Today’s post will be short. I’m hitting up the Black Hat conference in Las Vegas today and tomorrow. For those not familiar with Black Hat, it’s a hackers conference. It’s not quite as hardcore as Defcon when it comes to hacking, but they warn you about getting your devices hacked. I personally plan to play it safe and not bring my laptop and to turn my cell phone off. Anyway, hopefully I’ll do some future posts on security based on what I learn at the event. I always find deep value in going to a conference that doesn’t apply specifically to what I’m doing. Although, in the past they’ve had some medical device hacking sessions, but I digress.
The title of this post describes a concept I was recently considering. In fact, it was inspired by a comment on a previous post by Suzanne McEachron, that talked about a clinic needing to upgrade their in house EHR server from Windows Server 2003 to Windows Server 2008. Here’s the full comment:
Your statement, “While it’s sometimes disappointing to look at the old technology that powers healthcare,” must refer to an ambulatory vendor I am aware of, which installed its software onto a Windows Server 2003 just 3 years ago, and is now demanding the provider upgrade to Windows Server 2008. The provider wants to upgrade to Windows Server 2012, but the software company’s software won’t reliably work (yet) on that version. What is a poor country doctor to do?
He will be dumping his current vendor and finding a software company which uses the cloud instead of servers in his office.
Companies which continue to not keep up, will be left with few customers.
The last two lines are probably worthy of their own post. So, we’ll mostly set them aside for now. However, I was struck by Suzanne’s comment that they would be going with a cloud solution after this experience with an in house EHR vendor.
I’d never thought of this before I read this comment, but is one of the benefits of a cloud EHR that the user has no idea what type of back end technology you’re using to deliver the software? Sure, some of them will ask some questions during the EHR selection process, but I’ve never seen anyone ask a cloud EHR vendor how they’re doing at keeping their technology stack up to date. The reality for end users is that they don’t really care what technology is being used. They only care about the end result. Does it work? Yes. Is it fast enough? Yes. Then, since it’s in the cloud, who cares what technology is being used?
Of course, this may be exaggerating the situation a little, but not much. Certainly very few if any people are asking cloud providers how they’re doing at keeping their technology up to date. No doubt some do care about this and run into this problem even with cloud providers. My favorite example of this is when a cloud EHR provider requires a clinic to use an extremely outdated version of IE (internet explorer) to run the EHR. Yes, then they start to care a lot more.
Maybe it’s a mistake that practices don’t keep after their cloud provider more. However, the reality today is that the don’t. That makes it a huge advantage for cloud EHR providers. At least it does until they’re so outdated that they can’t hide it anymore. For example, when they can’t launch an iPad app because there’s no way for their old technology to work with it. Sounds like I need to create a new jokes series called, “Your EHR might be outdated if….” The problem is the jokes won’t be too funny if you’re suffering through it.
Side Note: So much for it being a short post.