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Med Device Connectivity with a
BaaS is a Disruptive Innovation
Creating a data-centric Backend-as-a-Service (BaaS) is
good business and can generate new revenue
By Shahid N. Shah, CEO
NETSPECTIVE

Who is Shahid?
•

•
•

20+ years of embedded systems, software
engineering and multi-discipline complex IT
implementations (civilian government,
defense, health, finance, insurance)
12+ years specifically in healthcare IT and
medical devices experience
Entrepreneur and founder of multiple
startups

I blog at http://healthcareguy.com
Author of Chapter 13, “You’re
the CIO of your Own Office”
www.netspective.com

2
NETSPECTIVE

What you’ll learn in this briefing
Data from devices is too important to be left to others

Topics
•
•
•
•
•

Marketplace and industry challenges
for device vendors
Why connectivity is good business
Why connectivity is a disruptive
innovation
What is a “Back-end as a Service”
(BaaS)?
There’s nothing special about health
IT data that justifies complex,
expensive, or special technology.

www.netspective.com

Key takeaways
•

•

•

Hardware, sensors, and software are
transient businesses but data lives
forever. He who owns, integrates,
and uses data wins in the end.
Data from devices is too important
and specialized to be left to
software vendors, managed service
providers, and system integrators.
Implement a data-centric hardware
and BaaS technology strategy
3
NETSPECTIVE

Why connectivity is good business
Looming 2.3% excise
tax provision of the
Affordable Care Act
(ACA)

Longer product
development
timelines caused by
increased regulations

Higher customer
expectations due to
consumerization of
devices

Lower margins as a
reaction to
commodity
competition

More complex and
longer sales cycles as
devices need IT
approval

Raising money for
hardware is tougher
than software

www.netspective.com

4
NETSPECTIVE

You can use OSS to disrupt health IT
Customers trapped by
their EHR vendors are
begging for a way out

Device vendors aren’t
benefiting from industry
trends but can if they’re
smart about it

Clinical customer goals
have shifted from basic
automation to advanced
process optimizations

www.netspective.com

Customer base has
shifted from clinical to
clinical + IT + system
integration

Device manufacturer’s
access to regulated IT
and system integration
skills is growing

5
NETSPECTIVE

Healthcare industry / market trends

Major market and regulatory trends that are causing customers and competitors to shift

You must learn and be able to talk to customers about all these terms

PPACA

ACO

PCMH

“Affordable Care
Act”

“Accountable
Care Org”

“Medical
Home”

Health
Home

www.netspective.com

mHealth

MU
“Meaningful Use”

PCPCC
“Patient Centered
Care”

6
NETSPECTIVE

Why care about MU?

If you’re not talking about MU you’ll find it harder to get in the door

“Enable significant and measurable improvements in population
health through a transformed delivery system.”

2011

2015

MU Stage 1

MU Stage 2

MU Stage 3

No Impact

www.netspective.com

2013

Indirect Impact:
Start planning for
MU

Direct Impact:
Device integration
proposed
7
NETSPECTIVE

Implications of healthcare trends
PPACA

ACO

Software

Regulated IT and Systems
Integration Services

MU
Health
Home
www.netspective.com

PCMH
mHealth

DATA

Evidence Based Medicine
Comparative Effectiveness

8
NETSPECTIVE

Don’t give up data to others without a fight

Software vendors, systems integrators, and others don’t have your best interest in mind
Device
Teaming

Cloud
Services

Patient
Self-Management
Platforms

SSL VPN

Patient Context
Monitoring

BaaS Gateway
(DDS, XMPP ESB)
,

Device
Data
Data Transformation (ESB, HL7)

Remote
Surveillance

Management
Dashboards

HIT
Integration

Report
Generation
Device reimbursement

www.netspective.com

Enterprise Data
RCM, Financials,
EHRs

Device
Management

Cross Device
App Workflows

Device Utilization
Device profitability

Alarm
Notifications

Device Inventory
9
NETSPECTIVE

New revenue centers in software and services
Build the right roadmap so that you don’t leave new revenue on the table

2 year ranking comparison of Top 30 HIT firms by offering type. Pure play firms are failing behind

100%

Focus on
Services and
Solutions is
the way to go

80%
60%

Up

% of all
firms by 40%
offering

Down
Flat

20%

Ranking
YoY

0%
Hardware

Software

Services

Source - The 2012 Healthcare Informatics 100 ranks the leading 100 vendors by revenues derived from healthcare IT products and services earned in the U.S.
www.netspective.com

10
NETSPECTIVE

How do you get started?

Consider Dr. Julian Goldman’s proposal on improving the quality of clinical alarms

1.

2.
3.

4.

Use “integrated platform” to create “smarter” alarms by using
multiple data sources for earlier detection of events and more
meaningful alarms by improving alarm sensitivity and specificity.
(e.g. detect repeat small O2 desats that would not currently
trigger a conventional alarm). Crowd-source this activity.
Set “wider” alarm limits to decrease nuisance and false alarms
on each monitor/device. (e.g. SpO2 alarm at 80%). This
maintains “device level” alarms.
Collect clinical and alarm performance data to develop
algorithms and evaluate system performance. Document gaps
in current data sources and device capabilities.
Stop/adjust IV pump based on above.

www.netspective.com

11
NETSPECTIVE

Data-centric device architecture

Extensibility and adaptability will be key in a data-centric world

5

Device Components

• Presence
• Messaging
• Registration
• JDBC, Query
Sensors

Storage

Event Architecture

Display

6

App
#1

App
#2

Plugins

4

Location
Aware

Connectivity Layer (DDS, HTTP, XMPP)

3
Device OS
(QNX, Linux, Windows)

www.netspective.com

3rd Party Plugins

Web Server, IM Client

1

7

Plugin Container

2

Security and Management Layer

12
NETSPECTIVE

Ensure your devices fit in a modern IT architecture
Create a Back-end as a Service (BaaS) for your devices
Device
Teaming

Cloud
Services

Patient
Self-Management
Platforms

SSL VPN

Patient Context
Monitoring

BaaS Gateway
(DDS, XMPP ESB)
,

Device
Data
Data Transformation (ESB, HL7)

Remote
Surveillance

Management
Dashboards

HIT
Integration

Report
Generation
Device reimbursement

www.netspective.com

Enterprise Data
RCM, Financials,
EHRs

Device
Management

Cross Device
App Workflows

Device Utilization
Device profitability

Alarm
Notifications

Inventory
13
Visit
http://www.netspective.com
http://www.healthcareguy.com
E-mail shahid.shah@netspective.com
Follow @ShahidNShah
Call 202-713-5409

Thank You

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Medical Device Connectivity with a BaaS is a Disruptive Innovation

  • 1. Med Device Connectivity with a BaaS is a Disruptive Innovation Creating a data-centric Backend-as-a-Service (BaaS) is good business and can generate new revenue By Shahid N. Shah, CEO
  • 2. NETSPECTIVE Who is Shahid? • • • 20+ years of embedded systems, software engineering and multi-discipline complex IT implementations (civilian government, defense, health, finance, insurance) 12+ years specifically in healthcare IT and medical devices experience Entrepreneur and founder of multiple startups I blog at http://healthcareguy.com Author of Chapter 13, “You’re the CIO of your Own Office” www.netspective.com 2
  • 3. NETSPECTIVE What you’ll learn in this briefing Data from devices is too important to be left to others Topics • • • • • Marketplace and industry challenges for device vendors Why connectivity is good business Why connectivity is a disruptive innovation What is a “Back-end as a Service” (BaaS)? There’s nothing special about health IT data that justifies complex, expensive, or special technology. www.netspective.com Key takeaways • • • Hardware, sensors, and software are transient businesses but data lives forever. He who owns, integrates, and uses data wins in the end. Data from devices is too important and specialized to be left to software vendors, managed service providers, and system integrators. Implement a data-centric hardware and BaaS technology strategy 3
  • 4. NETSPECTIVE Why connectivity is good business Looming 2.3% excise tax provision of the Affordable Care Act (ACA) Longer product development timelines caused by increased regulations Higher customer expectations due to consumerization of devices Lower margins as a reaction to commodity competition More complex and longer sales cycles as devices need IT approval Raising money for hardware is tougher than software www.netspective.com 4
  • 5. NETSPECTIVE You can use OSS to disrupt health IT Customers trapped by their EHR vendors are begging for a way out Device vendors aren’t benefiting from industry trends but can if they’re smart about it Clinical customer goals have shifted from basic automation to advanced process optimizations www.netspective.com Customer base has shifted from clinical to clinical + IT + system integration Device manufacturer’s access to regulated IT and system integration skills is growing 5
  • 6. NETSPECTIVE Healthcare industry / market trends Major market and regulatory trends that are causing customers and competitors to shift You must learn and be able to talk to customers about all these terms PPACA ACO PCMH “Affordable Care Act” “Accountable Care Org” “Medical Home” Health Home www.netspective.com mHealth MU “Meaningful Use” PCPCC “Patient Centered Care” 6
  • 7. NETSPECTIVE Why care about MU? If you’re not talking about MU you’ll find it harder to get in the door “Enable significant and measurable improvements in population health through a transformed delivery system.” 2011 2015 MU Stage 1 MU Stage 2 MU Stage 3 No Impact www.netspective.com 2013 Indirect Impact: Start planning for MU Direct Impact: Device integration proposed 7
  • 8. NETSPECTIVE Implications of healthcare trends PPACA ACO Software Regulated IT and Systems Integration Services MU Health Home www.netspective.com PCMH mHealth DATA Evidence Based Medicine Comparative Effectiveness 8
  • 9. NETSPECTIVE Don’t give up data to others without a fight Software vendors, systems integrators, and others don’t have your best interest in mind Device Teaming Cloud Services Patient Self-Management Platforms SSL VPN Patient Context Monitoring BaaS Gateway (DDS, XMPP ESB) , Device Data Data Transformation (ESB, HL7) Remote Surveillance Management Dashboards HIT Integration Report Generation Device reimbursement www.netspective.com Enterprise Data RCM, Financials, EHRs Device Management Cross Device App Workflows Device Utilization Device profitability Alarm Notifications Device Inventory 9
  • 10. NETSPECTIVE New revenue centers in software and services Build the right roadmap so that you don’t leave new revenue on the table 2 year ranking comparison of Top 30 HIT firms by offering type. Pure play firms are failing behind 100% Focus on Services and Solutions is the way to go 80% 60% Up % of all firms by 40% offering Down Flat 20% Ranking YoY 0% Hardware Software Services Source - The 2012 Healthcare Informatics 100 ranks the leading 100 vendors by revenues derived from healthcare IT products and services earned in the U.S. www.netspective.com 10
  • 11. NETSPECTIVE How do you get started? Consider Dr. Julian Goldman’s proposal on improving the quality of clinical alarms 1. 2. 3. 4. Use “integrated platform” to create “smarter” alarms by using multiple data sources for earlier detection of events and more meaningful alarms by improving alarm sensitivity and specificity. (e.g. detect repeat small O2 desats that would not currently trigger a conventional alarm). Crowd-source this activity. Set “wider” alarm limits to decrease nuisance and false alarms on each monitor/device. (e.g. SpO2 alarm at 80%). This maintains “device level” alarms. Collect clinical and alarm performance data to develop algorithms and evaluate system performance. Document gaps in current data sources and device capabilities. Stop/adjust IV pump based on above. www.netspective.com 11
  • 12. NETSPECTIVE Data-centric device architecture Extensibility and adaptability will be key in a data-centric world 5 Device Components • Presence • Messaging • Registration • JDBC, Query Sensors Storage Event Architecture Display 6 App #1 App #2 Plugins 4 Location Aware Connectivity Layer (DDS, HTTP, XMPP) 3 Device OS (QNX, Linux, Windows) www.netspective.com 3rd Party Plugins Web Server, IM Client 1 7 Plugin Container 2 Security and Management Layer 12
  • 13. NETSPECTIVE Ensure your devices fit in a modern IT architecture Create a Back-end as a Service (BaaS) for your devices Device Teaming Cloud Services Patient Self-Management Platforms SSL VPN Patient Context Monitoring BaaS Gateway (DDS, XMPP ESB) , Device Data Data Transformation (ESB, HL7) Remote Surveillance Management Dashboards HIT Integration Report Generation Device reimbursement www.netspective.com Enterprise Data RCM, Financials, EHRs Device Management Cross Device App Workflows Device Utilization Device profitability Alarm Notifications Inventory 13