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Interoperability versus Usability in Best of Breed or All-in-One HIS Systems

Posted on January 31, 2012 I Written By

John Lynn is the Founder of the 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 and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In a number of my online conversations we’ve been having really in depth discussions about the idea of whether it’s better for a hospital HIS system is better as an All-In-One system or whether Best of Breed healthcare IT systems are better. Much of this discussion has been sparked from posts done on my Hospital EMR and EHR blog. So, if you’re in the hospital space and are not following that site, you should. You can even sign up for the Hospital EMR and EHR list if you’d like. Anne Zieger writes most of the content there and she doesn’t mince words.

In all of these discussions, something became really clear to me:

The best reason to use Best of Breed healthcare IT systems is for usability.

The best reason to use an All-in-One system is for interoperability.

Some people may see this as too simplistic, but I loved a quote I read recently that said you don’t truly understand something until you can describe it in a simple form. I actually heard Bill Belichick do this talking about what he looks for in receivers for his Football team (Anyone excited for Super Bowl Sunday?). He said he likes a receiver that can Get Open and Catches the Ball. Seems far too simplistic, but it’s so simplistic it’s genius.

I think the same could be said for evaluating hospital IT systems:

The thing I like most in a healthcare IT system is one that’s Usable and Integrates Well.

Wearable Fitness Trackers are a Dime a Dozen, So What’s the Difference?

Posted on I Written By

The answer to the question in the title is most likely, it depends.

There are all kinds of devices out there that can be worn on your wrist, worn on your key chain, or clipped to just about anything.  I found five just by looking at two websites that referenced other devices.  They are mostly in the same ballpark in terms of price; around $100-150.

Some provide websites, iPhone apps, or even games.  Some require a subscription while others include access in the original purchase price.  Some simply track movement while others also track your sleep and can help you wake up less groggy.  Below you will find a quick look at just a couple of these devices.

What might be really interesting is to get numerous different devices, and wear them all at the same time and compare the results.  A slight difference would be expected, but it would be very interesting to see how big of a difference that was.  If I had $1000 to blow I would be happy to do it, unless someone wants to send me a test model and let me do a review.


$100 (includes lifetime website membership)

The fitbit has been around for a while, and boasts a lot of the same features as most of these other devices.  Their biggest advantage is probably size as their 3 inch device can clip just about anywhere, so unless you spend your days walking around naked, you are set.  This is probably my favorite device based on first impressions.  The size is important, but I also like that just buying the device gives you a lifetime membership to their website which provides a little more than these other devices.  You can input your diet and monitor your calorie input versus the number you are burning.  Obviously this requires more effort on your part, but there is something about tracking your fitness that can help inspire you to do more.  It also has a sleep monitoring function which I find incredibly intriguing.

Nike+ FuelBand


This is the most recent in a long line of Nike+ offerings.  Like the other Nike+ offerings it is currently only available with the iPhone, but is expected to have an Android version in the spring.  The FuelBand is worn on your wrist and uses LED’s to give you some indication of your progress.  Synching with the app through bluetooth provides more in-depth data as well as earning points towards NikeFuel, though I was not really clear as to what that gets you other than typical social media stuff.  Interestingly, they admit that the device is not super accurate, but that being high sometimes and low at other times should even it all out.

Jawbone Up


There is a review on that could best be summed up like this: “It is really cool when it works, but it doesn’t work often.”  The Up is one of the devices that also monitors sleep and is supposed to wake you up at a more ideal time.  It is worn on your wrist and looks incredibly simple.  There are only two LEDs and a plug to sync it with their iOS app (another device that is limited by Apple).  They say that it is water-resistant to sweat and showers, but should be removed for swimming.


$249-498 (plus monthly subscription)

This is one of the oldest companies on the market, but also one that continues to make advancements with their devices.  That being said, they are also the most expensive on the market.  Most of their devices retail around $250 but can be found at least $70 cheaper with only minor searching.  They work with both iPhone and Android models, and they offer wristwatch type devices as well as those that can be worn on the upper arm.  With the substantially higher cost (including monthly subscription costs for their website, they clearly are not for the uncommitted, but if you are willing to foot the bill, it may be worth it.  They used to be used on The Biggest Loser, but the show has gone to their own device this season which is our last device.

The Biggest Loser® SLIMCOACH™

$130 (includes one year subscription)

Honestly, I was turned off by this device as it just seems to be another thing for this widely successful show to make money on.  They preached the value of another product for so long it is hard to understand why they developed their own, except to make money.  That being said, It appears to be a worthwhile device.  It is a little bit bigger than most of the other devices, at about the size of an mp3 player, and clips on to your clothes like many others.  The website appears to be the key to this system with the ability to set goals for yourself and see how you are doing throughout the day.  From what I saw on the show you also have the ability to have your trainer input feedback to help you achieve your long-term goals.  The price is right inline with most of the devices, and it is hard to argue with their success in weight loss, but the whole thing just rubs me the wrong way.

These types of devices are going to become even more prevalent, and I wouldn’t be surprised to see smartphones embedding these programs since most of them already have accelerometers anyway, and people almost never leave their phone.  For some people monitoring their activity will do them no good, but for others, it may provide the motivation they need to succeed.

What other devices have you heard of or used that were effective?  I would love to hear about your experience with these devices.