The factors that determine the total cost of ownership are: the cost of acquisition, cost of implementation, cost of maintaining the code to meet current industry standards and the cost of support.

The cost of acquisition is directly related to the development cost. A complex application will necessarily cost more to develop and maintain. But more often it is the choice of a programming environment and the lack of automated programming tools that raise these costs to an outlandish level. Given a choice, a good programmer will opt for a low level language such as C to develop programs, but in the hands of an inexperienced programmer, C code can become convoluted and difficult to debug and maintain. So a balance must exist between the power of a tool and its ability to cause self-inflicted wounds. Physmark programs are created using Oracle’s database and programming tools, making it easy to modify and maintain. Screen edits, drop-down lists, triggers for validating data content and format are all built into the program generation tools, forcing developers to conform to a standard and avoiding “spaghetti” code.

Software implementation should be about 50% of the software license cost but in healthcare it can cost 300% to 500%. Part of the reason for high cost of implementation is because the programs do not offer setup utilities, and in some cases, they even require the writing of code. Part of the reason is also that vendors have a disincentive to create clean programs that are easy to implement and cost less consulting hours. After all the recommendation to buy these systems are made by consulting organizations that later benefit from the consulting hours to implement the system. Physmark’s implementation time has always been one of the lowest in the industry. The most implementation of its web-enrollment system was completed 12 months ahead of an accelerated schedule, saving the client considerable amount of time and money.

Maintenance and support costs are affected by both design and development environment of the program. As stated earlier, when using programs like C and Visual Basic for development, it is the skill and talent of a programmer that determines both style and design. During the life cycle of a program, many programmers will make modifications and changes, and its quality will degrade with time increasing the cost to maintain and support. Physmark programs use Oracle’s development tools and, therefore, inherit the structure and standards defined by them. There is less freedom to go outside this structure and, therefore, less opportunity for programmers to damage code structure. This reduces cost of support and maintenance over lifetime of the software application.

Large healthcare organizations have a tendency to need many custom features specific to their way of conducting business and many choose to develop their own custom software. They start by acquiring database licenses and assembling a team of consultants to develop their application. While these consultant-designed packages will meet a client’s immediate needs, they rarely build-in flexibility to accommodate new trends or needs. Contrasted against this, licensing Physmark’s source code can help an organization kick-start its development, building on a robust base product, reducing risk and costs of development.

Operations cost arising from a badly designed product with inferior technology can also affect cost of ownership. New technologies, such as the Internet, change the way business is conducted, increase automation and reduce operations cost. But incorporating new technologies into a legacy system can be forbiddingly expensive. Physmark offers middleware solutions that can function as a front-end for the legacy system, bringing new features of the web for example, at little extra cost. Physmark clients use web enrollment to consolidate eligibility and benefit information and at the same time reduce their overhead by allowing enrollees to update and maintain their personal information.

One of the major reasons why people hesitate to change software is because of the business disruption caused during implementation, when a working system is being replaced by the new system. Physmark products are designed to work in parallel with existing systems and because they require no changes to the old system, business continues without disruption. Some of the products, like HIPAA Appliance™ are designed to “extend” the life of current systems, by bringing in new features such as data mining and web services, without forcing clients to invest in new software and systems. Preserving the value of your current software by extending its life, making new features available and causing no business disruptions are three ways Physmark reduces business costs.

In today's dynamic and rapidly changing healthcare environment, Physmark's cost-effective solutions can provide your enterprise with the tools it needs to make better decisions about patient care, operations, and financial management.