Hospitals are outsourcing and moving IT to the cloud

TORONTO – Demand for information from users inside hospitals – and from partners and patients logging into portals outside the facilities – is “becoming insatiable”, as one healthcare executive at Microsoft’s recent “Future Now” conference put it.

So how will hospitals manage the rocketing growth of servers and apps, as new systems are added to deliver the data, along with the privacy and security issues that are bound to crop up?

And it’s not just computers that have to be tracked.

“What do you do when you’re keeping track of 5,000 desktop computers, and you move to monitoring 100,000 sensors,” asked Lydia Lee, Healthcare Lead at KPMG, and the former CIO of the University Health Network. She was the session’s keynote speaker, and noted that every computerized device in hospitals is now being tied into a network – or soon will be.

“It’s a quantum shift,” said Lee. “You have to respond in a different way.”

Dr. Sarah Muttitt, VP and CIO at the Hospital for Sick Children, commented on the fast expansion of systems at the medical centre, which will only grow further with construction of a new tower for patient care. As well, the hospital has a leading-edge research centre, and has also embarked on a new initiative in artificial intelligence. “Data is pivotal, and reliability is critical,” she said.

One of the solutions is to outsource some functions to industry experts. As one example, she noted, the hospital has outsourced its network management and security to Telus.

Now, it’s also looking to the cloud as a way of managing the many servers and applications the hospital has spawned.

“We’re looking to see what we can shift to the cloud,” she said. “We don’t want to be in the data centre business.”

She said Sick Kids is now looking at every server, every blade, to see what could potentially be transferred to the cloud. “We’re spending the next year figuring it out.”

She noted that Sick Kids recently went live with the Epic electronic information system in all of its departments, which has had a big impact on the hospital. Now every user, in every department, can access information across the organization, in the same way.

“We were a siloed organization for decades,” she said. “The new system has been transformational.”

She said that access to information is now vastly improved. “What we’re going to do with that information will also be transformational.”

In particular, there’s a big emphasis on improving performance through the use of analytics – something she credited the hospital’s previous CEO, Mike Apkon, with fostering. Dr. Apkon served as CEO at SickKids for five years before leaving to become CEO at Tufts Medical Center in Boston.

“We’ve been putting in dashboards for every part of the business,” said Muttitt. “We’re looking at clinical, administrative, equipment, everything to optimize the organization.” Everyone needs this information, she said, and use of the Azure cloud has been speeding up the process.

It’s all in a bid to improve clinical outcomes, workflows and patient satisfaction. “We don’t want patients to come downtown and not find a parking spot,” she said. “Or to wait four hours for an appointment, or eight hours in the ED.”

For its part, the Ottawa Hospital, which has also implemented Epic, just completed a big cloud project using Microsoft Azure. The organization, which is also hosting systems for several surrounding hospitals, has shifted its disaster recovery (DR) to the cloud.

By moving DR to the cloud, “We’re saving $400,000 a year just for the Epic workload,” said Jean-Claude Lemonde, IT Lead at the hospital.

What’s more, the Azure cloud offers recovery services; and if there is a disruption, service can be switched over within 30 minutes.

Lemonde said the organization looked at shifting its day-to-day Epic systems to the cloud, but there wasn’t the cost savings available that occurred with DR.

“When we looked at the numbers, it would only have worked if we removed the whole IT team,” said Lemonde. “But we still needed the team to manage the other systems we’re using.”

However, he said like technology in general, costs for the cloud may continue to drop over time, making it more viable to put the mainline systems into hosted systems like Azure, Google Cloud or Amazon Web Services.

He mentioned that in addition to the Ottawa Hospital and its partners that are all on the Epic system, the group will extend Epic to 250 primary care clinics on June 1st. It’s going to be the first large-scale implementation in Canada of an Epic system that includes both acute and primary care providers, all in one integrated solution.

For his part, Lemonde doesn’t think all of the hospital’s systems will migrate to the cloud, even if prices make it enticing. “I don’t think an organization should go fully into the cloud, because with outsourcing, you lose your own expertise.” You’ll always need some feet on the ground, he said, for problems that come up on the site.

As well, he doesn’t believe in putting all of one’s eggs in a single basket. “You might want to go with AWS and Microsoft,” he said. “This is also an option.” On the other hand, he acknowledges that using two or more cloud vendors complicates things. “Then you’re using two massively different technologies.”

Mark Rajack, Director of Innovation at Niagara Health Systems, discussed how his organization has been building links to community health providers, like Emergency Health Services. He also noted the interest among the public for access to their health records.

For these reasons, Niagara Health just rolled out a solution that helps with identity management. The Identos system helps determine the outside user is authorized to access the information that he or she wants.

“How do we know you are who you say you are,” asked Rajack. “For example, when someone is calling us from their home?”

The new solution also works with mobile devices, which is increasingly the way people are accessing information of all kinds.

Overall, when it comes to innovation, Rajack said Niagara Health first looks at the problems its providers and patients are trying to solve. It then seeks out the best technology.

“What is the pain point that, for example, the imaging team needs help with?,” he asked. The IT and innovation teams at the organization will then work with the clinicians to source the right technology.

On the topic of surprises, Sick Kids’s Sarah Muttitt mentioned that her organization recently implemented a speech recognition solution for clinical documentation, along with Epic mobility tools for clinicians. “They both took off, with very little training from us,” she said, observing that users took to these technologies naturally and largely on their own. “Sometimes, you don’t know what you don’t know.”