Making visiting nurses more cost-effective

But the back-office requirements can be hell. Management software for such services represent a big industry. But when you're selling to providers, as HealthCareFirst is, you concentrate first on things like billing and coding, the parts of the software that make money for your customer.

Will Hicklin doesn't look at it that way. He looks at it, instead, from the point of the view of the patient, and the patient's family. That's because his late wife Sandy, who passed away in January, 2008 was on that end of the market, and thus so was he.

The result is a start-up called Ankota, which is delivering what it calls a three-tier solution of resource optimization, paperless reporting and care management.  He claims he can save providers $1,000 per employee per month. The software was shown at an industry conference in Boston this week.

Sounds good. But integration is the question that must be asked. Integration with hospital systems, with payment networks, and with Personal Health Record (PHR) systems like Google Health and Microsoft HealthVault.

Standards can be created, and you can claim to adhere to them, and you may in fact adhere to them. But will things work together as they should when a patient or family member wants to connect with the rest of the Web?

Those are the questions agencies need to be asking of vendors and prospects. Not just what's in it for me, but what's in it for the people I serve.