Tuesday, November 11, 2008

Winners and Losers in 2009

I was recently asked to predict IT Winners and Losers in 2009.

Rather than name individual companies, I'd like to highlight categories.

1. Electronic Health Record vendors, especially web-based applications - The Obama administration has promised $50 billion for interoperable EHRs.

2. Software as a Service providers - SaaS providers offer lower cost of ownership and faster implementation than traditional software installation approaches.

3. Open Source - I'm embracing Open source operating systems, databases, and applications as long as they can provide the reliability and supportability that I need.

4. Green IT - Winners will be innovative techniques to adjust power draw, such as idle drive management, cpu voltage adjustments, and high efficiency power supplies.

5. Cloud Computing offerings - These are remote infrastructure utilities such as storage and high performance computing. Friday's Cool Technology of the Week will describe a new technology called Cloud Optimized Storage.


1. Client Server applications - the cost of deploying, supporting, and maintaining client server applications is no longer affordable.

2. Proprietary operating systems - I'm eliminating Solaris, AIX, HP-UX from my data centers.

3. High end SAN storage - I find that 90% of my storage needs are met with lower end SAN, NAS, and appliances which use low cost, high density drives (SAS and SATA).

4. Devices that do not offer energy efficient operations.

5. Applications that require a specific operating system or a specific browser on the client side. To be successful in 2009, applications should be operating system neutral, browser neutral, and easily hosted as a service accessible via the web.

I welcome your thoughts on your own winners and losers for 2009.


Unknown said...

It is interesting to see that all categories listed under "Winners" are (or could immediately be) based in Open Source.

Regarding category 1. "Electronic Health Record", 30 years of hospital living and dealing with people from the "If it is IT will do it" brigade, have made me an "unbeliever" in the so called Electronic Health Record vendors.

But I still see goodness in some Health IT projects (like what you have doing in your hospitals) and in some software projects like the (open source) Germany based Care2x (http://www.care2x.org/) HIS supporting software. And I believe that if teh Care2x had some of yours Toyota Production System processes and a half-decent marketing machine behind them, they could easily become a true web based replacement for the venerable VA Vista.

J. Antas (e-HealthExpert.org)

Unknown said...

I agree with a lot of what you say. I did, however, notice that you mention many proprietary operating systems but one;Microsoft. I think there are many HIT projects that are open sources such as clear-health or OpenVista from Medsphere.

Unknown said...

As a Sun employee (well, for now, anyways :-), I feel I should point out the conflict between Open Source as a winner and Solaris (a "proprietary operating system") as a loser: Solaris is now fully Open Source.

As for loser #3, I expect you've seen our new "unified storage" line, which takes advantage of a number of recent Solaris capabilities (ZFS and DTrace most significantly).

Tutor Mentor Connections said...

Did you consider visualization technologies such as GIS, or concept maps, or Social Network Analysis tools for the winners category?

I demonstrate uses of these in articles at http://tutormentor.blogspot.com. I think the concept of Catalyst is great and would like to build bridges between health care, law, busiess and other communities around policies and practices that help kids in poverty neighborhoods get more of the supports they need to become future members of these groups.

Jane Sarasohn-Kahn said...

As always, fascinating, John. I would add consumer-facing web 2.0 tools in health: as citizens are taking on more financial and clinical decision making, and getting more engaged in wellness and health promotion, they've begun to link up in social networks, blogs, and other use-generated milieus where they're learning best practices and getting advice from people "like them." This is more application than technology, per se, but it's a real trend and will grow in 2009 and beyond. Be well! JSK

John Halamka said...

Thanks everyone for these comments.

I've blogged about Medsphere and various open source EHR projects, so they will certainly be companies to watch in 2009.

I agree that Web 2.0 applications for healthcare including Personal Health Records will be important in 2009. One caveat - the business models for these applications are still evolving.

Sorry about the Solaris/Open Source issue. I'm running older versions of Solaris which where not considered Open Source.

Gary M. Levin said...

When you state as a loser client server applications, do you include office or group practices with their own servers?

John Halamka said...

The total cost of operating those servers and client/server products will be higher than alternatives. The hosted web-based service that BIDMC has built for the community costs $300 per physician per month for all software/hardware and practice workflow support include upgrades and hardware replacement over time.

Artists Aflame - Peter Groen said...

Within the responses the two winning items I was going to mention emerged - Virtualization and Personal Health Record (PHR) systems. The entrance of Microsoft and Google into the PHR space will have tremendous impact, I believe. Continued Federal government involvement in supporting standards and spread of EHRs is also a winner. Interesting that RHIOs and NHIN are not being mentioned.