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How To Build A Healthcare SaaS Platform?

Healthcare is costly. In the US, healthcare spending accounted for 17.9% of total economic output in 2016, and the projection is that the figure will go up to 19.7% by 2026. If the predictions are correct, then healthcare spending will reach a whopping US $ 5.7 trillion in the same year.

The ever increasing price of medical goods and services are one of the main reasons why healthcare spending is so high. Technology can reduce costs by automating processes, however, the healthcare sector continues to lag behind when it comes to technology adoption, as this report by Accenture highlights.

This study finds that executives in the healthcare sector are increasingly looking to cut cost and improve operational efficiency through the use of modern technology. Many institutions are in the process of adopting cloud computing, and now Software-as-a-Service (SaaS) is very much on their radar.

SaaS is a service model in cloud computing whereby the vendor provides a complete package of software applications over the Internet to their customers, who subscribe for this ’service’. The vendor takes complete responsibility for infrastructure, security, upgrade, and overall management of the product. The application remains on the cloud so bypasses the conventional need for users to install software on their computers or servers.

The most famous examples are Salesforce.com, Microsoft Office 365, and Google apps.

SaaS removes the need for users to manage software infrastructure which not only helps get rid of headaches but also saves them money too. Users can choose to either pay a flat monthly bill or pay the vendor for on a consumption basis.

Having this predictable operation expense is a significant advantage to businesses when it comes to managing their budgets. While conventional on premises applications do offer this feature, it only applies until something goes wrong and requires the system to be fixed.

SaaS customers do, however, have to forego the customization that the traditional software offers since SaaS applications are very standardized.

In this article, I will describe how to build Software as a service in healthcare. To start, I will take a brief look at the advantages of healthcare SaaS and strategy for adopting healthcare SaaS solutions.

Contents

SaaS in healthcare: benefits and challenges
Healthcare SaaS solutions adoption strategy:
How do you estimate the cost to build a healthcare SaaS?
Examples of successful healthcare SaaS solutions:
Examples of successful healthcare SaaS vendors:

SaaS in healthcare: benefits and challenges

saas

Healthcare organizations can expect the following benefits from SaaS:

  • Cost efficiency: Organizations can improve deployment of electronic medical records (EMRS) and electronic health records (EHRs) using SaaS. This helps health organizations comply with the ’American Recovery and Reinvestment Act‘ (ARRA), specifically in regards with the ’Meaningful use‘ aspect of the law.
  • Less upfront investment: Organization can gain access to IT services without setting up their own IT infrastructure and development arms.
  • Meaningful use of their IT resources in developing their own strategic projects, while letting SaaS take care of the other functions.
  • Organizations have better interoperability and can share data easily between hospitals and insurance companies.
  • Regional health information exchanges can get new systems up and running quickly and don’t need to spend huge sums on setting up IT infrastructure.
  • Seamless integration between healthcare providers and insurance companies.

However, organizations need to address the following challenges when adopting SaaS:

  • Data security and privacy: Patient data is sensitive and requires strict protection, hence appropriate safeguards are required before storing the on the cloud.
  • Healthcare is a heavily regulated industry, and as a result, both healthcare organizations and SaaS vendors must comply fully with regulatory requirements.
  • The SaaS vendor must guarantee healthcare organizations regarding the suitability and safety of their solution.
  • Protecting patient data also requires appropriate controls on access, which is an area that requires the healthcare organization and the SaaS vendor to work together diligently.

Healthcare SaaS solutions adoption strategy:

Softserve, a leading software development company with significant healthcare industry expertise, points out in their whitepaper, a successful SaaS strategy in the healthcare sector incorporates the following:

  1. Analyze whether SaaS is indeed the right model for the company;
  2. Define business, functional, and non-functional requirements for functions considered as SaaS-candidates;
  3. Develop the infrastructure, architecture, QA, and delivery excellence parameters to measure a successful SaaS adoption;
  4. Identify business, technical and process risks arising out SaaS adoption and mitigate them.

Steps to build a healthcare SaaS

saas

I will elaborate on the required steps needed to develop a healthcare SaaS solution by using a case study published by a project team. It is certainly worth reading the complete case study here.

This project, executed in South Korea, intended to build a healthcare SaaS platform that would deliver healthcare information services at low cost. It will focus on high clinical value and usability.

The project scope included the following:

  • Sharing of ’clinical decision service‘ (CDS) content services;
  • Basic order entry system;
  • Immunization management;
  • Account management;
  • Patient information management;
  • Scheduling of appointments and admissions;
  • Mobile services for multiple platforms;
  • An EHR system supporting multiple device-types.

The platform aimed to create a mobile-enabled cloud-based modular EHR system.

Iin summary, the team then analyzed the architecture requirements, and outlined the following:

  • Interface;
  • Business support services (BSS) – a concept from telco industry with usage in IT systems for other industries too;
  • Operational support services (OSS) – like BSS, originally a concept from telco IT;
  • Cloud component for SaaS;
  • Quality attributes;
  • Data security and privacy requirements;
  • Multi-lingual services.

The platform must provide the following interfaces and frameworks:

  • BSS;
  • OSS;
  • A service consumer portal;
  • A service development portal;
  • A cross-platform framework to implement cloud SaaS.

The team finalized the following quality attributes:

  • Availability;
  • Performance;
  • Standardization;
  • Productivity;
  • Maintainability;

Architectural decision factors that the project team agreed upon included:

  • Support multi-tenant SaaS;
  • User authentication;
  • Support different mobile devices and platforms;
  • Cloud computing-based resource sharing should be supported;
  • Provide error-handling and ’root cause analysis‘ (RCA) ability;
  • Include comprehensive logging and monitoring of system events;
  • Stability and ease-of-use are required.

The project team studied the HIMSS Analytics EMR adoption model before analyzing the requirements of a general university hospital in South Korea with a CDS service (CDSS).

Their design included integration of patient management and order entry with the CDSS. The SaaS CDSS design also included knowledge-authoring tools, knowledge database, an interface for advanced CDS, and an interface for retrieving knowledge.

To facilitate any hospitals that are not operating suitably compatible IT networks, the design included the integration of basic patient management, appointment management, and order entry. The team also adopted the Health Level 7 (HL7) Infobutton standard to enable context-aware knowledge retrieval.

In this case study, the project team decided upon Microsoft Azure Infrastructure-as-a-Service (IaaS) and Platform-as-a-Service (PaaS) to develop the proposed healthcare SaaS for the hospital.

It was a comprehensive use of Azure, with the team utilizing the following:

  • Platform, framework, and cloud management;
  • Software development kit (SDK) for PaaS;
  • Virtualization, server, networking, and IaaS storage;
  • Azure service, such as:
    • BLOB storage,
    • Queue storage;
    • Table storage,
    • Database service;
    • Cloud services;
    • Visual Studio;
    • Traffic manager.

The team used the Mobile Enterprise Application Platform (MEAP), and thus catered to mobile platforms such as Android, iOS, and Windows Mobile. They also used the cross-platform mobile development framework MonoCross.

For the security aspects, the team consulted the governmental security and privacy regulations and reviewed the types of current security threats to cloud computing. The main security requirements they zeroed in on are following:

  • Authentication;
  • Access control;
  • Data encryption;
  • Back-up;
  • Other common areas such as patch management, vulnerability diagnosis etc.

A layered architecture was designed for the SaaS platform, consisting one each of the following:

  • Data source;
  • Data layer;
  • Business layer;
  • Service layer;
  • Business process layer;
  • Presentation layer.

The architecture composition was the following:

  • The cloud service consumer, i.e. the hospital;
  • A cloud service provider;
  • A cloud service creator;

There were APIs for the consumers, providers, and developers.

The platform included the following technical services:

  • A cross-platform UI framework for mobile apps;
  • Cloud computing security services;
  • The base framework used for developing business services;
  • Business services would be exposed to the web services using a service-oriented architecture (SOA) framework.

The external interfaces would be through SOAP protocol and REST/JSON.

The team also categorized the CDSS into rule-based services for medications, alert registration, and knowledge services.

They therfore designed the cloud configuration as a multi-tenant model with shared database that included a separate schema for each tenant. This was done to address regulatory constraints in the country prohibiting storage of EMRs outside the hospital.

In this solution, the hospital would still manage the healthcare data in their own schema. Additionally, a multi-tenant database to manage the tenant IDs for all tables and views was provided.

How do you estimate the cost to build a healthcare SaaS?

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Cost estimation of a healthcare SaaS development project depends on a number of factors including:

  • Targeted functionality;
  • Cloud service provider and services involved;
  • The location of the development team, i.e. the country they are based out of.

Here is an estimate for developing an app with a few key functionalities.

You will need to factor in your requirements to get a more exact figure for your own project.  To do this you can consult each cloud service provider’s price charts for their IaaS and PaaS service rates.

  • EMR/HER app Requires 4-6 weeks of work.
  • Medical workflow automation: 3-4 weeks of development and testing.
  • Medicare and Medicaid standards implementation: The most complex, time-consuming, and the most high-value projects, these can take 3-4 months.
  • Social component allowing doctors and patients to communicate requires heavy UI design, so estimate upwards of 2 months to complete this.
  • Integration with medical devices: This requires a lot of customization due to the variety of devices as well as the wide range of integration that a healthcare organization may need. These projects take a minimum of 2 months.
  • Medical mobile apps: Project development length varies quite considerably since there is a wide variety of apps – ranging from fitness apps to drug handbooks. A typical healthcare mobile app may take 4-6 weeks.

Keep in mind that the above estimates were for individual apps. To deliver a healthcare SaaS, you need to have architects in your team to define your cloud architecture and integrate it with your existing systems.

In addition to your normal IT team, you will also need infrastructure architects and cloud security experts. Their time requirement for the project will vary greatly based on the functionality, or the combination of functionalities, included in the project scope etc.

Check out the cloud services pricing tables from the major providers:

  1. Microsoft Azure cloud service pricing;
  2. Amazon Web Services pricing for the cloud;
  3. Google Cloud services pricing;
  4. IBM cloud services pricing.

Note: A project to develop healthcare SaaS solution is a complex one. Your team should be able to deal with any problem that SaaS development entails. Should you come up against problems your team cant handle, engage the services of a professional cloud application development company. It will save you money in the long run. 

Examples of successful healthcare SaaS solutions:

Check out the following examples of successful healthcare SaaS solutions:

  1. On-Demand Homecare: Organizations providing home healthcare services, for e.g. skilled nursing, home health aides, and personal assistant services can benefit from this product. It supports the following features:
    1. Billing and invoicing;
    2. Care plan management;
    3. Caregiver management;
    4. Client management;
    5. Field communication;
    6. Insurance management;
    7. Payroll management;
    8. Scheduling;
    9. Visit verification.
  2. Intelligent Medical Software: This product from Meditab is designed for medical practices handling a large volume of prescription medicines. There are EHR, practice management, and billing solutions integrated into it. The solution boasts of an impressive array of features, as follows:
    1. Claims processing;
    2. e-Prescribing;
    3. EMR;
    4. Healthcare CRM;
    5. Long-term care;
    6. Medical billing;
    7. Medical Imaging;
    8. Medical lab;
    9. Medical scheduling;
    10. Patient Case management;
    11. Pharmacy;
    12. Telemedicine;
  3. Insta HMS: Hospital Management Software from Insta Health Solutions, this is suitable for single and multi-center clinics, hospitals and diagnostics laboratories. It has a wide range of features, as follows:
    1. EMR;
    2. Hospital management;
    3. Medical billing;
    4. Medical practice management.
  4. Navicure: This is a claims processing SaaS solution. It has the following features:
    1. Billing;
    2. Payment;
    3. Claims management;
    4. Accounts receivable;
    5. Patient eligibility verification;
    6. Remittance and denial management;
    7. Reporting and analysis;
    8. Patient payment collection.
  5. Icertis: This is a SaaS solution for contract management. It has all the key contract management features, for e.g. approval workflow, contract management, compliance management, supplier modules, customer modules, government contracts, document management, contract lifecycle management, digital signature, and more.

 

Examples of successful healthcare SaaS vendors:

Here are a few examples of successful healthcare SaaS vendors:

Cerner: A key player in the healthcare sector, it has a market cap of US $ 21 billion. Their SMART (Substitutable Medical Apps and Reusable Technology) is designed with the expectation that most of these apps will be provided to customers using the SaaS model.

McKesson: An established technology player in the healthcare sector, their cloud-based supply chain solution is designed to completely automate the healthcare supply chain.