There has been an ongoing debate revolving around whether a hospital should develop a home grown integrated HIMS (hospital information management system) and EMR (electronic medical record) system or purchase an off-the-shelf software platform.

There are several factors to determine which of these best suits your Hospital’s needs.

• How specialized are your needs? Would an off-the-shelf product need extensive customization to handle your everyday business processes?
  • The first version of SoftLink’s PANACEA – HIMS solution was developed in year 2003-2004. Over a decade the solution has gone through several iterations and it is in its 7^th release now. Panacea is a Masters based Solution and has a Configuration module which takes care of most of the customization required in any hospital. As a thumb rule, Panacea can be used as it is, with about just 10-15% of customization.
• Are the commercial products in the market too large, complicated, and/or expensive for your needs? In other words, would implementing an off-the-shelf platform be overkill?
  • Panacea – HIMS is developed as a Product, thus the development cost is distributed over number of Hospital users and thus the Product licensing is very much affordable. With experience of over a decade, we can comfortably say that in a typical 100 – 200 bedded hospital, Panacea can be installed and configured in 3-6 months.
• Do you have the internal expertise and talent necessary to build your own system and update it in accordance with emerging industry standards?
  • This remains the most important point of consideration. Normally, it is very difficult for a Hospital, to attract and retain Healthcare-IT professionals for long time. As it is, IT professionals have a tendency to change jobs every 3-4 years, and this is even more frequent in case of IT professionals working in Hospitals. Software Product companies like SoftLink International can attract and retain such professionals for a longer time by offering them opportunities to work on new platforms and providing R&D budgets that allow them to create and implement new product concepts and ideas.
• What would the costs be in internal development man-power and upkeep of a custom system versus the initial and ongoing license and integration fees of a commercial platform?
  • HIMS is sort of an ERP and more. Typically developing software of this magnitude will warrant a team of 4-6 qualified IT professionals along with a Team Lead and a Project Manager working full time for over 2-3 years to match the features that commercial HIMS software’s can offer. Thereafter, maintaining the solution over the years will require at least a team of 2-3 IT professionals, along with a Team Lead and/or Project Manager. As against this the cost of a Software product along with Customization and implementation cost will be at least 10 times less. The typical maintenance cost after one year of warranty period is around 15-18% only.
  • Most importantly the Hospital can start using the entire software from day one as against the time period required for home grown HIMS to develop.

The above questions regularly influence IT decisions on how to best implement a variety of applications, like CRM, ERP, Asset Management etc. besides HIMS & ERP and, in these instances, the chosen path still varies greatly depending on the answers to the above questions. However, a consensus is being reached among the Hospitals’ community as it relates to the best approach for implementing a HIMS solution in today’s ever-changing and increasingly integrated healthcare system. There is a general agreement that an off-the-shelf HIMS system is almost always going to be the best bet for a hospital. There are a number of reasons for this shared belief. For example:

• Developing a HIMS system from scratch will require a huge amount of time, effort, and investment for the initial deployment. Furthermore, as the healthcare industry moves to a newer concepts like EMR, Cloud based solutions etc, you’ll need to have the internal expertise, bandwidth, and funds to adhere to emerging standards and protocols involving the sharing of health data. Leading HIMS and EMR system vendors have R&D funding available to accommodate these changes. Most hospitals don’t. It therefore becomes a question of the TCO (total cost of ownership) and ROI. If third party systems already exist in the market that can be customized to meet the needs of most hospitals, why reinvent a very expensive wheel by developing a system from scratch?
• A hospital should focus its efforts on its core business of caring for patients and not on developing IT solutions. A software vendor’s livelihood is built around enhancing and updating its software platforms based on the input of hundreds or even thousands of hospitals. This expertise, focus, and funding should arguably make them more capable of developing solutions that adapt to and satisfy the healthcare industry’s changing needs. With this in mind, off-the-shelf systems will likely be more agile in meeting the interoperability and privacy requirements of the healthcare market.