After EMRs, what’s next?
Allison HsiehFriday, October 30th, 2009
Signs are pointing to an economic recovery in the healthcare sector. PGR’s network of hospital administrators and purchasing executives indicate that capital budget freezes, while not at normal levels, have loosened up a bit. Evidence of this is best seen, if anywhere, in the allocation of funding for Electronic Medical Record (EMR) platforms, which is a direct result of the stimulus plan that was approved earlier this year. With Q2 revenue numbers in for players like QSII and MDRX, it looks like hospitals and physician practices are progressing nicely into the information age.
Now that purchases and implementation are underway, what’s next? Patient records will be electronic, but there is a plethora of data that needs to be integrated into these EMRs, as well. Imaging data, pacemaker readings, pathology diagnoses, and diagnostics results are just a few of the areas that will need to be seamlessly entered into a patient’s record. So, manufacturers of these devices and equipment are ramping up to develop the technologies to bring this data online.
It is too early to tell if this will be a game-changing differentiator for certain manufacturers, but they are certainly hoping so, especially in more mature markets. A good example is in the implantable cardiac defibrillator (ICD) market, where the three main players have come out with remote monitoring capabilities of these devices, which can sync with a hospital’s EMR platform. In an effort to minimize medical costs, CMS is encouraging remote monitoring practices by reimbursing for a higher amount, versus monitoring a patient through an office visit. Each manufacturer has a remote monitoring technology that works with different devices and can speak to an EMR platform with varying ease, but as doctors transition to this practice, this may influence their preference for a given manufacturer. Regardless, device and equipment manufacturers must stay on top of the technology from the IT perspective to avoid drowning in the wave of EMRs.
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Tags: Healthcare IT; EMR;
Posted in Health Care | No Comments »
Docsis 3.0 and its implications
Rajan VaradarajanFriday, October 30th, 2009
The Data-Over -Cable-Service-Interface-Specification version 3, more widely known as DOCSIS 3.0 or D3, is a cable industry standard for deploying broadband Internet service over HFC (Hybrid Fiber Coax) cable plant. The standard is managed and updated by an MSO (Multi System Operator) supported consortium called CableLabs based in Colorado. CableLabs defines the specification and certifies vendor products for interoperability. D3 specifications define technologies such as channel bonding and IPv6 which allow MSOs to deploy 100Mbps+ Internet service and cable IPTV. The products that must be D3 certified are CMTS (Cable Modem Termination System) at the operator premise and cable modem at the customer premise.
It has been more than three years since CableLabs issued the D3 specification in August 2006. D3 has changed the playing field in broadband Internet services, giving life to the cable infrastructure once thought to be out-dated. With D3 deployment well underway, cable has a defendable position against Telco FTTH/VDSL and potential for new advanced services. Cable Operators worldwide are gaining more subscribers through D3, and vendors stand to benefit from this growth for many years to come.
D3 was borne out of the need to answer Telco’s VDSL2 and FFTH (ex: Verizon FiOS). Prior to the D3, the channelized nature of the cable spectrum limited broadband speed to 40Mbps. Channel bonding in D3 allows MSOs to pump up speed in multiples of 40Mbps. In theory, MSOs can get 80Mbps, 160Mbps, 320Mbps, and even reaching 1Gbps. To deploy the service, MSOs need to either upgrade existing CMTS with new blades and software, or buy brand new D3 CMTS chassis. On the customer premise side, there is no need to change cable modem if the subscriber does not want D3 service. D3 CMTS is backwards compatible and supports older DOCSIS cable modems.
Deployment started even before CableLabs issued the specifications in 2006, and unlike previous Cable technologies, this one started overseas in places like Korea and Japan where the wire-line competition is fierce. Today, D3 installations are covering a vast number of homes in North America, Europe, and Asia. The tier 1 MSOs that have deployed D3 are Comcast (Cisco, Arris), TWC (Cisco, Arris, Moto), Liberty Global (Casa, Cisco, Motorola), Cox (Cisco, Motorola), Cablevision (Cisco), Virgin (Motorola), NumeriCable (Cisco), Ono (Cisco), and Rogers (Cisco).
Strangely, the D3 CMTS vendor community has shrunk over the years. Since the inception of the D3 concept, vendors like Juniper, Terrayon, and BigBand have shut down their respective CMTS businesses. The heavy engineering investment and the delay in D3 specifications made it difficult to maintain a reasonable P&L, particularly for vendors with a limited cable portfolio. However, D3 deployment in the last two years has rejuvenated the industry, and today we have a community of three dominant players (Arris, Cisco, Motorola) and a startup (Casa Systems). In the coming years, new CMTS vendors will surface from the QAM community with companies like Harmonics and RGB, and from the IP community with companies like ALU, Huawei, and Ericsson. As D3 subscription picks up, cable modem vendors will see upside also, but this is unlikely to happen until 2011. Today’s D3 subscription is less than 1% in companies such as Cablevision and Comcast.
In the coming years, MSOs will purchase even more D3 ports to beef up capacity for Cable IPTV. Cable IPTV, or Video over DOCSIS, demands much more network capacity than the current data service which is mainly tuned for emailing and surfing. MSOs will double or even quadruple the current DOCSIS capacity in order to deliver new service like “TV-Everywhere.” Operators like Comcast are reportedly working on a new architecture whereby DOCSIS will be the primary delivery protocol in the HFC spectrum. Today, QAM uses more than 90% of the cable spectrum to deliver TV channels to homes while DOCSIS varies from 5%-10%.
What is next after D3? PON has been in discussion but MSOs will likely focus on upstream bandwidth. This is the Achilles Heel for Cable and even with D3 upstream channel bonding, it is limited to 120Mbps, while FTTH can get as high as 1Gbps. This weakness will hurt cable in the growing enterprise subscribership. Work is underway to look at how to re-design the 4Gbps cable spectrum to enable more speed on the upstream side.
Posted in Author, Rajan Varadarajan | No Comments »
BRCD Survey: Switches and HBAs? Selling to both sides…
Unni NarayananThursday, October 29th, 2009
It is PGR’s view that BRCD has solidified its hold on the FC switch market and is maintaining solid margins in a macro environment favorable to Greenfield storage deployments. Additionally, our network continues to report BRCD is picking up HBA share but the question remains: at who’s expense?
For different reasons, our network is positive on BRCD. Here’s a summary:
1.) All agree BRCD is really the only game in town in core switching products and margins are robust;
2.) But the value of BRCD’s solid market position is offset somewhat by questions about the fundamental viability of the Fibre Channel market itself. Many of our experts see lackluster growth over the next year, the result of better traction in FCoE;
3.) Right now, our network does not think BRCD poses an immediate threat to QLGC or ELX in HBA but their position gives customers a look at how BRCD can work both sides of the equation. The question remains whether BRCD can get enough out of HBA to drive switch sales. The jury’s still out on that.
Clearly, storage is a key battlefield in the war for the data center. And no clear victor can emerge from the likes of CSCO, HPQ or IBM until a major player focuses on the idiosyncrasies of areas such as SAN switching. So, in the meantime, BRCD is secure in its role as a profiteer selling to both sides.
Tags: BRCD, CSCO, ELX, FCoE, HPQ, IBM, QLGC
Posted in Data Center, Storage, Unni Narayanan | No Comments »
ADBE buys OMTR?
Laxmi PoruriTuesday, October 27th, 2009
On the face of it, the Adobe Systems/Omniture acquisition screams of desperation on ADBE’s part. Indeed we have heard that their appetite for software auditing has grown in the last couple of months (which usually indicates that sales are not going so well). But why buy a company when you can do the same thing via a partnership? Some experts asked the same question. What many people do not know, however, is that OMTR’s ability to tag and record flash content is a bit more advanced than what is out there. There has been a need for advertisers, media concerns and similar companies to monitor what happens to visitors once they go off of a flash video file. If ADBE can integrate OMTR technology, then this will be a huge differentiator, esp for media clients.
We’ll see how the cards fall on this one, but no doubt, ADBE has a great opportunity if they can get this right. And, as the market knows, they need it.
Posted in Author, Laxmi Poruri | No Comments »