Does Canada need something similar to the One Health Alliance?

A group of US and UK software vendors have launched a “one-size fits all” consortium of healthcare IT solutions aimed at the EMEA market. It appears to be aimed at acute care facilities and operates under the principle of a CIO being able to go to the Alliance for all of their IT needs. I’m not sure this would work under the current public buy RFP process in the Canadian market, but the idea is interesting. Vendors in the alliance claim to support interop standards, making it easy to buy an integrated stack from them. Vendor include:

  • Lawson Software, which provides enterprise resource planning and business software applications;
  • Perceptive Software, based in Shawnee, Kan., which develops enterprise document management, imaging and workflow software under the ImageNow brand;
  • Perot Systems, a Plano, Texas-based provider of IT solutions and services;
  • Sun Microsystems, a Santa Clara, Calif.-based provider of interoperable, secure and scalable network computing hardware and software infrastructure and solutions;
  • SciQuest, a Cary, N.C.-based developer of procurement automation and supplier enablement solutions;
  • Ardentia, based in Stafford in the United Kingdom, which provides business intelligence and Web-based information management solutions;
  • Clinical Solutions, a global company with headquarters in Basingstoke, Hampshire, in the United Kingdom, which offers evidence-based decision support and clinical software solutions; and
  • System C. Healthcare, based in Kent in the United Kingdom, which offers healthcare information systems and implementation and consulting services.

What is striking about this is not the vendors involved, who with the exception of SUN and maybe Lawson have little footprint in Canada, it is the model. The Canadian market (for Admin and Clinicals in Acute Care) is dominated by Meditech, Cerner and McKesson. Is their a place in the Canadian market for other vendors adopting a similar model, or is the market too small? If so who would those vendors be and would they be acute or primary care focused?

An interesting idea nonetheless.


4 responses to “Does Canada need something similar to the One Health Alliance?

  1. I think that this initiative is a reaction to the emergence of what I am calling the “Healthcare Enterprise “vendors who offer a broad range of functionality. While there is some variation in business processes and services offered among healthcare organizations, there is a common superset of functionality across these organizations that can be packaged and sold by a single vendor. Vendors like Cerner, McKesson, and even Meditech are asesmbling broad interoperable product portfolios that provide a comprehensive list of functionality from which a client can choose and are displacing (or acquiring) smaller, point solution vendors.

    One of the main benefits of working with a single vendor is having “one throat to choke”. While the consortium approach may reduce the problems associated with trying to integrate products from multiple vendors , I suspect that it does little to reduce the finger pointing and multiple points of contact when a problem does arise. Plus, I don’t believe that the consortium can achieve the same economies of scale (each has their own accounting, HR, sales, and marketing departments, for example) that a large Healthcare Enterprise vendor can achieve.

    So, do I think that this approach will work? No, not in Canada and not likely in the U.S. There are simply too many self-interests at play to make a partnership with so many participants vaiable in the long term. The partnership will implode under its own weight and competing corporate agendas and cultures.


  2. What Canada does need is commonly agreed upon data, messaging, and interchange standards for health information. Canada Health Infoway is taking a leadership role in this regard though there is considerable debate as to whether they are applying enough pressure to drive conformance.

    I was actively involved in the early days of the Internet in Canada. I can remember a time when each vendor had their own proprietary data communication standards (IBM had SNA, DEC (remember them?) had DECnet, etc). Heck, IBM even had a competing standard for how the bits were transmitted over a wire (remember token ring?). In a few short years TCP/IP became the lingua franca for data communications and we don’t even given a moments thought to how we will connect computers from diverse manufacturers.

    I argue that although the challenge of developing health information standards is more complex than developing data communication standards, the basic philosophy is the same and that similar approaches can be applied.

    I’d like to see Infoway take a more active role in driving standards adoption and product certification. If vendors were assured that specific standards would be widely adopted they would develop products that met these standards. Buyers would not be locked into proprietary systems and smaller vendors would be able to more easily sell specialized systems to a wider audience.

    The Internet has clearly shown what happens when widely adopted standards are put in place. Innovation is rampant, prices drop, and adoption increases. I contend that we can achieve similar results in the healthcare IT market through standards, not through consortiums or government selection of specific vendors.


  3. I agree with most of your logic on the emergence of the healthcare enterprise vendor, especially on the “one throat to choke” concept. You can interop as much as you like, but there is large value in having a relatively simple single channel. My main concern is that this one size fits all from a single vendor concentrates all of the power into a small number of hands. Not a bad thing if you are part of the in group, but not so much fun if you are on the outside.

    As far as CHI and standards I am 100% in agreement. CHI has the clout, mandate and ability to create/extend health information standards in a number of ways. I strongly support a single set of standards whenever possible as it reduces the cost of bringing products to market for the vendors, but more importantly (at least in theory) makes it easier for the end users to exchange relevant admin and clinical data.


  4. A couple of thoughts with regard to your first point (“concentration of power”):

    – It is a natural evolution in most markets. Take for example, operating systems. In the early days of computers there was a plethora of operatinmg systems. Today there are just a few (Windows, Mac OS, and Linux).

    – Widespreaed adoption of standards provides a mechaism for smaller vendors to offer specialized solutions. Going back to the operating system example, the widespread adoption of Windows as a defacto-standards has opened the market to many specialized application vedors. Another example is the Web. While there only be a handful of web browsers, just look at the wide variety of web based applications that use the browser as the means to access them.

    I argue that the situation for hospital or physician office systems is akin ot the early days of computers where you bought the hardware and all the software from the same vendor. Over time a few dominant hardware and operating system vendors emerged. This situation has created an environment in which software vendors can write applications that take advantage of a large installed base of computers running on a similar hardware / operating system enviroment (Windows on an Intel platform, for example). Widespread adoption of common standards for the exchange of health information will create a similar environment in healthcare that will allow healthcare organziations to choose one vendor for most applications but select specialized applications from other vendors as needed.


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