business consulting services © copyright ibm corporation 2002 global healthcare trends presentation...

Business Consulting Services

© Copyright IBM Corporation 2002

Global Healthcare TrendsPresentation to IBM Public Sector Leadership Forum

Friday, February 7, 2003

Presenter: Neil Stuart, IBM BCS Canada

2



Overview of Presentation

Purpose of presentation: to provoke thinking about the future needs of our clients/customers and opportunities for IBM

The big trends Some potential surprises Implications for our customers/clients Developments in the market Opportunities for IBM

3



Thought Leadership – Lots Done, More to Come

Futures analysis - PricewaterhouseCoopers’ HealthCast 2010, and HealthCast Tactics- E-Health Transformation – PWC Europe- IBM’s Healthcare 2012

More in the works- Multi-client study on payor operations/performance in U.S.- Canadian POV – Health on demand

4



The Big Trends

More demanding, better informed consumers Genomics E-world Demographic change Financial sustainability of healthcare coverage Human resources concerns Evidence based-practice Patient safety

5



Consumers will be a Continuing Story

Consumers are and will be transformed by- New attitudes – demanding and aging boomers, paying for a bigger part of their care- New expectations – a voice, choice, personalized care, partnerships with providers- New tools – report cards, patient charters, personal electronic health records- The Internet - information, new knowledge, much greater health literacy and new

models of accessing services- Genetic foresight – knowledge of their own genetic futures

Demand driven healthcare Consumer-inclusive solutions Health organizations that do not get it will fall behind

6



Genomics, a Sleeping Giant

Accessible genetic testing- Individual awareness of our genetic futures- Longer disease life cycles and greater demand/costs- Demand for new kinds of preemptive services

Gene specific, designer drugs- Much more effective drug therapy- Huge cost escalation

Consumers anxious about their genetic futures Greatly increased clinical precision and clinical complexity Much greater density of clinical information Costs pressures

7



E-world - Larger Markets, Extended reach for Healthcare

E-delivery of services- Remote diagnostics, specialist consultations, even remote surgery!- Remote monitoring of chronic conditions- Teletriage- E-mail primary care consults- Information, appointments, test results, prescriptions, referrals

Electronic health records E-markets and e-purchasing

Increasing the reach of providers Globalization and blurring of old health jurisdictions Patient access to EHRs giving consumers one more lever to increase control Scale challenges for suppliers

8



The Sustainability Question

Multiple pressures on the the cost and affordability of healthcare- Demanding consumers- Demographics – aging population- Expensive drugs that work even better- Costs of new technologies - IT, Dx, Rx- Costs of updating old infrastructure/facilities

Healthcare consuming ever larger part of government spend – ‘the healthcare monster’

Opportunities for new players and the private sector Increasing health inequities Focusing resources on interventions that produce outcomes Pressures in the U.S. for a national health plan

9



The “Healthcare Monster” – a headache for governments and payors that will not go away

“The rising cost of healthcare has brought on a fiscal crisis in many (U.S.) states. Their combined budget deficit is estimated to worsen to $60 - $85B in 2004, which is equivalent to 13 – 18% of their total expenditure.”

-- Kaiser Family Foundation, January 2003

10



Potential Surprises

Prolonged war in the Middle East leading to an economic downturn- Taking money from health budgets, particularly capital budgets

Massive bio-terrorism offensive against major ‘Western’ cities- Diversion of health resources

Globalization of infectious disease continues – West Nile, Mad Cow, etc.- Global health surveillance and collaboration

Increasing numbers/prevalence of drug resistant disease strains- Return of long inpatient stays, isolation care

Sooner than expected breakthroughs on gene therapy- New ball game

Surprises always reveal new needs/gaps (think of HIV, anthrax) Look ahead, spot the customer need, respond smartly and quickly

11



Four BIG PICTURE business directions for our customers/clients

1. Managing demand for services

2. Measuring, managing and paying for performance

3. Providing ready access to health information

4. Making health care organizations employers of choice

12




Consumerism is changing the way clinical/service decisions are made – decisions no longer just with providers

Concerns about sustainability and overwhelming growth in demand

Strategies to manage demand and channel consumerism- Partnerships with patients/users- Matching providers and patients and team based care- Informing and educating patients- Tools for self-monitoring, self-care, self-service- Devices that offer/require choice, e.g. defined contribution plans, MSAs- Taking advantage of of opportunities for e-service- Disease management – focusing on chronic diseases (cancer, diabetes,

asthma, cardiac, etc)

13



FUTURETODAY

For U.S. health plans, the need to address costs and consumer demands will fundamentally alter their role

Employer-driven Insulated consumer Defined benefit/limited choices No decision making tools Full service health plans Antiquated business infrastructure

Member-driven, with member more financially accountable

Movement toward defined contribution Emergence of assisted decision making More specialized health plan focus Flexible technology infrastructure Emergence of non-traditional competitors

Banks/ Financial

Institutions

Health Advisor/BrokerHealth Advisor/Broker

EmployeeEmployee$

TPATPA

Network

Network

Care MgmtCare MgmtOtherOther

Insurance

Insurance

EmployerEmployer

EmployeeEmployee

Health Plan BHealth Plan B

Health Plan CHealth Plan C

Health Plan AHealth Plan A

Benefits Consultant/BrokerBenefits Consultant/Broker

$

EmployerEmployer

Health BenefitPackage

The Pain Transplant

14




Some relevant IBM offerings- CRM- Payor systems, including outsourced services (Empire-Blue Cross-U.S.)- Consumer surveys (HealthInsider-Canada)

15




To date there has been little financial reward for quality and service excellence Escalating costs and concerns about sustainability highlight the importance of

focusing resources for maximum impact Research on preventable errors is underlining concern re patient safety

Some actions that will shift more attention to performance include:- Developing and implementing patient safety and quality indicators- Measuring and rewarding for patient satisfaction- Giving quality incentives to service providers- Informing stakeholders on what works and what is excellent- Transparent resource allocation- Payor concerns with efficiencies- Paying attention to system performance too

16




Some relevant IBM offerings- Data warehousing- Many BCS assignments on report cards (Canadian Institute for Health Information)- Program evaluation- Consumer surveys – e.g. IBM HealthInsider- Addressing payor performance

17



3. Providing ready access to information

Access to health information to support the patient care process is slow and fragmented

Inadequate access to information has been an impediment to evidence-based practices and linked to patient safety issues

Strategies to support ready access to useful information include:- Point-of-care computing - Ensuring privacy and security- Setting realistic timetables- Developing open, flexible architectures- Investing in data warehouses and performance monitoring metrics- Providing ongoing training- Patient access to and even control over their EMR- Consumer access to system/provider performance information

18



3. Providing ready access to information

IBM’s offerings- HIPAA work in U.S.- Vendor alliances e.g. Cerner- Healthcare integration e.g. Alberta we//net

19




Health care organization used to be a prized place to work - - security, helping people, status

New entrants to the job market are looking for other features to their work - - flexibility, team-based, learning/development opportunities, state-of-the-art technology

Some strategies to make health care organizations a work place of choice- Flatter organizations – pushing decision making down the hierarchy- Career options/development/training- Team environments- B2E/employee portals- Flexible pay and benefits- Linking employee and patient satisfaction- Above all, respect for employees

20




IBM’s offerings- BCS’s Human Capital Solutions, including Learning Solutions- Examples of assignments completed (hospitals as employers of choice, HR

retention)- B2E portals

21



Some nearer-term market trends

Consumer driven health plans Wireless/mobile solutions (mainly from established vendors) get traction Growing use of web in healthcare supply chain Convergence of electronic physician order entry and e-procurement Outsourcing takes off – offered by vendors – an answer for customers’ lack of

capital Healthcare spending on outside IT services surpassing internal IT spend Healthcare IT spend will have to a show strong business case IT will be seen more as answer for human resource shortages

22



IT Opportunities for IBM*

Consumerism and demand management drive CRM- CRM opportunity will grow 25% from 2003 to 2006

E-world drives SCM opportunity, e-markets and e-procurement- 20% plus growth rates projected in SCM and e-markets for IBM

Services are the biggest IT opportunity- Services are the largest and generally fastest growing segment of opportunity by

geography and solution market

* Source of projections: IBM Market Intelligence – Sales & Distribution

23



IT Opportunities for IBM (more…..)

Mobile computing- Implementation – application vendor alliances- Security issues- Hardware – product to compete with Compaq/HP, Microsoft, Palm?

Outsourcing- Payer systems, claims management, back office, PC/network support

Privacy and security- US market being driven by HIPAA, parallel interest in other jurisdictions

Healthcare integration- E-business integration, portals, B2E, B2B, B2C

Business on Demand, Information on Demand, Healthcare on Demand

24



Questions and Discussion

25



Healthcare Solutions by Geo and Solution: CRM and ERP are Largest Opportunities

$2,137

$635

$301

$2,220

$1,485

CRME-markets

e-ProcurementERP

SCM$0

$500

$1,000

$1,500

$2,000

$2,500

Mill

ions

of d

olla

rs

Healthcare WW Solutions Oppty2003 -- Large Enterprises (1000+)

Source: 2H02 Solution Market View

26



Healthcare Solutions by Geo and Solution: CRM and ERP are Largest Opportunities

Americas

$5,217

77.0%

EMEA

$1,299

19.2%

AP

$262

3.9%

Millions of dollars

Healthcare WW Total Sols Oppty by Geo2003 -- Large Enterprises (1000+)


27



Total WW Healthcare Sols Opportunity 2003 (Large Enterprises) $6.8B

$1,717

$525

$242

$1,829

$904

CRME-markets

e-ProcurementERP

SCM$0

$500

$1,000

$1,500

$2,000

Mill

ions

of d

olla

rs

Healthcare Americas Solutions Oppty2003 -- Large Enterprises (1000+)


28




$390

$59 $40

$354

$456

CRME-markets

e-ProcurementERP

SCM$0

$100

$200

$300

$400

$500

Mill

ions o

f dolla

rs

Healthcare EMEA Solutions Oppty2003 -- Large Enterprises (1000+)


29




$30

$51

$19$37

$125

CRME-markets

e-ProcurementERP

SCM$0

$50

$100

$150

Mill

ions o

f dolla

rs

Healthcare AP Solutions Oppty2003 -- Large Enterprises (1000+)


30



CRM Has Highest Growth Rates in Geos, While ERP Has Lowest Growth

Solutions 2002$M

2003$M

02-03 %Change

2004$M

2005$M

2006$M

03-06 CAGR %

CRM 1,369 1,717 25.5% 2,226 2,749 3,280 24.1%e-Markets 435 525 20.1% 670 779 991 23.6%

E-Procurement 203 242 19.2% 292 341 400 18.2%

ERP 1,748 1,829 4.6% 1,841 1,772 1,892 1.1%SCM 770 904 17.4% 1,081 1,292 1,572 20.2%

Total 4,525 5,217 15.3% 6,110 6,933 8,135 16.0%

Americas Healthcare Solutions Growth Rates (Large Enterprises) Source: 2H02 SMV

31




Solutions 2002$M

2003$M

02-03 %Change

2004$M

2005$M

2006$M

03-06 CAGR %

CRM 346 390 12.7% 514 600 735 23.5%e-Markets 45 59 31.1% 73 86 106 21.6%

E-Procurement 33 40 21.2% 46 53 60 14.5%

ERP 316 354 12.0% 342 354 372 1.7%SCM 381 456 19.7% 540 652 789 20.1%

Total 1,121 1,299 15.9% 1,515 1,745 2,062 16.7%

EMEA Healthcare Solutions Growth Rates (Large Enterprises) Source: 2H02 SMV

32




Solutions 2002$M

2003$M

02-03 %Change

2004$M

2005$M

2006$M

03-06 CAGR %

CRM 22 30 36.4% 39 49 60 26.0%e-Markets 40 51 27.5% 63 80 97 23.9%

E-Procurement 17 19 11.8% 22 28 31 17.7%

ERP 31 37 19.4% 45 54 62 18.8%SCM 96 125 30.2% 158 190 223 21.3%

Total 206 262 27.2% 327 401 473 21.8%

AP Healthcare Solutions Growth Rates (Large Enterprises) Source: 2H02 SMV

33



Services is Largest Solutions Opportunity in Americas for CRM, ERP and SCM

App SW$291

17.0%

Bus Consult$171

10.0%

Clients$52

3.0%

IT Consulting$59

3.4%

Other Svcs$673

39.3%

Servers$55

3.2%

SI$351

20.5%

Technology$34

2.0%

2003 Americas CRM Oppty By P/SHealthcare -- Large Enter. ($ Millions)

Source: 2H02 SMV

34




App SW$137

15.2%

Bus Consult$82

9.1%

Clients$6

0.7%

IT Consulting$46

5.1%

MW$28

3.1%

Servers$33

3.7%

SI$364

40.5%

Technology$34

3.8%

2003 Americas SCM Oppty By P/SHealthcare -- Large Enter. ($ Millions)

Source: 2H02 SMV

35




App SW$330

18.1%

Bus Consult$1327.2%

Clients$41

2.2%

IT Consulting$1618.8%

MW$71

3.9%

Other Svcs$662

36.3%

Servers$80

4.4%

SI$311

17.0%

Technology$37

2.0%

2003 Americas ERP Oppty By P/SHealthcare -- Large Enter. ($ Millions)

Source: 2H02 SMV

36




Services (SI, IT Consulting, Bus. Consulting, Other Services) total 73.2% of Americas CRM oppty, 69.3% of ERP oppty, and 73.5% of SCM oppty

HW (Servers, Clients, Technology) is a relatively small portion of Americas solutions oppty (8.2% for CRM, 16.8% for ERP, 8.2% for SCM)

CRM, ERP and SCM Apps SW are relatively small portions of total Americas solutions oppty (15.2% to 18.1%), but will drag many Services purchases

SI is the largest segment of Americas SCM oppty (40.5%), more than double the percentage for CRM and ERP

37



Services is Top Opportunity for CRM, ERP, SCM in EMEA

App SW$51

13.1%

Bus Consult$27

7.0%

Clients$33

8.5%

IT Consulting$7

1.8%

MW$4

1.0%

Other Svcs$150

38.7%

Servers$14

3.6%

SI$94

24.2%

Technology$8

2.1%

2003 EMEA CRM Oppty By P/SHealthcare -- Large Enter. ($ Millions)

Source: 2H02 SMV

Total 2003 CRM oppty: $390M

38




App SW$74

21.0%

Bus Consult$32

9.1%

Clients$21

6.0%

IT Consulting$14

4.0%

Other Svcs$106

30.1%

Servers$24

6.8%

SI$57

16.2%

Technology$10

2.8%

2003 EMEA ERP Oppty By P/SHealthcare -- Large Enter. ($ Millions)

Source: 2H02 SMV

Total 2003 ERP oppty: $354M

39




App SW$40

8.8%

6.0%

Clients$3

0.7%

IT Consulting$14

3.1%

MW$8

1.8%

Other Svcs$105

23.2%

Servers$13

2.9%

SI$230

50.9%

Technology$12

2.7%

2003 EMEA SCM Oppty by P/S

Total 2003 SCM oppty: $456M

40




Services (Bus. Consulting, IT Consulting, Other Services, SI) is largest part of all 3 EMEA solutions opportunities: 72% of CRM, 59% of ERP, 83% of SCM

HW is a small part of CRM, ERP, and SCM opportunities in EMEA: 14% of CRM, 16% of ERP, 6% of SCM

SI is much larger part of EMEA SCM oppty (50.9%) than for CRM (24.2%) and ERP (16.2%)

Application SW is a relatively small part of EMEA solutions opportunities (13.1% of CRM, 21% of ERP, 8.8% of SCM), but drags through many services dollars

41



Services is Top Opportunity for CRM, ERP, SCM in AP

App SW$3

10.4%

Bus Consult$5

17.4%

Clients$2

6.9%

IT Consulting$1

3.5%

MW

Other Svcs$7

24.3%

Servers$1

3.5%

SI$9

31.3%

Technology$1

1.7%

2003 AP CRM Oppty By P/SHealthcare -- Large Enter. ($ Millions)

Source: 2H02 SMV

Total 2003 CRM oppty: $30M

42




App SW$7

18.9%

Bus Consult$2

5.4%

Clients$2

5.4%

IT Consulting$1

2.7%

MW$2

Other Svcs$9

24.3%

Servers$2

5.4%

SI$11

29.7%

Technology$1

2.7%

2003 AP ERP Oppty By P/SHealthcare -- Large Enter. ($ Millions)

Source: 2H02 SMV

Total 2003 ERP oppty: $37M

43




App SW$17

13.6%

Bus Consult$11

8.8%

Clients$3

2.4%

IT Consulting$6

4.8%

MW$4

3.2%

Other Svcs

Servers$12

9.6%

SI$46

36.8%

Technology$10

8.0%

2003 AP SCM Oppty by P/S

Total 2003 SCM oppty: $125M

Healthcare -- Large Enter. ($ Millions) Source: 2H02 SMV

44




SCM is largest solutions oppty in AP ($125M in 03), and SI is largest single segment of the AP SCM oppty (36.8%)

Services (Bus. Consulting, IT Consulting, Other Services, SI) are largest oppty for solutions in AP: 76.5% of CRM, 62.1% of ERP, 63.2% of SCM)

HW (Clients, Servers, Technology) is relatively small segment of AP solutions oppty: 12.1% of CRM, 13.5% of ERP, 20% of SCM

Applications SW is relatively small part of AP solutions oppty (10.4% of CRM, 18.9% of ERP, and 13.6% of SCM), but drags other IT dollars

45



Solutions Definitions: Customer Relationship Management (CRM)

Customer Business Goal: - Increase customer loyalty- Increase profitability- Increase productivity- Gain competitive edge through access in new sales, service and marketing channels

Business problems/functions addressed: Improve the analysis and understanding of the customer preference & purchasing behavior across the CRM value chain including the marketing, sales and service functions aimed at providing direct personalized customer sales, service and marketing activities through multiple channels or "touchpoints"

High level definition: CRM encompasses the business processes an enterprise performs to identify , select , acquire , develop and retain its customers through multiple communication channels.

I/T functions involved: * Focused Definition: Sales Force Automation, Customer Service & Support (including eService and

contact center), Marketing automation (including analytical and content mgmt capabilities), Voice Interaction, Text Interaction and Multimedia Interaction

Exclusions: *Generic business intelligence *Telephony based hardware *Billing and payments *ATMs and ATM networks, * Reservation and ticketing systems *Internal help desks * Store operations

Inclusions: * Market information retrieval * Sales transaction initiation Examples in products and players: Siebel, PeopleSoft, Oracle, SAP, Onyx, Pivotal, Nortel, Avaya,

Accenture, PWC, CGE&G, Deloitte, KPMG, eLoyalty etc.

46



Supply Chain Management (SCM) Customer Business Goal: The Supply Chain Management solutions allow customers to improve responsiveness, lower

cost, reduce cycle time by optimizing internal logistics and by linking suppliers and trading partners to deliver the right products at the right time and price to the right place.

Business problems/functions addressed: Sourcing, distribution, warehousing and transportation, Production logistics, Customer order fulfillment and services, Forecast and demand planning

High level definition: A. Focused definition -- Linking two or more I/T applications and functions supporting the supply and production of goods.

B. General definition -- I/T applications and functions supporting the supply and production of goods. I/T functions involved: A. Supply Chain Planning: 1) Forecast and Demand Planning, 2) Distribution and Warehouse Planning, 3) Manufacturing Planning, 4)

Transportation Planning, 5) Advanced Scheduling, 6) Order Promising, 7) Data IntegrationB. Supply Chain Execution: 1) Order Management, 2) Order Promising, 3) Inventory Management, 4) International Trade Logistics, 5)

Transportation Management, 6) Warehouse ManagementExclusions: Shop floor operations, Retail store operations, Retail electronic media distribution, Retail electronic order Inclusions: Supply Chain Automation (SCA), Electronic internal distribution, Content of Utilities (phone, water, electricity)

Examples in products and competitors: A. ERP Vendors: SAP (Scope), Baan, Oracle, PeopleSoft

B. Supply Chain Planning Vendors: i2, Manugistics, ILOG SA, Logility, AdexaC. Supply Chain Execution Vendors: IBS, EXE Technologies, IMI, Manhattan Associates, McHugh Software InternationalD. Processware Vendors: CrossRoute, CrossWorlds.E. Consulting and System Integrators: Andersen Consulting, Arthur Andersen, E&Y

47



Definition: B2B-eProcurement Customer Business Goal: B2B eProcurement enables ·buy-side, sell-side, and content management solutions

allowing an entity to obtain information, create a request that can be routed for approval, issue a purchase order to a supplier, and fulfill the request with a receipt, receive notification of delivery or order status, together with electronic means to settle the payment. In addition eProcurement allows automation of the process of connecting to business buyers, and·the automation of the presentation layers of B2B sites, especially for displaying commerce-oriented information.

Business problems/functions addressed: Sourcing, distribution, warehousing and transportation, Production logistics, Customer order fulfillment and services, Forecast and demand planning

High level definition: eProcurement is the element of B2B functions that handles policy control, business workflow and rule

compliance, B2B content management, and catalog conversion in buy-side and sell-side electronic purchases between businesses, their suppliers, and customers over the Internet.

I/T functions involved: - Policy control, - Business workflow and rule compliance, - B2B content management, - Catalogue conversion in buy-side and sell-side electronic purchases between businesses and their suppliers over the Internet

Exclusions: Inclusions: Examples in products and competitors:

- Ariba, Commerce One, Oracle, i2, Broadvision, SAP, Vignette, MRO Software, PurchasePro, WebMethods

48



B2B - eMarkets

Customer Business Goal: B2B are the business process solutions that enterprises use to identify, select, acquire, develop, interact, and retain its business customers through multiple communication channels. These business process solutions can be further defined by the solution areas, Supply Chain Management (SCM), e-Procurement, Partner Relationship Management, and Business Intelligence (BI), etc. These solutions can be implemented as inter-enterprise solutions, or as a part of a broader e-Marketplace in either Private or Public forms, allowing for one-to-one, one-to-many or many-to-many connections.

Business problems/functions addressed: Solutions that allow the creation of Web-based eMarketplaces, public and private, allowing for one-to-one, one-to-many, or many-to-many connections..

High level definition: B2B eMarketplace solutions automate the creation of Web-based trading communities, public and private through specific attributes

such as registration and authentication, auction, reverse auction, request for proposal (RFP) and request for quotation (RFQ) posting, dynamic matching of buyers and sellers, strategic sourcing, supplier selection, contract negotiation, compliance and management, demand planning and aggregation, and integration into legacy environments.

I/T functions involved: Sourcing & Procurement, Logistics, Finance & Accounting, Integration & Security, eHR Exclusions: Electronic data interchange (EDI) services, Inclusions:

Examples in products and competitors: eMarketplaces: Commerce One, Ariba, i2, Oracle, SAP, Broadvision, PurchasePro, WebMethods, Websphere commerce suite

Marketplace; eMarketplace Services: IGS, PriceWaterhouseCoopers, Accenture, Cap Gemini Ernst & Young, CSC, Deloitte, KPMG, EDS, Oracle, C1; Collaboration: Agile Software, Exterprise (purchased by C1), PTC, MatrixOne, Tecnomatix Technologies, SDRC, Alventive, E3 Corp. and Agilera.

49



Core ERP Solution Definition

Customer Business Goal: Management of business processes to lower cost and improve operational efficiency Business problems/functions addressed: Human resource, accounting, finance, manufacturing, logistics,

procurement, customer service, internal manufacturing and logistics management, Business Intelligence, and e-Commerce

High level definition: An integrated set of applications that automates finance and human resources departments as well as handles jobs such as order processing, financial operations, corporate services, manufacturing and logistics management organized by industry verticals.

I/T functions involved: Core ERP Financial Operations (Financing, Customer Payment, and Settlement (AR), Collaborative Financial Processing, Vendor Invoice

Verification and Processing (AP),Bank processes and Relationship Management, Allocation of Shared Services), Accounting(Financial statements, General Ledger and Subledger, Revenue and Cost Accounting, Job and Product Accounting, Product and Service Costing ), Corporate Services (Real estate management, Travel management (TEAs), Treasury and finance management ) Human Resource Management (HR Strategy and Planning, Recruitment, Payroll, Compensation and Total Benefits, Employee Development ), Manufacturing and Logistics (Production planning, materials management, inventory management, order entry and processing, warehouse mgmt, transportation mgmt, project mgmt, plant maintenance, customer service mgmt)

Exclusions: point solutions that will not be considered as a function in the ERP solution Inclusions: All software applications developed and/or sold by traditional ERP vendors. This includes Cash mgmt, payroll processing

(e.g. ADP), piece part of traditional ERP, and industry unique applications (e.g. retail banking, airline reservation), payment mgmt, and manufacturing and logistics management

Examples in products and competitors: SAP, Oracle Apps, PeopleSoft, JD Edward, Baan, SSA, JBA, Intentia, QAD, Lawson, Symix, SCT.

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