I was very intrigued when Mr. HIStalk revealed that Baylor Healthcare System’s The Heart Hospital in Plano, Texas, will be first to go live on Centricity Enterprise using an ASP model. Here is the link to the HIStalk reference and here is the link to the press release. Below is an excerpt from the article:
GE Healthcare... announced the launch of Centricity Enterprise Remote Services, which will facilitate the adoption of integrated electronic medical records (EMRs) by mid-size healthcare organizations....Remote hosting puts sophisticated health information technology within reach of many more hospitals, not just academic medical centers and large integrated delivery networks....Hospitals using Centricity Enterprise Remote Services will have access to enterprise-wide clinical and financial applications, without the initial outlay required to purchase hardware and software, and without dedicating resources to implementing, maintaining and upgrading the software....Under the ASP arrangement, the Centricity Enterprise system will run on HP... servers owned by GE and located at its hosting center in Chicago. GE will be responsible for all technical support of Centricity Enterprise software versions, including installation of new release software and maintenance of the ... servers.
The application service provider model (ASP) is analogous to the remote hosting or remote services models. Here is a definition for ASP (link here):
An Application Service Provider (ASP) hosts a variety of applications on a central server. For a fee, customers can access the applications that interest them over secure Internet connections or a private network. This means that they do not need to purchase, install and maintain the software themselves; instead they rent the applications they need from their ASP. Even new releases, i.e., software upgrades, are generally included in the price.
Although offering the Centricity software using a remote services model is relatively innovative in the context of healthcare IT, it is important to point out that this approach is now being overshadowed by a new computer management model that is often referred to as software as a service (SaaS). Here is a definition for SaaS (link here):
Software as a Service (SaaS) is a model of software delivery where the software company provides maintenance, daily technical operation, and support for the software provided to their client. SaaS is a model of software delivery rather than a market segment....The reason for moving away from the term ASP or application service provider is that the ASP generation was merely traditional client-server applications with HTML frontends added as an afterthought. ....Because the applications were not written as net-native applications, performance was poor and application updates were no better than self managed applications. By comparison, current net-native SaaS applications or independent portions are updated regularly, many daily.
I don't know whether the SaaS architecture will be deployed soon in the healthcare IT domain but it is based on very compelling logic. Most, if not all, of the ASP models being offered in healthcare are, as noted above, retooled client-server systems with PCs functioning as the client and a secure Internet-based VPN connection to the backend server hosted by the vendor.
Such an architecture can offer a hospital client a number of advantages such as those listed in quote above. However, in the long run, the most efficient web-services model will require the development of "net-native SaaS applications" with only a front-end browser required by a user to interact with the system. As noted above, enhancements to such a system can be added rapidly by the SaaS provider without any changes required of the system users.