Guest Column | July 26, 2017

The Internet of Things In Healthcare

Retailers Anticipate Substantial Changes Driven By IoT

By Eileen Haggerty, senior director enterprise business operations, NETSCOUT

The world of healthcare IT is well immersed in the Internet of Things (IoT). As healthcare technology continues to innovate, advance, mature, and adopts a more patient-care centric approach to delivering healthcare services, dependency on intelligent devices and the Internet has exploded. Prompt, secure, cost-effective access to patient Electronic Medical Records (EMRs), imaging services, and test results is part of daily life in hospitals and clinics today. After all, this data is essential for collaboration with specialists and communication with patients to the point where having access anywhere, and from any device, is considered “table stakes.”

Handheld devices, carts on wheels, smart phones, and multi-form tablets have replaced paper charts in healthcare organizations. And, with rare exception, access to the information healthcare professionals depend on is available via web-based services. Whether it is a Software-as-a-Service (SaaS) application or a multi-tiered application with a web-front end, quick access to this data has rightly become the expected norm, all of which contributed to the transformational impact the IoT has had on healthcare.

IoT Drivers And Hidden Dependencies
There is no doubt the IoT is a considerable leap forward in quality patient-care services. One only needs to recognize the value of a doctor standing bedside, showing a patient the results of an X-Ray on a tablet and discussing treatment options, to know this is a better approach than waiting hours or days for film to be developed. IoT adoption has led to greater dependency and expectations too, such that slowdowns, delays, and outages can bring prompt patient care to a screeching halt.

Optimizing healthcare application service performance in the age of IoT is therefore essential and demands a need for greater visibility into the data crossing healthcare networks, as well as a view of how to better manage the technology itself. Vendor-independent visibility is paramount due to the valuable time lost in finger pointing among various application, infrastructure, and third-party Internet providers when analyzing slowdowns and outages.

The benefits to be gained from the IoT are well recognized, and speed of treatment and safe administering of care and patient information are top among them. This, in turn, is driving the explosion of web-based services, support for hand-held devices, greater dependency on Wi-Fi networks, and improved network protocols for authentication and approval to use these resources. And, collectively, this can pose a major challenge in the modern healthcare environment.

When hospital staff experience delays in getting to the patient records, it is understandable why they might blame the EMR. Or when they don’t get the message approving patient insurance, they blame the email system. In many cases, it is not the EMR or the email system, but some other supporting service.

However, much like treating a fever, which is symptomatic of some underlying infection, so too are response time delays in application services in a healthcare environment.

Tackling Network Issues With Greater Visibility
Full visibility into the multi-tiered application service is needed to correctly diagnose the source of this symptom and problem. It could be a configuration issue, a bandwidth issue, an access privilege issue, or a multitude of other sources. Quick triage and troubleshooting with vendor-agnostic visibility into the application service and its dependent services is, therefore, needed to ensure patient-impacting services are operating at peak efficiency.

Consider any web-based service, for example. Users type in a URL to reach the EMR system and expect to be able to log in with the proper user ID and start pulling up patient records, history, and treatment plans. One day, individuals at one member hospital experience problems logging in. It could be the EMR system, or the connection between the hospital and the data center or SaaS service, or it could be a problem recognizing the URL.

DNS (Domain Name Service), a protocol that resolves the URL to the proper server IP address, is another critical enabling service to healthcare organizations as a result. It facilitates many web-based activities, including email services, cloud-based services, and either multi-tiered, web front-end EMR solutions or outsourced Software as a Service (SaaS) deployments for e-prescription services. When DNS performs badly, all or many of the healthcare’s services will suffer; they may be unable to update patient records, retrieve emails, approve treatment plans, or order diagnostic tests.

The Network And Application Visibility Imperative
Recently, a hospital was using hands-free communications devices for their medical staff while they care for neonatal ICU patients. These devices, or badges, allow for communication in a more sterile way (i.e. without relying on a phone) and leave hands free to hold and administer treatment to the baby. However, staff experienced issues with these devices. The neonatal badges were completely inoperable, hampering communication between nurses and doctors attempting to care for their critical, premature infant patients.

Proper visibility and analysis into all the services that support this communication badge discovered errors in a server supporting an essential configuration protocol for devices to connect to the network (DHCP — Dynamic Host Configuration Protocol) that prevented the devices from ever getting access to the network. Once the problem with the server was corrected, the critical communications tool in the healthcare provider’s neonatal unit was restored.

As these examples demonstrate, the reliance on today’s hyper-connected, IoT world depends on more than the service or application the healthcare staff is using at the moment. The physical and virtualized infrastructure, hybrid cloud, wired or wireless connectivity, multiple vendors, and supporting network protocols all play a part in ensuring the EMR and imaging services operate properly. When (not if) slowdowns and outages occur, broad, complete visibility is necessary to avoid further delays in restoring those critical patient-care impacting services to optimal performance.

The IoT age has certainly changed and improved the way healthcare organizations deliver a high-quality patient-care experience. As healthcare IT continues to expand with innovative technologies, dependency on high availability before, during, and after implementations will only drive the critical need for complete, vendor-independent visibility and service assurance even more.