As exorbitant amounts of data increasingly become available at physicians’ fingertips to improve patient care, healthcare organizations must develop thoughtful methods for managing how that data is stored. At Atrius Health we have developed a unique approach to virtualization to better care for the 740,000 patients we serve in Eastern Massachusetts.
Virtualization enables organizations to quickly run applications, provide resilience and protection to their applications, store information, streamline processes and integrate mountains of data from several different places. The effectiveness of virtualization depends more upon how technology is used, rather than the technology itself. This is particularly true in healthcare where diagnosing and treating patients relies on many interconnected systems and data streams housed on virtualized systems.
Two years ago, Atrius Health merged three previously independent physician groups and a home health and hospice agency into a single enterprise IT organization. We began a restructuring and consolidation of all IT services, including our electronic medical record, clinical, and business systems. We took our virtualization platforms and coalesced them into a segmented yet interconnected architecture we call the Atrius compute pod (C-POD). C-POD allows faster and more efficient IT systems that better position us to provide the type of care that is best for our patients. Technically, we increased the performance of our systems by multiple orders of magnitude, decreased our physical footprint by nearly 65 percent, and reduced our power consumption by over 80 percent, all while increasing the resources the IT organization can provide to our practice and care providers.
As an organization that takes responsibility for the total cost and quality of care for a significant percentage of our patients, we rely on complex software running on our virtualization pods to support our clinical teams to proactively provide care, manage chronic conditions and prevent unnecessary hospitalizations. To do this, we utilize advanced analytics and natural language processing to integrate medical histories and claims from our patients in a data warehouse. By analyzing patients on a population level, we can identify those who require the necessary care interventions to prevent illness from occurring later on. Moving forward, this model of leveraging virtualization will become even more important for healthcare organizations as the industry moves towards using machine learning, advanced analytics, and healthcare informatics to develop better models for intervention.
"The effectiveness of virtualization depends more upon how technology is used, rather than the technology itself"
Atrius Health has built our own private Atrius Cloud and uses public cloud services when needed to provide more unique offerings to the organization. As the IT industry shifts from using purely localized virtualization on physical servers into the cloud and hybrid-cloud technology, organizations must develop their own unique approaches to navigate this shift. Though the cloud can be useful for storing, exchanging and sending information, company IT professionals lose a degree of control over their ability to fine-tune applications once they go into a cloud. This makes it more difficult to analyze performance and/or data integrity issues with applications in the cloud. There are recent examples of well-respected companies in which failures occurred, taking critical systems offline for weeks, leaving customers with no control or recourse other than to wait. It could happen to anyone, but limiting reliance on one solution–the proverbial “all eggs in one basket” approach–is fraught with hidden pitfalls.
Another challenge organizations will face is the cost of implementing and leveraging this technology, a concern now amplified by the extreme consolidation of the technology industry as a whole. With fewer choices among technology vendors, businesses face rising costs in keeping their IT systems running efficiently along with forced upgrades in many cases. Additionally, software providers have taken advantage of the flexibility virtualization offers to build applications that require significantly higher levels of resources, despite the reality that virtualization is not free. Furthermore, the same vendors supplying local virtualization applications are driving the market shift to cloud virtualization, putting organizations in the difficult position of needing to purchase new technology.
In the face of these challenges, it is important that businesses collaborate with their vendors to leverage and apply the technology in the way that best suits the businesses’ needs. At Atrius Health, we actively work with our electronic medical record vendor to automate previously labor-intensive tasks, making it easier for our clinicians to navigate and access patient information. We have open lines of communication and respond collaboratively to incidents such as delays in viewing patient charts and medical records, and activities such as data replication, business continuity planning, and backup. Trust in the partnership and a shared goal is critical.
This level of partnership must extend beyond customers and vendors to relationships among the vendors themselves. For too long, software and hardware technologies have been siloed. It’s crucial that these two development streams co-create together and mitigate obstacles to deploying new technologies before they reach customers. Developing added functionality for an EMR, radiology or business operations environment cannot be done in a vacuum because such advancements have ripple effects across a customer’s enterprise, both in dollars as well as supportability and confidence that the systems will function properly. We saw this with a recently deployed application that required added resources to bring it to a nominally functional state. Our perception was that this application was developed in a silo by the vendor with little to no stress testing, and therefore they misrepresented their technology specifications. In this case, the cost of operating the application has doubled from a resources perspective and confidence in that software vendor has been lessened.
Virtualization technology solves some problems, but the people behind the technology are doing the thinking. Constant and transparent collaboration is the catalyst for innovation and new ways to apply technology, benefitting business and the industry as a whole, and most importantly for healthcare: our patients.
Hesham Abboud, MD, PhD, Director of the Multiple Sclerosis and Neuroimmunology Program and staff neurologist at the Parkinson’s and Movement Disorder Center at University Hospitals of Cleveland, Case Western Reserve University School of Medicine