mika torhola

Atostek Oy

How modern suppliers add value in healthcare systems?

22.9.2015

Mika Torhola

Atostek Oy

2Atostek Aatos - Tueksi hankintoihin30.9.2015

• Founded 1999

• 43 employees

• Turnover 3,5 M€ (2014)

• Location: Tampere

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Definition of modern?Is modern by default something to strive for?

• “involving recent techniques, methods, or ideas”

• “of or relating to present and recent time; not ancient or remote”

• “characteristic of present and recent time; contemporary; not antiquated or obsolete”

• “of or relating to the historical period following the Middle Ages”

• “new”


Nudity! Perspective!

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Characteristics of modernity [in health IT]?

• Closed system vs. data interchange

• Proprietary vs. open source

– Subcategory A: Using Open Source components

– Subcategory B: Producing Open Source SW

• Monolithic vs. modular

• Local installations vs. shared installation

• Business model: Proprietary licensing vs. “pure open source” vs. “hybrid”


Do the texts in bold add value?

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Closed Systems vs Data Interchange?


Old schoolNothing

new here, either

XDS (Cross Enterprise Document Sharing)

CDA R2 (Clinical Document Architecture)

Hype

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Proprietary vs Open Source?Some aspects of added value:


Security

Try before you buy

Freedom

Auditability Support options

Quality

Flexibility

Cost

Interoperability

Customizability

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Some Existing Open Source Health Care SW


Libraries and

toolkits

Back-end implemen-tations (eg.

XDS or DICOM-archive)

Integration Platform (IPF)

EMR/EHR implemen-

tations

DCM4CHEE(PACS)

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Producing Healthcare SW as Open Source?Completely another story.


Let’s assume a context: Health Care Software for Finnish public sector

Simple process?

Develop 1.0 for organization A

Deploy 1.0, agree on running as

service

Develop 2.0 for organization B

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Producing Healthcare SW as Open Source?


Just a few real world questions that need to be tackled:

1. Development decision-making (governance)• Who decides, what features are allowed / will be implemented to 2.0?

• Ie., who is the ”owner” of the SW• What is the decision making process?

2. Funding• Development of features?• Running SW as service for later organisations? • Procurement legislation: Yikes!

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Producing Healthcare SW as Open Source?


Existing work in public sector:

13.9.2011

Tuotteenhallintasuunnitelman tekoa pilotoitu ”Pilviväylä”-hankkeessa

We need more pilot projects!

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Monolithic system C

Monolithic vs. Modular?What does that even mean?


Monolithic system A

Monolithic system B

Monolithic system D

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Modular system C

Monolithic vs. Modular?What does that even mean?


Modular system A

Modular system B

Modular system D

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Local vs. shared installations?


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Local vs. shared installations?


Shared installation needs elaborate internal modeling of organisations, departments, users, etc.

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What should we call an integratable functional module with UI, that needs only one shared installation?


How about eHealth microservice?

”You need to have a single source of truth, but not necessarily in one place.”

“In short, the microservice architectural style is an approach to developing a single application as a suite of small services, each running in its own process and communicating with lightweight mechanisms, often an HTTP resource API. These services are built around business capabilities and independently deployable by fully automated deployment machinery. There is a bare minimum of centralized management of these services, which may be written in different programming languages and use different data storage technologies.”

-- Martin Fowler

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Business model?


Proprietary business model

”Standard” Open source

business model

Hybrid business model

Sell support and maintenance subscriptions for OS product

Sell licenses and maintenance for closed product

Run and sell a SaaS service, which is based on OS platform, but has proprietary added value components. Contribute strongly back to OS.

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So, archetype of a modern healthcare IT system / provider, [that adds value]?


XDS.b

Hybrid businessmodel

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Atostek’s endeavor:


eRA• ePrescription SaaS microservice• KanTa-EHR SaaS microservice• Not a full archetype of modernity, but satisfies some aspects of it

30.9.2015

Thank You!

Mika Torhola+358 50 412 3453

[email protected]

mailto:[email protected]

mika torhola

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