Consumer expectations about easy, personalized, AI-driven digital experiences — the sort they enjoy with brands such as Uber, Marriott, Amazon, and Google — have begun to influence healthcare application development. This goes far beyond the push to integrate systems so that, for example, a patient need not fill out the same form five times during a single hospital visit.

“We can now layer in personalized information that’s more relevant to the complete well-being of the patient,” said Erik Wagner, head of provider strategy, healthcare and life sciences at Salesforce. Responding to customer requests, Salesforce continues to add new technologies to its technology stack, with AI being one of the most recent additions.

Wagner, who has 27-plus years in healthcare, said the journey to this more personalized patient experience has been decades in the making, in part because of the slim margins in healthcare and a fear of making “a million-dollar (or multimillion-dollar) mistake.” Moreover, the client-server technical infrastructure in healthcare didn’t encourage experimentation. EHRs, Wagner observed, weren't designed to be “an engagement platform.”

Compare this to environments where, as Wagner explained, “you’re able to try different modes of engagement and ways to personalize,” tweak the application or process, and finally determine success or failure of an idea within 30 or 60 days. (And if an app works for a tranche of patients, it can be deployed to hundreds, thousands, or hundreds of thousands more rapidly and easily.)

The upshot is that healthcare organizations needn’t wait for the next release to personalize an application. If a survey reveals patient preferences, “we can now tweak this application or process in real time, instead of having to wait 6, 8, or 12 months until the new version of the software comes out,” Wagner said.   

Cloud subscription

Software as a Service (SaaS) and other cloud-based subscription models are changing healthcare rapidly. These models let healthcare organizations take faster advantage of the latest trends in computing, from big data to artificial intelligence.

“Where SaaS really adds value is giving people that constant access to the latest technologies, concepts, and advances,” said Todd Donzelli, SaaS transformation leader at GE Healthcare. “When the imaging devices themselves become commoditized, it is the technology around those devices that becomes the real value-add for clinicians and patients.”

“From a vendor perspective, we need to continually advance the software or the products that we’re producing,” said Wagner. “A subscription-based model allows the customer to know these advances are coming on a regular basis, automatically, as part of the subscription, with no additional payment due when the new release comes out.” 

“This subscription model allows for you to kind of kick the tires, so to speak, because you didn’t make this massive capital investment,” Wagner added. “You can go in and experiment.”

What does Wagner see as the long-term impact of subscription model adoption? “We’re going to start to see an incredible adoption of technology really pick up the pace in healthcare,” he said.

Many hospitals and private practices are migrating databases, applications, and services (such as disaster recovery) to the cloud. Two-thirds of IT leaders from health systems, hospitals, and other large healthcare organizations reported that they currently use the cloud or cloud services at their facilities, according to data published by HIMSS Analytics.^[1] Nearly 9 in 10 of these respondents (88 percent) said their organizations are using a SaaS model, up from 67% in a HIMSS cloud survey from 2014.

A recent HIMSS Media survey on personalized medicine and SaaS found healthcare organizations are generally positive about their perceived ability to deliver personalized medical experiences, with only one-third of respondents indicating significant room for improvement.^[2]

SaaS is well-established, the survey found, particularly for patient-facing applications and applications serving clinicians at the point of care. While specific use cases are diverse, nearly half (45%) use a subscription-based EHR system, followed by clinical information systems (40%), telemedicine/remote patient monitoring (38%), and storage/archiving/backup (35%).

Overall, 89% of respondents are using or planning to use SaaS for one or more use cases. Regarding a subscription-based approach to devices and hardware, 1 in 3 showed a high level of interest, and 8 of 10 reported some level of interest.

Yet respondents said the least effective use of SaaS was for facilitating interorganizational data sharing/analytics (a key barrier to personalized medicine).

Asked about challenges to delivering a personalized medical experience, survey respondents put two at the top: difficulty in demonstrating the clinical value of personalized treatment to enable reimbursement (51%), and achieving the needed level of data integration/interoperability (38%). Another 21% of respondents cited the lack of adequate/capable IT infrastructure as the biggest challenge.

Nevertheless, for Wagner, one of the most important outcomes will be patient-centered technology, which he said, “really fits well with this [subscription] model of being able to fail fast, fail cheap, and move on.”