BLOG on IT/IS in Healthcare & Life Sciences Joerg Schwarz on Healthcare [Health + Care]

Peter Neupert, VP for health care and as such functionally my counterpart at Microsoft, got to buy some interesting technology after he took his job in 2006. At the Health 2.0 conference last year in San Francisco he announced that they had made 9 sales of the EMR acquired as Ayaxxi and now named Amalga. I was perplexed, as recorded in the blog entry live from the conference. First of all, you would think nine application sales in a multi bilion dollar company like Microsoft are nothing to brag about. Secondly, every major EMR vendor uses Microsft technology for their front end, and in some cases for the back end also, so one could ask why a company would risk trust and partnership with the leading companies in the market for an unimpressive number of sales. And quite frankly, I can't answer that question. I can tell you we, Sun Microsystems, wouldn't.

After reading in Ted Aytan's blog (which is referenced as a bookmark of my blog for quite a while) about Amalga, I got a bit confused  if Amalga is an EMR or a PHR or both. So for the benefit of myself and those of you who wonder how Sun compares and positions towards Amalga, I did some analysis and came up with this:

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Components	Microsoft	Sun
SOA Framework	Microsoft Amalga:  "an innovative system that allows hospital enterprises to unlock the power of all their data sitting in clinical, financial, and administrative silos. Without replacing current systems, Amalga offers leading-edge institutions the ability to capture, consolidate, store, access, and quickly present data in meaningful ways."  Sounds to me like marketing speak for a SOA environment that exposes services of existing applications to a services bus for interoperability. Adding Ted Aytan's insight, it also seems to have a single patient view with emergency relevant patient data.	Yes, we do have this. We have a full blown SOA environment in Java, called JCAPS,  and Sun wouldn't be Sun if we didn't have an open source version of it, called open ESB. For clinical applications we have an [integrated/stand alone] HL7 communication engine with hundreds of ready to use adapters (eGate). And JCAPS and eGate are deployed in over a thousand instalations worldwide. We also have a single patient view module  and of cousre a Master Patient Index, too. JCAPS plays nice with .net, so in this category we have nice interoperability. Difference: Sun has open source AND support services.
Hospital Information System (HIS)	Microsoft Amalga HIS is a "fully integrated hospital information system designed for developing and emerging markets"  Wow.  Another HIS, another EMR. Another proprietary data architecture. But from a company that makes, say, 99% of it's revenue, roughly guessing, with other products.	We don't have this. We never had, and the only reason I won't say we never will is that you should never say "never". But Sun's philosophy is not to build vertical applications. We work with partners that use our technology to do this. For example Creative Healthcare Systems (CHS) in Springfield, MO.  Their solution is build in JAVA on MySQL and delivered on energy saving, cost efficient Sun Rays. Or ORBIS from Agfa, which is also a JAVA application with hundreds of installations from small to large hospitals.  We believe that vertical solutions like this are best designed, implemented and supported by companies that are focussed on this. Like CHS and Agfa and many others.
RIS/PACS	Microsoft Amalga RIS/PACS is  "available as a stand-alone system as well as an integrated component of Microsoft Amalga HIS. Its integrated architecture means the radiologist can use a single software application to manipulate study images and access the entire patient medical record."   okay. cool. A RIS/PACS system.	Well, we don't have that, either. We work with companies like Siemens, Agfa, Carestream and Teramedica. And MedGenix from CHS has also an integrated RIS/PACS. We provide comprehensive, media independent archiving solutions for these PACS (btw - we'd be happy to archive for Amalga, too). I do agree that it is important to integrate the RIS/PACS with the HIS. That's why we have our SOA framwork (JCAPS, see top box), so that a hospital can decide to have, for example, a Siemens PACS and a EPIC HIS/EMR. So we help our partners to create this interoperability.

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In essence. Microsoft Amalga is a vertical solution product from an IT company, competing with hundreds of vertical solutions form companies focussed on this area. I'm not in a position to give advise to Microsoft, but I feel very good about our strategy: to be the infrastructure provider, from hardware to middleware, for companies that are really focussed on this business. Not that we are not focussed, we're just focussed on providing open, secure, scalable and interoperable platforms for healthcare.

What will be really interesting to see is if Amalga ill be the first EMR to be connected to Microsoft Health vault. Or even more interesting: what if an Amalga customer would want to connect to Google health? As I said in my blog entry about google health,  connecting a hospital EMR like Orbis or Epic to google health is something we can easily do with our SOA environment, JCAPS. And we don't have to think twice if we should connect EPIC to ICW, Tolven, google or Microsoft, because as a infrastructure provider in a world of open technology we just do what the customer decides is best for them.

So, let's see how Amlaga fares in the market space going forward. And given that we are reselling Microsoft Windows along with our award winning X64 servers, I'd be more than happy to design a datacenter for Amalga users. The beauty of being an infrastructure providers is that we can play whereever customers want us ;-)