HealthITGuy's Blog

The evolving world of healthcare IT!

Evolving Healthcare IT and how do you adapt?

To prep for the Cisco panel discussion, Ben Gibson asked what my role was at my organization.  The answer was something like “it started out as managing the network infrastructure: the cabling, LAN/WAN, servers, etc.  Then it continued to evolve into virtualization and storage to where I am now.”  So I now refer to my role as the manager of technology infrastructure.  What Ben said after my explanation has really got me thinking . . . he simple said something like “oh, just like the way the industry has evolved”.

Ben is right.  In my healthcare organization my role and responsibilities evolved overtime as the technologies changed.  Based on our IT department size this was partly due to having a small head count and needing to do more with the staffing you already had in place.  This approach can be challenging at times but also lends itself to being creative, expanding your knowledge by trying and doing new things which in the end can be down right fun at times (the opposite can also be true :)). 

The benefits our organization has gain from the way we have been able to consolidate and manage the different staffing roles as we have changed technologies has made us more flexible and able to move forward.  I am not saying this is easy and does not take work to make it happen but looking back at how we got to where we are has made me think about it.

As I have been meeting and talking with people from other organizations there is a wide range of comfort, adoption and acceptance with industry change.  For example, we gained the comfort level with VMware DRS and vMotion very early on and have been allowing VMware to decide where a server workload should reside by allowing it to automatically moving the servers between hosts.  I am surprised when I hear of others who still “balance” the VM workloads by checking DRS recommendations manually and then vMotioning the workload.  Or worse, talking to a network switch vendor’s “virtualization expert” and hearing him say virtualization is still in its infancy; that comment/belief saved me time in the end and made my investigation with that vendor shorter. 

To take the thoughts further, one of the keys to reducing costs, complexity and increasing your flexibility is when you really start to converge and maximize your datacenter resources.  It becomes very difficult to realize these savings and efficiencies if your staff/groups/teams do not work together.  You need to ask yourself, does my storage team talk with my server team?  Does the network admin know what our virtualization guy is doing?  In the organizations where I have seen a storage group that works in their own bubble, that organization begins to struggle by spinning their wheels and wastes resources and dollars.

So why this topic for a blog post?  Yes, my team and organization get to use a lot of cool and exciting technology that makes our jobs fun at times, saves the organization time and money and has made us flexible and agile, but it did not just happen.  You have to change as the technology changes, if you can do that you will be on the right track.

Disclaimer:  No workplace is perfect and my organization is far from perfect, but it is pretty damn good to be here.

Addendum:  My director read this post and reminded me “It’s certainly worthy of bringing that weakness (poor communication) to light.  If you think about it we unfortunately have some of the same symptoms.” 

That is true, communication is always a work in progress whether it is in professional or personal life, there is always room for improvement!

April 14, 2010 Posted by | Healthcare IT General | | Leave a comment

UCS and a Team Approach

Over the years at my organization we often would comment on the quantity of work our IT group is doing to meet the needs of the healthcare organization. We did all of the upgrades for Y2K, expanded with mergers, installed more and more specific systems while not really added FTEs to the mix. Through this time I found the quality of work produced to be very high with a focus on why we are doing what we do; to provide quality healthcare.

Contemplating recently about the successful implementation of Cisco UCS and our clinical data warehouse project it got me thinking about what things went into the success. I have touched on things in this blog about getting funding, short time lines, positive experience with Cisco Advanced Services, the UCS technology and how my staff worked well together.

I think I may have overlooked how important having a staff that works well together can play such a strong role in the success of a UCS implementation. This insight has grown out of a lot of interaction with other organizations around reference calls for Cisco UCS. I have been able to take it for granted skilled engineers with many years of experience in SAN, LAN, servers, virtualization and application delivery who all have the same reporting structure and get along. In addition, management who recognizes individual skills and talents which allows staff to explore new technologies. So I want to give a big thank you to my team for knocking it out of the park with Cisco UCS, you rock!

Yes, Cisco UCS is a very cool, state of the art system for delivering compute capacity but a successful implementation does not just happen. I think UCS can sing when an organization is able to work together as a team to pull all of the components together. Talking with some organizations where the server and network folks do not talk with the storage folks would be a very difficult environment to be successful. On the other hand, putting in a system like Cisco UCS may bring the groups together and may simplify and clarify the need for interactions.

March 9, 2010 Posted by | Cisco UCS, Healthcare IT General | Leave a comment

How will ARRA work: American Recovery and Investment Act of 2009

As I talk to people about the increase in IT projects related to the “Economic Stimulus” package (i.e. ARRA: American Recovery and Investment Act of 2009) I always get asked “are you getting funds from the government now?”.  The answer is no, the government wrote the ARRA law using the carrot and stick approach.

The goal of the legislation is to encourage healthcare organizations to implement electronic health records to improve patient care.  These are things like prescriptions need to be dispensed electronically, computerized physician order entry (CPOE), closed loop medication dispensing using bar codes on the meds, patients and care giver, etc.  The goal being improved patient outcomes and care. 

Once you have all records and processes (i.e., dispensing medication) in an electronic format you have a lot of data and information that can be used to improve treatment protocols, determine trends and measure the effectiveness of treatment (i.e., which physician, hospital, region, state, etc. have the best outcomes for treating specific diseases).  This in turn should further improve the delivery of patient care resulting in better outcomes and reduced costs over time.

To encourage healthcare organizations to move forward the government is providing greater reimbursement for steps being implemented by 2011, 2012, 2013, etc.  Meaning the sooner a healthcare organization has systems in place the more reimbursement they will receive.  Starting in 2015 the penalty phase begins for those organizations that have not meet the goals defined in ARRA.

The ability to meet the deadlines is dependent on many factors; one major factor being will your system provider (the vendor you purchase your patient electronic medical record, radiology, lab, etc. systems from) modify or build the system to meet the government’s requirements.  This all translates into a lot of growth coming to the healthcare information systems field.

I will soon start to get into more technical topics, but I wanted to provide a basic foundation to why I think technology is so cool and useful in healthcare.  We are not just making a widget . . . we have a positive impact on patients.

October 26, 2009 Posted by | Healthcare IT General | , , | Leave a comment

The Start of a Blog . . .

I have been working in healthcare information systems for 14 years in North Carolina.  My role has changed over the years as technology, systems, requirements, etc. have evolved.  We have been through the early Internet, the dot com boom, Y2K, the dot com bust, HIPAA, Electronic Medical Record, virtualization and now the new requirements of the American Recovery and Investment Act of 2009 (ARRA).  The last item ARRA being a huge game changer for American Healthcare.

Electronic health record (EHR) technology is changing the way healthcare organizations meet the needs of their patients, physicians and employees.  According to HIMSS officials:

 “EHR technology is “meaningful” when it has capabilities including e-prescribing, exchanging electronic health information to improve the quality of care, having the capacity to provide clinical decision support to support practitioner order entry and submitting clinical quality measures – and other measures – as selected by the Secretary of Health and Human Services.” (from Healthcare IT News April 28, 2009).

 This translates to increased requirements for overall computerized system availability.  Clinical systems need to be architected to provide electronic health record services at all times in a flexible and secure manner.  To achieve this level, a heavy investment in advanced technical infrastructure has to be implemented.  The underlying information system technologies used to build a redundant, resilient datacenter are the network, storage, computing capacity, power, cooling, and adequate space.

 All healthcare organizations will be required to provide “meaningful” EHR technology.  Due to the technical complexity this will be a financial and technical challenge for many.  The options available to organizations would be to build and maintain their own technology infrastructure, purchase applications from a provider (Software as a Service model), merge or consolidate with other organizations and or lease technology capacity. 

We are at an evolution period for healthcare IT which will change the way healthcare is delivered in America.  I am excited to be a part of it, shaping how we move forward.


My plan is to use this blog as a way to lay out my thoughts on healthcare IT with a focus of the underlying technology infrastructure.  Key pieces being datacenter, compute capacity, storage, virtualization and application delivery.





October 23, 2009 Posted by | General, Healthcare IT General | | Leave a comment