Healthcare IT Blog

2013: Looking Ahead

Published on 01/03/2013 by Jim Fitzgerald Matt Donahue Rob Bruno
Category: Healthcare IT

As we begin 2013, we’ve asked a few of the senior technical experts at Park Place to provide their insight on technology trends, challenges, and opportunities that will influence how hospitals will deploy and manage their MEDITECH systems in the coming year.

Jim Fitzgerald, EVP & CTO: Hospitals using the MEDITECH HCIS enter 2013 with a level of mission and seriousness that has ticked up significantly. The ARRA-fueled adoption of advanced clinical software has changed the stakes when it comes to availability, security, access, mobility, and data protection. Systems for managing compliance, security frontiers, data availability/integrity and system availability that did not exist or would not have been considered in a health IT budget 10 years ago are now at center stage. Our thinking about how to provision IT has changed, too. While we used to think about technology, software, and service in traditional categories or capital and operating expense, and build 1-5 year “infrastructure evolution plans” (e.g. what?, why?, whenever!) that achieved a particular IT posture, we today tend to consider cloud hybrid models that break IT into layers of services and share the work between purpose-built internal systems and general-purpose or customized cloud services. With HCIS vendors integrating more and more clinical content, and early adopters installing their first genetic profiling suites, there is no doubt in my mind that a massive amount of health information will continue to be acquired and managed on-premises for the treatment of patients, and yet at the same time, data that is mainly maintained today for compliance reasons can begin to move transparently into secured, lower-cost “file cabinets” out in the cloud. Securely striking a balance between what must be done in-house versus what is best managed in the cloud is a key challenge for Healthcare CIO’s and IT people in general in 2013.

The quick review provided by Matt and Rob below on virtual mainframes and VDI are just two of the enabling technical tools behind this trend. A lot of people know that we are vendor neutral at Park Place International. That is to say we believe a conversation with our customer should be about what is good for them, versus what is good for their technology provider. It’s not that we don’t like, appreciate, and seek strong, certified, friendly relationship status with our technology providers; it’s just that in a world of relative priorities, for us, customer needs have to outweigh vendor agendas. As the last remaining MEDITECH collaborative solutions partner who is both MEDITECH–centric and vendor neutral, and works with all of MEDITECH’s certified technology platforms, we are taking the next step and becoming IT paradigm neutral. That means that when you call us there is no single big “push to the cloud” nor is there a “thirst to ship and install hardware”. What I expect of our sales team, engineers, and consultants, and what you may reasonably expect of them, is help in creating a sustainable IT platform for MEDITECH and your other critical IT applications. They will listen to what you are trying to accomplish, understand your skills and preferences, and share what they have learned working on similar challenges within the MEDITECH community. There is a “right mix” of internal IT services and cloud-provisioned IT services for each unique environment, and we are developing the tools and disciplines to help you explore and implement your options.

Matt Donahue, Sr. Solutions Engineer:   Whether it be server virtualization, desktop virtualization, storage virtualization or application virtualization, it is nearly impossible to go into an IT department these days and not find some fashion of virtualization somewhere.  Virtualization, it seems, has truly become the rule as opposed to the exception.  This has enabled high availability and ease of deployment that was previously unattainable for all but a select few.  Virtualization is a great thing and has changed the way IT looks at what used to be traditional hardware assets.  A server is now longer a physical server.  Your desktop is no longer tied to that black box sitting on your desk.  These are now just images that exist on pieces of iron in the data center.  You still have those same physical assets that need to be managed.  A server is still a server, a router is a router, a switch is a switch and a storage array is still where all your data is stored.

So, where do we go from here?  Wouldn’t it be nice to have a single architecture or device that can handle everything?  UCS, vBlock, FlexPOD, HP MATRIX and IBM PureFLEX are all attempts at this, but they are really just overlaying management software between the traditional IT architectures and the end user.  These are great systems and certainly have their place, but to be quite honest, I do not see them as game changers.  What’s going to bring that “wow factor” back to IT?  I have a vision of the future that may be completely different than what has traditionally been available.  Why not have a single architecture that combines all of the traditional IT assets from access to computing to storage to networking.  Now take that architecture and make it capable of directly integrating into the cloud, giving you the ability to house everything onsite, nothing onsite or almost any combination in between and have it all perform.  This is what I see as that next “wow factor” for MEDITECH hospitals.

Rob Bruno, Sr. Technical Principal:   As Virtual Desktop Infrastructure (VDI) is becoming more widely accepted, several challenges are coming to light.   One specific challenge comes to mind: accessibility.  Without a highly available and resilient access methodology, VDI environments are less than efficient. Accessibility can be thought about from two distinct points of view:   from the “inside” or from the “outside”. Inside access is access from within the local environment.  Outside access can be thought of as any access from the public infrastructure (i.e. Internet). High availability has many components that need attention.

Let’s focus on “outside” access.  Access to your VDI environment from the outside requires DNS, load balancing, sufficient bandwidth, and a client platform. DNS is a methodology for naming the VDI endpoint and usually provided buy your Internet Service Provider (ISP). Most enterprise level ISP’s provide resilient DNS methods so there should not be much to do on that front. Load balancing is a method of presenting multiple connection destinations as a single entity. This can be achieved by various methods from dedicated appliances to more elaborate systems. Load balancing is something you can do at your facility to provide two benefits. First, as the name states, you can balance connections among several devices for redundancy. Second, these devices allow you spread the connection load to even out the bandwidth allocation. This leads having enough Internet bandwidth. These days bandwidth is relatively inexpensive, so get the fastest Internet circuit you can afford to ensure both accessibility and high availability.

In 2013, we resolve to provide insightful, interesting articles that explore a variety of technology topics for MEDITECH and the healthcare enterprise to help you in the pursuit of Operational Sustainability.  Happy New Year!