This ain't your grandma's locker! - PHI in the Cloud

So, recently I was talking to a potential customer about our MAx on Demand offering, which is our SaaS Healthcare Informatics platform and he said that one of the challenges he's been facing is convincing his Sr. Executives that it is safe to host Protected Health Information (PHI) in the cloud. He asked me if I had any arguments for it. Boy, where do I begin? Here is a stab at it.

Not your grandma's locker!

That's right, this is not granny's locker where the key hangs "securely" around her neck! If you have doubts about how sophisticated our data protection capabilities are, take a look:

Companies like ours, take the security of our clients' and their customers' data very seriously. So, there are two high levels of security in place, Physical Security & Network Security.

Physical Security

To access our data center physically, you have to go through a series of checks. If you are an employee, you are given a badge (after background checks of course!). This badge lets you in the parking lot and to the office spaces. You still can't get to the data center. To get to the data center, you have to have biometric access and a secure access code. This will let you into the data center. From the data center, to access your server, you have to have another secure pin that allows you to physically touch the servers. All of your actions are monitored by security cameras and stored.

If you are a visitor to our data center, you have to register with the guard station. You are ID'd and photographed. You will be escorted by an employee during your visit. 

Network Security

Our network security policies and procedures ensure the protection of company wide networks, related devices, and their services from unauthorized intrusion, modification, destruction, or disclosure. Network security provides assurance that a network performs its critical functions correctly, efficiently, and without any interference. Its primary goal is to provide a reliable and secure platform, designed specifically so that users and programs perform only the actions allowed.

Firewalls – Firewalls are utilized to provide dedicated, security specific processing hardware and a complete set of Unified Threat Management (UTM) security features including stateful firewall and web filtering.

Virus Protection – Antivirus software is installed on all Microsoft based servers and workstations. Automatic updates are configured to ensure latest signature download for system protections.

Logging – System logging occurs according to system settings defined by the administrator. Log records can be retrieved as needed. Successful and failed logon activities are logged by domain controllers.

Attck Monitoring - If that is not enough, you can always request 24x7 attack monitoring for your servers!

Disaster Recovery - If a disaster strikes, you can still sleep tight knowing that there is a triple redundant power supply to our data center. Oh, by the way, did I mention that this is a Category 5 hurricane resistant building?

Business Associate Agreements

And if you are still worried about liability, most reputed companies like ours will sign Business Associate Agreements as defined by HHS that makes us adhere to HIPAA laws and liable for breach of Private information: (http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/contractprov.html)

So yeah, we know that you take your data protection seriously, so do we!  

Predictive Modeling in Healthcare

Ok, so these are my musings over predictive modeling, not a knock on it. (That is the disclaimer). So, as I was sitting around, pretending to watch TV and ignoring the dog who seemed to want to go out and play, I thought about Predictive modeling, in a healthcare setting. Specifically, in a Healthcare Provider setting. I actually asked this question on several groups on LinkedIn and asked folks if they have had success with it. The only person who responded with a success story was Mr. Alex Zverev (you can view his profile on LinkedIn here: http://www.linkedin.com/pub/alex-zverev/1/a01/b03), and the scenarios in which he has had successes here (http://www.linkedin.com/groupAnswers?viewQuestionAndAnswers=&discussionID=90342387&gid=93115&commentID=65616962&goback=%2Egmp_93115%2Eamf_93115_10544349&trk=NUS_DISC_Q-ncuc_mr#commentID_65616962). So here are some of my thoughts.


My primary interest is in the Return on Investment of using predictive modeling. I see quite a few software providers out there touting to have predictive modeling capabilities, but haven't heard of a lot of success stories, especially in a healthcare provider setting. Even lesser information is available on the ROI of implementing a predictive modeling solution.

To me, an ultimate predictive modeling solution would be something that can predict the stock market, which has infinite number of variables to consider. But if it were that simple, everyone would be doing it. On the other hand, in healthcare, people are touting Clinical Decision Support capabilities using predictive modeling. "Which patient of yours is most likely to develop cancer?", for example. In my humble opinion, that again is quite a stretch, because of the number of variables that need to be taken into account, not to mention "objective research" that is available to create the model in the first place. 
For example, it would be easy to say that a smoker of Asian descent between the ages of 18-40 may develop cancer quicker than others. But what if he is a smoker with healthy eating habits and hits the gym 4 days a week? What if that person only smokes three cigs a day? What if he has no genetic predisposition to cancer? To me, this a cool exercise to conduct and eventually, as you gather more and more data and "evidence" really starts supporting your research in cancer, your model becomes much more reliable and this will start generating a measurable ROI, by reducing the cost of treating a patient through early screening and through preventive medicine. 


My thought is that if you are going to do predictive modeling, start with an area with a limited number of variables. Your "bang for the buck" would be realized sooner and it would be greater in that scenario. For example, the scenarios that Alex describes (Capacity Planning and Measured Display Times for Display Stations) have a better chance of an "immediate" ROI than, let's say, a cancer predicting algorithm. Now, if you are reading this, and have had successes with using Predictive modeling in different settings other than the ones described above, please let me know. I'd like to hear your stories.

The Informatics M.U.S.E

Recently, I was talking to a customer and he asked what I thought about a comprehensive informatics platform should contain. Currently, our focus is on Healthcare, but as I thought about it, I realized this applies everywhere. So, I said to him, "you have to have your M.U.S.E.". Ok, I am not talking about the Hollywood version with Sharon Stone, but the informatics version. So what is an informatics MUSE?
Measure
You have heard me harping about this over and over again. What are you measuring? Why are you measuring it? When you measure your business (healthcare or others), you understand your business better. So, measure everything that impacts your customers (internal or external)


Utilize
Alright, the second element for you to have a successful implementation, you need to have utilization modules. For example, in healthcare, you measure OR Utilization. Great, now that you know that your utilization is below 100%, what are you going to do about it? How about a OR scheduling module that allows you to maximize your OR scheduling? Utilize the information that you gathered during your Measuring process.

 SaaS (Software as a Service) it!
That's right, I said SaaS it. The biggest advantages between a SaaS solution for your business versus you buying the tools and technologies and building it yourself is cost savings and a much faster implementation lifecycle. It puts the focus on "information" and not the technology. Apprehensive about your data being hosted elsewhere? Don't be. Most reputable SaaS solution providers have hardened, HIPAA compliant Data Centers, with 24X7 monitoring capabilities.

Evaluate
That's right. Once your implementation is complete, constantly evaluate your data, decisions you make based on the data and evaluate your performance improvements. This'll allow you to revise your strategies on the go and allow you to make decisions as fast as small companies do.

So there, get your MUSE!

Micro Informatics

Recently, we launched our FREE, yes FREE, iPhone app to help providers keep track of OR Utilization. (To appease our sales and marketing folks, here is more information about the app: http://www.metaanalytix.com/page.php?page=35). It only does one thing, that is, keep track of OR Utilization. You ask me, when you have the Cadillac of informatics solutions, why launch a "micro informatics" app? One very simple reason. Delivery of information at the point of decision making. The reason why we built the app is because a couple of friends of ours, who work at surgical departments said, we are always asked how we measure in relation to our goals. We have no way of knowing it till the end of the month, nor do we have an effective way of tracking where we are or justify a lower score than what is expected of us. So, here are some reasons for "micro informatics":

* It is a great motivational tool. If you can keep track of where you are, you can change directions accordingly to achieve more.

* Educational purposes: Research is usually done at a macro level. But if you can use the results of that research and deliver it at a micro level, you can deliver the latest information at the point of care. For example, an ER doc running from patient to patient, maybe able to quickly access the latest findings in research at the point of care.

* It is a great data collection mechanism. You get better data from the "horse's mouth", so to speak. Better data, better analysis.

Skim on it now, you'll pay later

Everybody wants to cut costs. "Bad economy, can't commit enough money right now...", we have heard it all. The thought process is, let's do the one thing I need right now (at dirt cheap prices), and then we'll go from there. Well, it would be a sound financial decision.... if you are buying groceries! If you are planning an informatics initiative, however, it is a bad idea. Now, solutions like ours, are designed specifically with that kind of need in mind and can scale to need. But most are not. So if you are investing in an informatics solution, invest in it. It doesn't go bad after a week. In fact, in the long run, it will help you cut costs and save money. It really is not like buying a car where, as soon as you drive off the lot, the value drops by 10%. Over time, the more data you have, the better your analysis is going to be. It is an investment. It may not be a revenue "generator", but it certainly is an "expense reducer", if used properly. Some food for thought.

Feedback Requested

As I was talking to a very smart friend of mine who is in PR & Communications, she asked me what my company did. As any good technologist would do, I told her that we are a health informatics company and that we have an end to end informatics platform that extracts data from disparate systems and presents reliable information to key stakeholders in Healthcare for better decision making. She asked me again, "what do you do?" and explained to me the importance of simplifying our message. So here is an attempt. Your feedback will be greatly appreciated. Especially if you are in healthcare

Which one of the following sentences resonates with you about what we do?

1. Helping improve quality of care and reduce healthcare costs through reliable information.

2. Providing business and clinical intelligence to decision makers in healthcare.

3. Providing cloud based analytics and data warehousing for healthcare.

4. An end to end informatics platform for healthcare at a fraction of the cost.

5. None of the above, I still don't know what you do.

Mental Health

Ok, so this is not really a blog post, but thought I'd let you know that we have now partnered with a Mental Health screening provider to provide analytics. You can read the press release here:

http://www.metaanalytix.com/upload/File/Meta%20Analytix_Medical_Outcomes_PressRelease.pdf

Informatics for Improving Quality of Care

A well designed informatics platform can not only improve profitability among healthcare providers, but allow for “Improved Quality of Care”. This white paper provides the possibilities, design considerations and thought leadership in designing and implementing scalable information architecture for Healthcare Providers to improve quality of care through research. You can download the whitepaper here: http://www.metaanalytix.com/page.php?page=33

Information Based Design - Next Gen Data Warehouses

Recently, in my webinar done jointly with expressor, I was asked a question: "Is the best practice for deploying warehouses a "single, enterprise wide warehouse" or a warehouse with different data marts for each line of business?" My answer was "it depends on the client". Very simply said. As I was talking to a colleague of mine, we knew the answer wasn't that simple and we decided to write a whitepaper about it. So here we are, with a brand new, hot off the press (or Adobe for that matter), FREE whitepaper on "Information Based Design - Next Generation Data Warehouses for Healthcare providers". Here is an excerpt from the whitepaper:

"Very large companies can afford big investments and long lead times to build out new enterprise data warehouse environments. These can be several year projects that cost tens of millions of dollars, or more. Success (based on full achievement of the initial vision) is far from guaranteed. Not uncommonly, after several years, planning for the “next generation” data warehouse begins to take root and the process begins anew… Meta Analytix and End to End solutions present a white paper on Information Based, Incremental, Data Warehouse design for those organizations with limited time and budgets."

Continue to White Paper here: http://www.metaanalytix.com/page.php?page=15

Active vs. Passive Intelligence

During a recent webinar I gave, I was asked about delivering intelligence to the end user. It got me thinking as to what are the best ways to deliver information in the "I have the smallest device I can fit in my eye coolest toy that you don't have" era?

As any good technologist would do, I thought about the different types of users and how they would access information. Then I thought about "what" information they needed. So, in a healthcare informatics setting (after all, that is what we are talking about here), to me, there are two types of users who could benefit from informatics. The Active Intelligence Users and the Passive Intelligence users.

Active Intelligence:

Take an ER doc, for example. She sees a multitude of patients in a single day, works ungodly hours (trust me, I know a few) and probably works in more than one hospital. If you asked her if she is up to date on the latest research in heart conditions (after all, if you have a heart attack, you are not going to your local world renowned cardiologist, you are running to the ER), she would either laugh at you or worse, walk away in a huff, vowing never to speak to you again. Enter the words that we are all familiar with, Clinical Decision Support. This is a form of active intelligence. Delivery of information to the end user ( our heroine in this case ), at the "point of care", where she can quickly browse through the latest guidelines on heart conditions before seeing the patient or fancier still, input patient information directly into her "eyeball wearable device" and the suggestions are automagically transferred to her brain.

Passive Intelligence:

Passive intelligence in much simpler, but not any less important. We have always heard that "history is a good teacher" (whether we listen to history is another question altogether), but for the sake of this blog, let's say history is indeed, a good teacher. Who are the cool customers of this type of intelligence? Your researchers, your administrators and the people who have to run the "business of healthcare".

So, there you have it, two broad categories of intelligence (and I am sure some of you may have thought of umpteen number of other types of intelligences), but that's your problem!

Metadata for Healthcare

In my webinar, I spoke of how expressor helps you manage metadata "in-process" rather than as an afterthought. Dr. David Fenstermacher, Chair and Executive Director of the Department of Biomedical Informatics at the H. Lee Moffitt Cancer Center & Research Institute is giving a webinar on "Metadata, the cornerstone of tomorrow's healthcare information systems", a more detailed dive into the use of metadata. It's Free. You can register for the webinar here:

http://pages.expressor-software.com/metadata-the-cornerstone-for-tomorrows-healthcare-IMS-webinar.html

Meaningful Use - Final Rule - Again!

Ok,

So my sales team twisted my arm to put this on here. So, please bear with me: Here it goes.

By now, you have all read the 864 page meaningful use Final Rule and are prepared to be compliant right? Well, if not, we’d like to talk to you about Compliance Reporting for Meaningful Use.

As you may already know, there are 15 core measures that you have to electronically report to CMS to be compliant. And you may already know that a CCHIT certified EHR alone is not going to help you get there. Let us take a moment to introduce you to Meta Analytix’s comprehensive informatics platform designed specifically for Healthcare, Integra.

As a savvy executive, you already know what Informatics can bring to the table in increasing profitability, improving your organization’s competitiveness in the marketplace and having a single view of your entire organization. Some of the statistics that you may not know are these. Best in class Hospitals that have used centralized business intelligence have achieved:

* Increased profitability from 1%-9% (Aberdeen Research)

* An average of 36 days to receive payment on accounts vs. 46 days for all others (Aberdeen Research)

* A nurse turnover rate of 10% vs. 14% for all others (Aberdeen Research)

Given this scenario, how can we help? Take a look at the salient features of Integra

* Over 400 Healthcare measures pre-loaded, including meaningful use measures

* Enterprise Class ETL platform built in (http://expressor-software.com).

* Can acquire data from your EHR software, SAS, COBOL and others

* Standardized data definitions pre-loaded for Healthcare

* Flex Dimensional^TM Data Model ready for staging and reporting

* Enterprise Open Source BI platform for reporting, drill down analysis and dashboard building.

* Low Total Cost of Ownership (TCO)

* Low implementation lifecycle. (Avoid making costly purchases of individual components and building from scratch)

* Experienced Consultants to work with you to implement your informatics platform seamlessly with minimal workflow interruption

As you can see, Integra is the only informatics platform pre-built for Healthcare and ready to get you to to Meaningful Use in the quickest possible time. For additional information, please see the attached brochure or visit our website: http://www.metaanalytix.com

Contact us for a demo or for your consulting needs:

Phone: 866.611.8595 Ext. 1 or Ext. 2

Email: info@metaanalytix.com

Meaningful Use - Final Rule

The final rule for meaningful use is here, finally! The good news? Number of measures have gone down. The bad news? It is more complex to collect and report. Take for example the following stage 1 measure as defined in the final rule :

"More than 30% of unique patients with at least one medication in their medication list seen by the EP or admitted to the eligible hospital’s or CAH’s inpatient or emergency department

(POS 21 or 23) have at least one medication order entered using CPOE".

Huh? Think about it. What would the measure for this look like? Let's say the measure looks like this: "% of patients seen by EP (Eligible Professional) in Emergency Department or Inpatient with at least one medication order entered using CPOE".

Easy enough? Not so fast, my computer savvy analyst ( yes, you know who you are...usually known as the "data queen" in your organization). Think about the data elements you have to collect.

Let's break down the measure into chunks to better understand it:

1. Number of patients who was seen by an EP (Eligible Professional) - Who are eligible professionals? (We won't go into the definition here, but if you are so inclined, you can read page 358 of the meaningful use rule to find out.) Bottom line for you to make this measure work, you will have to find out the "type of provider". This information is stored where now? In your HR database, I presume?

2. Seen in an Emergency Department or Inpatient facility: Ok, so what happens if a patient was seen both by your ER and then admitted to your Inpatient facility? No matter, we can work around it, by looking at whether the patient was treated by an ER doc before she was sent to inpatient, right? Where is the data for this? Well, the EMR guys should have this info for sure, right?

3. Medications that are on the medication list ordered by CPOE. Well, the EMR guys should have this data too, correct? Great. It's 2 for EMR, one for HR!

4. Hmmmm....what is the fourth element? Do we have all we need? Not yet, data queen. To calculate this measure, you also need to know the total number of patients who were seen and who were ordered medications "without" the use of CPOE. Where is the data for that?!!! Your appointment scheduling system? Maybe your claims system? Doctors' notes?

Final score? Measure - 1. DQ - 0. The point, I am making, is invest in a really good Informatics platform. The measures are not going away and they are getting more complex. Once in place, you, my dear DQ, will be able to pull this data at the click of a button, or better still, program it to run automatically and send a PDF to your boss as an email attachment!

Vendor's view of Meaningful Use

Take a look:

http://www.healthdatamanagement.com/news/meaningful-use-final-rule-vendors-hitech-40645-1.html?ET=healthdatamanagement:e1348:144427a:&st=email&utm_source=editorial&utm_medium=email&utm_campaign=HDM_Daily_072010

Informatics Webinar

So, someone really wanted me to speak about Healthcare Informatics and I complied! Here is the link to the webinar: http://www.expressor-software.com/healthcare-informatics-meta-analytics.htm

Competition

No, I didn't get lost on the golf course and am just finding my way back! A client kept me busy...imagine that! But that is not the reason for this post. The reason for this post is "Competition"! Well, if you abstract to another level, it is about "Goals".

Have I managed to confuse you yet? Well then, read on. Things are about to become clearer. So, as I was talking to a potential client, I approached him with the same questions that have listed out in these blogs. One of them was "Have you defined your measures yet?". But before he answered, he said "Kishore, my biggest problem is competition. I often make 40 cents on the dollar, there are several other clinics who offer the same services we do in the general area and I am losing my shirt. Someone suggested business intelligence as a solution, but I have no idea where to start". As I was listening to him, light bulb went off in my head! Folks, I am going to tell you something that I normally don't tell anyone...I was wrong! See, just then, I realized I had made a big assumption. I had assumed that everyone knew they WHY of informatics. Not so. So, here is step 1. Know your GOALS!

How do you define your goal? Well, you know this better than any consultant you will ever hire. Your goals may be to "Save more money" or "Comply with ARRA" or "Need to improve my quality of care". Once you know your goals for your measures, i.e, what are you going to do with them, you now have a good idea of "What to measure". Now you can define the measures and follow the steps I have outlined in my previous posts. So folks, happy "goaling"! (Is that a new word? Hmmm....need to check it!)

Metadata & Master Data Management

Hmmmm...interesting topic, eh? Why bother? What can I do? How much is it going to cost me?

Well folks, I am going to tell you a secret. This is a secret that we, I mean technologists, have hidden from you for long. Much like the wall street "experts" who are now "fixing" the problems they created in the first place and getting paid for it, we are doing the exact same thing. This is an issue that we created (I mean technologists). Now we have cool technologies like metadata repositories and dictionaries that can give you standardized data definitions across the enterprise, but we'll need you to pay us for the "cool technology" we created to solve "your issues"!

Why bother?
Answer is simple. Have you ever had Gatorade? Yellow, Blue, Orange? Well if you have, you get different "flavors" of the same thing. Same thing with business intelligence. If you want to call something a pot, call it a pot. Don't call it pot in one place, a vessel in another and a container in another place. Unfortunately, the reality is just that. A pot is called a pot in one system, a vessel in another and a container in a third. If you tried to print out the value of a "pot" for your CEO to see, you would have to sit there and explain "well, it is the same thing, but it may be called a container on page 2"! You can imagine the reaction. Enter metadata and masterdata management! We take the pots and the containers and the vessels, call it a pot, make sure the attributes of all three are the same, store it in a dictionary and charge you a couple of millions for it! Sound cool? No?

What can I do?
There are things you can do and not break the bank while doing it. Old fashioned discipline and planning, for example. And you, as the healthcare exec, is in luck! Because, if you are like most companies, you have a clean slate to start with, in terms of informatics. So, with a little bit of planning upfront, you can avoid a lot of costs later. Incorporate metadata/master data management into your informatics initiative early on. In other words, don't build a warehouse without it! Just like you put planning and thought into collecting your measures, think of having standard data definitions across the enterprise. Reach out to folks like SNOMED to see what they are doing. Trust me, your upfront costs will be a drop in the bucket if you have to do it as an afterthought. It will also ensure better data quality as the data won't get into your system without rationalizing with your dictionary first.

So when your buddy from the other hospital is worried about his/her metadata, you can simply say, "we have incorporated that into the "front end" of our process", take a long hard look at the fairway, judge the wind speed and let it rip!

Why Informatics?

Now that I am back from a little time off, let's look at the very basic question, Why Informatics? How does this work in healthcare? What are the reasons why I should even think about it? And I am over the subject of the cloud, just so you know.

Savings!!
If you are seriously considering reducing cost of care, the only way to do it is through knowledge. I mean, knowledge of your business. What are my central line infection rates? What is the average waiting time for my patients? What is the average bed occupancy rates? Having answer to these questions and many more will help you produce an effective strategy to make your business more efficient. Efficiency will then translate to savings. We all know that.

Legislation/Compliance!
If you are not already on top of this, please take some time to read through it. You will avoid a lot of heartache down the line. ARRA has some 20 odd measures that you have to report on. With penalties associated with it, if you don't comply. But other than that, when you are looking at an informatics solution, you should probably think ahead to more than just those measures and how implementing a comprehensive solution will affect the bottom line of the business. Also, you could be missing out on the Medicaid funding allocated to provider organizations under the ARRA. $2-$8M allocated for hospitals and $44K allocated for individual physicians. ROI is very evident.

That's about it.

The "Un" Case Study - The never ending Informatics Initiative!!

I play golf. In fact, I am sort of obsessed with it at the moment. Recently, a friend of mine invited his co-worker to play with us. I welcomed him as a friend of a friend and went to play. The man, first of all, showed up while we were on the 5th hole. Then he joins us (thank God the rangers never found out) and starts playing. Long story short, every time any one of us tried to make a shot, he would loudly point out that it was our "2nd", "3rd" or "4th" shot and "cheer" us to make the shot! I kid you not, he did a "back flip" on the golf course when he chipped a ball in straight to the hole. At the 18th, since he had fewer number of shots on the hole than either of us, he decided that he was the "winner". Needless to say, he was never invited again. My friend profusely apologized to the rest of us.

How does it relate to Informatics, you ask? Well, consider this. You are in the market for a vendor ( as I have said earlier in one of my blogs, I don't like the term "vendor" when it comes to Informatics initiatives. I think of it as a partnership, because, guess what, if the initiative fails, so do we and vice versa ). So you are in the market for a "partner" to take you through a complex informatics initiative. You ask your friends and a friend suggest "OverPriced Consulting" as a partner because she has heard good things about them. "OverPriced" does a presentation for you and tell you about all the clients they have and how they have had "successes" with other firms. You feel warm and fuzzy. You hire them to implement your initiative. They come in with their solutions architects and do a "roadmap" for you (3 months, $150K). Looks good. The roadmap includes a project plan with their technologists, data modelers, ETL architects, developers and BI architects and developers. The Solution Architects have moved on to other clients by now. They suggest you buy Cognos/Business Objects and AbInitio/Informatica.
"Isn't the price tag a bit steep?" You ask. Scalability, Metadata management, Data governance and other terms convince you that you need the Ferrari instead of the Prius. All the time, they cheer you on as to what a great purchase you made and you can't go wrong with these purchases.
3 monhs later, you find out that Cognos can't write to the database and you need a Java interface to manage security. 8 months and $5M later, you are still working on bringing data to your warehouse and the blame game starts. Fault of the product we purchased, dependency issues, data not in the right format, data quality issues....the list goes on.

What went wrong? Let's look at the golf game I talked about. First of all, he was late. We should've told him to come another day. But since he was already there, we let him play, starting from the 5th hole! But since he is a friend of a friend, we thought it would be ok. He started "cheering" us. We should've stopped and taught him some golf etiquette. We never did. He is the friend of a friend after all! At the 18th and a painful 13 holes at that, he declared that he was the winner. By that time, we were licking our wounds and too anxious to get out of there that we didn't care.

Parallel, you ask to the informatics initiative? Even with the company you hired having a great reputation and being a "known" entity, they never stopped to do the "first"thing in an informatics initiative. "Define your measures". They put together a "roadmap" and said you needed the Ferrari. What they should've done is to look at your measurements, what data elements you needed, what requirements you had (security and others), do a gap analysis with your existing technology and "then" suggest what technology to buy.

It is a "partnership" folks. While we are all in business to add to our bottom lines, the responsibility of executing lie in the hand of the "vendor" and you. So remember, if someone walks on your line on the green, call them out on it!

Buzz (kill) Words!

If you have talked to a technologist or a technology sales person lately, you have certainly heard of SaaS, Cloud, Disruptive Innovation etc. Hmmm... "disruptive" innovation? Do you really have to say that innovation is "disruptive"? Didn't people stop riding horses to work when cars came around? So, when you are trying to choose your informatics solution, kick the first sales person that tells you that their solution is "in the cloud"!

Cloud is Water Vapor!
Don't believe me? Ask Larry Ellison, the CEO of Oracle (http://www.youtube.com/watch?v=8UYa6gQC14o). So what prompted him to give a (ahem) "passionate" speech about the cloud?
Let's examine the facts. If you really want to put your software "in the cloud", a fundamental engineering shift is needed than what is being purported as cloud computing. The closest thing we have seen to a truly "cloud" architected software, is the screensaver that SETI(Search for Extraterrestrial Intelligence...to you and me, that is looking for E.T! ) put out 10 years ago (http://www.planetary.org/news/2009/0521_SETIhome_Celebrates_10_Years_of.html). Yes folks, "Cloud" computing happened back then! People downloaded the screensaver, and when they were not using their computers, the screensaver kicked in and started analyzing data for SETI, sending data back to their main computers once the analysis was done.

What is being sold as "cloud" computing today is nothing but a software that resides on one or more servers at the vendor's data center. In other words......wait for it....an ASP model! Remember that term? Application Service Provider model? Remember all the VCs who wanted to invest only in ASP model companies? Now, here is the kicker. Application Service Provider - Software as a Service (SaaS). You "lease" the software. Just like leasing a car. See the similarity? Are you seeing a pattern here? So, yes, I agree with Mr. Ellison..." we change the term and think that we have invented technology...".

The point being, forget cloud, forget SaaS, look for "functionality" in the software. Can it deliver what you need? Once you have ascertained that, then you can think of where it is going to be hosted!