Not many hospitals are investing in technology in a smart way, which includes digitizing existing workflow and adopting virtualization to drive efficiency. This, according to one IT chief, is one of the easiest ways to gain a competitive edge in the medical industry.
According to Leon Jackson, head of IT at University of Malaya Specialist Centre (UMSC), hospitals have traditionally seen IT more as a supporting service rather than a means to gain an advantage over their competitors. As such, the role of chief information officer (CIOs) tend to be less valued and invested in by medical institutions, he said.
This is why when Jackson was hired in 2009 to help develop UMSC's IT system for its new premises in 2016, he started the hospital on a journey which would see the establishment of an internal IT department, its processes digitized, and making a move toward a unified virtualized IT environment.
One of his main tasks then was to plan for an infrastructure that would support the digitization of biomedical imaging and other medical information, as well as the electronic workflow for processes such as prescribing drugs and ordering diagnostics. The system would need to scale to accommodate 4,000 concurrent users, up from the current 100, he elaborated.
"When I first started this project, people told me I was crazy and that it couldn't be done," he said, referring to the common perception that medical systems should not be messed with as they were mission-critical.
"The biggest problem that has come to the healthcare industry is it has a lot of specialized software--driven by life sciences companies--with very little thought in terms of the IT-ness of IT," said Jackson.
The end result of having so many different programs would be 10 years on, hospitals would have very "siloed" systems that would make these hard to integrate, he stated. Currently, he estimated that 80 percent of Malaysian hospitals were still paper-based and "whatever was electronic was still siloed".
These IT siloes will need to be broken down in order to improve information access for clinicians, the IT chief said. Without access, they may have to repeat tests which not only takes up more time and costs but also raise a feeling of suspicion and doubt among patients that the doctor does not know what he's doing, he said.
Improving accessibility, productivity via virtualization
With this in mind, Jackson developed a virtualized environment that would make it easier for the IT team to manage resources, consolidate hardware, and balance workloads across the hospital's infrastructure. VMware's vSphere tool was selected and the hospital started implementing it in the hospital's two data centers in 2011, he said.
By early 2012, he said the medical center had cut hardware and infrastructure spending to 60 percent of the cost of a purely physical server environment. Vendors that could not adapt to its new infrastructure were gradually phased out, the executive added.
Virtualized desktop infrastructure (VDI) was another area Jackson found had plenty of potential for driving efficiency in the healthcare industry. UMSC implemented a thin-client architecture based on VMware View, which allowed clinicians to access data from various locations.
The IT head explained, for example, that if a doctor was giving a lecture on campus and received a call from a nurse, he would be able to remotely access his files and provide the required information for a particular patient.
Operating theaters are also linked up to VDI, which allow for more "sterile" equipment through the deployment of thin-client touchscreens with washable mice and keyboard, he added. This was an improvement over the previous arrangement where the computing hardware in these theaters "drove him nuts" because they started to look like server rooms and were hard to maintain, he shared.
With the VDI implementation, the cost of a workstation over a 3-year period, factoring in maintenance and man hours, amounted to 3,000 ringgit (US$962). By comparison, it costs 8,000 ringgit (US$2,565) to own a thick-client terminal, he noted.
"We found that desktops were becoming irrelevant, with most stuff provisioned through browsers," said Jackson, adding that VDI helped the company ride the bring-your-own-device (BYOD) trend by giving staff the opportunity to be mobile workers.
He added UMSC is moving toward a service-oriented architecture (SOA) for its application development and has started work on a common dashboard interface that would eventually be the main point of contact for employees in 2013.
The existing VDI deployment has bought the hospital time in this transition, and would remain useful for running some of the applications in the future, he said. The hospital is currently running about 100 VMware View desktops, and expects to increase this over the following year to 300 concurrent users.
To support this migration, UMSC had invested up to 4 percent of its revenue each year for the last three years on IT, he revealed.
"Healthcare has to move to this virtualization model. We are going to be one of the biggest consumers of IT. One of the easiest things you can do in healthcare to drive efficiency is investing in IT, but it takes good leadership, good planning, and good knowledge," he said.