GLG News by Shawn Burgess

Implications: Typically the macro economy does not have immediate effect to the healthcare market.  As the current US economy struggles from the rising cost of fuel and burst of the housing and mortgage bubble the effect is beginning to be realized in various areas that impact the healthcare market.

Analysis: It is inevitable the rising cost of fuel has a direct hit to the cost of supplies that are staples in american hospitals; medical supplies, food, energy, etc.
These rising costs do not have an impact on patient or procedural volumes or reimbursement, but definitely operational costs which feed the capital budget.  The cascade effect of the economic recession does impact employer healthcare benefit plans and ultimately the level of care patients seek; leaving some to not seek treatment, and/or leave hospital bills unpaid (or seek charity care).

Implications: This article hits the mark on the financial aspect of EHR adoption. The other challenge is realizing the value of electronic over traditional paper in bridging the gap of the techno phobia that inhibits adoption.

Analysis: Electronic health records, albeit marketed as perhaps improving charge coding through enhanced documentation, have yet to improve productivity for physicians to see more patients.  It becomes a give and take and taking extra measures to enhance the collection and documentation of clinical data to improve the overall clinical record. 
It boils down to the design of the clinical system used to document patient care--work flow, work flow, work flow.  If the technology does not mimic and streamline the physician's workflow all the other benefits are cast aside.  The system needs to enable the physician to see just as many patients in a given day (and ideally increase patient through put) or where is the motivation.  Physician's are realistic more so that altruistic (not  to be construed as a negative)--costs to implement must have an equal or higher benefit.

Implications: Other OEMs are developing business strategy on VMWare's innovations? As a consequence the expanding competition landscape is threat to VMWare's market share?

Analysis: VMWare emerged on the IT infrastructure scene several years ago with an innovative solution to ever increasing growth on hardware and management resource demands.  Remarkably the solution performed extremely well as it was rolled into IT operations.  The ROI offered through implementing this technology paradigm shift is nothing less than extraordinary.

Several of the major players in the IT infrastructure market have developed solutions mimicing VMWare's innovation.  Citrix for example is making strides in capturing the virtualization market by leveraging their already successful framework by folding in the virtualization strategy and further strengthening their brand.

Implications: Storage demands continue to growth in the wake of digital growth and evolution. Digital storage management requires a prudent approach to life-cycle management.

Analysis: Information is a commodity that more often than not has a shelf life that deteriorates the value with the passing of time.  Although digital storage enables the capture and storage of vast amounts of data--it does come at a cost.
For an enterprise to effectively manage what is required and expected to be stored an life-cycle management policy must be developed.  It is unreasonable to continue to store infinitely grow capacity for data that his minimal and degraded value.  It makes little sense to storage data at a cost of $64 a megabyte if the value to the enterprize is less than $63 a megabyte.  Application developers and OEM storage vendors need to development tools and methods to purge data that is beyond regulatory constraints and value to an enterprise's operational and strategic value. 
For example a phone book, or road map from 10 years ago has very little, other than esoteric value.

Implications: Apple's effort to limit and restrict iPhone users to subscribe solely to AT&T's wireless phone service backfires.

Analysis: Consumers do not like to have restrictions placed in a free market society; ultimately finding ways to unravel and release the strong hold forced upon them.  The staggering numbers of un-accounted AT&T subscribers demonstrate consumers efforts to release the bounds Apple tried to put upon users of the iPhone.

Implications: Advancing technologies and system design have made it possible to significant improve hospital patient safety and improve clinical outcomes. Technologies can enforce safeguards in a nurse's workflow to administer medications.  The technology forces checks and validates the right drug, right dose, right patient, right time, right route, right reason and correct documentation.  Additionally, advanced IV pump infusion technology can prohibit the incorrect infusion of drugs and prevent adverse effects and sentinel events from otherwise occurring.

Analysis:  Introducing technology and controls in clinical workflow can provide significant safety gates in medication administration.  The annual cost of drug-related morbidity and mortality is nearly $177 billion in the United States. Approximately 7,000 deaths occur each year and medication errors occur in just about 1 of every 5 doses given in hospitals. The FDA states that there is at least one death per day and 1.3 million people are injured each year due to medication errors. (http://www.universityhealthsystem.com/carelink/docs/Prescription-2005-07.pdf)The statistics are alarming despite approved clinical protocols to prevent such mistakes.  The Federal government mandates use of bar codes on all prescription medication... Technology solutions are available that take advantage of this mandate by forcing checks at the point of administration to the patient.  As stated above these systems force checks and validates the right drug, right dose, right patient, right time, right route, right reason and correct documentation.

Implications: IP addressing is dynamic and simply a the primary means of assigning a networking session identification for routing communication traffic from a unique networked device.  EU ruling could be interpreted to have future implications of individually assigned IP addresses.

Analysis: From a technical perspective IP addressing is a dynamic means of managing network traffic--not for individual user identification.  Network login aka password/ID combinations is the method used for individual identification in a network environment. 
IP addressing is essential in tracking cyber crime the the field of computer forensics but there has to be a definitive link back to an individual in order to confirm a particular IP address (and relative traffic routing) to a specific individual. 

Implications: Technology markets are driven by demand--innovation brings it to fruition.  If not Sprint Nextel--this innovative step will be introduced to the market with a competitor.

Analysis: Indeed it appears Sprint has lost its focus in allowing a breakdown in negotiations to halt an innovative step towards delivering WiMAX standards; and henceforth a newer, robust service to a consumer driven market.
No one company owns open source standards on which technology is developed and evolves.  (One would be hard pressed to think of any company that tried to dominate a market based on proprietary technology--long term success is restrictive in this siloed vision).
Rest assured standards will be developed and delivered to the market in spite of Sprint Nextel's current inability to move forward.

Implications: VMWare has an edge in the server virtualization market when folded into Disaster Recovery and Business Continuity Plans. Able to run multiple and disparate Operating Systems on Intel based hardware platforms to include Linux, and variety Unix flavors provides and edge over other well known virtulization technologies.  Running indentical "virtualized" servers on multiple hardware platforms (that may be geographically separated) fits well into DR/BC objectives.

Analysis: When considering elements of business continuity and disaster recovery VMWare's technology provides significant advantage over Citrix and other virtulization vendor's technologies.
Real world benefit comes when virtualized servers are configured in a VMWare hardware farm.  The technology provides the safety net of enabling several identical "virtual servers" to operate on different hardware platforms.  In the event the primary hardware fails the virtualized server "fails" over to the secondary hardware without interruption to the services.

Implications: Social Engineering is an age old tool of spy's and new age hackers.  Using access credentials of authorized users is the easiest and less noticeable means to assume controls of technology resources.  "What you have" authentication factor(s) can provide administrators an upper hand in ensuring only authorized users access.

Analysis: Information Security technology is hard pressed to cover the gap between prudent security policy and technology when social engineering trumps the best of efforts.  Social engineering is an effective tool in the hacker's toolbox; preying on the nativity and/or unwarranted trust of their victims.
Technology that requires the user to have possession of a token or object gain access to information technology resources is the best measure to tackle this ever growing challenge.  Two, or Three-factor authentication requiring  something such as a key fob or software token to validate the use of a specific user ID not only provides a higher level of authorized use, but can also combat infamous dictionary attacks.
Certain technologies use rotating keys to ensure the token is in sync with back-end resources.

Implications: This is truly a market driven segment in which vendor/developer can differentiate their product feature, service and support from competitors.  Satellite navigation thrives on ingenuity and leveraging open source technology.  The "value add" of satisfying niche markets will improve competitive advantages. 

Analysis: Blending satellite radio and navigation into a single device would see a possible partnership with Sirius/XM. Rather than mobile phone enables features for weather, traffic and peer-to-peer communication a pure satellite based could be the beginning for more innovative features.