Healthcare Tech - Implementing a complete digital healthcare facility

Mohanachandran, Head-Information Technology, Meitra Hospital, Calicut | Friday, 16 October 2020, 10:09 IST

Mohanachandran, Head ITTechnology has transformed nowadays to be the utmost solution, to face workflow challenges of hospitals. This has to be thought out from the early stages of building a facility from scratch, so that you won't have any challenges while moving into operations, from the project stage. Various sensational areas of patient connect and clinical expertise can be made easy, by implementing proper technology as required. Still, the key area to be taken care of here is not to complicate the system, by implementing many information sources/repositories in bits and pieces. Listing down some of my thoughts/views on this, while you start.

1.Infrastructure Planning
An area that is still not thought wide during the initial planning phase, which could be your base to implement several technologies ahead.
1.1. Datacentre Architecture
An initial decision has to be made on the DC hosting methodologies, case to case. Below options can be considered
1.1.1. On-premise DC
Manageability on the high end, nonindependent of external factors like connectivity, highest data transfer are some of the advantages while opting for this model. Still, as negatives, we could consider huge CAPEX, spontaneous changing technologies, end of sale/support challenges, etc. 
1.1.2. Cloud Hosted DC
No initial CAPEX, pay as you use, the security of the infrastructure, no worry hardware configuration, etc can be seen as positives while opting for this approach. Still, where your data is, manageability of your data, privacy, and data transfer concerns can be on the negative side 
1.1.3. Hybrid DC
If you are having a highly exposed application running with huge realtime hits/IOPS, we consider a hybrid DC setup that can cater to this requirement. SAS and IAAS services are a prime example of this scenario.
1.2. Network Infrastructure
Based on the complexity and coverage of applications you used in the facility, the network has to be defined redundantly including wired and wireless.
While defined the scope of network infra, other medical modality aspects also to be taken care of along with enduser computing and mobility. The major components that contribute to this aspect would be end-user devices, medical modalities, PA systems, CCTV cameras, telephony, access control systems, patient monitors, bedside systems, and nurse call systems. If you can establish a redundant network between all these spokes, a major challenge of 
communication internally would be solved.
1.3. Server Architecture
While defining the server architecture, you may consider below three approaches based on the count of applications hosted and it's complexity
1.3.1. Traditional Setup 
One Application/server which may not be cost-effective.
1.3.2. 3-Tier Architecture 
Storage-SAN Networkserver model through different components, with high uptime and scalability, but have high TCO and difficult to manage because of
its complex nature.
1.3.3. Hyperconverged
Server-Network-Storage in a single mode with its simplicity,ease of deployment& maintanence and cost savings.
2.Security & Compliances
One more key area of focus should be on the below aspects of security , in the current scenario of targeted attacks specific to patient data/hospitals. 
  • Excellent firewall
  • Good Endpoint security & DLP
  • Email security
  • Firewall for Web applications
  • Secure VPN Tunnels
3. Finding the right software’s
To drive the core business, there is a combination of multiple software's to be considered as the backbone. While evaluating, areas to be considered are redundancy, performance, platform dependency, and high integration capacities.
  • HIMS- Complete hospital information systems with the capability of handling complete EMR/EHR should be considered. This should be talking to all patient modalities such as LIS, RIS, ICU monitors, kiosks, and many more. Also, the application to be user friendly in UI and features.
  • ERP- To consolidate all your financial transactions, inventory and human resources, an appropriate ERP to be selected and fully integrated with your HIMS
4. Complete Integrations/interfaces
Ensure that the entire solutions you host are communicating across, to function smoothly and error-free with ease of consolidation. Failure of this can cause serious business impacts and clinical errors.
5. CRM Solutions
To connect with patients and provide a good experience, we need excellent CRM solutions, which can communicate in real time with patients. This includes SMS, IVR, patient engagement tools, etc. Websites/mobile apps can be the entry points to these solutions, for experiencing real care.
6. Remote connecting tools
Latest in the current situation, Teleconsultation, and Tele-ICU platforms should be the prime area of focus to connect with patients, even from home or remote clinics.
7. IoT
IoT can be made useful in remote patient monitoring, RTLS within the facility, and also in various other areas like IoT for physicians, patients, and hospitals to improve the business model.
8. Internal Communication tools
There should be an excellent tool hosted inhouse to communicate properly with the inhouse team. This area is the most ignored one, which can cause a huge impact on internal communications and hence the business.
9. Analytics and Dashboards
The world has moved to realtime information streams, which can help the operations team to take appropriate decisions spontaneously. This would enable the team to take corrective actions in real-time, instead of corrective measures postincident. 
10. Bedside devices
For a completely digital facility, bed side end-user devices play a vital role. Most of these requirements can be catered using a COW(Computer on wheels), tablets, and even mobile devices. These devices help care providers to record and implement appropriate patient care measures and orders instantaneously. This can also help with medication administration tasks to reduce medication errors if done within the HIMS.
Taking care of all these aspects in planning phase of a hospital, would result in an excellent digital facility with ease of operations and excellent clinical outcomes along with high patient satisfaction.