Smarter Hospitals Require Smarter IT
Effective delivery of healthcare innovation in the real world depends on enhanced infrastructure — and new approaches to infrastructure management.
Information has always been an essential element of medical care. Doctors get information about a patient’s symptoms, vital signs and health history, then compare that information with a knowledge base of illnesses and therapies to make a diagnosis and prescribe a treatment. After that, they continue to monitor information about the progress of the patient’s recovery — responding to changing data over time.
Technology has dramatically enhanced this process in a number of important ways:
- Electronic health record systems: EHRs aggregate patient data in a standardized, secure way so that multiple medical practitioners can effectively, efficiently and safely collaborate on cases.
- Clinical decision support systems and analytic tools: CDS solutions use research-based rules and machine learning to guide doctors in their day-to-day decisions about diagnoses, tests and treatments.
- Internet of Things devices and wearables: IoT systems gather data to enable faster, higher-quality medical responses to patients, both in hospital and at home.
- Process automation: Automated tools streamline and control routine tasks such as dispensing medication and distributing it to patients using robotics, barcode scanners and other technologies.
- Telemedicine: This solution expands the geographic reach of practitioners with specialized skills and enables doctors to treat patients who can’t get to a medical facility, such as homebound seniors, children of low-income families and people in rural areas.
These technologies and others have enormous potential to improve outcomes for patients while driving down medical costs. But to implement these technologies at scale and within real-world budget constraints, hospitals must significantly improve their underlying IT infrastructure — as well as the way they manage and support their rapidly expanding technology portfolios.
Keeping Pace with Innovation
According to Frank Marano, chief technology officer at Holy Name Medical Center, a 361-bed acute care facility in Teaneck, N.J., healthcare IT departments must “use technology to keep up with technology.”
For example, server virtualization enables Marano’s team to support a growing number of applications while maintaining a limited data center footprint. Virtualization also greatly speeds up deployment of new servers.
Marano advises healthcare IT teams to stay ahead of the demand for network services. As more clinical and mobile devices connect to a hospital’s wired and wireless networks — and as hospital staff utilize these networks more intensively — old approaches to infrastructure build-outs have become obsolete.
“These days, we’ll deploy a 48-port switch in a circumstance where, at one time, we might have added only 12 ports,” he explains. “We don’t want to be forced to scramble later if some new requirement comes out of left field — which it inevitably will.”
Eric Hanselman, chief analyst at 451 Research, agrees that network density is a major issue for hospitals. But, he says, it takes more than just capacity to address intensifying network data traffic.
“Because hospitals often operate in buildings that were not originally designed with wireless networking in mind, it’s not unusual for them to have interference issues,” he observes. “Hospitals must also isolate their different data streams, such as medical device telemetry and paging, from each other.”
Mobility and security requirements also make it important for hospitals to improve asset management, geofencing and related disciplines. “If someone on the second floor needs a crash cart, they need a way to see that the closest available one is on the fifth floor,” says Hanselman. “And if someone is rolling a crash cart out of the building, you probably want to know that too.”
No. 1
Information management in EHRs is the top patient safety concern in 2017, ahead of other worries such as unrecognized patient deterioration, antimicrobial stewardship and opioid administration in acute care.
Source: ECRI Institute, “Top 10 Patient Safety Concerns for Healthcare Organizations 2017,” March 2017
Innovating for Effective, Efficient Support
Healthcare facilities that deploy infrastructure elements effectively find that this IT provides valuable support for innovative initiatives. For example, the Medical University of South Carolina has been at the leading edge of clinical research and the adoption of technologies such as telemedicine. MUSC’s telemedicine programs for rapid stroke response, pediatric care in public schools and long-term diabetes patient support are particularly innovative in their use of remote IoT devices and multimedia conferencing tools such as Cisco Jabber, says Ben Rogers, the organization’s IT director.
As MUSC expands its clinical applications and services, Rogers says, his IT organization must do more than just build robust infrastructure. It must also become more disciplined in its service management processes. MUSC has launched a major initiative to improve the effectiveness and efficiency of its support operations through ITIL, the IT Infrastructure Library, which recommends practices for technology service management to align IT with business needs.
“IT service management best practices like ITIL are a must if you’re going to keep a growing number of critical applications up and running within your finite staffing constraints,” Rogers says.
He also advocates the adoption of cloud services. MUSC has adopted Software as a Service for several of its applications, including clinical trial patient management, credit card processing and collaboration.
Rogers acknowledges that healthcare providers are especially concerned about cloud security due to the potentially disastrous consequences of a breach of personal health information. However, he believes that several factors — including new technologies for cloud security and the legal protections afforded by business associate agreements (BAAs) under the Health Insurance Portability and Accountability Act — now effectively mitigate cloud-related risk.
“Cloud providers have plenty of skin in the game when it comes to legal and reputational exposure in the event of a breach,” Rogers says. “So it’s really worth offloading ownership burdens onto reputable cloud partners wherever practical.”
What’s Next for Healthcare IT?
Medical technology is evolving rapidly. Among the top trends healthcare IT professionals should keep an eye on:
The testing revolution: Researchers are developing new ways to diagnose diseases, especially cancers. According to the nonprofit ECRI Institute, one particularly promising area is liquid biopsy, a type of genetic testing that samples a patient’s blood or urine, rather than tissue, to identify genetic markers of interest to oncologists. These tests could greatly improve medical care, but they are likely to put new strains on hospital lab management systems.
Opioid abuse prevention: Hospitals are on the front line of the nation’s battle against epidemic opioid abuse. Prescription drug monitoring programs represent a valuable weapon in this battle by detecting patterns in the dispensing of medications. Another emerging tool is spectroscopy analysis, which helps clinicians understand the drugs in an individual’s system. This information could be aggregated and shared with law enforcement to detect patterns of abuse in local populations.
Accountable care and coding: As private insurers, Medicare and Medicaid adjust to changes in healthcare legislation, hospitals will need highly adaptive systems that help make sure they get paid for the care they provide — and report accurately on metrics such as readmission rates to maintain their access to funding.
Solutions and services from CDW can help your organization deliver healthcare innovation.
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