Strategies for a Seamless Software Transition: Tips from a Seasoned Integrator

Bruce Becker, a distinguished technical leader with over 15 years of experience in designing, developing, deploying, and maintaining software components and systems, offers valuable insights into the complexities of the healthcare industry’s software landscape. In this enlightening interview, Bruce delves into the challenges faced by software vendors and IT professionals in healthcare, shedding light on topics such as cybersecurity, interoperability, and scalability.

With a strong track record of addressing critical issues and implementing innovative solutions, Bruce’s expertise provides a unique perspective on the ever-evolving world of healthcare software technologies. Join us as we explore the intricacies of this dynamic field through Bruce’s eyes.

Q. Can you share some insights into the most common challenges you’ve encountered when designing and maintaining software components and systems unique to the healthcare industry?

Cybersecurity remains a game of catch-up, with hackers having an initial advantage, having previously targeted other sectors. However, in recent times, they have increasingly set their sights on healthcare systems. Meanwhile, the Healthcare industry is now compelled to develop more comprehensive medical records and share them across the entire spectrum. This has forced the IT staff to become more security savvy very quickly with bigger targets on their backs.

Having this in mind – plus the ever-changing HIPAA guidelines – forces the software vendors to spend more time building increasingly complex security aspects into their system. Fortunately, other sectors had already been facing many of these challenges, so there are many tools and techniques available to employ and adapt to the specific requirement.

The Healthcare sector provides a very wide range of user experience expectations. When building and implementing a software system, it is important to understand the passion of the people that use it. In the business office setting, the people using the software look at it as a vital tool to help accomplish their jobs. It reassures them of completeness and accuracy.

On the other end of the spectrum, in clinical settings, the number one priority is the health and safety of the patient. In some ways, having to interact with the software can be looked at as an extra burden for clinicians. In recent years, the software used by clinicians has become so powerful to the degree where it is frequently used to help make life saving decisions. This has created a greater demand on the horsepower of the systems that run the software, and the need to adopt more modern software architecture approaches like microservices and decision-making rules engines.

Q. Many companies grapple with interoperability and scalability issues in their software systems. Could you discuss instances where you’ve addressed these challenges and the strategies you used to ensure the success of the project?

Interoperability is an evolving and dynamic challenge. Over the years we have seen many ‘standards’ emerge over the need for interoperability. Today, we don’t think twice about assuming that TCP/IP is a part of the network fabric of most implementations. There was a time where this was not the case. Two of the dominant network protocols for a while were the OSI model and SNA. As the Internet emerged, neither of them took hold and something simpler and less mature took hold: TCP/IP. That outcome sent a message that at the end of the day, simple, straightforward, and adaptable become the adopted standard.

Over the years, I have stayed with that philosophy. Early on, most interoperability challenges were dealing with disparate systems, and we were required to manually build software components to connect them. By knowing the desired outcome and not over-engineering the solution, we were able to achieve success.

As new building blocks and tools emerged, it added layers to the overall solution, but it also provided much more functionality. My job as an integrator or software developer changed and I was forced to step further away and take a higher view of the solution and visualize the big picture. It was during this transition that I found drawing diagrams not only helped me visualize the overall desired outcome, but it also provided a way to communicate with stakeholders, other developers and the people that were required to support the solution.

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Q. In your role as a go-to resource for critical and difficult issues, you’ve likely encountered unique problems that demanded innovative solutions or outside-the-box thinking. Could you share an example of such a problem, the approaches you considered, and the ultimate solution that was implemented?

While designing a new Document Management System (DMS) for a recent customer base, one of the challenges that we faced was where to house all the documents and images that the existing system was using. The decision was not only based on what was most ‘technically’ prudent, but we had to consider the ongoing cost to the customer and the customer’s ability to adapt to the eventual solution. We knew that the DMS system would be in the cloud in the form of hosted systems and microservices, so this required migrating all the metadata from on-premises to the cloud. But we determined that it would not be possible to migrate all the documents and images from on-premises to the cloud systems based on previous attempts and based on the sheer cost of the storage and availability of the amount of storage we would need from our cloud provider. We determined that this could be a Phase 2 of the project at a future date.

This set the stage for the design of our DMS system. The solution was a hybrid of on-premises and cloud services. Our customer’s IT department was content in knowing the investment of their on-premises systems was still being put to good use. The User’s experience was positive because the access to the documents and images was over a high-speed local network. And the solution could easily be adapted to having cloud-based image storage when the timing was right.

Q. Different industries may present unique technological hurdles. Have you observed any recurring trends that are common to all industries?

Both the software and its hosting system exist in a rapidly evolving environment. Which really means that they don’t exist very long, in reality. So, as much as we would like to consider them a long-term asset like a building or some kind of machine, we really need to be more concerned about the care and feeding of them. We need to plan on how we are going to keep using the most current version, how do we become proficient with all their features, make sure we stay aware of security implications, etc. We also need to be realistic about how long they will remain viable, what are the upgrade possibilities, what are the re-use possibilities, (For on-premises systems) etc.

It is inevitable that you may have to switch to a different vendor for one or more of the software components that you use. This can cause disruptions to your day-to-day operations, unhappy users, and loss of productivity. Speaking as a vendor or an integrator it is our job to stay ahead of these kinds of obstacles. In my experience here are a few specific examples:

1. Be familiar with both sides of the coin. 

Showing empathy can only build part of the bridge. Eventually the integrator needs to add value to the situation by leading with confidence and experience.

2. Listen well along the way.

Be attentive to the concerns and questions that the users are expressing. Use these as opportunities to do homework and provide thorough answers and anticipate future concerns or confusion.

3. Prove what you’ve said.

As soon as it is possible, an integrator should collect metrics and data samples. These can then be communicated to the users and stakeholders in the form of graphs, reports, and diagrams. The most important goal is to instill confidence early and often.

4. Deliver on your promises.

Another way to state this is don’t over promise. In terms of the migration project, the integrator should establish realistic milestones with specific details and deliverables. If it is necessary to change a requirement or put off the delivery of a specific feature, making that decision earlier in the process is more palatable for both parties. 

Key Takeaways: Cybersecurity, Simplicity, and Establishing Trust

Our interview with Bruce Becker provides valuable insights into the intricate world of healthcare software technology. As the healthcare sector grapples with escalating cybersecurity threats and the imperative for greater interoperability and scalability, Bruce’s extensive experience and innovative problem-solving approaches offer vital lessons. He highlights the need for continuous adaptation and the adoption of tools and techniques from other industries to bolster healthcare software security. His practical approach to interoperability encompasses knowing the desired outcome, prioritizing simplicity, and focusing on adaptability to forge a path to success.

Bruce’s reflection on the diverse user experience expectations in healthcare accentuates the critical role software plays in both clinical and administrative settings. The demand for scalable, adaptable solutions that enhance efficiency and patient safety is increasingly clear.

In a rapidly evolving technological environment, Bruce’s advice to be empathetic, attentive, and trustworthy resonates with integrators and users alike. His emphasis on delivering on promises and setting realistic milestones enables confidence and transparency in every project, leading to a seamless software transition.