The various technologies that make up IT infrastructure are the foundation for all the other forms of health IT that make hospitals and health systems operate effectively. As such, infrastructure technologies are among the most important in the healthcare information technology arena, and they must be operating optimally.

Here, three infrastructure technology experts from Cisco Systems, Dell Technologies and VMware offer best practices for optimizing infrastructure so that it is working best for individual healthcare provider organizations. They target their advice at healthcare CIOs and other health IT leaders who are looking to make sure their infrastructure is rock solid and humming along smoothly.

The entire business transformation journey

To fully optimize infrastructure, IT needs to plan for the entire business transformation journey to include reimagining their apps for the patient/clinician experience and then build the infrastructure for those experiences, said Kathryn Howe, Cisco healthcare director, Americas industry digital transformation.

“Patients today need humanized experiences from healthcare providers, personalized interactions, easy access to information, and on-demand responses from clinicians,” she explained. “To keep up with the ever-changing patient needs, healthcare organizations are becoming more digitized, offering new apps and more. Adopting new technologies can create as many challenges as advantages if organizations focus only on optimizing IT infrastructure. IT needs a digital transformation framework to succeed.”

"It’s the enablement stage where healthcare providers optimize their IT infrastructures to digitize existing services."

Kathryn Howe, Cisco Systems

Integrating, securing and optimizing the IT infrastructure is the first step in the digital transformation framework, she said.

“It’s the enablement stage where healthcare providers optimize their IT infrastructures to digitize existing services,” she noted. “This step will streamline and enhance employee and customer experiences through primary offerings such as home care services, mobile engagement and location-based analytics. With the infrastructure in place, CIOs get to optimize their resources to deliver more value, such as implementing personalized engagement strategies, offering online support groups and virtual services.”

The IT infrastructure is fully optimized when it is being used to power the organization’s most sophisticated endeavors, she added, from new business models to disruptive digital experiences like AI-driven patient scheduling and predictive analytics.

Looking at internal resources

On another front, typically, when a healthcare provider organization is looking to invest in an IT optimization project, it first considers its internal resources, specifically budget and the potential for staff disruption, said David Dimond, healthcare and life sciences chief innovation officer at Dell Technologies.

“We can learn from some of the recent rocky implementations of electronic health records in which budgets exceeded expectations and significant delays were experienced in implementation and integration,” he stated. “According to one survey, 56% of respondents didn’t believe that the challenges of adopting a new EHR system were equal to, or outweighed, the benefits of integration.”

"Some infrastructure optimizations can free up resources to invest in innovation, as is the case with multi-cloud deployment."

David Dimond, Dell Technologies

Examples like these have made healthcare organization boards circumspect in investing in digital health projects, Dimond contended.

“This thinking is unfortunate, as some infrastructure optimizations can free up resources to invest in innovation, as is the case with multi-cloud deployment,” he explained. “Adopting, or optimizing, a multi-cloud infrastructure allows healthcare organizations to capture, process and access data significantly faster – wherever it resides – improving everything from patient care delivery to billing.”

Just as every healthcare provider organization must have its own specific business model, each company’s cloud strategy must match its specific clinical and business workload needs, he asserted.

“Cloud strategies are ever-evolving, not simple one-off solutions,” he said. “Multi-cloud solutions have come a long way – you adopt a hybrid cloud environment with an integrated cloud infrastructure – compute, storage, networking and security – that runs on premises and in public clouds. Organizations should expect consistent operations with infrastructure across private and public cloud, and the edge – for a true hybrid cloud experience that is seamless to its end users.”

For example, on-premises solutions may be optimal for certain workloads and ideal in terms of risk reduction and monitoring, while off-premises solutions offer better manageability, ease of procurement and cost, he said.

“For this reason, every healthcare provider must decide their own workload priorities and optimize their cloud strategy to match the best location for data and applications,” he said. “A multi-cloud infrastructure provides a single pane of glass to identify and monitor the data across the healthcare ecosystem, simplifying intelligence at the point of care and collaboration among clinicians.”

Operational automation and workforce transformation

Christopher Logan, director of healthcare industry strategy at VMware, offers another best practice when optimizing infrastructure technology: operational automation.

“Automation in healthcare, when coupled with emerging technologies like AI, does not get its fair amount of press or headlines,” he said. “When applying automation across/within the infrastructure, basic operational tasks and administration can result in a number of efficiencies like better patient experience, greater employee satisfaction, increased quality of services, improved project delivery and a significant reduction in cost.”

"When applying automation across/within the infrastructure, basic operational tasks and administration can result in a number of efficiencies."

Christopher Logan, VMware

Another best practice, he said, is workforce transformation. The workforce is constantly evolving, due to factors such as technological advancements and the demand for new skill sets.

“Coupled with the fact that employees today have high expectations for their digital experiences, workforce transformation is critical in achieving broader digital transformation,” he explained. “It is imperative that all healthcare organizations find the right tools and technologies that provide employees with flexibility and secure access to ease IT management burdens and improve productivity.”

This does not stop there, as providing a consistent user experience has the capability to transform both the patient and employee experience, which is critical for engagement and retention, he added.

Securing data

When it comes to optimizing infrastructure, cybersecurity strategies need to permeate infrastructure as well as all levels of a healthcare provider organization, said Howe of Cisco.

“Today’s CIOs face more than the risk of costly data breaches,” she said. “Failing to meet standards like HIPAA can result in fines for up to $1.5 million per year. In order to protect patient data and meet compliance standards, CIOs need to enforce a strategy that permeates all layers of the organization, from technologies to the people.”

At the network level, a fully integrated secure IT infrastructure will be key to enabling IT teams to maintain a pulse on all activities in real time and address potential risks before they occur, she advised.

“An effective tactic is using micro-segmentation to limit the spread of attacks between devices and across the network by creating profiles, policies and permissions that are specific to those devices, reducing unauthorized access for all users,” she said.

At the user level, it is vital to empower and train teams to keep data secure.

“Implementing two-factor authentication platforms for patients, healthcare staff and third-party vendors should be a non-negotiable, and can help organizations stay compliant and safe by ensuring that only trusted users and devices can access certain sensitive applications or data,” she cautioned. “This is especially important as more healthcare organizations adopt remote access technologies and devices to deliver seamless connected experiences to patients and streamline workflows for clinicians.”

Cybersecurity posture and cloud migration

Logan of VMware agrees with Howe that cybersecurity must be a big part of infrastructure optimization.

“Sophistication and frequency of cyberattacks are increasingly placing a strain across all sectors, especially in healthcare,” he noted. “In order to navigate these complex and dynamic environments, healthcare organizations and their leaders must have a strong investment in digital technologies, and an even larger investment on cybersecurity strategies.”

A proactive cybersecurity strategy and shift needs to continue happening across healthcare to protect patient data from security threats, ensuring the availability and integrity of critical healthcare workloads, he added.

Elsewhere, he said that hybrid and public cloud migration is an important part of infrastructure optimizxation.

“Organizations across all industries are increasingly adopting hybrid and public cloud models, due to its offerings of scalability, agility and speed to market,” he said. “By making use of cloud solutions – whether from Google, Amazon, Microsoft or another provider – healthcare providers can simply scale the technical resources needed to run critical applications and drive cost savings.”

At the same time, this is preparing those providers to adopt IT modernization to deliver dynamic on-demand services to meet the needs of their workforce and patients, he added.

Building out an IoT strategy

The Internet of Things is a big part of healthcare IT infrastructure. An emerging focus for healthcare organizations is building out their IoT strategy.

“IoT and edge solutions have been adopted by consumers, most notably, fitness trackers and smartwatches,” said Dimond of Dell Technologies. “A study by Statista found that more than 56.7 million people wore wearables like smartwatches and Fitbits in 2019. This market will continue to grow and analysts predict the number of users will increase to 67 million people in 2022.”

“In an acute care setting, there are 10-15 connected devices for every U.S. hospital bed, which creates a significant amount of data,” he noted. “Overall, healthcare data grew 878% from 2016 to 2018, with much of it coming from sensors, wearables and mobile apps for preventative care and chronic disease management.”

However, it is one thing to generate all this data, and quite another challenge to digest it all and generate patient insights. Healthcare providers are investing in distributed analytics to improve patient safety and monitor recovery, expand chronic disease management, enhance precision medicine through research, and manage pharmaceutical supply safety – just to name a few applications, Dimond said.

“Real-time analytics at the edge creates an opportunity to identify, refine and understand the data where it originates, for the fastest possible insights and action,” he said. “To support the distributed network of data-driven devices, healthcare organizations require a multi-faceted approach.”

As healthcare provider organizations build their edge and IoT strategy, they need to evaluate their unique multi-cloud approach in parallel with specific application workloads, he advised.

“Depending on classification, some data – such as EHRs, laboratory information systems and clinical decision application data – may be stored on-premises,” he concluded. “Other data may be stored in the cloud – whether private, public or hybrid. It is important to consider how data can flow securely and efficiently from the edge to the data center and to multiple clouds.”

Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himssmedia.com
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