When attending these shows I feel compelled to try to decipher the "buzz," to name the hot issues or key trends that characterize the event. This show has gotten so large and so diverse that, like the elephant and the blind men, buzz is perceived through your own perspective and interests. So, HIMSS this year is all about connectivity - not really, but that's what it seems to me. I was talking to Matthew Holt last night and the buzz for him was more around broader health care policy (EHRs and consumer health). In the end, whatever you're interested in, you can find plenty of buzz around it at this year's show.

Since patient flow interests me, all of the patient flow and bed management vendors are on my list to visit. I started with StatCom who officially introduced their new product at this year's show. Their new release is a combination of new architecture upon which they're running current and new applications. According to StatCom CEO Eric Morgan and EVP Ben Sawyer, the new release takes StatCom from a departmental orientation to supporting patient flow and the delivery of care on a new enterprise-level scope. Automation in support of the efficient movement of patients through the care delivery process is the health care equivalent of industrial logistics management - health care may lag 10-15 years in this area, but we can take advantage of concepts, software application design and architecture that have been refined over many years. Obviously, we can't just apply industrial management techniques to health care, but the concepts and processes are readily transferable to the delivery of care. StatCom is keenly aware of this and is drawing heavily on industrial logistics to guide and inform their approach to automating the care delivery process to increase patient velocity through the hospital.

Ken Kiser MD, CEO of MedSphere, is probably the most visible proponent for bringing the open source software model to health care. MedSphere is using the VA's VISTA EMR as the code base for their EMR. Last week MedSphere had two big open source releases. They released server and clinical information system services under a GPL license and another release under a Mozilla variation that they call an MPL license. This is their first big contribution of new features to the code base, that's available to the public. They've reserved some rights like attribution, but there are no license fees. Their business model is based on providing implementation services and ongoing software support and enhancement around their code base.

Ken believes the open source business model is well suited for health care. There are many applications and capabilities that providers would like to have. In a market dominated by large health care IT vendors, new software (what little they actually develop rather than acquire) must be justified by large market opportunities, leaving many market requirements unmet. Open source efforts can fill this gap by providing complete applications or software components that meet those needs that lack the big market potential conventional vendors need to justify new product development. The challenge for the open source business model is to come together into an effective organizing structure to facilitate interoperability, consistency and quality. With this most recent code release, MedSphere hopes to contribute to advancing the open source model. Rusty Lewis, MedSphere's CTO, is leading this effort and MedSphere plans to add dedicated resources to advancing open source software in health care.

Later I came across an RFID vendor I'd never heard of called RadiantWave. Business models in the RTLS space are presently going through considerable transition. Some vendors are moving to become enterprise infrastructure providers, others are moving into the application space. Some RTLS vendors have developed their own technology, while others have OEM'd their technology. RadiantWave is an unusual chimera - they are tag agnostic through an "edgeware" positioning engine that they developed and an enterprise mobile resource management system licensed from Red Prairie. RadiantWave has been working with large health care delivery providers (multi site providers is their sweet spot) by providing an enterprise logistics system and configuring specific applications for providers on top of that enterprise architecture. The result strikes me of an enterprise oriented custom application development business model. I can't decide whether this is an oxymoron or a brilliant business strategy.