| Hospitals belong to the category of organizations | | | | - they have the knowledge and focus, the hospital |
| with the highest information density. This means | | | | can focus on their core business. They can |
| that the business that is organized in a hospital is | | | | innovate faster. |
| very independent on information. | | | | - the ASP will develop a generic and best practice |
| For instance: a patient gets ill suddenly, possible | | | | approach according to the common sense in the |
| cause maybe a heart-attack. Someone calls an | | | | market in which the ASP operates. Most hospitals |
| ambulance which arrives and than the | | | | will face similar business issues. |
| hospitalization process starts. The life of the | | | | - the ASP can offer a use per transaction which |
| patient depends on questions like: what is the | | | | is scalable (in-house variant only). |
| exact cause, what is the best location to go to | | | | A few of the disadvantages: |
| inside the hospital and who do we trigger (call) | | | | - the hospital or healthcare provider is limited to |
| first to cure the patient? | | | | the (develop and maintenance) priorities of the |
| This whole process is dependent on: the | | | | ASP. |
| information on the patients' health (record), | | | | - small hospitals have little say in the new |
| hospital protocols defining who is doing what under | | | | application development |
| certain circumstances and the available resources. | | | | - tailoring a system to specific proprietary needs |
| In a matter of minutes a series of what-if | | | | is costly and maintenance sensitive. |
| questions follow and the patient is routed to the | | | | - The hospital may have developed their own |
| right location and the right specialists... | | | | system which is costly to replace and convert |
| One could argue that any different hospital is a | | | | into the new one. |
| just like an other hospital. They all "operate" more | | | | - The ASP partner may become insolvent.. |
| or less the same, with: an incoming patient, | | | | - The cost structure of an ASP is explicit and |
| available resources, information systems, hospital | | | | looks more expensive as in-house-development is |
| logistics, etc... If some company is able to develop | | | | implicit and looks less expensive |
| a system that supports this flow of information | | | | - the ASP will have to service more parties and |
| (or events) it can deploy this to whatever | | | | when successful will risk unstable system |
| hospital. | | | | development due to the large number of new and |
| The reality is that hospitals started their own | | | | unique requirements for each and every hospital |
| software development in a time where "focus" | | | | user. |
| was not yet an issue as it is now. Some hospitals | | | | - ... etc. |
| are more developed in this sense than others. | | | | All thought the disadvantages may outnumber the |
| Than specific companies started to develop these | | | | advantages this doesn't mean there is no point in |
| "generic" hospital systems to support and service | | | | ASP or a packaged or standard healthcare |
| a niche (hospital) market. iSoft is one such a | | | | software development. Each case must be |
| company that has built a system called Lorenzo. | | | | examined and each hospital situation is unique. |
| So one of the main and still existing dilemmas | | | | These advantages and disadvantages are not |
| hospital information management is the question | | | | valued. |
| for hospitals to either self-develop their | | | | Then very important; although most service |
| information systems or to have a "standard" | | | | providers mention an integrated system, this |
| package like that of Lorenzo. | | | | integration needs to be established and often |
| The next question then is to outsource the | | | | implies a high cost. |
| application -- which is done by an Application | | | | One of the main challenges in implementing the |
| Service Provider (ASP) -- or to host the | | | | healthcare application is the fit of this single |
| application in the hospital environment and only | | | | system with the whole hospital business |
| "buy" the software application. | | | | architecture. Introducing such a system affects |
| A few of the advantages in choosing a specific | | | | the whole organization. |
| ASP are: | | | | |