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Scalability and the Growing Hospital Network

May 14, 2013
by Gabriel Perna
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In a recent report, researchers from HIMSS Analytics, the wholly owned not-for-profit researched-based subsidiary of the Healthcare Information and Management Systems Society (HIMSS), explored the network demands hospital IT leaders are facing with the increasing digitization of healthcare data. At HIMSS13, the report’s authors conducted “study groups” to find out how these leaders saw IT infrastructure in the present and how they think it will change over the next few years.

One of the ongoing themes of the study, which was supported by Comcast Business, was that IT leaders’ concerns of today and tomorrow are focused on the growing presence of wireless devices in a hospital setting. Jennifer Horowitz, the senior director of research at HIMSS Analytics, says quite frankly, mobile devices are not something healthcare organizations can ignore.

“When we were doing this research, someone [they talked with] said, ‘It’s not if we decide to do mobility, it’s when. It’s coming. We have to figure out how to deal with it,’” Horowitz explained in an exclusive interview with Healthcare Informatics’ Associate Editor Gabriel Perna.


Horowitz says organizations need to ensure that they have the scale to meet these growing demands.  Wireless connectivity is currently a part of every hospital’s network environment and most of the IT leaders the organization talked with at HIMSS said they could handle the demands for now. However, this will change over the coming years, not only with more mobile devices, but as healthcare organizations grow in size as well.

“It’s a challenge to support an environment that’s not just inside the four walls of the hospital. It’s making sure as mobility goes, they are able to support, not only physical structures that are in the environment, but the community that’s out there,” Horowitz says. Investments will have to be made, she says, in ensuring there is coverage in “drop zone” areas.

The report covers numerous technologies that can solve the “drop zone” challenge including the virtualized desktop. This helps those who have experienced a dropped signal while in the middle of completing a task, it allows them to come right back to the same place and pick up where they left off when wireless access was restored.

In terms of scalability, healthcare organizations will have to make investments to either scale legacy technologies like T1 lines or if they choose, they can reconfigure their environment, Horowitz says.  Furthermore, as these networks expand and cover different capabilities, the nature of the IT team will change as well and investments will have to be made there.

“As organizations look at a network environment that’s both wired and wireless, and use a multitude of types of solutions to accomplish their needs, there is a potential recognition you are going to need people with different skill sets to manage different technologies,” Horowitz surmises.

HIE and Cloud

In the report, the authors note one of the main technological barriers that relates to infrastructure is health information exchange (HIE). In a broader sense, Horowitz notes, healthcare organizations have to support HIE on multiple different levels, such as provider-to-provider or provider-to-home clinician. The various external and internal networks will have to be supported, she says. In addition, HIE is a network challenge in the sense that clinicians will be exchanging between mobile and wired devices within the hospital.

Another challenge mentioned in the report is in regards to imaging. The growth of the picture archiving and communication systems (PACS) market over the last five years has made storage ability a concern for hospital IT leaders. “They are imaging so many more layers, so we’ve gone from gigabytes to terabytes, and it’s clearly something of a concern,” Horowitz says. “They are doing so much and it takes up so much space.”

Cloud storage solutions aren’t exactly the answer, yet, the report’s authors found. Most of the hospital IT leaders surveyed are proceeding with caution when it comes to the cloud. Horowitz says they are more likely to be receptive to the cloud if it is hosted by a vendor with whom they are familiar. However, even then, there are security concerns.

“They are much less likely to store personal health information (PHI) in the cloud, and more likely to store business type documents. Part of that concern comes from the fact they [the cloud vendor] wasn’t willing to sign a business associate agreement, and that puts them [the provider] at risk for potential security breaches,” Horowitz says.

Overall, Horowitz and company found that hospital IT leaders agree on numerous issues related to the changing hospital network infrastructure. While they are faced with different challenges and presented different solutions to scalability, they all agreed on the importance of a highly operational and reliable network that ensures data is available when and where a clinician needs it.