Siemens' Tom Miller on outsourcing, Soarian

FRAMINGHAM (03/16/2004) - Tom Miller, president of Siemens Medical Solutions Health Services, oversees one of the biggest health care software development groups in the world. At 7,000 strong, the group's main project now is Soarian, the all-encompassing health information system that besides just digitizing paper will have a workflow engine and promises to eventually have a sophisticated knowledge engine. In part 1, Health-IT World News editor John Dodge talks with Miller about Soarian and where Miller stands on the U.S. and Europe losing programming jobs. (Another Siemens executive recently announced that 15,000 programming jobs would be transferred from the U.S. and Europe to India and China.) Part II on Thursday looks at Soarian in depth.

Q: How does the shift in programming jobs affect you?

Miller: It's very simple. They are an entity that offers central IT development resources to any Siemens business. On the other hand, we already have an optimum global balance of resources. So the medical business of Siemens is unaffected by that announcement.

The reason is we already have a balance. We have 500 people already in India and some percentage in Europe. We will also have some working in China soon. We are a global business. We do business in a mere 190 countries in the world. The only other organizations that do business in more countries are Coca-Cola and the Catholic Church.

Therefore it would be expected we have a global deployment of resources. We have IT systems deployed in India. We will soon have IT systems in China and Japan. We have Soarian being deployed in seven countries in Europe. All of those need localization.

Q: Would software written in China be for just the Chinese market or available worldwide?

Miller: Those resources would be working on localization for the Chinese market, although clinical systems are (much the same the world over). The Chinese (like us) have two kidneys, one heart, etc., but they don't need claims scrubbers in China. Those types of administrative systems would be local. In Italy, they're local. In Germany, they're local. But they will all follow the Soarian architecture guide.

Q: How do you decide when to use the central development or your group on a project?

Miller: Internally, it is a decision I would make, that the business unit would make. We have resources in Europe, Asia, and the Americas. We need to develop (Soarian) using resources around the world. We have the great advantage of having global resources.

Q: How big is the Soarian project and what is it?

Miller: It's probably the largest medical investment in any project that Siemens has made in its history. Soarian is an enterprisewide healthcare information technology system that will have a totally Web-enabled uniform and homogeneous architecture and will ultimately reach three levels of productivity in healthcare.

Siemens is in the medical device business. We think the network becomes a medical device. Soarian is about automating manual work, (then) re-engineering processes to become efficient.

Q: What are these three levels?

Miller: I like to think of it as Maslow's hierarchy. It's elimination of manual work through electronic work. It substitutes electronic means for manual means. That's the bottom level of Maslow's hierarchy, equivalent to eating and shovels.

The second level is re-engineering today's processes and making them more efficient, to take out redundancies, to take out interfaces and make sure first-pass yield is higher and outcomes are ultimately better. To do this, you can't simply connect everything and pass information from one to the other. If we give all information to everyone every time, it will shut the system down. What you want to happen is capture the activity in the organization and capture what people are doing with the information (as) it's flowing.

We have a workflow engine that says if I give these two people the same information and tasks, one of them is going to be more productive and make fewer mistakes. One of them is going to do it faster. One is going to have a better outcome. (We have to) capture what they did differently so I can make the more efficient one translate to the rest of the organization. This is the first fundamental differentiator of Soarian. Capturing activity can accelerate learning and best practices not only inside a hospital but in other institutions as well. And you can do it in icon-based representation and say 'This is how your work flows.'

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