Why PaaS is the Future of Healthcare

The following is a guest post by Anil Kottoor, president and CEO of MedHOK.

The need for improved data management and quality reporting is increasing exponentially as various healthcare reform measures take effect. From hospitals and physicians participating in Accountable Care Organizations (ACOs) to Medicare Advantage and prescription drug plans looking to improve their Star ratings, it seems that no healthcare sector is exempt from this litany of change.

Take for instance ACO participants. While the newly formed care model promises to improve care coordination and cut costs, doing so requires that providers invest in patient population management platforms capable of collecting and sharing patient information across the continuum of care.

Similarly, Medicare Advantage and prescription drug plans are seeking out platforms capable of monitoring and tracking quality metrics. That is because under the Centers for Medicare and Medicaid Services (CMS’) continually evolving Five Star Rating System, the pressure is on to improve quality or miss out on incentives such as year-round enrollment under a newly created special election period.

Despite the system-wide need for these advanced technology tools, few organizations have the resources necessary to invest in the hardware and software required to manage and track patient information and quality metrics. Small- to medium-sized businesses in particular are finding that they simply do not have the space or technical expertise to house and manage additional servers in-house.

As a result, many providers are seeking alternative solutions to their data management needs.

Software-as-a-Service Model

Perhaps the most well-known alternative to purchasing costly hardware and software is the Software-as-a-Service (SaaS) model, which provides organizations with the software they need via intuitive web interfaces. By eliminating the need for upfront hardware investments and ongoing maintenance costs, cloud-based software eliminates the hefty cost barrier that many providers face with their IT infrastructure investments.

Further, unlike traditional software, SaaS-based solutions do not require the purchase of multiple licenses across the organization. Most subscriptions can be tailored to the organization’s user needs and customized as staff size fluctuates. In addition, because software is hosted by a vendor or service provider and made available over the Internet, users can access information anywhere with Internet access.

However, while the SaaS model has experienced a rise in popularity over the last several years, the reality is that it does not provide the holistic approach to care and quality management that healthcare organizations desire. That is because many organizations must subscribe to a number of SaaS-based solutions to meet their data management needs. As a result, information is stored in multiple silos across their various vendor networks.

Platform-as-a-Service Model

This has given rise to the Platform-as-a-Service (PaaS) model. In essence, PaaS provides users with both the SaaS-based solution and industry-specific application platform or operating system they need to manage data needs. For healthcare organizations that utilize various software solutions, this means that all of their solutions and the accompanying information can be found within the same user-friendly interface, thus removing the silos inherent in the SaaS model and streamlining information management and sharing.

In other words, PaaS provides all the benefits of SaaS with the added convenience of having all products within the same platform. Because these solutions are compatible with most existing software solutions, including electronic medical records (EMRs), they also eliminate the need to “rip and replace” systems that providers have grown comfortable using.

Unlike traditional IT infrastructures, PaaS solutions can be rapidly deployed to meet healthcare organizations’ comprehensive patient population management and data tracking needs. In fact, where traditional software solutions may take up to two years to implement, PaaS-based solutions can take as little as 90 days. Further, because PaaS providers manage both the software and the infrastructure, organizations can easily scale offerings to manage an increase – or decrease – in patient population.

Finally, because the PaaS models allows software to be deployed as individual modules or comprehensive end-to-end solutions, providers can easily add or remove products as the customer’s needs change. This also eliminates the need for investment in long-term technology strategy that may be outdated before the phase ever goes live.

The Future of Healthcare

The reality is that healthcare reform is rapidly changing the business of healthcare as new regulations and requirements continually roll out. To remain competitive in today’s market, health plans must remain extremely agile, and be willing to upgrade their software and reporting solutions before requirements are fully defined. However, doing so often requires a hefty upfront investment and a great deal of risk for those organizations that do not have the internal resources to manage the evolution of the required technology.

PaaS removes both of these obstacles and provides organizations with the agility and flexibility needed to rapidly respond to regulatory and market changes. Further, by leaving all of the heavy lifting up to a software vendor who specializes in holistic healthcare data management on a single platform, providers can focus their time and efforts on what matters most – the patient, who at the end of the day is the true consumer of healthcare.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • Do you have examples to EHR offering PAAS?
    I’m really interested at looking into them. Our IT structure is getting old and the cost of replacing everything plus the time to do it is huge. PAAS would seem to be the best solution of us if the price is right.

  • Hi yael,
    I’ll see if I can get Anil who wrote this post to respond as well, but I’m not sure I’ve seen any EHR’s that are designed as a PaaS. I think the EHR vendors would act as one of the services that sits on top of the PaaS.

    What isn’t as clear to me, and hopefully Anil will see this comment as well and can answer is whether PaaS is really more about data aggregation or whether we can really get a two way interface between the PaaS and the various systems that sit on top of the PaaS. In some ways this reminds me of a vendor neutral archive, but for all the healthcare data.

  • Thanks John. Yes, I agree about EHR not offering the PaaS solution, but they may or at least should have partnership with other companies willing to over that kind of solution.

    I found one for Aprima, but it was $2500 per month for 35 users without counting the license cost of Aprima. It makes it really expensive even though the cost shouldn’t increase much with other software/EHR on that PaaS.

    Then the big questions comes with all the HL7 interfaces that have to be managed through the PaaS.

    Though for all the meaning full use 2 and the backup and recovery, PaaS makes more sense.

  • yael,
    It’s interesting that you find that price for Aprima expensive. I guess like most things it’s all relative. Compared to many EHR vendors, that’s quite economical. Although, I don’t know how much the license cost is for Aprima. That could change things a lot. Plus, I don’t remember if Aprima likes to nickle and dime you for other things like training, interfaces, etc or not.

    I think the PaaS is still a pretty new concept and I’m not sure many EHR vendors have gotten on board. Hopefully they’re using more than an HL7 interface too. HL7 has its place, but the best PaaS will need a deeper integration.

    The question of meaningful use is interesting. I’m not sure how many PaaS are going to become “certified EHR” or not. Certainly this is why there is the modular EHR certification. I’m not sure that’s the path that PaaS companies will use.

  • For Aprima $2500 per month for 35 VDI vs the $12,000 for a server with license. That’s is expensive for me.
    Know, of course, you get more IT “feature” with a PaaS, but with all the existing healthcare cost and the one coming up, it’s a huge investment. I work in a rural hospital with a lot of medicaid and medicare patient so our resources are very limited.

  • I guess some clarity on who this is aimed at would be good.

    When I saw $2500/month I laughed…as I think from the perspective of a private practice.

    In a hospital situation, this would be different, but how many hospitals have under 35 users?

  • Our Hospital includes small clinics and that EHR is for that clinic which should explain the number you see. We’re in a rural area and we’re not for profit critical access hospital.

  • Anil and John, great article! I enjoyed reading your insight on the future of Healthcare IT. As a whole, we are seeing the healthcare industry struggle with data spread out in different silos. A PaaS solution is definitely the key to having greater insight into this data and freeing up time for more focus on the patient experience.

    I thought you might appreciate this whitepaper (http://www.hc1.com/images/uploads/hc1_5_Habits_High_Performance_Labs.pdf) that analyzes why healthcare organizations must rapidly adapt to this shifting landscape, and what they must do to remain competitive.

    Thanks for the great read, looking forward to future posts on this topic.

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