One of the really interesting things I noted while attending the NextGen user group meeting had to do with the move to SaaS based EHR and other SaaS based EHR software. I partially mentioned this in the write up I did at the conference, including a tweet where I talk about how Scott Decker really pushed the idea of NextGen making the move into the SaaS based software world.

I think there’s little doubt that NextGen sees the value of SaaS based software. I think they see the convenience to doctors of not having to manage a server. Most importantly, I think they see the value of not having the healthcare data stored in EHR in silos.

One thing that Scott Decker mentioned in his keynote was improving their coding rules engine based on the feedback and experience across all of their SaaS based EHR users. I found this really intriguing since it highlighted some of the challenges and limitations of the client server EHR model that’s so prevalent in healthcare.

After hearing these comments about NextGen’s move towards more and more SaaS based software, I wondered what users at the meeting thought about the move by NextGen to SaaS EHR. The nice part of a user group meeting is I had a chance to talk to a number of them.

One company I talked to said basically, “We have 30 Citrix servers in our NextGen EHR installation. That’s a huge investment we’ve made and I don’t see us changing that any time soon.” They’ve got an interesting point. There’s a lot of money invested in training, equipment, software, and general understanding of the current client server EHR installs that NextGen employs (or is it employed?) for its large EHR customers.

It’s quite a stark contrast to consider this entrenched client server user base that is unlikely to change even if NextGen’s direction is headed towards SaaS EHR software. To be completely honest, I’m not exactly sure how this “conflict” is going to play out.

I previously posted about the EHR stimulus tour (no link since I don’t want to promote them). Today I saw what seems to amount to a press release that talks about the “EHR Stimulus Alliance” and their tour to “educate 500,000 U.S. physicians about opportunities aligned with the American Recovery and Reinvestment Act (ARRA) of 2009.”

This type of puffery just makes me sick. No. Not the educating 500,000 physicians. That’s a good thing and part of the motivation for this blog. The thing that makes me sick is this seems like just a big marketing campaign for Allscripts. Sure they have a list of other partners, but they’re basically partners of Allscripts. Check out the list: Allscripts, Cisco, Citrix, Dell, Intel, Intuit, Microsoft Corp., and Nuance. The press release calls it a “broad coalition of healthcare and technology companies.” Too bad Allscripts is the only true healthcare company in that list. All the others are technology companies that sell some healthcare products.

I just don’t like when an “education tool” is really just being used as a marketing tool for a certain EHR company. If they really wanted to help adoption, they’d sponsor a tour with a whole variety of EHR vendors where they can help doctors to be able to see the wide variety of EHR vendors that exist.

Someone recently emailed me about any conferences that exist for a doctor to be able to evaluate EHR companies all in one place. I know there have been a number of other ones in the past that no longer exist. The only one I know is still going is HIMSS. Does anyone else know of other places where doctors can see a bunch of great EHR? I ask this knowing that many really great EHR just haven’t seen the benefit of these types of shows.

Also, if anyone has a chance to go to one of these EHR Stimulus tour stops, I’d love to have you do a guest post on the experience. I sent them a tweet asking if they can stop in Las Vegas so I can check it out.

Turns out the fish are starting to feed. Check out this website that talks about the “EHR Stimulus Tour: Educating the Nation.” Ok, I don’t really want you to check out the website, since I think it’s kind of sad. At the bottom it lists the “EHR Stimulus Alliance.” The following companies are listed in this EHR alliance:
Allscripts
Cisco
Citrix
Dell
intel
intuit
Microsoft
Nuance

What a group of large companies trying to sell a bunch of product. I guess we should have expected something like this, but maybe I’m just a little surprised that they made a website for an EHR stimulus tour and everything. Interestingly the twitter link on the site goes to an Allscripts twitter account. I think we can clearly see who’s behind this website.

Honestly, this reminds me of an Amway or other MLM convention. Is it any wonder the type of information that will be given at this type of tour? I guess $18 billion is a lot of motivation to market your EHR software. I just wish they were stopping in Las Vegas so that I could go and check them out.

I found this article which described a number of the offerings that Dell has offered to help Healthcare IT. I’m sure this could sound a lot like a sales pitch for Dell. It’s not intended to be a sales pitch for Dell. In fact, most of the solutions are being offered through Dell partners like Symantec, VMWare, Citrix, etc. I’d caution that you should look around since you can certainly find the exact same products from other sales channels than Dell. As always, it’s best to look around when purchasing any of the products described below.

What I did find interesting was all of the various types of packages that Dell and its partners are trying to offer to healthcare IT. My big question for you, is how can we ever keep up with all these cool technologies?

The following are snippets of the article linked above. I’ll add my commentary in italics below each section.

Dell Mobile Clinical Computing Solution

Among the new offerings announced is Dell Mobile Clinical Computing Solutions. This lets physicians access patients’ records from any terminal using smart cards and Symantec’s (Nasdaq: SYMC) Workspace Corporate product for single sign-on and secure authentication.

This capability is not entirely new, however. Sun Microsystems (Nasdaq: JAVA) has offered roaming capabilities using smart cards and single sign-on access through its Sun Ray technology, both in the U.S. and worldwide, for several years now. U.S. Sun Ray customers in the healthcare field include Denver Health, which provides healthcare for a quarter of all residents of Denver, Colo.

Smart Cards are interesting to talk about and interesting to see in action, but I just personally have never been fond of trying to manage smart cards. They’re expensive and prone to be lost. Can someone else make the case for them? I’d be interested to hear it.

On-Demand Desktop Streaming

Another element of Dell’s new lineup is On-Demand Desktop Streaming. This is for stationary environments where data management and security are critical. Virtual disk images will be streamed to desktops. This enhances security because users get a new, pristine image every time they boot up.

While Dell partners with VMware (NYSE: VMW), Microsoft (Nasdaq: MSFT) and Citrix (Nasdaq: CTXS) for virtualization, it’s likely that Citrix has been picked for this solution, as it is based on streaming images to the desktop.

On demand desktop streaming is a really cool concept. I think that in the next 2 years, the thin client on the desktop will become a major reality. Of course, I think this really only applies to large scale implementations that can benefit from the savings of virtualization and thin clients. Small offices will still be buying the regular old desktops. I don’t know what Dell will do, but I see VMWare becoming the dominate player in this space and Citrix losing some of its hold.

Virtual Remote Desktop

Virtual Remote Desktop offers centralized control and management of end-user devices while enabling personalized end-user desktops, access from any device — whether within our outside the corporate firewall — and session mobility, where a single desktop session can follow the user from one device to another.

The solution was developed in collaboration with Citrix. It consists of Citrix XenServer Dell Edition; Citrix Desktop Delivery Controller; Citrix Secure Gateway; and Citrix Provisioning Server.

This sounds like the idea of taking the desktop to your mobile phone. The mobile phone is getting there now with 3G speeds. I’d like to see this work. I’m afraid it’s still not going to be as nice as using a desktop.

Dell, Perot and the Cloud

In addition to Mobile Clinical Computing, Dell is teaming up with Perot Systems to provide virtualized desktop, storage, server and electronic health records on-premise, hosted off-site or in secure private clouds.

Perot also works with other major vendors in healthcare IT, such as IBM (NYSE: IBM) , HP (NYSE: HPQ) and Sun. “We’re vendor-agnostic,” Moss said. “We work with whatever’s best for the client.”

I don’t know anything about Perot systems, but it sounds interesting. I might have to learn more. Anyone else ever used Perot systems before that can tell me what it’s like?