There is no more challenging an environment for true ECM (Enterprise Content Management) than that of healthcare. 

Over the past few years a number of leading US hospitals have subscribed to our research and advisory services as they attempt to better leverage and co-ordinate broad content management needs. The panoply of use-cases -- EMR/EHR, diagnostic tools, rules driven scenarios, patient management, self management, and education -- all demand (in theory at least) a seamless operating and integration environment.  Inconsistency and potential contradictions in information can be critical in clinical settings.

Of course, none of this is new.  However, a co-ordinated and updated approach to managing information and content is rising on many hospital agendas -- due in part to increased US government funding, a general drive for greater efficiency, and a highly litigious and competitive commercial environment. 

Alas, the fact remains that few suppliers of content management technology have any substantial presence in this sector. Fewer still have the domain expertise and proper grasp of these highly complex and industry-specific requirements to be able to deliver much real value.

That said, some vendors are trying to build up their presence and offer better solutions. Hyland has long had a presence, and now Xerox is trying to get a foothold for its DocuShare Suite via its acquisition of WaterWare (a small firm that had build an EHR application on top of DocuShare).  But the major players you would expect to see regularly in this space -- such as EMC, Oracle, IBM, and Microsoft -- have patchy reputations and a history of trying to fit generic solutions into specialized environments.

In fairness, the healthcare sector is itself disconnected and difficult to navigate, where suppliers are severely challenged to develop high quality, co-ordinated solutions.  Clinicians usually rule the roost, and their expectations and requirements are often out of line with IT reality. Similarly major hospitals consist of a multitude of near autonomous departments, making co-ordination and alignment between them near impossible at the best of times. 

Nevertheless, healthcare is an area where ECM can deliver profound benefits. Healthcare (in both its private and public incarnations) also represents an industry sector in real need of serious improvement when it comes to managing information resources.

Current investment by document management and broader ECM vendors in developing better BPM, analytics, integration, and case management capabilities could ultimately deliver some valuable new technology solutions.  But in today's healthcare world, ECM is poorly represented in the broader technology portfolio.