athenahealth News & Views | Cloud Services | Ideas & Research | Practice Management
Welcome to the Cloud Clan
I’m watching ads during the ballgame (I watched the kick-off and the ads—the rest, not so much) and who should be declaring itself a “cloud solution” but Microsoft?!
See the ads here and here, in case you don’t own a TV or computer or newspaper.
OK, I’ve gotta admit my gut reaction was: Microsoft in the cloud? Seriously? But my next thought was…YES! FINALLY! I’m watching evolution unfold before my very eyes, and it’s oh so comforting to see others walking upright on two feet, using modern tools, and cooking their food.
What am I talking about? Well, let me explain. Gather round kids for a quick tour of the museum of ancient computing history. There will be time for a bathroom break later.
Here in the lobby is a giant diorama like you see in other ancient history museums. (For a larger version, click here.)
In the lower left corner, on four legs and covered with hair, is the software product (Latin, Rebootus-maximus). The Latin root designates high up-front costs and a low relationship between the maker of software and the benefits received by the user. Also, since maker and user sit on different instances of the application and can’t see what the other is doing, the only way this species ever evolves is through primitive gatherings called “user groups.” Here cave drawings are put on flip charts by pained customers and users thump their chests in desperate efforts to get future generations of software to improve.
Then, draggin’ the occasional knuckle but proudly waving a stick that he has learned to use as a weapon, is the ASP (Latin, Rebootus-less, Payus morem). Here, the Latin indicates higher overlap between buyer and seller and lower up-front costs. This is because the seller BUYS the software and the hardware for the users and rents the whole finished thing as a package. Ongoing costs are much higher, and, as before, the maker of the software and the user can’t see what each other is doing and have no shared responsibility for business outcomes. The ancient user group antics and chest thumping continue in this era, with a little less body hair.
Moving up and to the right from there, proudly wearing a helmet and a (smallish) chainmail skirt…and looking surprisingly like Marc Benioff…is the SaaS company! This is the first true use of cloud-computing. Here, the maker of the software maintains a single instance of software on the web. It is fully hosted in a web-native setting, and there is no cost for it. Ongoing costs for the users decline compared to the Payus morem species, but, most importantly, innovation happens at a massively higher pace with Payus servicum. The reason for this is that software maker and ALL software users are on the same instance of the same application. The programmers watch users suffer through bad reporting models or clunky workflows. The web-logs from these weaker members of the species flow through to the hive and are killed off quickly. Also, the idea of an “interface” becomes effortless. Meanwhile, species of applications can intermingle and cross-mate in a new tribal ritual called the Appus storem. The resultant functionality and reporting still has the data integrity of the original species, and the pace of innovation spikes as many tribes are unconsciously moving along the same path in different ways. While one or another version may be unsuccessful, it is easy for it to die without harming the tribe.
Finally, in the upper right corner, wearing a stylish sweater and looking like a more dashing and fully upright version of, let’s say…Jeff Bezos…is the cloud-based service (Latin: Payus resultum). Here the idea of the shared application in the cloud gets taken to another level. Now, other terrestrial things enter the cloud, like knowledge and work. The ongoing cost of the software has receded almost completely from view. Here the vendor sells only outcomes. The software sits in the cloud as a common “store” that customers enter to get their goods. For athenahealth, these goods are electronic medical records, medical billing services, and a patient portal. We’re responsible for keeping the fires burning with cloud-based computing and security and we also take on the hunter-gatherer work of processing documents, posting claims, tracking down payments, etc. We continuously inject knowledge into the cloud, tracking and updating payer and clinical rules, formulary requirements, and P4P program incentives for everyone at once.
That’s my tour folks. So now, I hope, you know what athena means when we talk about this newfangled thing called “the cloud.” And that’s where health care is heading—or being dragged kicking, screaming, and knuckle-dragging.
Welcome to the clan, Microsoft!
Loved the diorama of the evolution of the cloud. I was refreshed to see that someone has finally gotten IT. Your applications mean nothing if they are not helping you get the accounts receivable due or the patients are not getting the outcomes they expect from the practice. Loved the use of humor to squarely punch in the eyes the reality of the business of health care.
I am anxiously awaiting for Athena to evolve to a level that allows access to it’s applications using any compliant web browser such as mozilla, safari, opera, etc. If Paypal can be accessed through these other (non-Microsoft) browsers then you really can not use “security” as an excuse.
I wholeheartedly agree with Dr. Gershon. We’ve been on Athena since 1/07 and are still waiting for the “cloud” to include being able to use a Mac. There is more to the “cloud” than Microsoft.
First, thank you for reading our blog and taking the time to comment.
For the patient-facing side of athenaNet, the athenaCommunicator patient portal, we support multiple Web browsers the same way that PayPal does. But, for the hundreds of screens used by providers and staff in athenaCollector and athenaClinicals, we only support Internet Explorer at this time.
We certainly understand the interest in having athenaNet support browsers beyond Internet Explorer and we’ve spent a lot of time discussing the possibilities of supporting this with our technical leadership. Unfortunately, the initial effort to support multiple browsers is significant and would come at the expense of functional and productivity improvements that our clients have prioritized. Also, there would be an ongoing cost of testing each monthly release of athenaNet with additional browsers. This ongoing support would require us to allocate additional testing resources and would have to come at the expense of other ongoing product improvements.
There are a small number of practices that are accessing athenaNet from iPads and MacBooks by using third party solutions such as Citrix. While these are not fully supported by athenahealth, and sometimes offer decreased application response time and performance, they nonetheless work for many use cases. We continue to follow the market rates of browser adoption and will continue to ask our client base if they would be willing to give up the introduction of some new features for the support of additional browsers.
While there would be expense and perhaps a slowing of new features or releases of the current athenahealth products, I consider this to be part of the cost of doing business. If a company wants to remain competitive in the marketplace, they need to offer the consumer what the consumer wants or suffer the loss of the consumer’s business. Giving the consumer the choice and flexibility of hardware and browsers would only be a positive for athenahealth and will ensure that athenahealth remains a leader in health IT.
Stay on top of the curve, grasp a larger market share, and increase physician productivity with your cloud services! Although the recent partnership with Microsoft may help develop some new enhancements to the athenaNet interfaces – I don’t believe it can go far enough!? I think it would be beneficial to provide athenaNet on more platforms natively than just IE for Windows platforms! Give providers more flexibility and extend the benefits of the cloud to the devices that were designed for cloud computing – such as tablets like the iPad and Android. And now, seriously, what could be more attractive than the athena health Logo on a well designed app for the iPad. I’m keeping my fingers crossed for the day!
[...] best systems—whether on a cloud (private or public), or client-server platform – observe basic information security practices. [...]
A “cloud” play that is tied to one system, or worse yet, one browser on one system, is more hot air then cloud. My practices want tablets for meaningful use, and windows based offerings are pathetic – strictly speaking, there is not a single one out there that meets Athena’s battery life requirements.
Athena needs to get on the ball *now* with either a standards based platform, or at least an iOS or Android client, or practices like ours will have to look elsewhere for meaningful use of emr.
It is really a shame that Athenahealth has not adapted into other browser platforms like Firefox, Chrome and Safari. We would like to start usin the IPAD for our practice and just learned that Athena does not support IPAD. This is a shame as there are several other products out there that would allow this use. So hoping that Athena steps up to the plate and does not allow Microsoft to be the monopoly is already is.
As an Athenahealth client for 4 years, I am now looking at other solutions. I have requested countless times support for multiple platforms. To claim (Mr. Grossman) that “the initial effort to support multiple browsers is significant and would come at the expense of functional and productivity improvements” disagrees with every other web developer on the planet. I can only hope that Athenahealth is procuring HUGE development dollars from Microsoft to maintain their exclusivity. It’s insulting to those of us that know a bit about web programming that the cost is enormous. I have personally directed multiple offices to Athenahealth and will now avoid recommending them as they refuse (despite YEARS of requests) to support open standards. Welcome to the Cloud? Indeed, Mr. Bush, let us know when you might want to join the rest of us in the cloud!