Markham Stouffville first in Canada to use INFRAM model

As part of a plan to upgrade and modernize its IT infrastructure, Markham Stouffville Hospital, located north-east of Toronto, has become the first medical centre in Canada to make use of the INFRastructure Adoption Model (INFRAM).

Initially developed by the Cisco healthcare team in Australia and New Zealand, INFRAM has been officially adopted by the Healthcare Information and Management Systems Society (HIMSS) Analytics as the global model all health care organizations should adopt and follow when creating architectural infrastructure to support their Electronic Medical Records (EMR) and other technology rollouts.

Markham Stouffville Hospital began laying the groundwork for a major digital transformation more than two years ago, with a focus on two major priorities: patient care and future-proofing the hospital’s IT systems.

“Much of the technology we had supporting our network was in need of a refresh,” says Michael Cole, who came on-board in 2017 as the hospital’s Chief Technology Officer. “For example, our wired and wireless infrastructure was end of life in many areas and end of support in others.

“A refresh was necessary not only to ensure stability and the improvement of our security posture, but also to enable ourselves, our providers and our patients with the foundation for the technology requirements needed now and for the foreseeable future.”

In February 2017, the hospital announced one of its first digitization projects – a shared health information project with Newmarket’s Southlake Regional Health Centre and Alliston’s Stevenson Memorial Hospital. This new project will support seamless patient care across the three organizations by centralizing patient records and streamlining access for healthcare professionals, patients and their families.

Markham Stouffville has already moved its Meditech deployment into a new managed data centre in preparation for the alliance.

However, working with the hospital’s IMIT (Information Management Information Technology) leadership team to continue making digitization a top priority, Cole quickly concluded that the new data centre implementation was not enough. The hospital needed a stronger, underlying infrastructure for its entire digital network.

Markham Stouffville engaged Cisco Canada to undertake a complete network assessment, with the ultimate intention of designing a full refresh of the hospital’s wired and wireless network. Key to this assessment was the INFRastructure Adoption Model. For the assessment, VertitechIT, an IT consultant with a holistic view of IT strategies, worked closely with Cisco and the hospital, helping to lead the review and engagement model.

The INFRAM review takes organizations through a detailed process and assessment from an infrastructure perspective, focusing on five technology pillars: transport layer, data centre, unified communications and collaboration, mobility and security. It provides an infrastructure architecture roadmap that can be used to detail the organization’s specific technology requirements based on what they already have in place, and where they want to go.

INFRAM is complementary to the HIMSS Analytics Electronic Medical Record Adoption Model (EMRAM) and its corresponding levels. Using it, healthcare organizations can improve care delivery, reduce cyber and infrastructure risk, and create a pathway for infrastructure development tied to business and clinical outcomes.

INFRAM can also help them achieve cost-savings throughout the upgrading process, while adopting EMR or when looking to drive efficiencies throughout their infrastructure. By increasing transparency in the assessment, evaluation and planning stages, it provides a more accurate picture of where resources should be allocated, reducing the risk of wasted investment.

“Cisco took an agnostic approach, regardless of technology involved, that basically says ‘here’s where you are’ in order to give Markham Stouffville Hospital a baseline from an infrastructure perspective,” says Rob Campagna, Regional VP of Ontario Public Sector, Cisco. “The power of INFRAM is that it can be mapped in such a way that organizations can create a strategic architectural roadmap from the technology perspective, focusing on how they want to achieve clinical excellence in their hospitals. A model like this has never really existed before.”

Cole is extremely pleased with the result. “INFRAM gave us a great opportunity to have a third party come in and give an objective point of view of where Markham’s infrastructure was to date,” he says. “It provided a strong starting point, showcasing where we were at the time and what we needed to do to craft tangible steps to drive forward.

“In addition, it gave us a succinct snapshot not only of our HIMSS (EMRAM) score, but also of where we stood around security and stability. Using it, we were able to easily communicate with our leadership team.”

Cisco continued to work with Cole and the IMIT team on the infrastructure design, at which point they brought in TELUS as a technology partner to provide the equipment needed to build the new foundation.

Cisco worked with TELUS on a complete redesign of the hospital’s network layer, wireless infrastructure, data centre and security. TELUS was responsible for the network access control, firewalls, LAN and wireless LAN, cabling, racking, stacking and mounting of equipment, as well as all networking configuration.

“TELUS’ role was to hone Cisco’s design and make it more specific to Markham Stouffville’s needs,” says Cynthia Esnard, Healthcare Account Executive with TELUS Business Solutions. “It’s our job to implement that design and establish a partnership going forward to continue to assist the hospital in reaching that higher INFRAM level. Ultimately, we are the enabler of the foundation for the recommendations resulting from INFRAM.”

Markham Stouffville now has a roadmap to become one of Ontario’s leading digital hospitals. Some of the areas that will be focused on in the near future include cybersecurity and an upgrade in collaboration tools.

“This has been a crucial step in elevating Markham Stouffville’s digital transformation journey to the next level,” says Cole. “Over the next few years, we can start mapping out projects to improve the patient experience and enable our providers to deliver even better care.”