Overview
Country or Region: United States
Industry: Healthcare
Customer Profile
Health InfoSTAT is a start-up focused on helping individuals manage their health information. The company is based in St. Louis, Missouri.
Business Situation
Health InfoSTAT wanted to enable people to manage their own health information and make it available online for emergency access.
Solution
The company created Solace, a software-plus-services solution that makes it easy for individuals to assemble and maintain their personal health records—and, if desired, to publish that information for access by others.
Benefits
n Rich, responsive user experience
n Strong security and privacy
n Rapid time-to-market and low implementation costs
n Easily extended functionality to meet new business opportunities / “With a software-plus-services approach, I feel like Ihave no constraints or limitations. We’ve built a framework that allows us to adapt quickly and that gives us maximum flexibility.”
John Struckhoff, Founder and Managing Partner, Health InfoSTAT
When Health InfoSTAT set out to provide a means for individuals to publish health information that would be of value to others in a medical emergency, it needed to do so in a way that maximized ease of use and privacy. Solace, the company’s solution, enables individuals to organize, manage, and update their personal health records and, if desired, make that information available at any time to healthcare providers and loved ones on the Web. A software-plus-services approach helped Health InfoSTAT deliver a solution that is easy to use and helps ensure privacy by enabling users to choose whether information is stored locally on their PCs or, for greater value, uploaded to hosted servers for access over the Web. The approach also provides strong benefits for the solution provider, including rapid time-to-market, low costs, and the ability to easily capitalize on new revenue opportunities.
Situation
Health InfoSTAT is an Internet company based in St. Louis, Missouri. John Struckhoff, the company’s Founder and Managing Partner, has been developing software for 30 years, a good part of that time in the healthcare field. His idea for Health InfoSTAT came 10 years ago, when he first thought of providing a way for people to better manage their own personal health information.
“People don't treat their personal health records with the same respect as they do financial data, but, in an emergency, the right information can save a life,” says Struckhoff. “We tend to depend on healthcare providers or the family health historian, also known as Mom, to manage this information for us, but this simply doesn't happen. In many cases, people have a better overall picture of a pet’s health than a family member’s. In addition, consider the impact of Hurricane Katrina, California wildfires, and Midwest tornadoes wiping out paper records of healthcare providers and important family documents at home.”
When Struckhoff first examined the viability of such a business, he looked at a model in which information was faxed to and from a central service provider, but deemed it too costly and shelved the idea. Three years ago, with the ubiquity of the Internet, he again looked at the idea and what technology it would take. “We wanted to make it easy for people to assemble the information needed to help keep them alive, and we wanted to avoid privacy concerns that people might have about entering personal health information on a Web site,” says Struckhoff. “Also, we still needed a way to distribute the application and enable users to provide others with controlled access to their information.”
Struckhoff also needed to ensure that the technology he chose wouldn’t limit him from a business perspective. “From a revenue viewpoint, we envisioned an offering where it would be free to assemble a health profile but require a paid subscription to share it with others. We also had several other ideas for revenue streams and wanted to make sure that we could remain flexible, both in the additional services that we might choose to provide and how they can be accessed.”
Solution
Solace, the company’s initial offering, makes it easy for people to organize, manage, and update their personal health records—and, if desired, make that critical information available at any time to healthcare providers, emergency personnel, and loved ones. Health InfoSTAT met both architectural and business requirements for Solace by using a software-plus-services model, in which software running locally on the user’s PC is complemented by centrally hosted services that are accessed over the Internet.
“From an architectural perspective, market requirements dictated a desktop application that made use of the Internet but was not necessarily tied to it,” says Struckhoff. “A software-plus-services model made sense because it offered the ability to provide a more compelling user experience, best met our needs in terms of privacy and ease of use, and will afford us the greatest flexibility in terms of additional business opportunities moving forward. Solace could have been easily developed and deployed as an entirely Web-based solution, but we saw immense value in delivering the user experience on the desktop and enriching that experience with centrally hosted services.”
From an architectural perspective, Solace consists of:
n Desktop software, which is distributed for free on the Web and allows for the easy entry and management of personal health information.
n Centrally hosted services, which keep the desktop application up-to-date and, for an annual subscription fee, enable users to selectively share health profiles created using the Solace desktop software with others over the Web.
“The ability to get customers to download, use, and realize the benefits of Solace on their local PCs is a key component of our distribution strategy, and a free desktop client that stores data locally enables them to do so with a minimal amount of risk,” says Struckhoff. “The user only pays for the subscription service, which makes the information available online.”
How It Works
Solace is free to download and use on a single computer. Users also can download a free “workbook” from the Health InfoSTAT Web site, which can be printed and used to help collect information—for example, by taking the workbook to a doctor for help filling it out. Personal health profiles can be created for as many people as desired, enabling each family member to have a separate profile. Profiles can include a list of medications, conditions, illnesses, food allergies, medicinal allergies, key emergency contacts, and more. In addition, electronic copies of important documents such as a power of attorney or living will can be stored in the profile. The software also enables users to print a profile, as may be desired to provide a paper copy to family members or a new doctor.
All data is stored in an encrypted format on the user’s hard disk until he or she chooses to subscribe to the Solace service, which enables the user to securely publish the information to a Web site for round-the-clock access by healthcare professionals, family members, or others specified by the user. Subscribers have complete control over who can see what information online, with different passwords unlocking different levels of access—for example, a man may choose to give his wife full access, yet limit his children to only certain information. (Subscribers can print a wallet-sized card that tells healthcare professionals how to access their personal health profiles.)
The service also enables subscribers to download personal health profiles to a PC other than the one on which they were created, and keeps track of all changes that are uploaded. In the future, this will enable the user to, say, see the medications being taken at an earlier time.
Development Process and Technology
All solution components were developed with the Microsoft® Visual Studio® 2005 Professional Edition development system. The desktop software is based on Windows® Forms and runs on Microsoft .NET Framework version 2.0. The centrally hosted services are based on the ASP.NET technologies in the .NET Framework, are exposed for programmatic access by the desktop software as Web services, and run on the Windows Server® 2003 operating system with Internet Information Services version 6.0. A second server computer runs Windows Server 2003 and Microsoft SQL Server® 2005 database software.
Health InfoSTAT developers are working onthe next version of Solace and are planning to upgrade to Visual Studio 2008 Professional Edition and take advantage of several features in .NET Framework 3.5, including Windows Presentation Foundation, Windows Communication Foundation, and Language-Integrated Query (LINQ). The company also is considering a new user interface based on the Microsoft Silverlight™ browser plug-in.
“The new graphical and motion capabilities in Windows Presentation Foundation will enable us to deliver an even more rich and intuitive user experience,” says Mohammad Aftab, Lead Architect at Health InfoSTAT. “We’re hoping that we will be able to utilize Extensible Application Markup Language created for the Windows-based desktop application to also deliver a Silverlight version, which is also currently in planning.”
Developers also are taking advantage of Windows Communication Foundation, which they’re using to expose the Solace hosted services in binary format over TCP/IP instead of as Simple Object Access Protocol (SOAP)–based Web services. “By using a binary format, we’ll increase performance for our current solution,” says Aftab. “And because binding to a specific protocol is managed through configuration files, we can easily facilitate SOAP calls later if needed. We’ll gain a lot of flexibility by doing this. As we move to .NET Framework 3.5, we’ll likely also implement LINQ to manage querying the database.”
Benefits
Health InfoSTAT is making it easy for people to assemble and publish health information and documents that would be of value to first responders or loved ones ina medical emergency. A software-plus-services approach helped the company deliver a solution that is easy to use and helps ensure privacy by providing a choice over whether data is stored locally on the user’s PC or is uploaded to the Solace Web site to share with others. A software-plus-services approach also provides strong benefits for Health InfoSTAT, including rapid time-to-market, low development and infrastructure costs, and the ability to easily capitalize on new revenue opportunities without technology getting in the way.
“The delivery of quality, cost-effective healthcare is based on access to information,” says Struckhoff. “Such information is usually scattered all over the place, with no single healthcare provider having the whole picture. A family doctor who you see regularly may have a copy of your chart, but an emergency room physician knows almost nothing about you. Solace provides peace of mind by combining the best of desktop software with the best of Internet-based services to maximize ease of use, capabilities, choice, and privacy for our customers.”
Rich, Responsive User Experience
The Solace desktop software takes advantage of local computing resources on the user’s PC—such as processing power, memory, and hard-disk space—to provide a richer, more responsive user experience than possible with a Web-based application. For example, after installing Solace, users can work offline and save the information that they enter as frequently as desired. The software displays the status of the user’s Internet connection, running the process in a background thread to avoid negatively affecting the user experience. The desktop client also checks for access tothe Solace service before the user is prompted to do any work that would require such a connection, enabling the user to avoid starting tasks that can't be completed due to lack of connectivity. Finally, the client connects regularly to the hosted service to check for updates to itself, notifying the user if one exists.
“The Web is halfway usable today, but when we started developing Solace in 2006, Web sites were more primitive,” says Struckhoff. “Even today, it would have beenhard to enable users to print a well-formatted copy of their personal health record had we taken an entirely Web-based approach. With a desktop application, we can take advantage of the resources on the user’s PC—and the capabilities provided by the Windows operating system.”
Strong Security and Privacy
Because the Solace desktop software is free and all data is initially stored locally, people can begin taking advantage of the solution without perceived risk. The software allows them to securely manage their information on their home PC and, only if they choose, publish it online to make it available to others—with complete control over who can see which information. Profiles stored on the user’s PC are encrypted using Triple DES 128-bit encryption. If the user chooses to subscribe to the service, profile data is uploaded to the Solace service using Secure Sockets Layer (SSL) encryption. Once the information arrives at the data center, all personally identifying information is encrypted within the SQL Server 2005 database.
“Perceived risk—both in terms of privacy and initial cost—is the biggest obstacle to acceptance,” says Struckhoff. “Our business model is based on the fact that users are in complete control over the information that they choose to publish. A software-plus-services approach is ideal for delivering that level of privacy and choice.”
Rapid Time-to-Market and Low Implementation Costs
The entire solution was created by a single software developer in just nine months, including the time that it took to build the company’s Web site and test and deploy all solution components. “I was able to lay out on paper what I wanted, see quick results, and modify my ideas as we gained insight,” says Struckhoff. “Even though we pushed to get Solace launched as soon as possible, the resulting product was better than I expected. And thanks to that rapid time-to-market, we were able to keep associated development costs to a minimum.”
Adds Aftab, “This project really illustrates the value of Microsoft technology. I can’t think of another operating environment that could have supported the development of a software-plus-services solution as easily. Had we chosen, say, Java 2 Enterprise Edition running on Linux for the Web site, we would have had to develop the desktop client on a different platform. With Microsoft software, we developed all solution components using the same tool set and programming framework, which reduced the effort required and helped ensure that the desktop and server components would work together.”