Non-clinical technology in healthcare has been decades behind other industries. Providence—a not-for-profit health system with over 117,000 caregivers (employees) across 51 hospitals and 1,000 clinics—was no exception. Providence has been on a four-year journey to transform business processes and technologies. In July 2022, we achieved a monumental milestone implementing an enterprise-wide integrated ERP cloud platform. Since go-live, others have been reaching out to learn from our journey. With that, I’d like to share our story.

Overview of our journey

Providence’s technology landscape previously consisted of a dozen disparate, outdated systems – a result from decades of mergers and acquisitions. There was a lot of variation with our processes and policies, and overall, a poor experience for our caregivers. Activities were manual, with limited controls, cumbersome to get insight into spend, and in some cases, no automated workflow in place hindering productivity. Providence needed solutions that could scale as we grew and aligned with the evolving complexities of healthcare (e.g., unions, compliance/regulatory requirements). We needed to improve our caregivers’ experience, so they could focus on providing quality patient care.

With these needs, we replaced our legacy HR, Finance and Supply Chain systems with an integrated ERP cloud solution and streamlined processes and policies. Providence is now the largest healthcare system on a single cloud ERP instance delivered at 2-3 times the typical scope implemented in a single go-live. Adopting a cloud-based ERP enabled Providence to accelerate and reduce our deployment time by 25-50% compared to other large-scale ERP implementations. CIO/EVP B.J. Moore states, “This program has propelled us forward in the healthcare industry, eliminated our technical debt and aligns with our strategy to simplify our processes and technology, modernize through a cloud SaaS solution and innovate with AI. Our caregivers are working in one seamless digital platform accessible from anywhere, anytime from any device.” In addition, Providence is now an industry leader with one cloud ERP and one EHR where we’ve laid the foundation to rapidly adopt changes and innovation and are well-positioned to influence how the industry maximizes the existing capabilities of RPA, AI and ML.

Providence is now an industry leader with one cloud ERP and one EHR where we’ve laid the foundation to rapidly adopt changes and innovation and are well-positioned to influence how the industry maximizes the existing capabilities of RPA, AI and ML.

Providence demonstrated resilience throughout this initiative. This was one of the most complicated and challenging initiatives implemented at Providence. Also, it was deployed during one of the most turbulent times in history for healthcare with a trifecta of crises – the COVID-19 pandemic, financial difficulties due to inflation, low volumes and increased labor and supply costs, and global workforce shortage. Despite these challenges, we remained focused on delivering the complex program by finding creative solutions to keep the program moving forward, while 100% remote and reallocating 90% of business resources to support COVID-19 response and recovery. The 500+ program team responded rapidly to evolving business needs due to the pandemic. For example, we pivoted quickly to design changes with hiring processes (e.g., updating COVID-19 policies and vaccination requirements, and accelerating new caregiver onboarding) – expediting deployment of changes like these were essential for the program’s success.

While we focused on pushing the program forward, Providence responded as a unified organization and continued delivering high-quality care to our patients. And continuing the 165-year legacy of investing in communities, Providence contributed $2.1 billion in 2022 to the communities we serve.

Key learnings from our journey

PEOPLE – Gain commitment from executive leadership and business stakeholders. Providence executives, CIO/EVP B.J. Moore, CFO Greg Hoffman, Chief People Officer Greg Till and COO Erik Wexler, had the foresight that investment to simplify processes and technology was critical for our future and would better prepare us for major market disruptions. I’m grateful for their leadership towards making the vision of an integrated ERP solution a reality.

Do not underestimate change management and implement a comprehensive plan across all levels and throughout all phases of the program. Establish a change agent network and listen and respond to their feedback – input on the user experience is invaluable. Facilitate end-to-end process training and leverage embedded learning tools to accelerate adoption. Communicate early and often that go-live will not be perfect, plan for surprises and unplanned issues.

Proactively manage resource burnout and engagement. This is not a sprint, but a marathon. It’s a long, emotionally-taxing journey. Focus on how to keep people motivated and engaged, including reinforcement of why we are doing this.

PROCESS – Set the vision that this is a transformation of business processes and technology. Seize the opportunity to rationalize and transform processes and policies. Develop a strong partnership between IT and business – my deepest appreciation for the leadership of SVP of HR Ops/Payroll Lynne Farlow, VP of Transformation Todd Perry, and VP of Supply Chain Ehab Sahawneh. Our partnership was critical for go-live and continues with our business transformation efforts.

Have a strong post go-live support process in place. Develop operational contingency plans and quick escalation paths to minimize impact on operations.

TECHNOLOGY – Acknowledge go-live will never be perfect. Even with thorough testing, issues will occur at go-live. Strive to find the right balance between going live with the appropriate support structure for quick issue resolution and delays to the timeline to refine the system.

Focus on both go-live and post-stabilization period. Align with business stakeholders and vendors on an operating model tailored for cloud solutions.

Gaurav Dhiman, VP of IT applications, on my team emphasizes, “With a transition to a cloud ERP, it is crucial to strike a proper balance between customization and out-of-box functionality. Too much variation can lead to increased maintenance and hinders scalability and innovation.”

What’s next with our journey

Our focus for the future is on design optimization and driving value through innovation with RPA, AI and ML. We’re continuing to partner with our vendors, providing our expertise in healthcare to help shape vendors’ future product roadmaps. We will continue looking for automation opportunities to advance our operational metrics.

Lastly, I’m reminded of the resilience of our founding Sisters of Providence. It is this same resilience that helped deliver this huge accomplishment for Providence during one of the most challenging times in history for healthcare.

The post Resilience Through Crises: Providence’s Journey to an Integrated ERP appeared first on HealthTech Magazines.

Every day there is a new need for technology. New use cases and opportunities continue to challenge the status quo, if the status quo as we know still exists. The iPhone, now celebrating its 15^th anniversary, revolutionized the world. But the newest and youngest generation does not know life without these devices and expectations of delivery of information are rapid and instant. Healthcare needs to also deliver overall in this space.

In a business sector that has traditionally been behind on the transformation maturity scale, how do you pivot to the quicker and more effective delivery of technology? Among many things that came from the pandemic, one important finding is that healthcare professionals’ understanding and awareness of technology has increased substantially. This drastic maturity forward in how technology is delivered now brings a crossroads. The maturity model now must include more clinical involvement. What do nurses need? What do doctors need? What do patients need? How can clinicians deliver patient care most effectively? What is the true lexicon they work in now? Internally, we developed a council that brought stakeholders from different areas in the organization to discuss foundational technology and roadmap. The most important deliverable is to focus on those business needs and collaborate on technologies and transformations that bring the most value. This feedback loop is essential to understand how rapidly the demands have grown for these areas, which challenges the need to deliver quicker.

Traditional Infrastructure and Operations has to give way to stronger business partnerships and understanding of needs, especially as technology has aligned so closely to patient care. With a technology focus on business, it is important to grow the depth of technology, beyond the traditional data center, endpoint, and mobile. So the new challenge is how traditional I&O teams engineer and administer these newer technologies in the same ecosphere as traditional technology. Today’s transformational journeys of healthcare organizations are full steam ahead. This is the maturity of transformation. But what is the lift needed to not just grow from the legacy systems, but to accelerate that journey quickly? A careful balance. What brings this together is a fully realized roadmap that must be matured to adopt new architectures and platforms that focus on the new deliverables and innovation needed. 

Foundational technology is a building block for the delivery of services, whether it is through the traditional data center or cloud partners and connectivity and technology.

Now, an expanded focus on delivery foundational architecture leads to outcomes for today and tomorrow for delivering better patient care. But what does an organization do to provide focus on sunsetting the current and technology platforms? Years ago, it was the ability to virtualize servers; then it was the ability to build in the cloud; then it was building containers to deliver quickly. But what if an organization is still using a large number of physical servers? This is an essential challenge for I&O leaders. Here is where the partnerships between IT and healthcare stakeholders must provide focus on what is needed to move forward. Steering committees and councils are habitually the avenues to discuss this. My organization focuses on this balance and need. We have developed roadmaps with achievable timelines so delivery of new architectures can be completed in congruence with twilighting the right legacy systems.

As this journey of digital transformation endures, infrastructure and technology teams can accentuate the opportunities to deliver quickly to support patient care. The technology roadmap to move maturity must prevail to be successful. Skillsets and capabilities must also mature. 

With the expansion of patient care virtually through the pandemic, one area that continues to accelerate care is the ability for home health. The different technologies for home health, such as wearables and other monitoring solutions, bring a new focus. My organization is working collectively to connect all these different devices seamlessly and securely, beyond the traditional means. Self Service and automation accelerate these capabilities, delivering critical success factors for patient care. This does not go without a challenge. How do we balance the safety and security of technology with enablement? The internal collaboration and partnerships allow for the most appropriate architecture to be created, especially with Cyber Security. New partnerships need to be formed to deliver self-service models and conjoin the interoperability opportunities up and down the stack. In the end, it is important to continue to be patient-focused.

This portfolio of technology expansion increases the need of interoperability. As my organization continues to grow and expand, the demand for additional smart devices, such as patient beds and RTLS, brings more avenues for data needs. The effort is finding the right strategic partners for foundational technology to support these additional data, considering the needs to transport this data effectively. It is imperative to solidify wired and wireless network architectures for the increased density of data, but also magnify other technologies like Bluetooth and IR. What types of devices do patients interact with during their in-person care and how to deliver these interoperability mechanisms are the new focus.

Foundational technology is a building block for the delivery of services, whether it is through the traditional data center or cloud partners and connectivity and technology. It is important to continuously evaluate the technology maturity roadmap. The rapid pace of delivery and maturity can certainly bring a loss of focus on the important milestones needed on the journey. How does traditional technology I&O balance the need for 5×9’s or better, while also supporting a growing digital transformation practice where trial and error is key to find the right solution? This is addressed with the right collaboration and expectations set.

There is an excitement about the possibilities of digital prospects. The importance of organizational vision and support drives how technology decisions bring new value. The foundational technology must support the needs of clinicians, researchers and especially patients in this digital age.

The post Delivering Technology in a Rapidly Changing Ecosystem appeared first on HealthTech Magazines.

Healthcare brings unique challenges to technology adoption. The data representing people, diseases, and medicine is complex and voluminous. Consumers and providers of healthcare desire easy-to-use and increasingly mobile solutions and need more virtual options to keep up with the ever-changing landscape, while researchers want safe access to data at scale to make discoveries that increase knowledge and improve care. The healthcare industry needs solutions that provide a simple yet engaging experience, as well as mechanisms to leverage massive amounts of complex data safely – all with a level of reliability appropriate when dealing with the health and wellbeing of individuals and communities. On top of that, for non-profits like Memorial Sloan Kettering Cancer Center (MSK), these solutions and mechanisms cannot be cost-prohibitive. Collectively, these needs seem daunting, but cloud technology is proving to be capable of making innovation more efficient and agility more feasible.

Cloud technology has become an engine for transformative change in a business setting. Hyperscale cloud platforms offer unparalleled compute capabilities, offering a seemingly unlimited capacity that can scale dynamically. Additionally, this technology includes rapidly evolving services that take care of more and more infrastructure heavy-lifting, enabling a concerted focus on feature functionality. Little upfront or capital investments are needed, and you only pay for what you use, making experimentation more feasible. This combination of elastic scalability, on-demand advanced functionality, and minimal commitment makes the cloud the ultimate fuel for transformation, especially when coupled with a rich ecosystem of SaaS offerings.

At MSK, we embarked on a cloud journey that emphasized innovation. This journey was based on the premise that providing our clinical and research technology teams access to cloud services with minimal friction while adhering to standards would result in innovative solutions. Cloud services can easily handle the volume and variety of healthcare data while still meeting institutional needs for security and reliability. However, we have already experienced how the cloud enables us to respond rapidly to the changing needs of healthcare and create solutions that allow us to reach new markets with fewer physical presence requirements.

Almost overnight, the demands of our telemedicine options exploded where the cloud played a vital role in operations.

We are aware that, beyond MSK, there is potential for ramifications globally. Atti Riazi says, “Although the cloud helps lower the volume of greenhouse gases by reducing the number of servers used by so many of us, much of the electricity needed to maintain the cloud, unfortunately, is derived from fossil fuels and coal. We as technologists must take a position on the impact of technology on the environment, especially e-waste. We need to be a society and a collective of organized responsibility as technologists and innovators.”

In a regulated industry like healthcare, security and governance are must-haves. Our institution needed effective cloud governance and controls provided by default and mechanisms to ensure security was baked into the design of each cloud application. Next, we needed to level-up the cloud technical skills of our existing teams, and supplement them with cloud experts acquired in today’s highly competitive market. We also needed to balance our desire for agility and innovation with fiscal responsibility and transparency, understanding the risks of adopting the cloud with a blank-check mindset. And above all, we needed to maintain our standard of premium care.

While our cloud adoption approach includes many facets, a few core pillars have proved essential to the success we have experienced to date. A central cloud platform team was created to build a common foundational layer in our two clouds—AWS and Azure—that provide standardized configurations of our cloud accounts and shared services for cloud application teams to consume. We then established a Cloud Center of Excellence (CCoE) as a central body to drive cloud policies and standards in close collaboration with our compliance, cybersecurity, cloud platform, and cloud application teams, as well as initiate FinOps practices and organize a cloud community of practice.

During the COVID-19 pandemic, many clinical services needed to pivot to a more virtual experience for the safety of our patients and care providers. Almost overnight, the demands of our telemedicine options exploded where the cloud played a vital role in operations. In response, a plan was formed to reimagine our telemedicine solution as a cloud-native application, capable of dynamically scaling with demand, leveraging the built-in reliability and security of cloud services, and providing a rich, integrated experience for the patient and the care provider. This new telemedicine solution would use Microsoft Teams and cutting-edge Azure services such as Azure Communications Service and the Azure Bot framework. An agile approach coupled with close collaboration with our Microsoft Azure team would enable the rapid and iterative development needed to deploy quickly.

In a matter of months, our telemedicine offering was transformed. The central cloud platform team implemented our cloud platform on Azure to provide standard networking, audit logging, security controls, and dedicated cloud accounts for all the telemedicine environments. The telemedicine application team developed the infrastructure code (IaC) and application code for the new solution, fully automating the deployment via Azure DevOps pipelines. This empowered the application team to experiment with various Azure services, finding the right mix to meet their functional and non-functional requirements. This new telemedicine solution now serves 30% of our outpatient visits, up from 1% before COVID-19, and will scale up and down as demand changes and the pandemic evolves.

In retrospect, we have experienced positive impacts of cloud technology in healthcare with some challenges. Our development teams are more empowered and building valuable new skills. When they can spend more time focused on user needs and have robust cloud services in their toolbox, innovative solutions can be deployed rapidly. However, cloud technology is complex and evolves quickly. Our code-first DevOps approach asked our developers to learn new skills and own things in a way they did not before. The collaborative culture at MSK and the support of Microsoft has eased this task, but we understand learning must be continuous.

And then there are those global ramifications to keep an eye on.

Running our telemedicine solution on cloud-native services has given us unprecedented visibility into the costs and usage, which creates unique opportunities to optimize code to improve performance and increase cost-efficiency.

The post How the Cloud is Transforming Healthcare appeared first on HealthTech Magazines.

If we look back almost a decade ago, any search that occurred for the term cloud computing would likely reveal a few links to the meme that cloud was simply a fancy term for someone else’s computer. While in the early days of using many cloud services, that meme may have been a somewhat accurate description of how cloud worked, the current state of cloud computing has pushed far beyond just simply being someone else’s computer. Cloud adoption has often brought considerable advantages to organizations such as potential cost savings via economies of scale and the ability to be much more flexible in its IT infrastructure offerings as capacity can quickly and easily be scaled up or down. Moreover, cloud has opened up the door for many hospitals to have greatly improved business continuity and disaster recovery options as well as other critical advantages. The flexibility provided by cloud showed its advantages in healthcare during the pandemic as many hospitals had to rapidly rollout capacity for remote work, telehealth, and remote patient monitoring (RPM). Hospitals that had significant investments in cloud technologies (either public or private) were far more able to readily adapt to the challenges brought about by COVID-19 as they could readily scale up VDI for remote workforces, spin up the infrastructure required for telehealth, or perform other required changes far more easily. 

Cloud is not inherently insecure and can even have a positive impact on security when done well.

Moreover, many of the advantages of cloud are just starting to be realized. Cloud service adoption increasingly brings with it the option for Big Data Analytics, machine learning (ML), and other analytic techniques to be applied to the health data that healthcare delivery organizations (HDOs) collect. When one considers the vast treasure trove of data that is now sitting in EHR systems, PACS, and other clinical systems, it becomes apparent that there will be identifiable patterns contained within those vast data sets that medical professionals can use to find ways of improving diagnoses, refining treatment options, or enhancing our understanding of conditions that can lead to disease. Cloud-based storage and analytics for the first time makes the resources required to conduct such analyses feasible for many healthcare organizations. Cloud has the potential to fuel not just the next round of IT innovation within healthcare, but also the next round of clinical innovation. When one further considers all of the additional data collected and harnessed via cloud from RPM systems, it becomes easy to imagine how a more complete and consistent mapping of the metrics that define health, for a given patient, can be examined than ever before. It’s an exciting time to be involved in the clinical aspects of healthcare IT.

The promise of all the discoveries and advances offered by cloud really shows that cloud has in many ways far outgrown that snarky old meme of simply being someone else’s computer as that meme does not do many of the benefits of cloud justice. With that being said, however, the meme while now inaccurate due to its oversimplicity, does still convey one very salient point. No matter the benefits of cloud offerings, any form of public cloud offering is not something that will ever be under full control of the HDO that subscribes to the service. It is important to remember that while cloud can be done securely, and in many cases, can even result in security improvements, cloud offerings do come with elements of third-party risk. There have been a number of high-profile data breaches and ransomware attacks in recent years where cloud services were compromised; compromises resulted in operational, clinical, and legal issues for impacted HDOs. As HDOs begin to adopt, or enhance their adoption of cloud services, they need to consider the risks of outsourcing these services to a third party. After all, HDOs can outsource the responsibility for certain aspects of security to these third parties, but they cannot outsource accountability when something goes wrong. A breach of third party housing the HDOs data is still effectively a breach of the HDO. 

Any organization looking to adopt cloud services needs to consider implementing a third-party risk management program if they don’t already have one. HDOs need to assess vendors before onboarding them and begin to vote with their wallet by not onboarding vendors that do not meet their security requirements. This risk management process needs to include more than just getting a vendor to sign a BAA and needs to include some due diligence to ensure that the vendor can actually meet the terms of the BAA. Moreover, vendor risk management should not be a one-off process but needs to be assessed on a continuing basis to ensure that the vendor complies with security best practices. Organizations also need to pay special attention to the contracts they sign with cloud vendors and ensure that SLAs and other security languages are specified and agreed upon. Finally, who is responsible for what aspects of security should be clearly spelled out so if an issue arises, it is clear who is at fault. HDOs need to ensure they have as complete a picture as possible as to what risks they are taking on by contracting with any cloud service. 

Cloud is not inherently insecure and can even have a positive impact on security when done well. When combined with infrastructure flexibility, disaster recovery, clinical analytics, and other advantages, it is easy to see why cloud is appealing and how it has the clear potential to improve IT operations and patient care. It is just important to keep in mind that cloud, as with any technology, is not a panacea and that it also has elements of risk. HDOs need to take the time to ensure they understand what those risks are before making investments in cloud services so that they help to ensure that the adoption of cloud brings benefits and not unexpected liabilities. 

The post More Than Just Someone Else’s Computer appeared first on HealthTech Magazines.

Health systems comprise a group of hospitals providing health care services to people. Information Technology (IT) plays a critical role in care delivery since it is typically responsible for the deployment, maintenance, and enhancement of the EHR system.

Cloud computing usage at health systems is on the rise. We can review the usage using cloud service models – SaaS (Software as a Service), PaaS (Platform as a Service), and IaaS (Infrastructure as a Service). In addition, using the cloud paradigms namely Private, Public and Hybrid Clouds.

The public cloud adoption for EHR systems at health systems has been slow but does show promise for the future. The EHR vendors have made progress in releasing software versions in the cloud that may get deployed at major health systems in the future. While clinical systems at health systems have been slow to embrace the scale, promise, and efficiencies of the multi-tenant public cloud, there is a growing desire to use the public cloud in the non-clinical areas of the health system, such as research, innovation, philanthropy, and education. Since the non-clinical areas of a health system seldom require EHR integration or real-time patient information, health systems have great opportunities to experiment and build expertise using the latest offerings from the public cloud vendors. This follows the general trend in the IT world to embrace cloud computing for new projects or initiatives. It is quicker to buy a subscription to a cloud software SaaS product or deploy/build a cloud infrastructure for bespoke purposes in a non-operational health setup compared to the rigorous procurement process involved in the operational side of a health system.

Additionally, talent can be augmented using professional services teams (from cloud vendors) and consulting organizations at health systems in the non-clinical areas. Even though the available tech talent experienced in cloud computing is expanding, there is significant competition in the fast-growing tech industry to hire talent. To maintain competitiveness, health systems are embracing the rapidly changing IT landscape (including cloud computing), making the working environment attractive to competent IT talent and retaining talent long term. To summarize, the non-clinical projects are good candidates to embrace the cloud service models (SaaS, PaaS, and IaaS) depending on the availability of ready-made software solutions in the market (SaaS) and technical talent expertise in-house (PaaS/IaaS).

The increasing focus on HL7® FHIR® interoperability standard at health systems accelerated by new federal mandates such as the 21^st Century Cures Act and the proliferation of mobile computing and telehealth needs, has provided an opportunity for the health systems to explore API Management for vendor integration, AI/ML tools for analytics as well as internet-scale cloud-native services from the public cloud ecosystems. The pandemic introduced a critical need for health systems to integrate with city, county, state, and federal health systems for Covid testing, vaccination, and reporting needs. Cloud computing usage has grown during the public health crisis to enable API integration and secure file transfers between organizations. Cloud computing service and deployment models are a natural choice for the health systems for any external integration with public or private organizations. Support for the FHIR® Bulk Export in EHRs such as Epic® will accelerate the adoption of cloud-based systems and integrations.

Private Clouds do exist at many health systems. IT systems critical to patient clinical delivery are predominantly hosted in data centers or private clouds. As mentioned before, there is minimal usage of public cloud environments for clinical systems involving patients. This is in line with patient and clinical data’s regulatory and privacy requirements. Hybrid models with a combination of private and public clouds may grow in the future. Unfortunately, widespread hybrid model usage will have slow progress.

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With the digitization of healthcare comes the discovery of newly developed areas of Artificial Intelligence (AI) and Machine Learning (ML). Converting film to digital pictures in Radiology is equivalent to developing a fully electric car. While the initial worries and concerns of digital radiography create uncertainty of the unknown, those worries seemingly disappear when looking at the current success and essential role in healthcare. An undersized initial investment has opened up a method that can have an immediate impact and create further advancement in the field.

Digitally well-organized data can be easily processed with an algorithm called CNN (Convolutional Neural Network). Using a GPU (Graphics Processing Unit) capable of high-speed operation through parallel processing, it is possible to develop an AI algorithm with a basic programming skillset and simple understanding of models that accurately predict complex outcomes. One prerequisite is data well organized and clearly labeled as accurately as possible. In order to create the most optimal processing, the quality of data curation is more necessary than the quantity of data available.

When the previously developed Cryptographic technologies are tested and implemented in the healthcare data flow, value generation through AI algorithm will become possible.

Before the arrival of modern AI, problems were solved through conventional solution methods like mathematics and engineering in a well-organized format. However, in the latest approach, given a case of organized data, it is possible to create an algorithm by discovering unknown weighting in the topology of CNN architecture. In general, a complex neural network composed of many layers has adequate performance. Though more data is needed to train this network, in this case, the quantity of the data plays a crucial role in estimating weights in the AI/ML model.

And so, if it is necessary to determine the rank of importance, the quality of data comes first, followed by the amount of data. The third essential aspect is high-performance computing power that is able to process not only complex, but also large amounts of data. Many startups, hospitals, and governments are now well aware of the importance of data and are developing data-oriented science platforms supported by expertise, copious data, massive computational power, as well as funding from outside of the hospital.

Cloud solutions such as Amazon, Google, Microsoft, and Nvidia are trying to provide a high capacity while also achieving a secure computing environment. The advantage of the cloud is its easy scalability. Users do not have to worry about hardware problems. There are also various models of the price according to its usage.

Currently, uploading hospital data to the cloud seems to hold unnecessary risk as the system is very unpredictable. From a hospital’s perspective, the risk of leaking sensitive patient information holds a more serious danger as not only would the act be unethical, but it would also cause the group to be legally responsible. The risk is simply too high. Nevertheless, a more convenient and secure method in which patients can safely store their own data can be created. 

In part, personal healthcare information (PHI) can be collected through mobile devices or IoT (Internet of Things), linked with healthcare apps in the cloud. Many AI-related business models are being proposed, and to implement them, there is currently a race to obtain data of high quality and sufficient volume. Ultimately, the source and ownership of data become a new issue to consider. Could it be possible to propose a method to compensate patients according to the contribution of fairly distributed data? If this method is transparent and safe, will people voluntarily trust and use it?

While the issues that currently exist in the hospital setting seem relatively new, the same issue has been around for a long time in cryptography with solutions found. In many cases, innovation solves our problems by sharing successful technology. Techniques that work well in one field can be easily translated to another and it is the translation of one to another that we call growth in technology.

Cryptography, which studies how to encrypt data to send and receive information safely, started from the mathematical basis of number theory and is used in many application fields in a practical sense.

• How do you authenticate with the other party without leaking any information? Zero-knowledge authentication.
• Is it possible to confirm that even a tiny amount of data does not change in a massive amount of data? Hashing
• Can I confirm to others that I am the real me? DID (Decentralized Identifiers)
• Can everyone confirm that I am the valid owner of this digital content? NFT (Non-fungible token)
• Can you trust the result of the two data calculated after encrypting the critical data without exposing it? FHE (Fully Homomorphic Encryption)

When the previously developed Cryptographic technologies are tested and implemented in the healthcare data flow, value generation through AI algorithm will become possible. Those who provide data will be rewarded according to the accuracy and rarity of their data. Experts who label data can also be rewarded according to accuracy and difficulty. In addition, data scientists and entrepreneurs who safely manage and process data can be rewarded according to the performance and benefit of AI solutions. While the end goal will be a solution to our flawed hospital data systems, significant changes will come from many small successes.

The post Smart and Secure PACS (Picture Archiving and Communication System) on Clouds appeared first on HealthTech Magazines.

Technological disruption is transforming every aspect of the future of healthcare. COVID-19 emphasized the need for this digital world much more than ever. Social distancing and hygiene requirements forced hospitals and other providers to speed up their adoption of transformative technologies. Whether they were ready or not, organizations spanning every industry and size were forced over the last two years to fully embrace digital transformation. Virtual care delivery is persisting at exponentially higher adoption rates than pre-pandemic levels, and remote monitoring as well as digital diagnostics and therapeutics continue to gain attention and investment. As a consequence of the world’s digitalization, customer behavior is changing which also highlights why organizations need to evolve and adapt to this digital environment.

To compete and succeed amid ongoing uncertainty and rapid change, provide an enhanced patient/consumer experience, and bring added value, healthcare organizations are focused on building “digital-first” business models. In addition, CEOs across healthcare sectors are evangelizing digital and innovative initiatives as strategic imperatives to seize the opportunities of disruption, create added value, and deliver new growth.

Cloud Computing has become the catalyst for digital transformation.

The Cloud-enabled business model helps organizations simplify IT infrastructure and focus more on digital transformation. It gives access to the ‘Everything-as-a-service’ model, utilizing multiple automation processes to build a customer-centric system. As these models become more prevalent, humans will work alongside automation to boost their cognitive abilities and skills.

Quick, on-demand access to reliable, scalable, and flexible technologies and IT infrastructure are the imperative requirements for digitization in any organization. Self-hosted on-prem solutions can be considered organization-controlled but involve time and money to scale up for business growth.

Implementing Cloud Computing solutions may be pretty straightforward. However, migrating without proper planning, preparation and governance can be disastrous.

Integrating new forms of technologies fast tracks automation and improves patient care. AI, ML, Big Data Analytics, and IoT are key components of such new solutions. Considering that these technologies require heavy computational power and storage space, Cloud Computing is the ideal solution to integrate and optimize these technologies and make them more scalable.

Benefits of Cloud Computing which empowers digital transformation

1. Agility, Flexibility, Scalability and Efficiency
   
   Healthcare is in constant need of continuous innovation, testing, and implementation to drive digital transformation.
   
   Cloud Computing is a key enabler for agile innovation. It offers agility by providing platforms and Computing resources where we can rapidly build, test, and deploy apps throughout the transformation phase to enable business growth and meet patient care and access needs, without a need for complex on-premise infrastructure that requires investment, time and IT resources to set up. It further helps to eliminate the need to maintain and upgrade systems and also solves compatibility issues between different types of infrastructure.
   
   Cloud Computing enables enterprises to quickly respond to customer needs, eliminating the problem of IT systems overload or over-provisioning.
   
   Enterprise storage solutions impose limits on the data capacity. Expansion is expensive, both for infrastructure and IT resources. However, Cloud-based storage in healthcare provides greater flexibility. It is a pay-as-you-go subscription-based model. It allows organizations to scale up or down quickly to meet demand.
   
   
2. Integrated Solution
   
   Cloud Computing enables organizations to access, retrieve, and process information at any time, from any place, ensuring efficient collaboration and improved productivity without restrictions and geographical boundaries.
   
   
3. Security
   
   Healthcare may constantly face the risk of losing critical information (including PHI) due to unexpected system shutdowns, data breaches, etc. Furthermore, in the case of AI-driven big data analysis, the chances of system failure increase considerably due to Computing and storage constraints.

Cloud solutions are built to comply with the increasing high level of privacy standards and threat protection postures, including compliance to HIPAA and GDPR. This enables organizations to create multiple defenses for data protection. It can be as good as on-premises solutions and sometimes when properly configured, it might even provide better security.

Despite Cloud Computing’s advantage and its enablement of digitization, significant challenges of Cloud Computing in healthcare include user misunderstanding or distrust of provided security and privacy, organizational barriers, loss of data governance, and poor safety standards. The use of Cloud Computing raises many legal issues such as local contract laws, IP rights, data jurisdiction, and privacy.

Migrating to Cloud for the organization is not a one-off decision that should be made in isolation. Cloud migration has company-wide, short-term and long-term implications. Implementing Cloud Computing solutions may be pretty straightforward. However, migrating without proper planning, preparation and  governance can be disastrous. 

Any organization can speed up their digital transformation by adopting Cloud solutions if they consider the following:

Business Goals

When considering Cloud solutions, organizations need to have a clear understanding of the business goals they will achieve and the alignment with strategic growth. For example, they should know whether technologies supported by the Cloud are compatible with systems and applications already being used in the organization, including legacy solutions.

Cloud Computing Security Concerns

Every organization is responsible for its patients, payers and their own confidential and valuable data. Therefore, they must be confident that their data is secure and know where and how it is being shared. PHI and PII data security is the primary concern for healthcare. Therefore, before adopting Cloud solutions, organizations must prepare their security and firewalls to guarantee the safety of their data. Cloud is secure, but it must be used correctly.

Governance

Different Cloud solutions like IaaS, PaaS, and SaaS provide ease of use, cost savings, and innovative features. Typically, they offer users a free trial account. Due to this flexibility, any organization may buy Cloud solutions without centralized IT control. Moving to the Cloud can save money, but this is not automatic. Therefore, strong governance in the organization is key for the selection and use of Cloud applications to avoid having siloed systems and risks.

In summary, one thing we can count on is that the Cloud has proven itself as a valuable tool and will be integral to all modern healthcare must-dos.

The post Cloud Computing Speeds Up Digital Transformation appeared first on HealthTech Magazines.

The U.S. Healthcare industry is transforming. With consumers having more financial accountability for their care and the government shifting healthcare reimbursement to a value versus volume-based model, the business is fundamentally changing. Before the pandemic, the shift to a more consumer-oriented and value-based healthcare service occurred at an evolutionary pace. Post pandemic change will be revolutionary.       

Supporting 92% of Fortune 2000 companies, SAP has a proven 50-year history of enabling business transformation through world-class enterprise software solutions and a partnership mindset. Healthcare organizations moving toward consumer-oriented and value-based service models can capitalize on best practices from across industries to facilitate their business transformation. “When we connect with healthcare executives, they want to know how SAP is helping customers in other industries such as retail manage consumers at the point of service and they want to see how they monitor business performance in real time” states Steve Risseeuw, SAP’s National Vice President for U.S. State, Local, Education, and Healthcare business sectors.

Steve is an SAP veteran who recently assumed responsibility for the company’s team supporting payers and providers. His background in collaborating with government and education customers to bring commercial best practices into their organizations makes him a natural leader for growing SAP’s U.S. healthcare practice.

SAP’s strategy enables healthcare organizations to be intelligent, sustainable enterprises with a solution platform and partnership comprised of analytics and process-oriented applications. The cumulative value provides executives with the speed, scale, and adaptability to manage the new value-based healthcare experience.  

“The solution platform is only a start. The relationship and mindset that SAP brings as a vendor partner is a key to effective business transformation,” states Deb Millin, Head of SAP U.S. Healthcare Industry, Cloud Services. “SAP’s success in transforming various industries was accomplished in collaboration with customers. We use the same blueprint with healthcare organizations as they transform to run more like a business.”  

Deb brings over 25 years of healthcare industry experience involving management, product innovation, and company strategy for Fortune 100 technology companies. She recently joined SAP as Head of the U.S. Healthcare Industry, Cloud Services.

Every healthcare enterprise needs to develop new value-based business models to avoid disruption, gain efficiencies to fund innovation, and transform mission-critical systems without business risk. SAP’s approach called RISE is the cornerstone of the company’s customer-as-a-partner approach: a framework that addresses each customer’s technology and business transformation needs for enterprise-wide resource planning. RISE with SAP builds upon that ERP foundation with additional services, such as embedded advanced analytics, workflow redesign, hosting infrastructure, a defined set of cloud managed services, and the Business Network Starter Pack, which facilitates connections with suppliers, distributors, and assets.

This is the heart of how SAP differentiates insofar as the choices of cloud software vendors. “We’re not just another cloud offering – we are an enterprise-wide business transformation company,” adds Deb.

SAP quickly pivoted to help the frontline healthcare providers and suppliers address supply chain constraints, workforce challenges, and real-time analytics needs to manage critical and virtual care.

The Pandemic Partner and Post Healthcare Revolution

SAP’s customer-as-a-partner approach proved to be pivotal in supporting the uncertain demands of the pandemic for frontline healthcare customers. “If there is one thing we learned from the pandemic, you can’t manage a real-time pathogen through the rearview mirror of traditional healthcare,” states Walt Ellenberger, Senior Director of U.S Healthcare Business Development and Strategic Alliances for SAP.

Walt has over 30 years of healthcare system and operations experience outside of his tenure at SAP.

“SAP quickly pivoted to help the frontline healthcare providers and suppliers address supply chain constraints, workforce challenges, and real-time analytics needs to manage critical and virtual care,” says Ellenberger.

Renowned healthcare systems, such as Parkland Health and Hospital System in Dallas, Texas, leveraged SAP’s solution platform to address surge capacity and critical care resource planning. Parkland, in partnership with SAP, extended the solution platform to proactively manage care demand by COVID risk scoring their surrounding population for community-based education and care outreach.

SAP’s partnership with pharmaceutical leaders helped lay the groundwork for architecting an integrated business network, achieving greater transparency to an end-to-end supply chain process and collaboration between manufacturing, distribution, administration, and post-vaccine monitoring. This innovative work set the stage for extending SAP’s solution platform to stakeholder collaboration with workflow and data insight integration along the entire healthcare industry value chain.

“The speed of change post-COVID 19 will become revolutionary to address the vulnerabilities of a fragmented and reactive healthcare delivery system to be better prepared for another pandemic threat,” comments Ellenberger. “The lessons learned from the pandemic will leave a permanent mark on shifting healthcare delivery and management to be more proactive and collaborative moving forward. “

The Next Generation of Healthcare Enterprise Resource Planning

Legacy healthcare ERP systems based on old technology and a reactive volume-based business model were never designed for the transformational shift to proactive value-based care. “SAP’s enterprise resource planning offering is different because we focus on providing the applications and analytics to manage enterprise-wide resources through the lens of healthcare value. We offer the next generation of technology and software solutions to integrate and proactively manage care experience, costs, and quality services, “explains Steve Risseeuw.

SAP differentiates its solution platform based on speed, scale, and adaptability, enabling healthcare business integration, insights, and innovation.

• Integration enables customers to unify care experience, cost, and quality data into the new formula for managing value-based healthcare.
  
  
• Insights from multiple data sources help healthcare executives make decisions on the go and proactively manage risk and performance for the entire enterprise. In healthcare, data is the most valued asset. Gaining insights into outcomes is the foundation for not just expeditiously improving care but also operational efficiencies and effectiveness.  
  
  
• Innovation enables new healthcare collaboration and risk-sharing for supplies, processes, and data insights across all stakeholders.

SAP’s Healthcare Path Ahead 2022

SAP’s healthcare focus areas in 2022 are Workforce Management, Procurement, Supply Chain, Financials, and Embedded Data Analytics. When paired with value-based services and a partner mindset healthcare organizations truly benefit.

A critical part of SAP’s healthcare go-to-market strategy is their partner ecosystem that leverages and extends their solution platform and business transformation service with depth and credibility for addressing specific customer and emerging market needs.      

“With the current crisis in nursing shortage around the world, but especially in the US, we are addressing predictive clinical staffing management needs,” says Deb Millin. “The pandemic has certainly prioritized nursing staffing needs, but there are many other resource use cases this solution can address.” SAP partner DXC Technologies built a comprehensive healthcare workforce solution on the SAP solution platform that enhances overall clinical staffing and workflow management to effectively solve customer challenges.

Being an ERP Global leader for decades, SAP has a proven record of helping organizations optimize revenue streams and reduce costs with an automated approach to resource management. “We are working with Nesa Solutions, an IoT Hub and analytics platform, to optimize the way healthcare organizations utilize and maintain their assets,” Millin reveals. Integrated real-time tracking monitors critical asset locations for improved inventory reporting and clinicians’ access to essential assets supporting patient care. Real-time analytics on the asset’s metadata can also provide deeper insight into the product’s lifecycle and asset utilization for better enterprise-wide purchasing decisions. Nesa’s alignment with SAP’s solution platform extends the value of real-time insights that hospital CFOs otherwise find challenging to obtain.

The healthcare industry has undergone unprecedented transformative shifts. The digitization of patient records, the shift of analog to digital peripheral devices whose data can be leveraged, real-time reporting, artificial intelligence, and process-oriented solutions that aid in clinical workflow and operational healthcare all help drive a new way of doing business. “We are at the forefront of this evolution with a 50-year track record that has provided the foundation for pivotal product suites that grow with the customer’s transformation journey”, Steve concludes. “Customers can leverage their investment with SAP and partner with a company who has a proven portfolio and best practices to transform their business.”

The post SAP IS ENABLING HEALTHCARE TRANSFORMATION WITH A SOLUTION PLATFORM AND PARTNERSHIP appeared first on HealthTech Magazines.

The need for agile IT infrastructure has never been greater. Two years into the pandemic, healthcare IT leaders face numerous challenges and increasing pressure to be more responsive to changes in care access and delivery. This is compounded by declining healthcare delivery organization (HDO) margins, cost improvement programs, lack of available SMEs, rising costs and supply chain issues. All of these are drivers for rethinking how IT services should be delivered in the future.

HDO technology professionals must remember they are in the business of delivering patient care, not IT. IT staff need to focus on how their subject matter expertise can support patient care and move away from core technology functions such as infrastructure and hosting. This is coming to life in many HDOs as a cloud-first strategy.

Identifying the Catalyst for the Cloud

The move to a cloud-based EMR was a key part of Seattle Children’s digital transformation strategy. We needed to unify and simplify our systems, be fortified to consume applications at a faster pace, promote seamless security, and make our system more agile and accessible. It was also critical our entire staff could access the EMR application at the point of care, anywhere at any time. These needs were heightened by the pandemic and a cloud-based system offered a myriad of benefits, including:

• Offloading responsibilities to the service provider (with a cloud-based managed EMR model), freeing up internal IT staff to deliver more innovation and focus on patient care initiatives.
• Building a technology platform that is future-proof and allows hosting of Epic applications and systems, as well as third-party ancillary and supporting applications that run alongside it.
• Maintaining high application availability and performance.
• Eliminating the need for in-house technical Epic SMEs to manage the system.
• Achieving predictable capped costs per year for the managed service and hosting.
• Maintaining a strong security posture and HIPAA-HITECH compliance.

On October 3, 2020, while navigating the pandemic, we replaced two highly customized EMR systems with a standard set of pediatric tools. We implemented an integrated EHR with Epic across 46 sites in four states. This was Seattle Children’s largest undertaking in the last 15 years and a momentous step forward to helping us provide the best possible care to every patient and their family.

We learned that demonstrating and communicating how the change will impact the IT team was a critical component for better change management and buy-in.

Changing the Culture

Implementing an enterprise-wide information system, such as a new EMR, is a major change project with a significant cost, which should not be underestimated. Moving to the cloud directly impacts IT staff, who will inevitably resist losing control of directly managing infrastructure they are familiar with. Early IT staff engagement outlining the upcoming changes and a good communication plan is important. In addition, having a well-defined process, some important milestones should be part of your framework: Building a business case, identifying the key considerations for your specific organization, and including your security team in the reviews. While many of these steps might seem obvious, when done right, you will gain credibility with your key stakeholders and simplify your approval process when it comes time to get funding for a project of this size.

In any project, there are always some failures; communication and engagement were areas we did not focus enough of our energy on. We learned that demonstrating and communicating how the change will impact the IT team was a critical component for better change management and buy-in.

When deciding on which vendor to select, we evaluated the costs and options for hosting with the internal IT team and two vendors, Epic and Virtustream (Dell). We explored fixed costs (per year), guaranteed service levels for availability and performance (with financial penalties), vendor size and capability, Epic certifications and subject matter expertise, track record of delivery, availability of a dedicated service desk, ServiceNow integration, green data centers, contractual flexibility, and the ability to connect data centers via multi-vendor, large bandwidth, dual resilient and diverse network circuits. With these criteria, we chose Virtustream (Dell) as our partner to host and fully manage the EMR.

Realizing the Benefits

Seattle Children’s hosted system has been live for over 18 months. Some of the benefits delivered include:

• Consistently exceeding uptime of 99.995%.
• One of our two data centers is 100% solar powered.
• Service levels at the infrastructure level for the cloud environment are backed by financial penalties.
• Log-in times, performance and user experience have improved compared to on-premises, and changes are delivered in days versus months.
• Epic upgrades are completed in 40 minutes versus 4 hours previously.
• The speed and ability to scale up and perform change control on the cloud environment improved. Changes can be made in days versus months.
• Costs are now predictable and future-proofed against increases with a shift from capital to operating expenditure.
• More advanced disaster recovery capability.
• Seamless integration with ServiceNow minimizes manual cycles for the staff while improving response times and reducing errors.

Considerations for Adopting a Cloud-Based EMR

As a starting place, organizations who are contemplating a move of their EMR to the cloud should:

• Inventory, review and refresh all your third-party applications and contracts.
• Develop a strong communication plan. Focus energy on change management.
• Build and manage the relationship. Your cloud provider needs to be a trusted advisor. Be diligent in the evaluation and select people-minded people. Retrain existing internal IT staff to manage the vendor rather than implementing the infrastructure.
• Properly prepare for contracting; it is time-consuming. Get an appropriate expert legal counsel to ensure that the terms and conditions and service level agreements are guaranteed and backed by financial penalties.
• Check the network bandwidth between data centers and ensure all network circuits are multi-vendor, dual, resilient and follow diverse routes.
• Guarantee flexibility. Work with a vendor who can adjust as plans change and is flexible, quick to respond and willing to negotiate terms.
• Ensure that the vendor has the right Epic certifications and SMEs, has a track record of delivery, provides a 24×7 dedicated service desk and integrates with your service desk ticketing system.

The post Why Moving the EMR to the Cloud Is the Next Natural Evolution appeared first on HealthTech Magazines.

When my daughter was young, she jumped on the beanie baby bandwagon and worked her way through the family governance structure to get a healthy capital investment so she could purchase every new beanie baby that hit the market. While the Peace bear was great last month, the only way to beat her goal this month was with Pounce the cat. I often compare our application collection to beanie babies because we collected them with the same level of enthusiasm and most have the same level of value today.

Providence is a large health system spanning seven states, 52 hospitals, 1000 clinics, 18 Home Health & Hospice agencies and more. Over the last decade, Providence has come together to operate as a single health system and along the way, has created affiliations with partnerships with many other health systems. While this has made for a stronger health system, it has given us a significant collection of applications totaling over 4000 unique instances or applications. 

We have been on a journey not just to consolidate our applications but to ensure we are moving to modern platforms that can thrive in a cloud environment and meet the needs of an ever-evolving health system.

We have been on a journey not just to consolidate our applications but to ensure we are moving to modern platforms that can thrive in a cloud environment and meet the needs of an ever-evolving health system.

At a high level, this seems simple enough. Figure out your application portfolio, evaluate the best products, create transparent governance, select the future state products, implement and finally sunset the old applications. Rinse and repeat. The reality is each step in the process takes significant effort and discipline. Our rationalization was such a large endeavor we have named the core projects after Greek gods (Hercules, Titan & Zeus). 

Technology can be transformational, but it is critical to have modern platforms. This means working with our clinician and executive leadership to create a clear vision for our future offerings. From there, we must work with our vendors to ensure health care applications have all the best that technology has to offer in 2022, not 2000.

No one is going to engage patients with 20 separate experiences,

No one is going to implement best practices with 5 EHRs,

No one is going to save money by having 1000 different vendors,

No one is going to ensure a secure platform with outdated software and very few health systems have one-of-a-kind Princess bear applications that should be saved at all costs.

Providence has learned many lessons along the way, but I am happy to share we have seen significant progress, including over 1000 applications instances moving to the cloud and 100M in cost savings due to both rationalization & sunsetting. Our tools and processes continue to become mature and we are well on the way to delivering significant value with our core applications.

Now back to the beanie babies, I clearly need to update my sunset plan as my daughter has moved on to adulthood and I am still storing bins of cute stuffed animals in my attic, but that is not something I recommend for our health care applications.

If anyone is just starting out of this journey, we are always happy to share our learnings. Health care has come a long way, but we still have a lot of work to do to ensure our technology is truly meeting the needs of our caregivers and patients.

The post Application Rationalization Journey in a Large Complex Health System appeared first on HealthTech Magazines.