Arch-rivals Apple, Google and Samsung (as well as other familiar Silicon Valley names) are offering glitzy front-end mobile platforms and applications that promise to seamlessly bring together data from multiple sources into a single interface.
The real unsung heros in mobile healthcare, however, are the middleware vendors who allow those front-ends to pull data out of gnarly back-end enterprise systems.
It goes without saying, then, that choosing the right middleware is critical.
When it comes time to make a decision, there are essentially two routes an organization can take: choosing from time-tested giants like Microsoft, Oracle and SAP, or opting for a relatively new cloud-based company like Catavolt, Kidozen and Kony.
Here's a closer look at those three cloud-based alternatives.
Catavolt
While Apple and Samsung partner with Catavolt on the front end, it's Catavolt's middleware software and healthcare platform that does the hard work of accessing that back-end data.
Although Catavolt can be described as a cloud-based service, it goes beyond simple cloud hosting, and becomes what CEO George Mashini described as “a shield over enterprise data.”
The cloud talks to the data in a generic form and then presents it on a mobile device. Although Catavolt is basically a tool for building mobile business process applicatons, it also offers pre-built healthcare templates.
Mashini said a very large insurance company (as yet unidentified) is about to sign off on a solution that will allow payers to access "sensitive" data on a mobile device.
With Catavolt's solution, the data is neither on the mobile nor in the cloud, so to speak; rather, it will remain behind the customer’s in-house firewall. Which means a physician sitting in Starbucks and accessing your network is still secure
Kidozen
Kidozen has what CEO Jesus Rodriguez calls a "cloud friendly" architecture. What he means by that is that while Kidozen can deploy completely in the cloud, it can also become a hybrid cloud solution subject to an organization's specific domain policies.
As far as connectors to that all-important back-end legacy software, Kidozen offers 80 APIs and 50 connectors to ERP systems from the likes of Netsuite, Oracle and others. The solution does more than just connect to an iPad or Android device, however; it also offers business analytics to understand how staff and consumers are actually using data.
For the most part, organizations can use any mobile software development kit to create front-end applications.
Rodriguez said HP soon will announce that it now supports Kidozen as part of its platform.
Kony
Last September, Kony was named a leader in Gartner’s Magic Quadrant for Mobile Application Development. The company offers solutions in a SaaS architecture, a cloud-based model as well as a private cloud on-premises, according to senior vice president Burley Kawasaki.
The Kony Mobility Platform provides both payers and providers with an integrated tool for designing and deploying mobile applications that include offline data synch, line of business integration and orchestration, as well as its mobile development kit.
The Kony Visualizer tool allows all the stakeholders to participate in the application design.
Kony's MobileFabric consists of a Services Coordination, Data Sync, Analytics plus Adaptors. Respectively these allow IT to create composite service calls to such systems as the EMR, ADT and CPOE, give offline data access within facilities, measure and track utilization in terms of auditing for HIPAA, and offer prebuilt data adaptors to commonly used systems.
What to know about picking a platform
Whether you opt to go in-house or out in the cloud, the cost for implementing these systems can be substantial — and with so many variables in play, pinning down the final ticket is not easy.
Cost evaluation should include, but not be limited to, data governance, testing, monitoring, end-user satisfaction, user interface control and service and support, according to Rick Ratliff, Accenture's lead for digital health. Other considerations are cost of software app development, testing on multiple platforms, maintenance and performance optimization.
In addition, recall that the old-school software giants offer middleware not originally designed for mobile. Rather, it has been retrofitted to make mHealth another option.
"The newer guys are smaller, more nimble,” said Maribel Lopez, CEO of Lopez Research. “They are more likely to design with ease-of-use in mind.”
Cost aside, what healthcare providers should look for are out-of-the-box connectors to a database, an ERP system and a CRM solution, as well as connectors to EHR enterprise software. The idea being that everything needs to talk to everything else.
While all of these middleware makers tout ease of use, rest assured there is no such thing. A company may promote the fact that they have connectors to Oracle databases, but that alone is only part of the equation. The truth is most IT departments, in healthcare especially, have over the years tweaked their legacy apps, customizing them. And that is all well and good, but a plain vanilla middleware connector doesn't necessarily know what your IT folks did and it may require a substantial amount of tweaking to get a particular piece of data out of the Oracle system and onto an iPad or Samsung Galaxy S Note, for instance.
On the flip side, mobile devices weren't built with an enterprise mentality but, rather, they were and are built to this very day for the consumer.
Lopez warns that "developers are like artists. They may not want the middleware vendor's tools."
"In order to work properly these platforms need to capture consistent, uniform data,” Ratliff said. “These types of capabilities should be focused on normalizing clinical information, tying the information to the same person, creating the right security controls, supporting appropriate consent, publishing API, and more.”
With so many solution providers out there, perhaps the most salient question to keep in mind is this: Does the vendor you are talking to have an understanding of what your business problem is?
If they don't understand your unique issues — and let's face it: with federal, state and even local regulations, healthcare has more than its share — no matter how good their software, is it won't be up to the mobile healthcare challenge.
Ephraim Schwartz is a freelance writer based in Burlington, Vt. Schwartz is a recognized mobile expert and columnist, having spent 15 years as Editor-at-Large for InfoWorld, half of them covering the mobile space. Prior to that he was Editor-in-Chief of Laptop Magazine.
See also:
New class of startups homes in on healthcare providers
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3 mHealth startups that might make a difference
