Is your IT infrastructure ready for the next industrial revolution?

For your next facility improvement project, infrastructure planning should be a leading topic of conversation, not an afterthought.

As the information age has given way to the Fourth Industrial Revolution, the healthcare industry is positioned to reap some of the largest and most meaningful benefits these advances in technology have to offer. This recent burst in innovation, which is just now becoming mainstream, is defined by the implementation of whole-industry-revolutionizing technologies such as artificial intelligence, the Internet of Things, 3D printing, autonomous vehicles, biotechnology, energy storage and nanotechnology to name a few.

The previous wave of advancement ushered in a highly sophisticated, multi-faceted data platform to manage medical care, improve patient outcomes, and automate resource-intense workflows in the form of the electronic medical record (EMR). Some of the EMR’s promises have been fulfilled while others, such as universal access to patient information in the inpatient and outpatient environments, are not always at the same level of service and may fall short of users’ expectations.

Delivering the promises of accurate and real-time medical data to clinicians ubiquitously requires robust IT physical infrastructure woven into the provider’s business strategy and into their facilities’ “bones” regardless of setting.

The outpatient care model is rapidly expanding in more ways than can be imagined, mostly fueled by the latest technological developments. A tech-forward strategy must also be embraced and extended beyond the medical complex to community-based sites where highly mobilized care is provided to facilitate the hospital-to-home continuum of care.

This universal access model places a reliance on certain heavy fault-tolerant technologies: fast, stable network connections (both wired and wireless) as well as onto the underlying building systems which assure this reliability and maintain the same levels of stability as those found in traditional high availability facilities such as 911 call centers, energy plants and data centers. In short, IT Infrastructure is now a utility.

As the delivery of patient care moves away from the centralized hospital setting, and the patient medical record data is also distributed across multiple environments for greater reliability, the interconnection between these remote environments of care, data repositories and mobile workforce must be linked reliably, securely and be scalable.

The truth is, that’s easier said than done. Beyond the sheer scale of the effort and the high price tag that comes with such a distributed undertaking, there are several challenges that make optimizing IT physical infrastructure that much more complicated. It’s time consuming to pinpoint specific infrastructure vulnerabilities (they’re usually found in a variety of locations, systems and processes). Analyzing these into actionable priorities requires specialized skillsets and resources that most facilities don’t readily have available or are committed to other valuable efforts.

IT equipment and mobile devices are shrinking in size and increasing their computing capacity every 18 months, in accordance to the exponential curve of Moore’s Law. This evolution is accelerating the amount of devices needing network and other IT resources at an explosive rate. The growth is seen in every type of device, particularly within new miniaturized sensors enabling everything from advanced building sensors measuring indoor air quality or analyzing foot traffic patterns to body temperature checks for patients who suffer from highly infectious diseases. This new Internet of Things (IoT) will transform healthcare. Facilities must be ready for the tsunami of devices on the network and the mountains of data these will produce. Mining this data for actionable care and overall trends will place extreme stress onto the most capable IT infrastructure. In healthcare, IT infrastructure is business strategy.

So, how do healthcare providers prepare for what comes next?

In order to stay ahead of the revolutionary curve: prepare for the onslaught of data, and the resources this data will require to transport it, process it, store it, analyze it and distribute it, healthcare providers’ IT infrastructure will make best use of the following “hosting” strategies in order to be more than flexible. Providers must embrace the idea of infrastructure being elastic: resilient, able to scale and contract when and where needed.

Scenario 1: Brick and Mortar
One of the more expensive options, the brick and mortar solution requires a data center on site to house all the information, with ample square footage, power and cooling to support it. Since you aren’t depending on the functionality of the cloud, there’s a smaller risk for losing invaluable data and the existing risk is all in your control with EMR and other critical systems having to transmit information only a short way. While there are upsides, it’s not reasonable to solely rely on this strategy for data management without some level of redundancy.

Pros:

  • Local and easily accessible
  • Short, fast transit of data
  • Direct control of repository

Cons

  • Costly construction and maintenance
  • Security and privacy compliance (HIPPA)
  • Redundancy adds to cost and complexity of systems

 

Scenario 2: Cloud Hosted
This approach takes advantage of third-party data center providers in a way that won’t require them to build a brand-new data center to run it. This has been a growing trend with many healthcare facilities or clinics. EMR providers’ ‘software as a service’ comes with a subscription fee model, with the added bonus of not requiring you to hire IT administrators, buy servers, or host your data locally.

The trade-off lies in the fact that you’re now relying on everything to be in the cloud (remote to your locale and out of direct/immediate reach), meaning that your network has to be extremely robust to ensure a seamless experience. Whether you’re a standalone clinic or big hospital system, in order for your system to completely rely on remote cloud resources, infrastructure should be designed to operate at full capacities with redundancies in the event of internet failure. In other words, you need solid backup, whether it’s a redundant copy of data and resources down the street or halfway across the country.

Pros:

  • Outsourced hosting
  • Dedicated security protocols
  • Limited local resources
  • Redundancy “on-demand”

Cons:

  • Limited direct control or access
  • Support resources must be deployed or hired locally
  • Pricing almost always based on real estate model (square footage of energy used)
  • Network connectivity can be costly

Scenario 3: The Hybrid
By far the most common-sense approach we see, the hybrid model holds critical and time sensitive information locally, and hosts other less critical information or redundant backups remotely. It’s an effective measure given that you can scale to your budget. It’s also more elastic. Distributed information is more fault tolerant (think tornadoes, earthquakes or tsunamis in your region), and locally hosted (while remotely backed up) provides low latency, and direct control of large data sets, like 3D imaging files.

Decision time: Cloud vs brick vs hybrid
Large, widespread IT infrastructure strategic changes aren’t something you need to address every year like spring cleaning; they may be best reserved for times when you’re bringing on big projects in the near future that will affect staffing and bed count, providing the rare opportunity to address potential long term goals such as preparing for the next technological advancements in healthcare.

As consultants, we walk our clients through an audit of existing physical infrastructure functionality and features, a discovery phase that helps us focus on their priorities and budget and ultimately, a recommendation to move forward.

Here’s how the conversation begins.

  1. Geography: It’s important to weigh the pros and cons of where you’ll be storing your information, whether that means on-site, remotely, or a combination. Then you take it a step further: is adequate connectivity feasible for your location? Are you in a natural disaster region that’s prone to power or other critical service outages? Do you anticipate hurricanes, tornadoes, or other disrupting factors that could adversely affect your IT capability? If so, data redundancies should be in place at other locations that don’t face this type of challenge and will be readily accessible after disaster strikes.
    Large medical systems and academic/research hospitals where clinical trials and drug development takes place, for example, recognized their physical vulnerability and secure a “cold storage” site in less vulnerable locales in off-site data centers.
  2. Power: Brick and mortar solutions require redundant power sources, that can survive for extended periods of time off the power grid. Cloud-based solutions are redundant within themselves, but not accessible from a disaster-stricken hospital for example. You’ll need to weigh the feasibility of local redundancy against more remote connectivity to your facility.
  3. Budget: The balancing act of budget vs. value and benefit are always at play when making critical IT infrastructure decisions. Ensuring all infrastructure components are accounted for within the budget will ensure a solution is truly feasible to implement or not.

No matter what, count on technology to continue to change the way healthcare is delivered, enabling a highly connected workforce and an explosive growth in micro sensors and related data. The next generation of patients will expect the same level of technology integration as the experience in their homes.

All that equipment has to be supported, data must be conveyed and extracted and actionable medical decisions must be supported by a robust IT back-end. While we can’t predict the future, it goes without saying that hospitals and the technologies they depend on will evolve at an increasingly faster pace.

For your next facility improvement project, infrastructure planning should be a leading topic of conversation, not an afterthought.