Plugging the IT gap

Today`s economic situation has reminded hospital administrators of some important lessons learned in the early 1990s when all projects, IT or otherwise, needed to pass stringent economic tests to receive funding.

Wolfgang Held, network consultant at 3Com SA, takes a closer look at the many IT challenges faced by healthcare organisations and provides some workable solutions.

We only have to skim through a technology journal to see the number one issue plaguing IT managers around the world. Life, they say, simply isn`t fair.

They are told by business bosses that they should implement systems that boost productivity and enable new services while protecting sensitive information from external and internal attacks. The problem is, they are told in the same breath that in most cases budgets will remain flat, at best.

The situation is no different in hospitals and other healthcare organisations. Hospital administrators have become aware of what technology can do for their business and are asking their IT teams to come up with new ways of improving conditions for managers, staff and patients, while streamlining processes and reducing operational costs.

Again though, in many cases there is no significant injection of cash to fund these projects.

So what can be done to make light of these challenges? Actually, quite a lot.

Vendors such as 3Com has been working with hospital technology staff for more than 20 years in more than 50 countries across the globe and in that time they`ve learned a thing or two about the problems healthcare organisations face and have created a number of ways to overcome them.

Each industry has its own specific needs from IT systems. In finance, for example, redundancy is king as millions of dollars can be lost for every second of network downtime.

In engineering, bandwidth is key, as the network has to be able to cope with huge CAD files being sent across R&D facilities. The following are a few of the important drivers that we see in the healthcare market.

The healthcare industry is subject to rapidly rising costs but at the same time, managers are under constant pressure from local authorities and insurance companies to provide excellent value for money.

Even the best run hospital is, therefore, a low margin business so administrators are constantly looking for ways to cut costs while ensuring a high level of care. One way to achieve this is to use technical innovation to improve operational efficiency - hone internal processes to reduce the number of repeated exams and make better use of clinical, technical and financial resources.

Competition between private hospitals has reached fever pitch. Even in the state sector, many governments and local authorities are publishing league tables and allocating resources accordingly. Healthcare institutions are desperate to provide proof of the quality of their care to reassure potential customers of their credentials.

In order to differentiate themselves, administrators like to advertise that the latest medical equipment is readily available, or that systems have been put in place to guard against accidents and error. Some offer patients Internet access within the hospital.

In the context of healthcare provision, a borderless environment saves lives. Whether it be between different nations, regions or hospital wards, it is essential that administrators put in place systems that facilitate the rapid transfer of relevant, accurate information across secure networks.

At the same time, members of the public increasingly want to share in the debate on how to best care for them and they are demanding access to their patient information and other hospital resources. Within the hospital, doctors and nurses must have access to information wherever they are, whenever they are there. Importantly, they must have the same view of the information - updates must be refreshed across the network in real-time.

Consumers are especially protective of data regarding their health as it can directly impact their career and personal life - they have to be reassured that this information is being held in a safe place, far from prying eyes.

On top of this, governmental regulation has been put in place to protect sensitive patient information and many have specified severe penalties for organisations that misuse or mismanage this data. It is therefore essential that the network is secured against theft or vandalism from external or internal hacking attacks.

IT and network managers find themselves working in a very different world to the heady days of the late 1990s. The drive to aggressively build new IT infrastructure - spurred by the Internet boom, stratospheric rise of the telecom sector and preparation for Y2K - has been replaced by a set of objectives grounded in business common-sense.

Often they can only spend money when the project will save the business the same amount of cash over a limited time. In other words, projects need to pay for themselves.

In many ways this is a positive step. It imposes a rational assessment of each project idea that naturally separates business-critical initiatives from nice to haves.

However, it also means that hospital managers must prioritise - do they want to implement an IT project designed to streamline operations and thereby cut costs, or should they invest in an improved network that speeds the transfer of information and makes it available to more people in more locations?

Both, however, are important, so which should they choose?

There is much to be done if healthcare IT managers are to achieve business goals within strict budget guidelines.

1. Do your homework

Before signing a contract with a supplier, make sure you have conducted a thorough examination of return on investment (ROI), which measures the financial benefit of a project measured against capital outlay, and return on assets (ROA), which assesses how well the new project will integrate with, and draw the best from, existing IT investments.

2. Choose centralised administration

Whatever you need from your network, it`s a good idea to choose a solution that can be managed remotely from a central location. This has a real bearing on the TCO (total cost of ownership) as central administration saves time, is a simpler process and requires less headcount, which is often a barrier to project approval.

3. Take a serious look at networked telephony

The cost benefits of a LAN telephony project are immediately apparent. Maintenance costs are reduced, as is the complexity of the administrator`s job as both data and voice now run across a single network.

Gone too are the significant monthly payments to the PBX operator. When users move department or join or leave the hospital, the system can be updated using a simple command interface - contrast this with the two-week lead time required by most PBX operators to carry out these simple changes.

Networked telephony also enables some seriously useful applications. Hospitals across a geographically dispersed local authority can communicate far more cost-effectively. Advanced automated response, forwarding and messaging functionality means that a phone call will never go unanswered.

4. Implement a strong and effective security infrastructure

Keeping customer information private is one of the most important ways of maintaining trust, and patient records are the most sensitive customer data of all.

Additionally, patient lives depend on a rapid transfer of accurate information between doctors and nurses, so if the network was brought down by, say, a denial-of-service attack, the results would be catastrophic.

There are a number of areas within a hospital network that are vulnerable to attack from external and internal users. IT managers should pay particularly close attention to end user client devices, the network infrastructure, the LAN perimeter, remote access services and centralised management tools, which all pose a risk to security.

5. Investigate a world without wires

One of the most important technological developments of the last few years is the emergence of reliable, secure, high-performance wireless networks. The applications of wireless local area networks (WLAN) in hospitals are innumerable.

Now doctors are able to cross-check patient drug allergies with electronic databases from the point of care, or can view patient records wherever and whenever they want, just by tapping a button on their wireless notebook or personal digital assistant (PDA)

The emergence of wireless technologies is reducing the amount of paper records clogging up hospital admin departments, reducing doctor error caused by conflicting or illegible paper-based reports and allowing healthcare managers flexibility in bringing up-to-date information to doctors wherever they are in the hospital.