Growing Demand for Mobile Enterprise Application Services

More capable smartphones and media tablets are now joining a variety of highly portable netbook computers that have already invaded the workplace. Many are being combined with mobile apps that tap into cloud-based productivity solutions.

According to the latest market study by ABI Research, healthcare is one of the most dynamic sectors for mobile technologies, and manufacturing is now the largest sector for mobile enterprise applications worldwide.

By 2016, manufacturing will generate approximately 23 percent of the nearly $5 billion in mobile enterprise application service revenues.

Mobile enterprise applications, also called mobile B2E applications, include dashboard apps, work flow approval apps, and line-of-business applications for both the smartphone and tablet.

ABI's mobile services practice director, Dan Shey, says, "Manufacturing beats healthcare for B2E app adoption and revenues because of its large employment worldwide and the breadth of occupations that can benefit from mobile apps."

China is also one of the biggest drivers for manufacturing B2E mobile app adoption.

Manufacturing is the second largest employer worldwide. Manufacturing also employs a wide range of occupations using B2E apps, including shipping or receiving workers, delivery drivers, management and supervisory personnel, sales, and installation and repair workers.

Moreover, China is the world’s manufacturing hub, which drives B2E app needs -- not only for Chinese manufacturers but also for companies visiting their Chinese subcontractors.

Healthcare is the top sector in B2E mobile app adoption when viewing the data at the regional level. Healthcare leads in Western Europe, the Middle East, and especially North America, where healthcare B2E adoption outpaces manufacturing by nearly five to one.

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Healthcare IT Spending on Cloud to Surpass $1 Billion

The healthcare and social services vertical marketplace is extensive. It includes companies that provide medical care and social assistance for individuals -- which includes ambulatory healthcare services, hospitals, nursing and residential care facilities, and social assistance services.

Healthcare has been a growth vertical in U.S. business markets.

According to the latest market study by In-Stat, research supports a forecast of continued growth, with healthcare spending $518 million on Infrastructure as a Service (IaaS) in 2015.

Overall telecom spending by the healthcare and social services vertical was just under $16 billion in 2010.

Wireless communications is the largest of the product categories, comprising about 40 percent of telecom spending in the healthcare and social services vertical. Cloud computing and managed services is the fasting growing component.

Wireline data and wireline voice comprise the remainder of the telecom spend.

Increased Demand for Managed Cloud Offerings

"The healthcare vertical segment, across all sizes of business, and across nearly all product groups, is fast becoming the most robust business vertical segment in U.S. business markets," says Greg Potter, Analyst at In-Stat.

Demand for cloud computing services in particular has exploded and In-Stat believes there's nothing that would indicate the trend won’t continue -- at least through 2015.

Additional insights from the In-Stat study include:

• Small businesses with 20 to 99 employees will be the fastest growing size segment in healthcare, growing over 35 percent from 2010 to 2015.
• Enterprise wireless spending in healthcare will increase roughly 12 percent from 2010 to 2011.
• Healthcare public cloud computing spending will surpass $1 billion in 2013.

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How TelePresence Improves Public Health Care in Chile

The hospitals in Talcahuano (Las Higueras), San Carlos and Linares have inaugurated Cisco TelePresence units -- the high-definition video technology that allows them to interact with their patients via tele-consultations, examinations and interviews. The TelePresence technology also helps them find solutions for cardiovascular pathologies, the main public health problem facing Chilean society that has resulted in great human and economic impact.

This HD video communication solution enables the hospitals in Linares and San Carlos to connect with specialists in Las Higueras Hospital in Talcahuano and carry out remote specialized consultations -- as a result accelerating the process of attending to patients.

As an example, now the time taken for a specialist's first response has been significantly reduced (from 12 months to 54 hours), as well as the time taken to resolve the problem that gave rise to the initial consultation (from as long as two years down to one month).

Enabling Just-in-Time Healthcare to Citizens

The Cisco TelePresence solution is a pilot project that forms part of and complements the Galileo Telemedical Program, developed in the Hemodynamic and Electrophysiology Unit of Las Higueras Hospital in Talcahuano as a solution for pathologies in the cardiovascular area, illnesses that produce long waiting lists and high mortality rates in Chile.

This managed solution is a contribution made by Telefónica Empresas -- based on Cisco´s technology -- in collaboration with the Talcahuano Health Services and Las Higueras Hospital, showing the positive impact of public-private partnerships in the implementation of technologies that can transform peoples' lives. This solution works through the Chilean Ministry of Health's communication network (administered by Movistar), and it includes three Cisco TelePresence System 1300 Series units.

This new system deployment facilitates effective and timely access to specialized health care for all citizens -- no matter where they live. It improves the quality of patient care and the efficiency of medical attention, helping to reduce or eliminate waiting lists for health care services.

Pilot Project Delivers Cost-Effective Treatment Options

It makes prioritization of referrals easier, improving the access of the most seriously ill patients to critical operations. It reduces the number of referrals to the specialty center, which saves money for the health care system overall, as well as for patients and their families. There are also benefits for the individual such as in terms of reduction in the number of trips needed to be made, hours or days missed from work or school, and avoiding disruption in family life.

It provides a solution within the system, optimizing current resources in an efficient way by empowering initiatives that are already present within the existing health care system.

Movistar is providing this Cisco technology as a pilot project at no cost to local health services in order to evaluate its impact and effectiveness. They do this as part of their corporate social responsibility initiatives in an effort to provide innovative solutions to the health care system's most critical needs and to alleviate the extra difficulties these hospitals have had to face after the 2010 earthquake due to the reduction of their operative capacity.

The Galileo Project is an initiative of Las Higueras Hospital's Hemodynamic and Electrophysiology Unit, unique in the country's health care services. It was promoted by Dr. Francisco Albornoz, and it defines a new modality of services to improve the quality of cardiovascular treatments by means of teleprocesses in medical administration. The project consists of Web-based solutions and integrates electronic joint consultations, electrocardiography in its different modes, and echocardiography, connecting remote sites of referrals to one specialty center, maintaining the concept of efficiency in clinical decision making and therapeutic resolution.

"The telemedicine project in Talcahuano is in line with the corporate e-health program whose objective is to make high-end technologies available for the benefit of every Chilean. Health is one of the great concerns, and this service will shorten waiting times, facilitate opportune diagnosis, and keep illnesses from getting worse. At Movistar we are very happy since, as strategic partners with the country and the government, we believe we are fulfilling the promise we made to our clients, that of making high-end technologies available wherever they are needed," said Pedro Pablo Laso, general manager of Telefónica Empresas.

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Increased Spending on Public Cloud Computing Services

This week, the world's financial markets have been negatively impacted by continued concerns about the global economic outlook. There has been little good news about the economy lately, particularly regarding the U.S. jobs forecast.

That said, enterprise related IT spending has apparently been one positive forward-looking market indicator -- particularly the current and planned use of managed cloud services.

According to the latest market study by In-Stat, enterprise business spending on IT and telecom services -- which include cloud computing, wireless, wireline voice, wireline data, and business IP/VoIP -- will move in a positive direction in 2011, increasing by healthy 6 percent.

"There will be positive growth across all 20 verticals with education and healthcare & social services leading the surge with growth of 10 percent and 9 percent respectively,” says Greg Potter, analyst at in-Stat.

These forecast increases in spending are across all product groups except wireline voice, which will decline by about half a percent.

In-Stat's latest market study findings include:

• Enterprise spending on public cloud computing services is set to expand 139% from 2010 to 2011.
• Enterprise spending on wireless data is set to approach $17 billion in 2015.
• Enterprise spending in the healthcare sector on wireline data will approach 2 billion in 2014.
• Enterprise spending on wireline voice will remain flat, with traditional TDM services continuing their decline, only reaching $3.4 billion in 2011.

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How Healthcare IT will Migrate to Cloud Services

According to the findings from a global market study, the healthcare sector has a highly complex IT environment that's supporting a very diversified professional user population (i.e., clinicians) -- along with their patients in life-critical situations. The industry is currently facing growing economic and regulatory pressures that make its IT infrastructure primed for change.

Therefore, all organizations will likely consider the potential benefits of migrating to cloud computing. Improvement in the quality of healthcare services is a key driver for managed cloud service adoption.

Billions of dollars of federal incentives are provided for the delivery of quality healthcare services, and expanding the use of electronic health record (EHRs) systems -- as well as providing the basis for the exchange of information and data across and between the providers. These EHR systems are expected to be used extensively by 2014.

Another significant opportunity is the consumer-oriented cloud application -- offering the potential of improving healthcare communications and enabling patients to manage their own medical records. The cloud platform fits well with new business models, which often require uninterrupted access from multiple providers to a single patient, such as a Patient Centered Medical Home (PCMH) model or Accountable Care Organization (ACO).

Cost Reduction Potential Across the Ecosystem

Reducing costs in the healthcare industry ecosystem is a key motivation for cloud service adoption. This is true for all healthcare organizations, irrespective of their size and area of specialization. In making future IT investment decisions, health organizations will likely measure the return on investment closely. For many new Health Information Exchange (HIE) models, the infrastructure is already in place.

In today’s healthcare system, access to good facilities often depends on the physical location. As more health data moves into the cloud and telehealth technologies become popular, everyone will be able to access health information in real-time from anywhere. The result will be better access to healthcare and relevant data, especially in the remote areas. However, risks around data privacy, security and safety, and state specific policy rules are among the top concerns raised for the adoption of cloud computing.

As a result, these issues currently are the greatest barriers for embracing cloud computing. However, according to the MarketsandMarkets assessment, the data security issue has the potential to increase cloud service adoption. By centralizing and standardizing handling of patient data across the healthcare ecosystem, the cloud could enable stronger security and authentication measures to be imposed by SaaS (software as a service) providers, thereby actually improving protection and integrity of data.

According to MarketsandMarkets latest research, globally 32 percent of healthcare facilities are already using some form of cloud application. Moreover, close to 75 percent of the organizations not using any cloud applications are already considering adopting them in the next three to five years.

In summary, the top priorities for the healthcare industry are:

• Improvement in the quality of healthcare services.
• Reduction of costs.
• Increasing access to the healthcare systems.
• Data privacy and security.

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IT Cloud Services Primary Sectors of Adoption

Theoretically, all types of organizations should be predisposed to consider the transition to managed cloud services -- due to the numerous anticipated benefits. However, based upon the results of recent market research in the United States, it now appears that some sectors are much more likely to be part of the growing early-adopter movement.

International Data Corporation (IDC) announced the findings of a new market study, which forecasts that from 2009 to 2014 the U.S. public IT cloud services revenue will grow 21.6 percent -- rising from $11.1 billion to $29.5 billion.

According to IDC's market assessment and forecast, the professional services, communications & media, and discrete & process manufacturing sectors will drive the greatest market adoption -- generating the most public cloud services revenue.

Broad Appeal of SaaS Offerings Will Continue
IDC believes that the professional services market, in particular, will be the primary beneficiary of increased public IT cloud service usage -- partly due to the multitude of information-dependent midsize companies that will adopt Software-as-a-Service (SaaS).

"This research breaks new ground by sizing U.S. Public IT Cloud services revenue by 18 vertical markets," said Ruthbea Yesner Clarke, a program manager at IDC.

Other findings from the IDC market study include:

• The services and distribution sector -- which includes vertical markets such as retail, wholesale, professional services, consumer & recreational services, and transportation -- contributes the largest share of U.S. public cloud computing services revenue. Currently a $3 billion market, IDC estimates that it will more than double to $8.5 billion by 2014.
• Applications account for more than half of revenues in 2009, but over the forecast period, applications will drop to one-third of the market revenue and infrastructure software will grow to 22 percent of all revenue.
• Verticals that are highly regulated or with serious privacy and security data concerns -- such as government, banking, and healthcare -- will likely limit their spending on public cloud IT services to applications such as email, messaging, and collaboration.

"While the healthcare vertical will represent less than 5 percent of this market's total revenue in 2014, it will experience a high compound annual growth rate of nearly 23 percent through the forecast period. Despite serious concerns about privacy, current healthcare reform and the rise of connected healthcare will lead providers to the public cloud for specific functions such as collaboration applications," Ms. Clarke explained.

According to the IDC definition, public IT cloud services are browser-based and are available to any person or entity. They are off-premise and do not require any dedicated, application-specific, or proprietary client-side hardware or software to support access.

IDC's data is segmented by vertical sectors and then by functional technology categories -- including applications, application development and deployment software, system infrastructure software, servers, and basic storage.

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Video Communication Applications in Healthcare

Just as architecture has the power to transform a skyline, create new vistas and reshape the horizon -- so technology has the power to redefine healthcare, that's the theme of this year's HIMSS09 conference and exhibition in Chicago, Illinois this week.

Cisco video technology was featured in the AT&T Telepresence Solution booth on the exhibition floor. Visitors to the live video demo described their perspective on potential new applications, and Wendy Bohling, Senior VP at Magpie Healthcare had a more profound point of view. She said, regarding the business impact, "Telepresence changes and differentiates a hospital."

Quest to Improve the Patient Experience
Enhancing communication capabilities in healthcare can be equated to the potential for productivity and cost-reduction benefits, which are clearly valued. However, perhaps the emerging opportunities will now also focus on patient safety and the overall patient experience.

A recent study, conducted by Zogby International, sheds new light on the heavy toll that communication lapses take on patient care, clinical efficiency and the overall ability of nurses to do their job. More than 250 practicing nurses were surveyed. They included those in medical-surgical, emergency room, operating room, and critical care or intensive care unit service.

The Key Survey Findings Include:

Improving "people-to-people connections" offers the greatest potential for progress. The primary issue centered on the opportunity to improve communications among care team members. The time that nurses spend chasing other people to get answers was twice as great as the time they spend locating other resources.

• When asked how many minutes per shift are typically spent "chasing other people to get answers," up to 86 percent of respondents estimated wasting as much as two hours per shift.
• When asked about information needed to improve communication, 48 percent of nurses surveyed said, "care team availability and location" is most needed from a communications device at the point of care.
• In an open-ended question about the most significant challenge that a nurse's communications device could address, 56 percent of nurses said, "better communication between staff."
• About 60 percent of nurses in the study estimate they work up to 10 hours of overtime each week due to time wasted or lost trying to communicate with other staff.
  

If the visitor comments at the AT&T Telepresence demonstrations are an indication of an emerging trend, then the opportunities for hospital administrators, and other healthcare industry leaders, to apply the latest managed or hosted service offerings certainly looks very promising. Clearly, IT transformation is a rising priority.

Updates:
View the Day Two video of additional demo visitor commentary.
More demo visitor perspectives on the Day Three video coverage.

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Transforming Healthcare with Creative IT Solutions

Healthcare is constantly in the spotlight as aging populations, technological advances and high-costs threaten the very fabric of the current system. Healthcare providers and insurers are under constant social, political and shareholder pressure to both improve quality of delivery and lower operational costs.

To proactively evolve, forward-looking insurers and providers need to focus on:

• Access -- ensuring that patients are properly insured and the facilities are available to treat them;
• Affordability -- driving down costs across all parts of the system;
• Quality -- ensuring quality and successful treatment outcome;
• Sustainability -- focus on managing labor force resources and green issues.
  

New Approaches to Technology Driven Transformation
Despite being an industry heavily dependant on the use of the latest in medical technologies, healthcare has traditionally been slow to use information technology and services to improve their business processes. Healthcare has some of the most stringent concerns about privacy and security, and regulatory constraints. It is a highly fragmented industry, with over 70% of healthcare typically dispensed by autonomous professionals.

This unique industry structure has resulted in both a lower uptake of technology and the desire for high-cost in-house IT development and operation. Research by Cisco IBSG (the company's strategic consulting arm) reveals that this is beginning to change.

To-date most of the focus has been on using information technology to address the eHealth, or patient records issue, with mixed results. In contrast, Cisco IBSG believes that implementing next generation managed services, outside of the clinical area, can have a significant transformational impact.

Creative Solutions for Challenging Times
We are now seeing both healthcare providers and insurers exploring the potential benefits of managed services to streamline their operations and to improve the overall customer experience. Insurers are eager to encourage competition amongst providers, to drive down costs.

IBSG research indicates insurers are experimenting with using healthcare-specific telepresence solutions to remotely deliver healthcare, reducing costs and improving the overall customer experience.

For example, United Healthcare recently installed a HealthPresence managed service at Cisco's main San Jose, California campus. This allows employees to conveniently access medical support at their place of work, and enables United Healthcare to deliver it using less expensive medical resources in a more streamline process.

Healthcare providers are using managed services to address the cost and quality impacting issues. A hospital wide wireless RFID solution allows caregivers to quickly locate wheelchairs, trolleys and critical equipment, saving not just time and money, but often someone's life. Similar examples exist with locating doctors, identifying their availability, and across other parts of the medical supply chain.

Healthcare providers need to compete on service quality and loyalty. Providers are turning to next generation managed services as a means to enhance their offerings. For example, hospitals are using telepresence kiosks to create in-house concierge services to aid both patients and visitors to improve their overall hospital experience.

Transforming healthcare is going to require radical change. Managed services outside of the traditional clinical area have great potential. However, service providers must work with both insurers and healthcare organizations -- across all aspects of their business -- to develop unique IT solutions that help them to deliver lasting business advantage, and reduce operational costs.

About the author: Stuart Taylor is a Director in Cisco IBSG. Stuart leads thought leadership and engagements with key Service Providers in managed services. He has over 15 years of experience focused on strategy, corporate development, business unit strategy, M&A and operational improvement with large mobile and wireline operators and high technology clients.

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