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 www.netspective.com 2 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”

NETSPECTIVE www.netspective.com 3 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. 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 What you’ll learn in this briefing Data from devices is too important to be left to others

NETSPECTIVE www.netspective.com 4 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

NETSPECTIVE www.netspective.com 5 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 Customer base has shifted from clinical to clinical + IT + system integration Clinical customer goals have shifted from basic automation to advanced process optimizations Device manufacturer’s access to regulated IT and system integration skills is growing You can use OSS to disrupt health IT

NETSPECTIVE www.netspective.com 6 Healthcare industry / market trends PPACA “Affordable Care Act” ACO “Accountable Care Org” PCMH “Medical Home” MU “Meaningful Use” Health Home mHealth PCPCC “Patient Centered Care” 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

NETSPECTIVE www.netspective.com 7 Why care about MU? If you’re not talking about MU you’ll find it harder to get in the door 2011 2013 2015 “Enable significant and measurable improvements in population health through a transformed delivery system.” MU Stage 1 MU Stage 2 MU Stage 3 Direct Impact: Device integration proposed No Impact Indirect Impact: Start planning for MU

NETSPECTIVE www.netspective.com 8 Implications of healthcare trends PPACA ACO MU PCMH Health Home mHealth DATA Evidence Based Medicine Comparative Effectiveness Software Regulated IT and Systems Integration Services

NETSPECTIVE www.netspective.com 9 Don’t give up data to others without a fight Software vendors, systems integrators, and others don’t have your best interest in mind Cloud Services Management Dashboards Data Transformation (ESB, HL7) BaaS Gateway (DDS, XMPP , ESB) Enterprise Data RCM, Financials, EHRs Device Inventory Cross Device App Workflows Alarm Notifications Patient Context Monitoring Device Teaming Device Management Report Generation HIT Integration Remote Surveillance Device Data SSL VPN Patient Self-Management Platforms Device Utilization Device reimbursement Device profitability

NETSPECTIVE www.netspective.com 10 New revenue centers in software and services 0% 20% 40% 60% 80% 100% Hardware Software Services Up Down Flat Ranking YoY 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 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. Focus on Services and Solutions is the way to go % of all firms by offering

NETSPECTIVE www.netspective.com 11 How do you get started? 1. 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. 2. 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. 3. Collect clinical and alarm performance data to develop algorithms and evaluate system performance. Document gaps in current data sources and device capabilities. 4. Stop/adjust IV pump based on above. Consider Dr. Julian Goldman’s proposal on improving the quality of clinical alarms

NETSPECTIVE www.netspective.com 12 Data-centric device architecture Extensibility and adaptability will be key in a data-centric world Device Components 3rd Party Plugins App #1 App #2 Security and Management Layer Device OS (QNX, Linux, Windows) Sensors Storage Display Plugins Web Server, IM Client Connectivity Layer (DDS, HTTP, XMPP) • Presence • Messaging • Registration • JDBC, Query Plugin Container Event Architecture Location Aware 1 2 3 4 5 6 7

NETSPECTIVE www.netspective.com 13 Ensure your devices fit in a modern IT architecture Create a Back-end as a Service (BaaS) for your devices Cloud Services Management Dashboards Data Transformation (ESB, HL7) BaaS Gateway (DDS, XMPP , ESB) Enterprise Data RCM, Financials, EHRs Inventory Cross Device App Workflows Alarm Notifications Patient Context Monitoring Device Teaming Device Management Report Generation HIT Integration Remote Surveillance Device Data SSL VPN Patient Self-Management Platforms Device Utilization Device reimbursement Device profitability

Thank You Visit http://www.netspective.com http://www.healthcareguy.com E-mail [email protected] Follow @ShahidNShah Call 202-713-5409