This will keep patient's safe, assist in data collection, improve efficiency and eventually help control healthcare costs.

Obama’s Score on having the ‘Right Vision’: 10/10

2. Right Knowledge:

Making everything digital is fine. I just hope it's all under one umbrella. A typical hospital has 40 to 50 software and systems in use - all different and unique. Physicians run between screens because patient labs are on one and X-Rays and MRI’s are on another terminal. At a machine level, these software programs don’t talk a universal language and work off their ‘own’ machines – servers that cannot be shared; programs that cannot be easily integrated. Any patient information has to be entered manually in each system - changes made to my patient's health data in one system does not automatically reflect in all other systems.

It’s almost like having to buy a separate device for every Nintendo game or software program and then networking the ‘server farms’ so that they can follow basic commands. You would soon need to accelerate your infant’s technology education so that you could eventually have ‘more hands’ attacking problems that the latest upgrade of software would bring to your abode! In healthcare, there is an update every day – whether it is drug or disease information or billing and payment codes. IT staff in hospitals do this 24/7 and within their department, there lie hundreds of such machines - each with ‘unused space’ – so much space that in a 2007 survey, there was $140 billion in excess capacity on the market and 77% of companies rated this inefficiency as being a ‘priority’ problem.

After hospitals buy more machines, IT would have to bridge every one of them to a national electronic data highway so that you and I can get a medical record when we need it. The costs are huge and all prior efforts at creating exchanges have failed. Obama’s plan of throwing money at the problem is reflexive. And primitive. He just has to look around and see how the development of Internet based products has solved this challenge for us in our homes. All we need today is an internet connection. We can log into Google documents and create, use, share and store all our files there. No hard drive capacity issue. No access issue since one could be at a party and access the document from a cell phone and work on it. Every time there is an upgrade, it’s done centrally and all users start benefiting right away – no one has to install, configure and reboot computers and devices anymore.

Now let’s look at what Obama wants to do. He wants to give away a staggering amount of tax-payer dollars so that hospitals can buy machines to become IT companies. Do hospitals and physician practices really need to run server farms and hire IT geeks to run them? Or should they be focusing on their core business, doing what they do best – taking care of people? It’s not like they have mastered that either - look at how NY area hospitals performed very poorly in the first ever patient experience survey conducted by the government and these hospitals are being penalized for poor scores on quality and satisfaction. (Go to http://www.hospitalcompare.hhs.gov and see how your neighborhood hospital scored).

The assumptions of yesterday cannot be the basis for our future work. The rest of the universe is no longer using server based systems of the 1960’s. They are using Internet based services. Why do Americans need to cough up 200 billion dollars for more of the same junk? Sometimes you need to abandon the past - just like those who had their heads in the sand building Hummers and Excursions instead of fuel efficient cars.

Obama needs to leverage the learning from the parallels drawn between the PC revolution and the development of Internet based services. Had we been left at the mercy of companies that make ‘servers and mainframes’ we would have server farms in our homes– storing everything from bank and credit card statements, documents, games to photographs and videos – literally running an IT department within our homes. But we are not doing that today. We use the internet to get us the service we need, when we need it, where we need it. Online gaming, video-on-demand and music-on-demand have made client-server obsolete. Why store locally, when you can store and access information globally? Even my data is backed up online. It’s cheap, efficient, reliable and painless. Best of all, I and my wife don’t have to be IT geeks to do it.

Hospitals don't need more machines and more IT staff to manage them. Hospitals need direction. They need better payments and easy access to capital to hire more nurses for patient care; upgrade patient rooms and lounges so that the patient experience improves. And all those ‘traditional’ Health IT companies that have been approaching this problem with the ‘server farms’ band-aid mindset – and are lining up ahead of Detroit’s CEO’s or in front of Senator Tom Daschle’s office with cookie jars and smiles on their faces – they all need to be shown the door!

Change cannot be more of the same. Obama’s team needs to shrug off lobbyist dollars and put purpose before self. Obama should know better than to allocate our nations scarce resources to the same recycled idea in the hope of getting a different result this time!

Obama’s Score on having the ‘Right Knowledge’: 0/10

3. Right Conduct:

This principle is about always trying to do the right thing to the best of one's ability.

Healthcare today is in the dark ages. We have a broken system where a provider has to provide service first in the hope of a possible payment 90 days from the date of service, at possibly 60% of the bill. Insurers dictate payments and routinely tell providers and hospitals to take it or leave it. Could I go to a Chevy dealer; even today; and dictate what price I will pay for their service or product? Can I retroactively pro-rate the fees for 'quality' of the service provided by my Attorney or Architect? Insurance companies constantly innovate to deny payments. Unlike physicians, their loyalty is never with their 'enrollee'. Their mission is to create shareholder value – denied payments do just that.

Another case in point is the mail-order medicine 'refill chase'. 10 days before your medicine runs out, you must call an automated voicemail system for refills. If you forget, you will need to pick up medications at a local pharmacy by paying cash. They don’t think you have vacation rights. They wouldn't let my mother pick her cancer pills a month in advance while she was going to India on an extended vacation. We had to find passengers to carry her medicines to India! They aren’t liable if your disease advances. By denying you a seven days of medicines every month via ‘process delays’ they increase stockholder value by 30% annually. We have thus created a society where we reward the denial of care more than its provision. In my practice, we print fax confirmations but can’t be sure that they have paper in their fax machines! Insured consumers face hurdles in getting their pills; the uninsured don't have these problems!

One way to look at it is that we have insurance plans that will pay for the service. Yet, we, the customers, need to constantly make calls, re-arrange our schedules just so that we can be plugged into our Physician's schedules when we are sick. Most specialists don't have openings for weeks. If you miss a Mammogram appointment you will fall back by 6 months. We do have the most advanced medical care in the world - we just can't get to it in time before the rash or cold disappears! And enough talk about Europe and Canada’s health systems. Their wait times for a Cardiologist is several months while their citizens pay some of the highest taxes on the planet. I don’t want to wait at a government run clinic with a ‘number’ and wait to be called like we do at the DMV. Their health systems represent yesterday. We need to look towards tomorrow. We’re Americans; we demand better.

We cannot secure the future of our citizen’s healthcare by merely tweaking what we have when we know it has not worked so far. Let's focus on results and value. Money ought to follow knowledge. Instead of paying hospitals for competing with each other and offer duplicated business products and services, it is time to have them compete for customers looking for quality and a better experience. Malpractice insurance regulations need to be re-worked so that our children won’t have to fly to India to have their babies delivered by Obstetricians. Instead of having businesses own and control a patient's information, consumers need to be empowered. We need to create a system that revolves around the patient - not the other way around. Cellular telephony and Internet were with the U.S. military for decades. Once ordinary consumers got their hands on it, they got into the driver’s seat and started a revolution that continues to transform our lives to this day.

A line from the gem of Puranas, the Vishnu Purana; would have helped us in 2008: “Leaders of Kalyug will be addicted to corruption…..wealth will confer rank and power; misinformation - the only path to success. Corruption will become a way of life…..ultimately ordinary people will seek the mountains - the last refuge in chagrin.”

America needs a leader that conducts with courage. Someone who realizes that healthcare institutions are up for bailout; next. One who sees tomorrow as opportunity that should not to be squandered. One that does not lose insight learned in 2008 as we embrace 2009.

Obama’s Score on having the ‘Right Conduct’: Remains to be determined.

Reference: The South Asian Times Article, Vol.1 No.37 January 3-9, 2009

SA Times Launches Dr. Jain's Healthcare & Wellness Series

Arvind Jain — Mon, 15 Dec 2008 19:32:21 -0800

SATimes, Vol.1 No.34 Decemeber 13-19, 2008: Starting from our next issue onwards, we will be adding a new perspective to our health section. This has become necessary given the rapid growth of our readership and the diverse health interests of our audience. This new series on health and wellness will be titled "Dr. Jain's Corner."

Sandeep Jain is a practicing physician in Brookdale Hospital Medical Center in Brooklyn, NY. "It was sheer luck that I became a doctor - the first in my family. I was 17th on the waiting list long after all admissions had closed and medical schools had begun their curriculum. There was simply no chance. Even when a position miraculously opened up two months later my family did not have the money to pay the fees - a neighbor - a farishtaa (angel) paid!"

He has spent a decade practicing medicine, first in East Harlem and now in East New York - the poorest neighborhoods in the US. When asked about this, he says: "My mother cautioned me to 'also' always see the poor patient. Fate was eavesdropping and only heard the last part of the conversation!" He continues, "The truth is that there is something special about providing care to those who need it most. I see such variety that I have to remember that diseases don't read books - we do. All I've learned, my patients have taught me over time. Time is a physician's best friend. For a surgeon - it's more like a girlfriend you can't predict!" he laughs.

Dr. Jain has broad interests from healthcare quality ("the benchmark for good care"), healthcare IT (he serves on the Board of Sowsia Healthcare Solutions, Inc.), medical education, to patient safety and journalism (he was the Editor for his College magazine).

As Director of Financial and Clinical Operations, he credits his mentors at work with helping him develop an understanding of the business side of healthcare and challenges that hospitals and physicians face in today's environment.

With the start of "Dr. Jain's Corner," you will now benefit from news, views and reviews of topics, products and services related to health through Dr. Jain's eyes. He brings to our newspaper, practical knowledge, real world experience as well as a distinct South Asian flavor - his own perspective on things we all need to understand in order to become masters of our wellness and the illnesses that threaten it. We want our readers to be in the driver's seat - confident, informed and taking charge of their healthcare decisions.

To this end, we hope that you will find Dr. Jain's corner informative and his conversations thought provoking. To quote him: "Our role is simply to 'light the wick'. The darkness will vanish on its own."

We welcome him to our family and wish him the best and look forward to your readership and dialogue with us. Dr. Jain can be reached at doctor@thesouthasiantimes.com.

News Brief: SA Times

Electronic Health Records (EHR) And Beyond

Arvind Jain — Mon, 21 Jul 2008 12:26:15 -0700

The need for Electronic Health Record (EHR) begins with an account of the cause of patient deaths in 1999, and the systems credited with - or blamed for (depending on your point of view) - the 98,000 deaths that occur in hospitals in the US each year because of medical errors. Early efforts with EHR aimed to fill the gaps left behind by legacy systems. Looking forward, as the specter of losing patients to errors diminishes, and public opinion on digitization of health information settles, EHR and ondemand information models would undoubtedly play an important role in shaping health outcomes for many.

Consider, patients need for best care and advice from medical experts around the world, and Physicians who want the best tools to deliver it. With the choices available today, there is no straight line to deliver such vision. It would cost system providers a lot more to build advanced capabilities to assemble and assimilate patient health information from various sources of care, and to meet clinicians’ demand of an instantaneous access whenever a patient walks-in to the clinic.

Most patients also want simple and straightforward access, but are not interested in or equipped to understand the technical distinctions involved in health data interoperability, regulated access environments, or technology components required to securing personal information assets inside data vaults or transient on the Internet. The needs are really very simple in the words of Rhona MacDonald.

"I don't want much - just for my medical records to be seen only by those whom I authorize, and for the record to be readily accessible . . . . . I would like a bigger say in what goes into my notes, and if I don't like something I would like it taken out." ^[1]

This small demand by consumers however, would require enormous changes in system architectures across a very large solution set. Proprietary solutions, complex integrations, and cost are the main impediments to an effective means of attaining success with existing solutions. It isn't surprising to find Physicians in America and worldwide continue to deliver care on paper, or with electronic templates created in Microsoft Word, Adobe PDF documents, and based on their own recollection of a patient's precarious health history on visits to their clinics.

Up to this point, an EHR with open standards and low cost was just a futurist wish list, and advanced solutions to help patients proactively manage their health, yet another pipe dream. If there is a special EHR that could be available for Free, 100% available globally, deliver seamless integrations, and on a highly secure HIPAA compliant platform, one might begin to wonder if it is the same paradigm or really a transformation of some type beginning to gain ground among Physicians and Patients.

Although a forecast of an EHR for Americans within Ten Years was made by Marc Wine at a conference in 2005 ^[2], the needs of patients and care providers has grown beyond the basic infrastructure.

ONDEMANDHEALTHCARE.net provides one such model for Physicians today delivering autonomy, privacy, and data confidentiality while providing an opportunity to evaluate best uses of health care resources, and improve delivery of all levels of care. Physicians can finally focus on efforts to reduce disease, improve safety, or deliver needed care at a higher level of efficiency, eliminating levels of caregiver inconsistency, and improve quality of care significantly. With SaaS platform that insulates costs for them, solutions built around standards and flows of care, Physicians are able to adhere better to medical standards, and get smarter on areas that need to be improved.

On another front, proactive health care management until this point was considered not possible. With ONDEMANDHEALTHCARE.net Physicians would collaborate to invent approaches that prevents disease or avoid health problems as we age. Patients not only get to know what optimal treatments and medications are being delivered, but also the kinds of solutions that will measurably reduce the rate of health complications. Such proactive systems of care will help patients to get a jump-start on avoiding various kinds of crisis or health-system problems. The solution is built to further help improve ground-level delivery of care for the people who have common and chronic diseases of everyday life.

By improving care for those diseases in systematic ways, Physicians on ONDEMANDHEALTHCARE.net are able to hold costs down and leverage the savings to do more. Ever wonder, what would it look like if an EHR system were to uncover disease patterns at patient visits? We are on the cusp of such an enormous change of a consumer driven care without boundaries.

References:
^[1] Macdonald R. Commentary: A patient's viewpoint. BMJ 2001;322(7281):287
^[2] Marc Wine, MHA, Program Analyst, Health IT Coordination, GSA, Office of Intergovernmental Solutions, July 19, 2005.

:- SOWSIA Collaborative Group
Copyright 2008. SOWSIA Healthcare Solutions, Inc. All rights reserved. (blog@sowsia.com) www.sowsia.com

Model for Level 4 Interoperability with Health Information Exchange (HIE)

Arvind Jain — Fri, 14 Mar 2008 03:11:56 -0700

"According to the Institute of Medicine and others, the U.S. healthcare delivery system is complex, inefficient, and highly fragmented”^[1] costing $1.7 trillion in 2003. The report reiterates interconnecting clinicians, as a national goal so that health information can be exchanged, and provides an estimate of the potential savings through the establishment of a National Health Information Network (NHIN).

The savings based on sharing information is estimated at: $78 billion with Ambulatory EHR's, and $44 billion with Ambulatory CPOE alone. Several other studies have projected a ten to eleven digit benefit from IT adoptions. True costs to deliver such huge savings however, cannot be easily determined. We do not know for example, whether a 50-cent spend would deliver a $1 benefit or would it take 5x to deliver the same result. One amongst several cost factors is Interoperability.

The healthcare system is a disparate environment of several functions such as: Registration, Laboratory, Radiology, Pharmacy, Finance, Clinical Order Entry, Medical Records, and such.

To evaluate the challenges of interoperability, it is first important to understand the information network pathways and bridges between applications across an enterprise. Can computer 'A' communicate health information with computer 'B' inside the organization? Can it share information with systems outside the enterprise? What elements of technology make this possible? What levels of data sharing are involved (paper, email, structured messages, standardized content, ...)?

When the information reaches computer 'B", how do other applications link with it. What middleware systems would be required to integrate it in a way that target systems can easily understand information for their use? Will systems need a language interpreter? If HL7 standard is used for interoperability, what is required to open up legacy environments so that they can share information?

What if? Computer A now demands the updated information from computer ‘B’? What methods and approaches do we use to create flexibility and harmony amongst various enterprise systems?

Overlay information ownership, security, privacy policy, HIPAA regulations, goal alignment, Stark Act, and the roadmaps to go regional before health information becomes nationally, and then globally accessible from anywhere in the world by patients.

Now add "on demand" to every step discussed above so that you get the information when you need it irrespective of what is involved, and control mechanisms to differentiate "my data from your data, and others data," so that, you only get information pertinent to yourself, and one can begin to truly understand the challenge and the cost of bringing all of this together.

We will next discuss innovative ways to achieve Level 4 and the highest order of interoperability across all boundaries in the SaaS series. Stay tuned.

References:
(1) David A. Powner, Director, Information Technology Management Issues, United States Government Accountability Office Memo Dated Feb 16, 2005, GAO-05-309R HHS's Estimate of Savings from Health IT

:- SOWSIA Collaborative Group
Copyright 2008. SOWSIA Healthcare Solutions, Inc. All rights reserved. (blog@sowsia.com) www.sowsia.com

Improving Privacy and Trust with Health Information Exchanges (HIE)

Arvind Jain — Wed, 12 Mar 2008 12:11:44 -0700

The vision for Health Information Exchanges (HIE) requires several computer systems across organizations and regions to co-operate in a harmonious fashion. Such information Hubs would link and share various pieces of an individual's health record with other systems and networks located within the care facility, and with external networks. However, because of the complex data flows in a possible HIE environment, maintaining patient confidentiality within a Hub and its interfaces becomes a challenging affair. The complexity compounds even more when HIE's bridge across other disparate network environments on the Web. To build and manage privacy across such fluid boundaries, additional capabilities are needed to secure portable health data and provision security profiles that are specific to target healthcare solutions - the ultimate recipient of patient data.

The privacy measures within such complex environments require more data monitoring, security, interface access and control management solutions for Health Networks, Health Vault or data storage infrastructures. Another challenge relates to the growing need for strong privacy policy with virtualization technologies used to deliver patient health data on the Web. The outcomes of service and liabilities (especially in the context of HIE) must be clearly understood beforehand^[1], and steps taken to fulfill compliance objectives. Solutions built on such principles would build trustworthiness of service providers on the health information networks of the future.

To improve Privacy and Trust between networks of confidentiality, and to further secure Doctor-Patient interactions on the Web, data exchange solutions need to ensure privacy is implied across all information pathways right from the time a demand is placed on the network, triggered by the immediate need of a patient from anywhere, and anyplace in the world.

References:
(1) Dr. Yacine Atif, Can Business Web Services Be Made Trustworthy? UAEU Funded Research Publications, Vol. 23, 2006
(2) Business Services Network, the 2nd Generation Web, A. Jain and N. Juneja, SOWSIA Publication, 2003

:- SOWSIA Collaborative Group
Copyright 2008. SOWSIA Healthcare Solutions, Inc. All rights reserved. (blog@sowsia.com) www.sowsia.com

SOWSIA LAUNCHES ONDEMANDHEALTHCARE.net

Arvind Jain — Tue, 04 Mar 2008 14:37:10 -0800

SOWSIA Launches Global Health Care Management Suite of Web Applications on HIPAA-Compliant OpSource On-Demand

03/03/2008 - 13:01

OpSource™, the SaaS delivery experts, today announced that SOWSIA, a leading developer and marketer of integrated healthcare management solutions, has selected OpSource On-Demand to deliver SOWSIA’s ONDEMAND HEALTH CARE and a broad Unified Health Performance Management suite, which manages all clinical, operational, and financial functions across the healthcare continuum. The uHPM suite comprises more than 75 application modules that enable individuals, care providers, administrators and insurers to serve patients’ health needs regardless of physical location or type of health service provided. OpSource On-Demand provides SOWSIA with guaranteed uptime to meet round-the-clock healthcare needs, as well as critical HIPAA compliance, which is essential for assuring confidentiality of sensitive medical records. The access to entire uHPM suite is free with 1GB of data storage. The SaaS offering has an attractive price for additional storage and information management and comes with an exclusive 90-day on-line trial. The combination of SOWSIA’s Web applications and Healthcare Services Network-OS™ with the efficiencies of OpSource On-Demand will enable individuals to securely manage their health records for pennies a day and physicians and hospitals to administer their services at costs 100 to 1,000 times lower than what the traditional electronic health record (EHR) systems allow.

In response to the soaring cost of healthcare administration, SOWSIA has leveraged software-as-a-service (SaaS) as the delivery vehicle to make a reality of its vision of healthcare management as a universally accessible commodity for every individual in the United States and around the world. After exploring traditional hosting vendors, SOWSIA chose OpSource On-Demand, the only complete Web application delivery solution priced on-demand. Moreover, only OpSource offered the entire spectrum of services required to bring SOWSIA’s Web applications to market, including application management, billing and analytics, security, 24x7 end-user customer support and business continuity, all underpinned by HIPAA compliance and SAS 70 Type II certification -- all critical for creating, securing, reliably accessing, confidently sharing, and fully protecting private health records.

OpSource CEO Treb Ryan said, “SOWSIA has pioneered SaaS applications in healthcare that will transform the way medical information gets managed online, and we are excited to play such a key role in bringing its vision to life. Healthcare organizations today not only have to take care of their core business of providing care, but also have to deal with the distraction of reining in runaway costs associated with IT deployments. Before SaaS, organizations did not have a choice but to spend millions of dollars in licensing, maintenance, support fees, and managing infrastructure obsolescence. SOWSIA brings all of the benefits of SaaS to the healthcare sector worldwide. Also, by simultaneously launching 75 applications that cover the continuum of care provided by Physicians, Hospitals, and Nursing Homes, SOWSIA has proven the massive scale and versatility of OpSource On-Demand as a Web application platform.”

Arvind Jain, SOWSIA’s Founder, added, “The significance of OpSource On-Demand is that it supports the latest application technologies, so we are not limited by old technology like many traditional players. We found that OpSource excelled in not only the infrastructure to deploy Web applications, but also in providing all the essential supporting services such as HIPAA and SAS 70 compliance, security, networking and platform administration for managing SOWSIA uHPM and SOA-Grid Appliances. In addition, OpSource was integrally involved in helping us navigate through our own evolution away from a traditional software licensing model, providing expert guidance to transform our application suite into a commercially viable SaaS solution. By relying on OpSource to handle everything related to SaaS delivery, we can focus solely on enhancing the capabilities and value of our healthcare applications.”

Sandeep Jain, M.D., Board Member, said, “In the face of reimbursement and financial pressures, healthcare organizations are eager to embrace a redesign that will remove costs and expand quality. Today’s emerging healthcare environment is also becoming increasingly complex and there is a need for a demand driven system that would connect the many diverse sources of information created by physicians, pharmacists, nurses, case managers, quality officers, administrators, and insurers. All of this data flowing over disparate systems from geographically distinct locations need to come together at the point of service.

"SOWSIA’s comprehensive offering launches healthcare into a state of evolution overdrive – changing faster than ever. By making the ONDEMAND HEALTH CARE model omnipresent with OpSource On-Demand, we gain the limitless potential of SaaS, enabling all of the patient’s medical information to be globally accessed and shared from a highly secure, centrally managed environment. With the need for quality and accuracy in medical information of potentially hundreds of millions of patients that ONDEMAND HEALTH CARE envisions, we could only put our trust in a SaaS delivery partner that has the level of proven reliability and security, which OpSource offers. Patients are finally in the drivers seat, and Physicians have all the tools to provide front-line care, on demand.”

About OpSource On-Demand

A comprehensive, award-winning Web application delivery platform, OpSource On-Demand enables Web 2.0 and software companies to quickly and securely deliver their applications and services to consumers and businesses alike. The only complete platform for Web application delivery, OpSource On-Demand includes:

Best-in-class, scalable software, hardware and network infrastructure
Application management and tuning
24x7 customer-branded end-user support
100 percent uptime guarantee for infrastructure and applications
Best practices: SAS 70 Type II audited, HIPAA and PCI DSS compliance and salesforce.com AppExchange and WebEx certifications
Enterprise services bus enabling easy integration of customer or third-party Web services that accelerate revenue generation
Fully integrated PCI DSS-compliant billing solution, including customer on-boarding, pricing, payment and collections
Application analytics that offer insight into the performance and usage of the on-demand application
The industry’s only Success-Based Pricing^SM, a unit-based pricing model that allows businesses to begin with a modest minimum commitment and scale expenses as revenues increase

About SOWSIA Healthcare Solutions

SOWSIA Healthcare Solutions is a global company with leadership in technology, software, medical sciences, medical practice, pharmaceutical sciences, and product development. The company’s founding team brings over 60 years of experience in caring for patients, designing products that affect millions of patient lives, and envisioning cutting-edge technological solutions for widespread information assimilation challenges. SOWSIA’s applications enable health care organizations to deliver high quality of care, facilitate real-time collaboration amongst providers, patients and other care entities, improve operations and financial efficiency, ensure conformance to coding and clinical standards, and comply with pay-for-performance measures. More information is available at www.sowsia.com.

About OpSource

OpSource delivers Web applications and software-as-a-service for on-demand companies, with hundreds of applications, millions of users and billions of transactions supported daily. OpSource On-Demand, the leading platform for Web application delivery, is defining how Web-based software is delivered. By choosing OpSource as their Web application delivery partner, companies are freed from investing in and managing the complex and costly infrastructure and services necessary to deliver applications over the Web. They can instead focus their resources on developing, marketing and selling their applications and services. OpSource On-Demand is suitable for companies at any stage of growth, with any type of on-demand application. OpSource is the only company to offer Success-Based Pricing^SM, a unit-based pricing model that allows businesses to begin with a modest minimum commitment and scale expenses as revenues increase.

Headquartered in Santa Clara, CA, OpSource has Web application delivery centers in Virginia, London and Bangalore. For more information about OpSource, visit www.opsource.net.

OpSource, OpSource On-Demand and the OpSource logo are trademarks of OpSource, Inc. Success-Based Pricing is a service mark of OpSource, Inc. All other trademarks and company names mentioned are protected by their respective owners.

OpSource, Inc.
Richard Dym, 408-567-2031
pr@opsource.net
or
Citigate Cunningham
Lisa Kennedy, 415-618-8726
lkennedy@citigatecunningham.com

Privacy in the eye of a storm

Arvind Jain — Sun, 02 Mar 2008 17:13:59 -0800

Health information privacy is achievable. However, fulfillment of this promise requires free flow of information between systems that are used to provide care, development of common standards so that patient data can be securely ported across clinical settings, safeguarding and tracking the communication and access to medical records; with special attention given to locking the pieces of health data that are considered very personal and privileged by the rightful owner of that data - the patient.

A patient cannot be expected to negotiate the complexity to manage scattered bits of private health data unless health information is collated and unified in a simple and easily accessible manner. We can all appreciate how the lack of availability of meaningful health information at the time when it is needed most (e.g. immunization and allergy records, medicating use history) contributes to errors and delayed care. Current market solutions do not provide solutions that address these issues. Actively provisioning for privacy at every step and securely protecting sensitive patient health information through patient driven control mechanisms is not something that is a burning priority lighting up their radar screens anytime soon. For Ondemand healthcare, this was a core premise around which all solutions were designed.

While legal framework is only just beginning to take shape and while it remains our collective opinion that well guided public policies driven by public debate can improve care delivery by increasing access to information while preserving the privacy of information considered sensitive by an individual; it cannot be a pre-condition for righteous action. And though there is little doubt that widespread use of Electronic Health Records has the potential to benefit patients and other stakeholders, lower administrative costs, reduce complexity for those providing care; much work still remains to be done by other Healthcare IT companies to ensure total privacy by patient determined choices.

The tenets of physical, organizational or informational privacy need not be subjugated to an IT enabled trade-off that mandates a servile surrendering of an individuals interests to the larger and more powerful interests of business groups whether through explicit promises or implicitly disguised yet clearly perceived benefit.

Nowadays, groups with as divergent interests as Health Insurers and Health Providers are seeking convergence in health exchanges, data banks, electronic registries, data vaults and Regional Health Information Organizations (RHIO's). Regulation and generous Government grants are making unwilling partners travel together to their preordained destinies of a National Health Information Network (NHIN). Conditions suddenly have now become conducive for the creation of something more than just a "privacy headwind".

Privacy, today is in the eye of a storm. Portability of health data over a network is taking priority. Individual patient rights thus stand threatened to become the sacrificial goat. It is therefore very critical that individuals understand the two divergent views on health record privacy as well as clarify the position that their vendors take on this issue.

To some, privacy means controlling patient's data within their closed environments even if it means disenfranchising the rights of patients through lack of provision for access by patients themselves. A subset of this group even openly advertises the fact that health data of patients will be mined (and sold for profit). Another variant hides behind the mechanism of "cookies" or the fact that "third party access has confidentiality agreements" which would therefore obviate the need for an autopsy of the issue. They have blatant statements in the user agreements that they hope someone will overlook. These statements claim “aggregated information from the Service for marketing” may be disclosed. Users who click "I agree" will be delivering future downstream concerns about privacy that would be dead on arrival. These vendors are so open minded that they even tout their storage in "other country(ies)" as an honor that deserves recognition from audiences worldwide. It is not without reason though. The thought is that downstream in some public court, this statement will somehow magically help their circumventing of HIPAA applicability on US soil and liberate them from direct accountability to their users; if not themselves. There are others who advertise their partnering or acceptance of "oversight" by external agencies. Sounds wonderful, doesn't it? Except for the fact that these "overseeing" partners would also need oversight - from the little guys - the patients to whom this data belongs in the first place!

To others, like us, privacy was a moral and ethical principle that could not be compromised ever. We chose to take the hard road. Ondemand healthcare chooses to spend their energies in educating members on our network, increasing patient awareness, empowering and enabling them to exercise their rights and collaborating with them in ways that will contribute to the richness of an open and yet hugely secure information infrastructure, one built on the flames- not ashes of privacy.

Just as physicians, patients too need their health information to be available to them when they need it. Their right to choose whether they consent or refuse, whether they elect to participate or not needs to be respected and embraced. Healthcare IT organizations today, therefore, need to embody privacy concepts within the framework of a patients right to self determination as part of their corporate mantra; like Ondemand healthcare has. Only then, can they lead the path with healthcare solutions that mirror these patient needs and develop novel methods and applications that comprehensively achieve such goals for their customers. Investments in valiant efforts like these will eventually serve to create the building blocks for highly secure information infrastructures built on trust and respect for patient's rights.

Collaboration: Empowering communities to deliver themselves

Arvind Jain — Sun, 02 Mar 2008 13:45:45 -0800

Individuals have the power to improve the environment they live and work in. Yet, their voices frequently get drowned in the corporate noise when the priorities of corporations differ from those of the individuals themselves. The time has come for technology to become its own best propagator, through ongoing collaboration between the users and those that create it. There is a need to cross the chasm, the digital divide - not just here, but everywhere around the world. Life has equal value. Saving life is no different. Doctors and nurses can use technology to save more lives and positively impact the well being of thousands more.

With the advent of the Internet and SaaS, the time has arrived for a new kind of community that has no boundaries, one that bases the development on collaborative best effort - not on development of singular and distinctive captive technology. Individuals within these communities can now begin to get empowered and capable of delivering themselves from situations down the road - when they become unwilling patients themselves.

Healthcare is a highly specialized and extremely complex business that continues to grow exponentially in the amount of data it creates. Healthcare professionals worldwide are respected for their ability to thrive and work in such demanding and ever-changing environments. They face new requirements and evolutionary changes of existing ones with great endurance and patience - whether it is medication safety alerts, refills, new reporting, pay for performance, quality measures or HMO related formularies, insurance approvals or authorization rules. And this is on top of all the other basic business processes that need constant monitoring and alerts - whether it is health maintenance issues or patient recalls or consultation reports or abnormal labs.

ONDEMAND HEALTHCARE .net team is a great mix of healthcare professionals like yourself who live and breathe in this environment on a daily basis and highly experienced software specialists in Information Technology as it relates to the concepts of the National Health Information Network of tomorrow. We understand the challenges that IT investments can involve at your end. IT headaches are the last thing that you need to get distracted by. They can not only consume a lot of time and energy but also leave you poorer and stranded with patient information locked in outdated proprietary systems. The Physicians, Nurses, Pharmacists and Case Managers and IT professionals on our collaborative groups have solved exactly these challenges.

While we cannot take away your business challenges, we can certainly make it simple for you to embrace the obvious advantages that technology has the power to bring to your practice environment - advantages that you all know of but couldn't afford; benefits that you have known can be delivered but no one has come forward to offer payment for.

Our SaaS model is the most affordable out there. It is based on cutting edge technology empowered by solutions that offer far more functionality than traditional systems- all designed and delivered by our collaborative group. They are innovative, user friendly and will enable you to continue to focus on managing your business. ONDEMAND HEALTHCARE .net team promises to take care of your software and network needs while you continue to take care of your patients and your non-IT business needs.

In keeping our end users in mind and improved patient outcomes at the center of this, we have simplified the use of software in healthcare by removing ambiguity and decreasing complexity. What you see is what you get. There are no hidden fees or captive contracts. We have not just eliminated equipment purchase costs today but also your downstream upgrade costs.

So why wait? Register now. Get your unique account ID and try all applications and services free for 90 days.

We do not sell your personal information or patients information. That's our promise.

SaaS and the alphabet soup in Health IT

Arvind Jain — Fri, 29 Feb 2008 15:23:56 -0800

SaaS: Software-As-A-Service is a business model where software solution companies such as SOWSIA offer their products for use over the Internet. More recently, a lot of ASP infrastructure vendors are evolving in to SaaS way of doing business, offering a more comprehensive set of hardware and network monitoring tools, billing, and other ondemand services for their hosted clients.

ASP: Application Service Provider is a term generally associated with infrastructure vendors such as IBM, and many others that host software applications for businesses. Some software companies such as Oracle host their own solutions.

Middleware: As a software, it provides the ability to integrate legacy applications with other solutions.

EMR: An Electronic Medical Record (EMR) is a specific patient record from one healthcare provider.

EHR: An Electronic Health Record (EHR) is a collection of health information of a patient from diverse systems within the care provider network. Essentially, there are multiple EMRs and EHRs for a patient.

CCR: The Continuity of Care (CCR) is a required subset of information from a patient’s EMR or EHR made available to another provider that needs to deliver care to that patient.

PHR: Patient Health Record (PHR) is a health record maintained by an individual.

NHIN: A $200 billion US National Health Information Network initiative to connect all entities in health care such as physicians, patients, hospitals, public health agencies so that they can share clinical information in real-time. The goal is within the next decade.

RHIO: Regional Health Information Organization are local versions of NHIN initiative for health information exchange, and are being organized in every state in the US.

J2EE: Java specifications from Sun Microsystems.

.NET: Microsofts solution for interoperability on Windows platform.

XML: A language used to define data structures and information specifications. Eg. Physician Name in XML could be defined as <Physician Name> Your Name here </Physician Name>. The tags or elements around Your Name are said to contain your information. Computer programs recognize the tags and process the information. XML is a loose language with many variants.

HL7: A flavor of XML used specifically for sharing information in Healthcare.

SOAP: No. This is not a physician's SOAP note, but it is a protocol which facilitates information communication over the Internet. Think of SOAP as an envelope that carries health information in XML or HL7 formats.

Web Services: It is a technology that allows software programs written in J2EE or .Net to expose themselves for discovery and use by others on the Internet.

SOA: Service Oriented Architecture is a software framework to facilitate interoperability amongst different applications. It can be used to build new breed of softwares, also called composite applications, from existing software solutions.

UDDI: It is a registry for locating business entities and their web services or software programs (usually in the form of a WSDL specification) on the Internet. Developers use UDDI to build and bind their code with services listed in the registry using WSDL.

Grid: As an enabling platform, it facilitates building of a Information Network on the Web.

Please note that the above definitions are not complete and were simplified for health care professionals to develop a basic understanding of various terms and accronyms used in Health IT.

Innovating Change, Globalizing Health IT

Arvind Jain — Sun, 10 Feb 2008 12:08:33 -0800

Medical science progresses exponentially. Health care based on Physicians and patients memory and paper records is not an efficient way of care delivery. It becomes important for Health IT to automate systems and reduce the number of steps it takes to accomplish a task. Health IT solutions should also offer solutions that deliver safe and consistent care across geographical boundaries.

SOWSIA's ONDEMAND HEALTHCARE .net is a suite of several integrated applications that can be accessed and used by Providers to manage all operational, clinical and financial functions using a browser. Physicians, Health Care Institutions, Insurers, Patients and their Families can securely create-access-share health information with complete control over diverse as well as specific health data. Built-in de-identification system and HIPAA compliance network ensures confidentiality across the enterprise and on the Web.

SOWSIA's innovative platform allows enterprises to securely connect with other clinics, hospitals, and other institutions globally on the Internet. It delivers Electronic Health Record on demand, is interoperable with other systems and applications leveraging XML, HL7 and several other formats, across choice platforms (including existing enterprise application infrastrucure). SOWSIA Healthcare Solutions are based on: J2EE, .NET, Web Services, SOA, GRID, Web 2.0 - the basic foundation for developing enterprise class software solutions.

SOWSIA's ONDEMAND HEALTHCARE .net ensures that those involved in front-line care have all of the information to deliver the best level of care to the patients.

Founders Note

Arvind Jain — Sat, 09 Feb 2008 14:24:45 -0800

Healthcare is a social problem - we all understand this pretty well and are willing to accept that at one level or another.

When the provision of medical care becomes inferior solely because of a lack of affordable healthcare IT, then, Healthcare IT too becomes as much a social problem as healthcare itself.

IT is the biggest hidden resource for healthcare. IT has the power to deliver the benefits of research and new advances to a global audience. Everyone in healthcare ought to be able to leverage this highly valuable resource and deliver the solutions to those who need it most at their time of need.

Healthcare is not really all about making a profit. Taking care of people is much more than that. It is about creating social value. And IT need not be about profits alone either. Especially when it can improve the living conditions of humans. I don't think you will find a CEO standing who will say it's OK if an infant in a poor country dies because of a lack of availability of healthcare IT.

However, Healthcare-IT today is stuck in the cretaceous period. Cost and resistance to adoption are the biggest obstacles. We can spend weeks arguing and pointing the blame on Insurers, Governments or Corporations. The truth is that while we are busy with all this, someone somewhere is suffering needlessly.

We need to focus on solutions. Things we can do to come out of this deadly situation. Not individually or in groups. We need to leap out of this mess as a society. The solutions should enable all of society to leap ahead, leaving no one behind. Only when we are able to embrace the marginalized and the most disadvantaged amongst us, will we be able to unlock the power of IT to cause a social transformation. Help bring the future to the people, today.

It needs vision, it needs commitment and indomitable will to keep on doing the right thing in the face of unrelenting odds.

Seven years in the making, we consider ourselves as social entrepreneurs, health scientists and engineers wanting to solve this massive problem globally - transform the way we deliver good quality healthcare in the form of sustainable SaaS solutions that are made available worldwide - as long as you have the power to connect to the web.

Global Healthcare Solution: Lower than cost of cable service!

Arvind Jain — Sat, 09 Feb 2008 13:22:13 -0800

ONDEMAND HEALTHCARE software use is always free. There is no software to purchase, no hardware infrastructure is needed at your site, no license fees, and there are no installation and maintenance costs.

The software applications are delivered and available through the Internet around the clock. Simply login and manage your business online. ONDEMAND HEALTHCARE provides the flexibility to store up to 1GB of data free and pay nominal fees for additional data storage, access and sharing. The overall cost of software use? Lower than the cost of cable service! That's the goal.

This is Software-As-A-Service (SaaS): the modern way of managing health care.