Best of breed RIS vendor fights wave of single-source IT hype

Swearingen Software is one of the last gunslingers, a best of breed RIS vendor fighting it out in an increasingly single-source world.

"We are plug-and-play, and we can work with anybody. Yet plug-and-play has been an extremely hard sell in the last two or three years," said founder Randall Swearingen. "Everybody has either teamed up with a PACS or an HIS single-source combo."

For a long time, they ignored RIS, as best of breed vendors such as Swearingen had tied up much of the marketplace with their dedicated IT products. Over the last several years, however, major IT vendors have adjusted their thinking to make RIS the engine that drives their PACS. They are pushing integration and the fear that best of breed systems will not fit into the overall IT scheme. Swearingen describes it as more hype than real.

"You peel the cover off of these RIS/PACS, and the individual modules are sitting there," he said. "They are interfaced, not integrated."

Swearingen has plenty of supporters. Many are small hospitals and imaging centers, which make up the majority of the company's installed base of 200 customers. But not all his customers are pint-sized. King of Prussia Hospitals in Pennsylvania includes more than 20 hospitals, and each has a Swearingen RIS. As the chain grows, each newly added hospital installs a Swearingen RIS.

Swearingen looks to his customer base for such success stories. Proponents of his best of breed approach naturally boost Swearingen RIS, or they would have moved on. Swearingen especially looks for cautionary tales from those who have joined his flock.

"We try to find some in our customer base who have had experiences with single-source and know the pitfalls and shadows that exist," he said. "They can be a reference to some of the folks who are looking to go the other way."

Swearingen is not above using his own scare tactics. Prospective customers need to be aware of the risks, he said. Administrators invest time and money in the selection, installation, and training. And it goes way beyond that.

"If you make the wrong decision, you are stuck for a long time," Swearingen said.

Many are receptive to his arguments. Best of breed thinking is part of everyday life in the U.S. Few consumers looking for a high-quality sound system buy an all-in-one solution, a truism that Swearingen has built into his sales pitch.

He compares single-source IT solutions to boom boxes and best of breed information systems to stereo receivers, speakers, and CD players. The RCA jack is to the stereo as HL7 can - and, according to Swearingen, should - be to IT.

But to offer best of breed, Swearingen Software must be the best, a tall order when competing against companies with comparatively huge R&D budgets. The company does so by focusing on not only technology but people.

Swearingen lists three key differentiators. Number one is customer attention. He boasts that his support staff can recognize 90% of the company's customers by their voices.

"When they call us, they don't have to say their names," he said. "And we don't need caller ID."

The kind of response given by Swearingen support is rooted in years of having been on the other side of the fence. Three of the company's five support staff and both sales people are either former radiologic techs or ex-radiology managers.

The annual user group meeting provides ideas for product improvements. Each idea is rated on a scale of one to 10. Those graded 7.5 and above are built into the software, according to Swearingen.

"It gives our customers a sense of ownership - a sense that they control their destiny," he said.

The second differentiator is ease of use. Swearingen RIS users can pull patients' names, addresses, dates of birth, and other information off driver's licenses. Fingerprint recognition technology expedites and simplifies the log-on process, while going beyond Health Insurance Portability and Accountability Act security.

There are some things, however, that Swearingen software cannot do. By its very nature, the company, which specializes in RIS, cannot offer the range of capabilities that RIS/PACS companies can. This inherent weakness has led Swearingen to partner with PACS companies. Many of the companies that have approached Swearingen, however, ask for exclusivity. And that is asking too much.

"If I hitch my wagon to the wrong star, it can have a significant negative impact on the company," he said.

Swearingen has opted to remain plug-and-play with any and all PACS that conform to the standards that increasingly are defining the IT environment. He expects that, in the decade ahead, true integration will be possible regardless of the vendor, as each one's products will adhere to HL7. RIS, PACS, pharmacy, and laboratory ITs will plug in like they were made for each other, he said.

Maybe then, Swearingen will get his wish.

"We would love to see all these other vendors OEM our software into their product lines," he said. "That is a long stretch, but that is what we would like to see."