On-line CIS: A Technology and Industry Analysis

Information technology (IT) has, at present is, and in future will continue to impact the health care (HC)/life sciences industry. Initially, IT companies had entered the market with a steady focus on all industry verticals. But, since the HC industry is a rather conservative industry, when compared to industries such as mobile communications; commercial application and market penetration in this industry took more time than in other industries. Thus, we see that the impact of IT in the HC industry has happened at a slightly later stage due to a late adoption of the technology by the industry, leading to time lag between market entry and industrial recognition of HC IT companies. However, at present the HC-IT industry is catching up fast. The best example of infusion of IT in HC domain can be found through the profound impact of clinical information systems (CIS) in this industry.

Clinical information systems include data collecting, processing, analysis, and reporting inference. CIS is an industry, which though a part of the medical and HC industry vertical, is more affected by the developments and changes in the IT industry. The most important use of CIS is to help reduce medical errors. This technical strategy has already proven to be effective in reducing the effects of human error and duplication of redundant work in industries such as banking and aviation. Clinical health information systems promise a substantial impact on medical quality and safety by integrating relevant automated decision making and knowledge acquisition tools into medical practices, thereby reducing errors of omission that result from gaps in provider knowledge or the failure to synthesize and apply that knowledge in clinical practice. These systems, when integrated on a national or even global basis, promise to improve medical decision making and the appropriate use of diagnostic tests and therapeutic agents.

In September 2007, Frost & Sullivan, Technical Insights (TI), HC vertical published an alert article on the CIS industry. This TI article contained a view and analysis of the CIS industry. TI had predicted that in the near future the HC industry will institute the use of IT technologies on a larger scale: national or regional integration of medical records or electronic medical records (EMRs) through the use of clustered server networks. The TI HC vertical had predicted that the clustered server network-based database management and networking system was going to make a nationally or globally centralized CIS a reality. TI had also stated that to make this concept a reality, the hospitals or the individual CIS manufacturing firms (storing the patient EMRs in their own individual servers), software companies and the government regulatory bodies will need to form a coalition triangle and work with each other. Going further with the analysis TI had predicted that Google with it's cluster server on-line data base providing easy access were poised to play a very important part in the creation of a Web-based clinical data repository for EMRs and other clinical data.

TI analyzes and finds that in late 2007, Microsoft has drawn first blood by entering the CIS segment before Google. Microsoft has innovated and launched its product named the HealthVault, which serves to be an on-line repository of clinical data for easy access by the patients and the consulting doctors, at their ease. This pioneering work from Microsoft is presently in its beta version and is already gathering extensive industry attention cutting Google's on-line repository, codenamed 'Weaver,' to the chase.

The Microsoft HealthVault record can be created and controlled by the user. The system allows the user to decide what goes into the personalized HealthVault record. It further allows the user to decide and select the people who can see and use the clinical information on a case-by-case basis, thus facilitating speedy diagnosis. The system has a nondisclosure agreement in place, which allows the patient to use the system, yet retain the rights to the information. It gives the patient security and peace of mind in terms of mis-usage of the critical health data. Using the HealthVault, any patient gets dynamic access and flexibility of importing the health records from doctors, hospitals, labs, prescription drug plans, and other HC providers. In order to access this ready-to-use, secure site, the user or patient requires a Windows Live ID and a password that the patient can share with HC providers. Microsoft HealthVault is now integrating itself with telemedicine vendors such as Alive Technologies, based in Australia, where this on-line system will allow the wireless patient monitoring system to easily upload the monitored data to the HealthVault on-line record using WiFi.

At present, Google is yet to launch its own product, which may be because it is concentrating on building a proprietary search engine specific to HC data; while Microsoft's HealthVault incorporates third party health-specific search engines such as Healthline for more accurate search. Thus, this still leaves Google a chance to come out and grasp the industry with a better and more efficient proprietary search engine as it has already done in the past. However, when discussing with industry executives, the opinion that gets voiced is that in reality Google might not be that interested in developing such an on-line Web-based EMR system. This is because of the fact that Google churns a major chunk of it's revenue through ads and it will be very difficult for Google to replicate the same in the on-line EMR system. The patients and doctors might not want the critical medical data to be represented along with ads in the on-line system thus digressing the importance, ethics, and criticality of the data.

Maintenance of on-line security while clinical information transfer occurs will however be the biggest issue in making the patient community adopt the on-line EMR system. New encryption algorithms are written every day and hackers use 'brute-force' technology to break theses codes and often they do succeed. While such is the problem, unless an encryption algorithm is written, which defies Bergofsky principle (Bergofsky principle states that every type of encryption can be broken by finding a particular standard 64 bit key using brute force technology), the security issues will always be a problem.

In conclusion, TI analyzes and states that the three-way tie-up between the CIS technology manufacturers/vendors and companies such as Microsoft and Google under the surveillance and supervision of government regulatory bodies (in compliance with international standards of clinical information flow such as Digital Imaging and Communications in Medicine, Health Level 7 (DICOM) will result in multimillion dollar IT deals. Such deals will act as stepping stones into a nationally or globally integrated clinical database, with the front-end allowing the users to communicate in local languages in select global locations.


Abhishek Dutta

Research Analyst

 Healthcare, Technical Insights

Frost & Sullivan

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E-mail: adutta@frost.com

URL: www.ti.frost.com

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