By Suresh Reddy, Wilco Source
Digital transformation has been underway in healthcare for the better part of a decade, and until a few months ago it was a slow-moving transition for many organizations. But that all changed recently with many forced to make rapid pivots (some overnight), and healthcare leaders learned speed is not only possible but necessary if they are to achieve transformation and thrive in the face of uncertainty going forward.
While COVID-19 has been a catalyst for speeding the adoption of long-term digital plans, it also served as a wake-up call for organizations that didn’t have as strong of a digital bedrock in place before the pandemic. As a result, many turned to off-the-shelf solutions for an immediate fix.
Though necessary for responding to the urgency of the situation, going forward healthcare leaders will need to take a more holistic approach to building a sustainable digital infrastructure. Often, that means migrating away from out-of-the-box solutions and over-customized legacy platforms to a hybrid technology model that falls somewhere in between and offers flexibility over the long term.
Navigating The Three Primary Verticals Of Healthcare It
At a high level, there have traditionally been three verticals of technology in healthcare: custom development using full-stack technologies, software-as-a-service (SaaS) platforms, and fully packaged solutions.
Custom development enables you to build what you want without boundaries. But it also means everything is from scratch, which adds more time and cost.
With SaaS-based platforms, the advantage is scalability, and updates and maintenance are generally taken care of automatically. These platforms range in terms of the level of customization vs. configurable functionality. Some are pre-built to serve a very specific use case, which comes with some limitations as not everything will align perfectly. Others are built with expansion in mind, providing a well-structured set of APIs and configurable functionality.
With fully packaged solutions, the primary advantage is solution readiness. A vendor or implementation partner who has a solution built to address similar problems will enhance or customize the solution to address your needs then oversee the maintenance. They are essentially owning the customization and taking full responsibility for the system. This structure combines elements of the two aforementioned verticals, so it can be slightly more costly than a straight SaaS model, as it involves both platform and implementation costs.
Customization Vs. Off-The-Shelf
Healthcare is facing an unprecedented level of regulatory burden and on top of it, each domain has its specific regulations and expectations to comply with. Traditionally, customized solutions have been alluring to healthcare IT leaders because of their ability to ensure compliance, maintain high-quality care and adhere to security standards of protected health information (PHI), and electronic-protected health information (e-PHI). But, as many have realized, these systems can put organizations at risk over the long term.
This is primarily because most healthcare systems are dependent on other systems to not only carry out certain tasks and functions but more importantly, in the exchange, interpretation and use of data. When customized systems are built specific to department needs, integration can become very challenging, especially considering the speed at which technology advances, systems can become obsolete quickly. As the healthcare industry strives toward semantic interoperability, flexible systems will be essential.
Customized solutions, like the full-stack model, also tend to be more costly, take longer to develop and implement, require additional technical expertise and significant reskilling of users, and increase the dependence on the original developers to make updates.
At the other end of the spectrum, out-of-the-box or off-the-shelf solutions, while generally quicker to set up, they are expensive and don’t always fit the exact needs of your organization. And this is where a lot of the “transformation” during COVID-19 occurred simply because there wasn’t time to anticipate what was needed over the long term.
We’re at a critical point now, however, in which healthcare IT leaders will need to assess their organization’s needs over the long term to create more sustainable solutions, and many are finding that solution in hybrid models that offer the best of both the customized and out-of-the-box worlds.
Configuration In The Real World
One prime example of this is Salesforce. In March, the company gave healthcare systems responding to an emergency health crisis-free access to various Salesforce solutions. Some of the tools that were part of the COVID-19 Care Response Solution were pre-configured to be quickly stood up in these organizations, but could also be customized if the out-of-the-box configuration didn’t quite match the need.
In Mexico for instance, two hospital groups wanted to get ahead of the impending surge in COVID-19 cases that were anticipated to hit the region. Knowing hospitals would be hit hard with testing and appointment requests, they wanted to be able to mitigate this by giving patients a way to self assess and help them make decisions about whether and where to seek care.
Working from the pre-configured structure as a foundation, they were able to build an interactive, patient-facing portal and back-end solution to help streamline and improve public health and safety. In this case, the configurable solution worked because the platform they chose had a proven track record in the healthcare domain. But that is not always the case.
Choosing The Right Hybrid Solution
Configurable solutions, while offering the greatest flexibility, come with one important caveat: they won’t be the right fit if there isn’t some element of domain expertise. In healthcare, this is mission critical.
In choosing a hybrid configurable model, there are a few things to consider:
- Relevancy to the domain. There will always be new, leading-edge technology on the market that promises faster, more lightweight functionality, but relevancy is key. In healthcare, for instance, if the technology does not meet internal and external compliance requirements like HIPAA, it won’t be relevant.
- Time to implement. When technology is new-to-market, there may not be enough of a skilled workforce in the market to support its development, which can delay the buildout and implementation.
- Cost. If you’re operating within budget limitations, can the system be built upon and expanded within your organization over time as budget allows? How much customization will it require to fit your needs? This also will add to the cost. Find the right tech stack that will help you with the other two factors: relevancy and time.
- Integration capability. Is the technology compatible with prior customization or legacy systems already in place? If not, you may have to wait to adapt previously implemented systems before you realize the true value of the new technology.
As organizations look to maintain or build upon the digital transformation that COVID-19 initiated, it will be key to first assess long-term needs and goals, then map the technology to that. And many leaders have now realized the value of cloud-based SaaS models that offer the flexibility of configuration, particularly when agility and timely access to innovation can make or break an organization’s ability to not just survive but thrive in times of crisis.
About The Author
Suresh Reddy is the VP of Engineering at Wilco Source, an end-to-end software development company and Salesforce Silver Partner with a history of success in healthcare and life sciences. Suresh is an accomplished technologist with more than 17 years’ product engineering and R&D leadership experience.