Biotech & Healthcare Blog Posts

This year Catalyst has seen a significant shift in areas of practice and the kinds of applications and interfaces we are engaged to develop. Part of this reflects changes in our own areas of interest, in particular, our work to support and develop sustainability initiatives. But I believe the shifts area reflective a larger move in the industry itself.

Compared to the last several years we have seen dramatic growth in the demand for application design services in sustainability and health care. There has also been continued growth in specific delivery styles of applications, such as SaaS and RIAs.  Desktop apps growth is relatively stable and flat, except in the area of health care, where this is an uptick in growth.  None of this is too surprising.

More interesting has been a rapid surge in interest for mobile application and gesture based interface design, as well as an increase in the requests for instrument control interfaces (perhaps reflecting the growth in embedded processors and remote monitoring).

For my own conceptual understanding of these trends I created color-coded matrix that shows the high growth areas relative to the lower growth areas.  It presents a heatmap-style view of application design trends with red representing hot areas and blue representing cool areas.

I often talk about how mission critical applications have unique requirements when it comes to RIA and user experience design. Broadly speaking mission critical applications require a combination high-performance, at-a-glance clarity, security, redundancy, scheduling, reporting and scalability.

I was explaining these characteristics to a client looking for an RIA front-end design for their green energy production system. I found that the easiest way to explain some of the real-time design requirements was to give examples from our own client work. I thought I would share a few of these from that conversation.

Example requirements for mission critical UI and application design

Scheduling - Trading systems
With most application, when you make a change to a preference of function, you save the change and the change is applied then and there. With international trading systems affecting large $$ trades/data, you need to be able to make changes and then precisely define triggers or schedule when these changes are applied.

Reporting and Tracking - Financial transaction processing
With mission critical applications there often needs to be an audit trail for changes to data, system settings and transactions. For example when changes are made to the interest rate on credit card there needs to be a non-alterable record that tracks who did it, when, and why.

Clear Conceptual Models - Flight planning
Complex or mission critical systems needs to designed it so that the user knows exactly what they're interacting with. In flight planning, the FAA uses a very particular type of document which is drilled into to every pilot or controller. The RIA interface for a flight planning application had to be modeled tightly around this existing model so it was immediately interpretable.

At-a-Glance Clarity - Telecommunications processing
Imagine a system with 200,000,000 transactions a day. The visualization and reporting system needs to be designed to represent mass volumes of things happening with automatic callouts and quick ways to drill down.

Privacy and Security - Medical diagnostic collaboration
While security is vital in every enterprise, security in medical records is a hot button item right now. Web-based medical records and collaboration applications need to have clear options to define roles, access levels, recurring re-validation requirements, and multiple layers of protection.

Redundancy and Validation - Emergency notification
For most web applications, it is standard to have simple error checking for things like entering an invalid email address. But advanced validation and redundancy become vital in mission critical applications. For emergency notification systems that trigger emergency first responders and can impact the physical well-being of many individuals, any alert messages need to have built in redundancy (i.e. you can't accidentally send out a notification without confirmation) and geospatial validation (you can't inadvertently send out a notice to residents in San Francisco about a threat occurring in Seattle).

Scalability - Insurance M&A
Scalability is desirable for any enterprise where there is an expectation for growth and change. But this was critical for an insurance carrier that grew rapidly due to acquisitions. The user base was to expand several orders of magnitude in the course of a very short time and the application would need to scale to accommodate the increased demands without requiring rework.

High Performance - Fuel management
Real-time reporting and high performance applies to virtually all mission critical applications. But when I was discussing this with the green energy company, rather than discussing our work in financial systems (i.e. where it is easy to see how even seconds of delay can translate to millions of dollars in impct), I instead referenced real-time remote monitoring, management and incident reporting of critical fuel supplies - such as in power plants, backup power systems, emergency fleets vehicles. As inventory drops or there is a change in the status of a critical fuel system, many actions need to quickly and automatically come into play to avert catastrophic failures.

Designing RIAs that address these mission critical requirements is not simple. In addition to the technical demands, it requires extensive user validation and testing as well as an understanding of the inner workings and organizational structures of large enterprises. Needless to say, it makes for very interesting and challenging work.

Most of the pundits for health care IT concur that a move to electronic records and in particular, a move to a SaaS, will significantly benefit insurance companies, hospitals, and physicians.

Looking at just the most basic factors:

• Insurance companies benefit from the online connectivity of SaaS.
• Hospitals benefit from the economies of scale using standardized data and processes.
• Physicians benefit by not having to operate their own patient management and billing systems.

The business case for moving to secure, SaaS-based solutions is real and compelling. But many health care organizations and service providers hesitate to make the first move, in part because of the magnitude of the transition. Where do you start? How do you undertake the project without creating a bloated, interminably delayed IT nightmare.

The answer is, of course, relatively unique for each company and can be determined as part of an application design evaluation. But one "off-the-shelf" approach is simply to identify processes that move electronic information to paper. In most cases these processes introduce both operational overhead expense and the potential for transcription error.

Eliminating this translation step can offer that first step in the design of a SaaS for healthcare markets. Key to success is to build the application UI using modular, reusable components. Re-usability means that you can take any of your modular elements and plug them into new applications or new screens as you expand your application or services. This lets you add on additional services discretely, in a predictable way, implemented over short time scales.

It used to be in the healthcare arena, that investment dollars followed the companies searching for the next new breakthrough drug or treatment. Recently however, the opportunities and incentives have started to shift to less glamorous products aimed at health care efficiency, and cost-control using SaaS, RIAs and optimized user experience design.

A $19 billion nudge

This move is spurred in part, by provider funding freezes, regulatory scrutiny and the growing push for universal health coverage. The other driving force, of course, is the $19 billion in the Obama stimulus package to encourage doctors to convert to digital medical records.

Efficiency and cost-cutting through health care software solutions can be achieved in many ways, across many sectors of the healthcare industry - in everything from research, to Pharma clinical trial management to patient scheduling, records and billing. The design of these applications will be a high growth area in both the short and long term. SaaS solutions will grow particularly fast as tighter regulatory compliance forces more standardization and interoperability in healthcare protocols, reporting and practice.

The success of these new applications will depend on how well they are designed to maximize efficiency, usability and performance. A few of the key best practices for successful application design include: define the high value scenarios, determine the best conceptual model, user-validate, design for perceived control using RIAs, and create application UI that is modular and reusable.

So where will optimized UI and SaaS application design play especially prominent roles? Here are a few targets that are already moving steadily in that direction:

Medical Research

Efficiencies in clinical research can be achieved from analyzing workflows, user interactions and then designing software interfaces to streamline the process. For example, for Ventana Medical we developed a dynamic Rich Internet Application (RIA) that interfaced to a piece of complex equipment for immunohistochemical assays for diagnosis of cancer and infectious disease. The new user interface greatly increased efficiency and reduced delays, allowing labs to do more screening in less time.

Pharma

Pharma is already moving to a SaaS model, particularly for clinical trials with electronic data capture (EDC) and analysis, and sales & marketing using CRM. The SaaS delivery model allows companies to easily scale resources as needed depending on the number of drugs in clinical trials or based on a dynamically changing sales force. Ease of use, performance and mobile access will be the key drivers.

Patient scheduling, records and billing has Service written all over it

Less than 9% of U.S. physicians in small practices and less than 30% in medium size offices are using digital patient records, according to a June 2008 study in The New England Journal of Medicine. This represents an enormous opportunity for companies to develop solutions to provide provides patient registration, scheduling, patient electronic health records with HIPAA compliance, clinical work flow, billing and collections. The key to success is to package the technology, functionality, and support at a cost/usability/perfomance level that makes it accessible to the average physician. This translates directly to user-validated UI and a SaaS business model. A well-designed modular SaaS application will be able to handle a sole practitioner seeing 20 patients a day or a multi-clinic operation seeing hundreds of patients a day.

Moving beyond the entrenched culture

Healthcare is one of the largest software and IT footprint has the most to benefit from the use of SaaS and user experience design. The biggest challenge will be cultural. But change is finding its way through the cracks and the new federal stimulus money will be a compelling motivator.