Guest Column | October 27, 2017

Assuring The Healthcare IT Evolution Enterprise-Wide

By Eileen Haggerty, Senior Director Enterprise Business Operations, NETSCOUT

Is EHR Tracking For Your Healthcare IT Clients Ethical?

In his keynote speech at the 2017 Healthcare Security Forum, former Department of Homeland Security Secretary Tom Ridge highlighted that a new reality exists with the proliferation of applications and access devices in healthcare. “IoT will become the Internet of Everything,” said Secretary Ridge. “Everything that makes healthcare more efficient, every access point, new device or algorithm, for every positive there’s a negative: risk and vulnerability.”

It is safe to say the former Secretary Ridge’s comments may have been influenced by several recent security breaches. But it is also fair to add that assuring the availability and performance of healthcare services, either in private or public cloud data center environments, across hospital networks, medical buildings, clinics, and payer/insurer systems is equally important.

IT Evolution In Healthcare
Recent research by Accenture revealed that 95 percent of the respondents from large, medium, and small enterprises believe network services will be virtualized. Further, 89 percent expect that their enterprise will evolve to an “as a service” model within the next three years. The fact is that 33 percent are using “as a service” solutions today. Many healthcare application services are already offered and deployed “as a service” most notably their Electronic Medical Record (EMR) applications. And others, too, are using Cloud storage (storage as a service) for elasticity and agility requirements that come with retaining many large imaging files.

The importance of these services to healthcare cannot be understated – disruptions, for any reason, are unacceptable and can be patient-care impacting. Forrester Research reported in 2016 that 46 percent of companies using public cloud used two or more providers. Pinpointing root cause in such situations can be delayed and time lost as equipment and service vendors claim innocence as the source of the problem.

These challenges can be broken down into three categories:

  • Architectural Complexity – Hybrid cloud and Infrastructure-as-a-Service (IaaS) bring challenges when the application service (e.g., EMR) includes components and enablers on different platforms in both private and public cloud and across multiple vendor technologies and physical locations (e.g., hospitals and medical buildings).
  • Disparate Tools Cause Ambiguity – The mix of multiple tool technologies throughout the service chain can compete and even conflict with each other, making analysis both time consuming and inconclusive. In healthcare, vendor finger pointing that adds to the delay in discovering the problem can have catastrophic repercussions.
  • Visibility Constraints – Service assurance depends on actionable intelligence. Packet-based visibility is ever more important, at precisely the same time it is becoming more challenging to implement. And to date, there has been a lack of solutions that provide the same visibility across the private, public, and hybrid cloud environments.

Healthcare organizations are experienced with the challenges of multivendor environments, having wrestled with different providers for EMR applications, imaging applications, e-prescription applications, and associated problems with pinpointing the root cause of issues within their own data centers. Hybrid cloud adds yet another layer of complexity.

Conquering the deployment issues and cost concerns have been barriers to achieving the necessary visibility into the hybrid cloud environment for seamless migration. Service assurance leveraging wire data is a long- recognized approach to successfully minimizing risk of slowdowns and outages in healthcare networks. Innovations that expand the reach of monitoring and analysis to places typically not feasible with a physical probe are strategies to overcoming these visibility challenges.

Keeping Healthcare Operating During It Evolution

IT evolution in healthcare, including migrating services to the cloud, is a daunting challenge. Frankly, it must feel like changing a tire on a car in motion. Patients don’t stop requiring treatment, illnesses don’t take a break, and surgeries don’t go on sabbaticals. Business continuity is at the forefront of that migration.

Consider a large mid-west U.S. healthcare organization that when it came time to upgrade and replace its existing on-premise EHR system, it selected a cloud-based EMR solution to take advantage of greater integrated services, improved access from anywhere and any device, as well as anticipated cost savings in the long term. The doctors, nurses, and clinicians continued to use the legacy EMR in the healthcare’s data center until the IT team was convinced the deployment and operation of the new cloud-based system were ready.

In order to migrate with confidence, the IT team leveraged a service assurance solution they used in their own data center to monitor and analyze the cloud EMR before, during, and after the transition. This proved fortuitous when they discovered the source of intermittent blocked test transactions was in fact several mis-configured firewalls at some of the hospitals’ remote locations. Fortunately, it was discovered prior to doctors, nurses, and clinicians being blocked on real patient- impacting transactions.

Successful IT Evolution For Healthcare Means Managing The Risks

If we go back to Secretary Ridge’s keynote at the Boston Healthcare Security Forum, he put things in perspective when he concluded with the following counsel: “You can’t eliminate risk – manage the risk before it manages you.” Complete visibility into your IT evolution, before, during, and after (e.g., new virtualized environments, storage as a service, and / or hybrid cloud application services) can be successful and rewarding with service assurance management.

In the case of our healthcare organization with the new cloud-based EMR, once the firewall configuration issues were corrected, the healthcare embarked on a whole new world of cutting-edge services and healthcare application interoperability. The benefit that the hospital and its staff most appreciated, however, was that in the end, this IT evolution into cloud EMR improved speed, safety, and efficiency of patient-care throughout their community. And isn’t that the ultimate testament to IT evolution!