Outlook Series | Jamie Coffin, VP of Dell Healthcare Strategic HIT Priorities Forced to Change

Strategic HIT Priorities Forced to Change

January 28, 2010

As government and healthcare leaders invest billions of dollars in healthcare information technologies (IT) to improve the accessibility, affordability and quality of healthcare for their citizens, hospital datacenters may not be ready for the demand that more patients and digital information will create, according to a survey of hospital IT executives at small and medium hospitals in the U.S., U.K., Canada, China, France and Germany conducted by the HIMSS Analytics.

The HIMSS Analytics survey asked hospital IT executives to assess the readiness of their hospital datacenters to support new information demands as reform initiatives such as electronic medical records (EMRs) and digital imaging become more pervasive. Results suggest that there will be challenges associated with scaling small and medium hospital datacenters to meet these demands and to supporting efficiently technology at the point-of-care — the No. 1 strategic priority of hospital senior IT executives in nearly every country.

The Healthcare Enterprise Survey revealed that hospital IT executives at small and medium-sized hospitals believe that EMRs, Health Information Exchanges (HIEs), capacity for storing digital images, needs of affiliated physicians and business intelligence will increase demand on their datacenters by an average of 20 to 50 percent over the next two years.

While many small and medium hospitals anticipate they will spend more on IT next year, they also describe datacenter challenges that Dell believes will make it difficult for them to efficiently manage new information demands. These challenges include a lack of standards, security, extended server refresh cycles and complexity created by a large number of servers and vendors and limited use of virtualization.

Lack of datacenter standards complicate the information sharing within and between hospitals necessary for diagnosis, decision making and coordination and management of patient care. With refresh cycles of five years or more, small and medium hospitals rely on servers that are less efficient and cost more to run and manage as they prepare for a significant increase in data over the next two years.

Without aggressive adoption of virtualization, hospitals that simply add servers and storage to their datacenters to meet growing data demand will end up perpetuating the complexity that already consumes a majority of their IT resources, leaving less of their budgets for strategic priorities even as they invest more in IT.

Now is the time for small and medium hospitals to prepare their datacenters to handle strategic reform and healthcare priorities and for government leaders to consider the significant contribution these hospitals can make to an information infrastructure that streamlines administration, improves diagnosis and decision-making at the point of care and coordination and quality of patient care across the healthcare system.

In addition, the survey pointed to individual country concerns, as follows:

In the U.S.:

Regulation Driving Requirements. U.S. hospital IT execs most frequently identified regulatory issues as the business issue that will have the most significant impact on healthcare over the next 2 years. Dell believes this could translate into regulation and compliance requirements for information management and security.

Server Proliferation. With an average of 75 servers, U.S. and U.K. small and medium hospitals run the greatest number of servers among similarly-sized hospitals in other countries. And because one-third have not virtualized to any extent, Dell believes many small and medium hospitals are under utilizing servers and over extending IT resources for server management.

Application Complexity. By and large, hospitals report that hardware choices are driven by software companies and that application support is the greatest inhibitor to virtualization. Dell believes this indicates that datacenter infrastructures have not been designed for the best performance or efficiency.

Encouraging factors for the outlook of small and medium hospital datacenters around the world include:

Growth of IT Budgets. Three-quarters of hospital IT executives indicated that their IT budgets would likely increase next year; only 8 percent indicated that their budgets would decrease.

A Pragmatic Action Plan:

Based on these findings and its experience with large hospitals, Dell recommends a pragmatic six-point action plan to help small and medium hospitals improve the efficiency and scalability of their data centers to support healthcare reform and business priorities and make the most of their current and future IT investments:

Eliminate Complexity. Adopt standards-based technology and an open and flexible architecture across the datacenter in order to automate routine management tasks, simplify virtualization to achieve optimal server and storage utilization and lay the foundation for interoperability and information exchange within the hospital and across the healthcare system. Standardization now will reduce maintenance costs, which consume 70 to 90 percent of IT budgets, and simplify scaling in the future.

Invest, but Invest Wisely in more efficient and scalable systems and management tools that reduce maintenance costs and have scaling capacity. For example, Dell’s PowerEdge Servers, powered by the Intel Xeon Processor 5500 Series processors, have significantly greater processing capacity than previous generations. They are easier-to-manage, virtualization-ready and can provide a significant increase in performance over previous generation servers allowing hospitals to run more compute intensive databases and applications more efficiently. Regular server refresh can save money by reducing management overhead and reducing power consumption and cost.

Virtualize Now to Prevent Server and Storage Proliferation. Accelerate server and storage virtualization to scale efficiently, minimize maintenance costs and free up budget and IT resources for strategic HIT priorities. Use system management tools to simplify management of virtual environments.

Consider Alternative Models. Look at SaaS models for applications with likelihood for substantial growth or with large bandwidth requirements-- such as electronic medical records systems. Also consider hosted application and datacenter usage models for additional capacity when and as hospitals need it.

Automate Routine Management Tasks to free up IT resources for strategic priorities. For example, Dell factory-installs server images to eliminate time-consuming manual configuration and reduce deployment and IT staff time. Also use servers with embedded management tools such as integrated controllers that monitor and manage performance from a single console.

Tier Data Effectively to reduce hardware costs, secure and meet data availability requirements.

“Small and medium hospitals are a sizeable component of the healthcare delivery system in most countries,” said Jamie Coffin, Ph.D., vice president of Dell Healthcare and Life Sciences. “We must ensure that all hospitals—large and small, new and existing—are equipped with the right IT infrastructure to support information demands today and in the future. We cannot simply throw servers and storage at information demand or complexity will over-run IT budgets and leave little support for the strategic HIT priorities which support healthcare reform and business initiatives.”