Moving towards the future

In health care what does one do when faced with growing storage requirements, shrinking budgets, and limited staff resources? One sits down and develops a comprehensive strategy to minimize the risks.

At my new position I am faced with these opportunities (sorry been hanging out with too many project managers) here is a rough outline of my thoughts.

1. Image Archival - implementation of an image archival solution that will integrate with our current EMR will allow us to remove the copious amounts of PACS images to a HIPAA compliant, redundant storage system. This will free up space on our primary SAN empowering a move towards virtualization.

2. Backup - implementing a new backup system such as EMC's Avamar, CommVault, or HP's solution for backup will eliminate the daily struggle with DPM, reduce the across the wire backup traffic, and ensure the long term availability of disk to disk backups. Additional benefits are de-duplication (reduced backup sizes) and no tape backups or management.

3. DR - Disaster recovery is critical in health care. The ability to quickly fail over and restore clinical systems is mandatory. VMWare Site Recovery manager will allow us little downtime in the case of catastrophic Data Center failure or network failure. Combined with vmdk backups we will quickly be able to restore server systems and applications. (network also needs to be addressed)

4. Virtual Infrastructure - The move towards Virtualization has begun. The reduction of server sprawl and consolidation of infrastructure is the future. A very conservative beginning will get us 60-70 servers on 8 HP blades in a C-7000 enclosure with another duplicate enclosure at our DR site. The amount of savings in hardware, electric, and cooling will be considerable.

5. Virtual Clinical Workstations - Once the archival, backup, DR, and virtual infrastructure is in place it will be time to plan a VCW solution. VCW will provide a multitude of benefits for our organization. See my earlier post for some general thoughts, there will definitely be more on this in the future.

The Virtualization of Health Care

Widespread EMR (Electronic Medical Records) Systems are a stated goal of the current US government. On the face of it EMR's improve patient saftey, reduce costs, provide highly available access to critical patient information, provide the ability to improve research, and the list goes on.

To hear most EMR software developers and President Obama, EMR's are wonderful and will solve many problems that exist in health care today. 

I agree that the benefits are many; however there are a couple of major problems. Many hospitals and Dr. Offices do not have the expertise to implement these new EMR systems in a way that is effective and that provides good workflow for the doctors and nurses that are suppose to utilize these systems. Far too often there are not enough PC’s available and logon times are long and repetitive. 

This is where virtualization comes to save the day. Now when I say virtualization I speak of small Endpoints, (Such as WYSE terminals) Virtual Machines, Terminal Services, Citrix, VMWare VDI, Symantec Workstation Corporate and others. My point is that a one size fits all approach is doomed before it begins. Each hospital or healthcare organization has different applications and requirements that effect which solution is best for them.

What would a clinician say if I were to provide a less than one minute logon first thing in the AM that automatically launches the correct applications, Signs on to the applications with built in SSO? Then we up the ante with 5 second reconnects, roaming from one device to another (in between floors and even between locations) along with roaming printing? Then we ice the cake by allowing remote access from the clinician’s home with SSO and everything? Well most clinicians would say sign me up.

EMR’s will achieve all of the goals that the President says they will; however only with careful implementation in a virtualized solution that provides solid workflow.