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What SaaS EHR Users Can Learn from the Megaupload Takedown

Posted on July 5, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

It’s time to talk about a subject near and dear to my readers hearts: SaaS EHR. In this article, we’re going to take a serious look at some of the risks associated with the pure SaaS EHR model. I’m sure this will leave many concerned about SaaS EHR software. Before I get into that, I want to be clear that I can (and probably will) make a future post about client server EHR software that will likely leave you just as concerned.

The point isn’t that SaaS EHR or client server EHR is better than the other. I take a much more “switzerland” approach to the topic. I think both approaches to EHR have their risks, challenges, benefits and advantages. To me it’s much more important that users are educated on the risks of each so that they can address them properly.

With that in mind, I was recently reading one of my favorite venture capital bloggers, Brad Feld, who posted a guest post by Dave Jilk about what SaaS software vendors can learn from the Megaupload and its impact on the future of Multi Tenant Services. For those not familiar with the Megaupload situation, the Feds basically took down Megaupload and seized everything they had in response to copyright infringement violations. Wired has an interesting article about the case.

What then can we learn from the Megaupload case that applies to SaaS EHR companies. I think Dave Jilk describes the SaaS risks better than I could:

What this particular case illustrates is that a company that provides your online service is a single point of failure. In other words, simply offering multiple data centers, or replicating data in multiple locations, does not mitigate all the risks, because there are risks that affect entire companies. I have never believed that “availability zones” or other such intra-provider approaches completely mitigate risk, and the infamous Amazon Web Services outage of Spring 2011 demonstrated that quite clearly (i.e., cascading effects crossed their availability zones). The Megaupload situation is an example of a non-technical company-wide effect. Other non-technical company-wide effects might be illiquidity, acquisition by one of your competitors, or changes in strategy that do not include the service you use.

So again, while this is a striking and unfortunate illustration, the risk it poses is not fundamentally new. You need to have an offsite backup of your data and a way to use that backup. The situation where the failure to do this is most prevalent is in multi-tenant, shared-everything SaaS, such as Salesforce.com and NetSuite. While these are honorable companies unlikely to be involved in federal data confiscations, they are still subject to all the other risks, including company-wide risks. With these services, off-site backups are awkward at best, and more importantly, there is no software available to which you could restore the backup and run it. In essence, you would have to engage in a data conversion project to move to a new provider, and this could take weeks or more. Can you afford to be without your CRM or ERP system for weeks? By the way, I think there are steps these companies could take to mitigate this risk for you, but they will only do it if they get enough pressure from customers. Alternatively, you could build (or an entrepreneurial company could provide) conversion routines that bring your data up and running in another provider or software system fairly quickly. This would have to be tested in advance.

As many of you know, I’ve been quite interested in this topic and risk for quite a while. I’m sympathetic to those doctors that want at least a copy of their data stored somewhere that they control. Yes, most SaaS EHR vendors have a good set of backup, disaster recovery and business continuity plans. However, as the above quote points out so well, that doesn’t deal with the “non-tecnical company-wide effects.”

I’ve long considered the idea of creating a set of standards that SaaS EHR vendors could adopt. Things like making a practice’s entire EHR data available in an easily downloadable XML format. That could be the starting point. I think it would also create a real competitive advantage to those EHR vendors that adopted these type of common sense, good customer service practices.

I’d even be happy to lead the EHR agnostic team that it would take to make this happen. Client Server EHR software vendors could be involved as well. Not to mention I’d be happy to provide a voice to the movement on my network of EMR websites. I think the key to success would be getting a couple EHR vendors to get on board with the idea and fully invested in seeing this happen. The challenge is that too many EHR vendors are blinded by the meaningful use lights.

Let’s just imagine for a minute that doctors that select an EHR didn’t have to worry about their data being safe. They knew that they could have their data available to them when they needed it where they needed it regardless of what happened to the vendor. I have that with my blog data. Although, instead of that making me wanting to change blogging platforms, it’s endeared me to WordPress even more.

I wonder if Todd Park could add this idea to his concept of EHR Data Liberacion.

Government Healthcare IT Dashboard from ONC

Posted on May 14, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

One movement that I and I’m sure many of you have seen unfolding by HHS and ONC in particular is what Todd Park calls Data Liberacion. As Todd Park has moved to CTO of the US, I expect he’s going to take the data liberation movement beyond healthcare.

The latest addition to the Healthcare Data Liberation movement by ONC is the Health IT Dashboard that was put up by ONC.

Here’s the description of what’s possible for the website:
The Dashboard currently provides summary information about all ONC HITECH grant programs, and detailed data from the Regional Extension Center, and Community College Consortia to Educate Health IT Professionals programs.

Using ONC’s Health IT Dashboard, you can:

  • Generate maps of health IT adoption statistics for common groups of health care providers & hospitals,
  • Examine the impact of ONC’s Recovery Act grant programs implementation at national and local levels
  • Download and analyze the data for your own research projects.

I haven’t had much chance to dig into the data. As I do, I’ll write future posts on what I find. Also, there’s nothing better than crowd sourcing the look at large amounts of data. So, if you’ve found some data that’s interesting, let us know in the comments.

Examples of Health Startup Opportunity

Posted on December 21, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Anyone that is part of the healthcare IT and EMR world has to realize that we’re in a really incredible time for healthcare IT and EMR. There’s has never been more energy, excitement and actual investment in the Healthcare IT world than there is now. If you don’t believe me, buy your ticket to Las Vegas and attend HIMSS 2012 and I’m sure you’ll see what I mean. I have a feeling that HIMSS Las Vegas is going to be bigger than ever with more money flowing as well.

Just to provide a few examples of what’s happening, the prominent IT investor Esther Dyson has invested in 20 Health IT investments. That’s a whole lot of investment in healthcare IT. She obviously sees some real opportunities available at this time in health IT.

Another recent announcement was the recent batch of 15 Rock Health Startup companies. This is just one of at least 3 or 4 health focused incubators out there. Plus, the latest batch of health IT startup companies from Rock Health even has Neil Versel singing their praises after a previous not so glowing review of the health startup incubator (or health accelerator if you prefer).

One other thing that is easy to underestimate is the value that the US government is putting on supporting healthcare innovation through entrepreneurship. Normally I’m as skeptical as anyone in putting any sort of faith in government to produce results. I still think they have their hands tied in a lot of things, but I give a lot of credit to Aneesh Chopra, Todd Park and Farzad Mostashari for doing their very best to kick against the challenges of big government while enabling health entrepreneurs to be successful.

Priya Ramachandran wrote about an example of one initiative the government is putting forward to help entrepreneurs: Access to Public Health Data. Every time I hear someone talk about the data that’s available from these public repositories of health data, the entrepreneur inside of me kicks in with ideas on how to use that data for good.

It is a really tremendous time to be an entrepreneur in healthcare. I do think we still need a better platform for health IT startups to launch their products and get funding. I have a few ideas I’m working on in this regard. More on this in the future.

Thoughts and Comments from Digital Health Conference in New York

Posted on December 1, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I think people have enjoyed a collection of my best tweets from the healthcare IT and EMR conferences I’ve been attending. If you don’t like them, let me know in the comments. I think they’re interesting since they’re nuggets of interesting topics. The following tweets come from the Digital Health Conference in New York. It’s been a really well attended event and includes a lot of the real health IT movers and shakers in the New York healthcare scene. Plus, they’ve had some really great content as well.

Here goes (with my comments after the tweet):


Healthcare.gov is an interesting site. Still too new to decide its impact though.


Todd Park did make a pretty compelling case for the healthcare data they’re going to make available from the government and it seems like they’re just getting started. I could see a lot of startups leverage that data in their companies. I wonder what assurance an entrepreneur will get that the data won’t get yanked.


Simple examples like this is why mobile health is so fascinating.


Todd Park really did do a great job. Attendees were commenting on how good he’d done all day. As Matthew Browning said, Practice Makes Perfect!


Obviously a lot of interest in the HIE stuff and in the notifications that they can do.


I know that NYC is large and has a lot of people, but I’m having a hard time understanding how it has 4 RHIO. Are there 4 regions in NYC? I’m sure there’s a long political story behind it.


This is why we’ll always need doctors. It’s just how they do what they do that will change.


Such a good point. If they were actually getting all that information then they’d have reason to complain. Although, we can’t make the systems filter the flood properly when there’s no flood.


Great funding story. I bet there’s even more to it than he shared. I’ll have to get him to share the rest some time.


Great quote from Matthew. I don’t mind a little slow dancing, but the dance floor usually empties for the slow songs and is hopping with the rock songs. This is a pretty systemic problem in healthcare. I met one healthcare salesperson who said he was just contacted about a deal he’d worked on 3 years ago with a hospital. They contacted him to say that they’d finally closed the deal. Too bad this sales person is no longer at the company.

Digital Health Conference in New York City

Posted on November 1, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.


I know that many of my readers are from in and around New York. So, I’m really excited to let you know that I’ll be attending the Digital Health Conference in New York City on December 1-2, 2011. It’s shaping up to be a great event with keynotes from Todd park, CTO of the US HHS, and T.R. Reid, Journalist and Author for The Washington Post and PBS. Plus, they have tracks covering: Innovations in the Inpatient Setting, Advances in the Delivery of Primary Care, Chronic Care Management, and Health & Wellness.

One of the smartest things they’ve done is they’re offering up to 9.0 AMA PRA Category 1 Credits™ That should bring a bunch of doctors to the event to get some more CME.

Plus, they’ve offered HealthcareScene.com readers a special discount: $200 off for non-providers and $50 off for providers. That’s only $195 and $145 respectively. I can’t remember the last healthcare IT conference I’ve seen that was that inexpensive. You’ll just need to use the discount code: HCS2011 to get those rates.

Of course, the real reason I go is to meet lots of interesting people. So, I hope that a lot of you make it to the event so I can meet more of you in person. I’m sure we’ll find one way or another to do a tweetup at the event. Plus, for those of you who can’t make it to the event, I’ll be tweeting about it on @techguy and @ehrandhit.

Here’s the full description of the Digital Health Conference Event:

New York eHealth Collaborative’s Digital Health Conference will bring together hundreds of health information technology (HIT) stakeholders and decision makers from across the region including providers of all types, the public sector, private industry, health plans, hospital administration, and others. The event will showcase the latest technologies, share best practices, inspire collaboration, and generally support the advancement of healthcare innovation.

Keynote Speakers

Todd Park, Chief Technology Officer, U.S. Department of Health & Human Services

T.R. Reid, Best-selling author and healthcare journalist, The Washington Post, PBS

Conference Highlights

• Learn from industry thought-leaders through a series of lectures, panels, demonstrations and otherbreakout sessions in each of the following tracks:

• Innovations in the Inpatient Setting

• Advances in the Delivery of Primary Care

• Chronic Care Management

• Health & Wellness

• Programming features an impressive array of health IT experts from a number of different backgrounds, including private sector innovators, government agencies, providers of all types, and hospital IT leadership

• Network with hundreds of healthcare stakeholders and decision-makers from across the region

• Earn up to 9.0 AMA PRA Category 1 Credits™*

• Connect with private and public sector innovators showcasing the latest healthcare technologies and innovations

To view the full program and to register, visit www.digitalhealthconference.com

*This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Medical Society of the State of New York (MSSNY) through the joint sponsorship of MSSNY and New York eHealth Collaborative. MSSNY is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates this live activity for a maximum of 9.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.