Heading for hybrid: the state of cloud in healthcare
Dr. Tim Calahan, Director of Healthcare Product Strategy & Management at Virtustream gives his analysis of the state of cloud in the global healthcare space.
A fundamental change is underway in the healthcare industry. Hospitals, walk-in centers and doctor’s offices are undergoing a digital transformation, integrating their electronic health record (EHR) platforms with new patient engagement systems and emerging precision health platforms. They have three primary goals: improve the quality of care, empower patients to take control of their health, and reduce the cost of IT operations.
The increasing complexity of the healthcare IT landscape is driving healthcare organisations to consider new options that can embrace digital strategies and increase agility while reducing costs. Worldwide, security mandates are understandably strict to protect personal health information, with country-level regulations and requirements adding additional layers of complexity. While on-premises solutions may offer perceived advantages, industry leading healthcare providers are closely examining enterprise cloud options for hybrid and off-premises deployment models that meet or exceed high security and compliance requirements, while offering utility-based billing and cloud-based agility and flexibility. For enabling digital healthcare transformation, enterprise cloud services provide a host of avenues to support healthcare providers.
Cloud enables healthcare transformation
While there are plenty of drivers for healthcare providers to adopt a cloud solution, there are also several factors inherent to a cloud offering that make this model attractive for more widespread adoption. A cloud solution can enable the transformation of hospitals, walk-in centers and doctor’s facilities by providing benefits that cannot be delivered through an on-premises deployment. Cloud deployments can address the changing budgetary needs of healthcare providers by shifting budgets to an operating model, thereby stabilising IT spend. Not only can a cloud platform cost less than an on-premises option, but it can also provide a greater time-to-value for the investment. This value is seen through lower startup costs, non-disruptive upgrades, increased agility to easily redeploy infrastructure resources, pay-for-use models, and the flexibility to scale-up resources during intensive development and usage, and, in turn, scale-down resources based on an organisation’s needs.
Enterprise cloud services can also provide the highest service levels for availability. Built with redundancy and business continuity by design, a managed EHR platform, when overseen by an enterprise-class cloud provider, can deliver up to 99.999% service level agreements (SLAs) for infrastructure availability, which is less than 6 minutes of unplanned downtime per year. Conversely, an on-premises solution can face limitations in the speed of deployment and scalability and it could be costly to meet comparable business continuity guarantees.
Hybrid is the way for healthcare IT
Hybrid architectures for mission-critical, highly connected environments are not new. In fact, it is the most common deployment model today. Enterprises regularly leverage and combine legacy on-premises environments with off-premises cloud services. The cloud environment must be thoroughly controlled, blending the best practices, procedures and security standards of both the healthcare provider and the partnering cloud company. It’s important to partner with an enterprise cloud service provider with deep experience working with healthcare organisations, and with experts on staff for planning, ongoing support and consultation.
Also, the application interdependencies need to be well understood. For example, it’s advised to have applications with high data interchange rates or with very low latency requirements to reside in the same location. This means that during the planning and assessment phase of any potential migration it’s critical to keenly understand the application landscape and varying performance requirements.
When moving any part of the healthcare IT landscape, including the EHR systems, to a cloud solution, it’s imperative to know who manages the applications and the interfaces that keep data moving smoothly between the separate systems. It’s also important to distinguish between the infrastructure operations in addition to the technical and the functional management of the applications. It must be well scoped, correctly implemented and comprehensively managed. When done correctly, the management of the entire healthcare IT landscape can provide the same or better service than an on-premises model, with potentially much lower delivery costs.
What to look for in a cloud provider
Healthcare organisations should partner with a cloud service provider that offers a full suite of security and compliance capabilities, guarantees the safety and security of patients’ health data, and delivers true “cloud” benefits such as pay-as-you-go, scale-up, scale-down and rapid deployment. Also, make sure there is always someone to call: a 24/7 white-glove service is critical to keeping healthcare IT systems, including EHRs, running around the clock while compressing costs. A 24/7 service will provide for rapid incident resolution, effectively dealing with problems as incidents become apparent. Lastly, healthcare organisations should search for a cloud provider who can monitor and manage the cloud environment to deliver proactive governance and preventative measures to determine potential issues and deal with them before they become a threat.
By choosing a cloud provider who can provide this level of performance, governance and security along with the utility cost benefits and flexibility of a cloud environment, a healthcare provider can make a positive impact on its current IT infrastructure. Additionally, the healthcare provider can efficiently and effectively modernise its systems and applications and transform IT to be future-ready, freeing the provider to put its attention on what matters most – the health and wellness of its patients.
How UiPath robots are helping with the NHS backlog
The COVID-19 pandemic has caused many hospitals to have logistical nightmares, as backlogs of surgeries built up as a result of cancellations. The BMJ has estimated it will take the UK's National Health Service (NHS) a year and a half to recover.
However software robots can help, by automating computer-based processes such as replenishing inventory, managing patient bookings, and digitising patient files. Mark O’Connor, Public Sector Director for Ireland at UiPath, tells us how they deployed robots at Mater Hospital in Dublin, saving clinicians valuable time.
When Did Mater Hospital implement the software robots - was it specifically to address the challenges of the pandemic?
The need for automation at Mater Hospital pre-existed the pandemic but it was the onset of COVID-19 that got the team to turn to the technology and start introducing software robots into the workflow of doctors and nurses.
The pandemic placed an increased administrative strain on the Infection Prevention and Control (IPC) department at Mater Hospital in Dublin. To combat the problem and ensure that nurses could spend more time with their patients and less time on admin, the IPC deployed its first software robots in March 2020.
The IPC at Mater plans to continue using robots to manage data around drug resistant microbes such as MRSA once the COVID-19 crisis subsides.
What tasks do they perform?
In the IPC at Mater Hospital, software robots have taken the task of reporting COVID-19 test results. Pre-automation, the process created during the 2003 SARS outbreak required a clinician to log into the laboratory system, extract a disease code and then manually enter the results into a data platform. This was hugely time consuming, taking up to three hours of a nurse’s day.
UiPath software robots are now responsible for this task. They process the data in a fraction of the time, distributing patient results in minutes and consequently freeing up to 18 hours of each IPC nurse’s time each week, and up to 936 hours over the course of a year. As a result, the healthcare professionals can spend more time caring for their patients and less time on repetitive tasks and admin work.
Is there any possibility of error with software robots, compared to humans?
By nature, humans are prone to make mistakes, especially when working under pressure, under strict deadlines and while handling a large volume of data while performing repetitive tasks.
Once taught the process, software robots, on the other hand, will follow the same steps every time without the risk of the inevitable human error. Simply speaking, robots can perform data-intensive tasks more quickly and accurately than humans can.
Which members of staff benefit the most, and what can they do with the time saved?
In the case of Mater Hospital, the IPC unit has adopted a robot for every nurse approach. This means that every nurse in the department has access to a robot to help reduce the burden of their admin work. Rather than spending time entering test results, they can focus on the work that requires their human ingenuity, empathy and skill – taking care of their patients.
In other sectors, the story is no different. Every job will have some repetitive nature to it. Whether that be a finance department processing thousands of invoices a day or simply having to send one daily email. If a task is repetitive and data-intensive, the chances are that a software robot can help. Just like with the nurses in the IPC, these employees can then focus on handling exceptions and on work that requires decision making or creativity - the work that people enjoy doing.
How can software robots most benefit healthcare providers both during a pandemic and beyond?
When the COVID-19 outbreak hit, software robots were deployed to lessen the administrative strain healthcare professionals were facing and give them more time to care for an increased number of patients. With hospitals around the world at capacity, every moment with a patient counted.
Now, the NHS and other healthcare providers face a huge backlog of routine surgeries and procedures following cancellations during the pandemic. In the UK alone, 5 million people are waiting for treatment and it’s estimated that this could cause 6,400 excess deaths by the end of next year if the problem isn’t rectified.
Many healthcare organisations have now acquired the skills needed to deploy automation, therefore it will be easier for them to build more robots to respond to the backlog going forwards. Software robots that had been processing registrations at COVID test sites, for example, could now be taught how to schedule procedures, process patient details or even manage procurement and recruitment to help streamline the processes associated with the backlog. The possibilities are vast.
The technology, however, should not be considered a short-term, tactical and reactive solution that can be deployed in times of crisis. Automation has the power to solve systematic problems that healthcare providers face year-round. Hospital managers should consider the wider challenge of dealing with endless repetitive work that saps the energy of professionals and turns attention away from patient care and discuss how investing in a long-term automation project could help alleviate these issues.
How widely adopted is this technology in healthcare at the moment?
Automation was being used in healthcare around the world before the pandemic, but the COVID-19 outbreak has certainly accelerated the trend.
Automation’s reach is wide. From the NHS Shared Business Service in the UK to the Cleveland Clinic in the US and healthcare organisations in the likes of Norway, India and Canada, we see a huge range of healthcare providers deploying automation technology.
Many healthcare providers, however, are still in the early stages of their journeys or are just discovering automation’s potential because of the pandemic. I expect to see the deployment of software robots in healthcare grow over the coming years as its benefits continue to be realised globally.
How do you see this technology evolving in the future?
If one thing is certain, it’s that the technology will continue to evolve and grow over time – and I believe there will come a point in time when all processes that can be automated, will be automated. This is known as the fully automated enterprise.
By joining all automation projects into one enterprise-wide effort, the healthcare industry can tap into the full benefits of the technology. This will involve software robots becoming increasingly intelligent in order to reach and improve more processes. Integrating the capabilities of Artificial Intelligence and Machine Learning into automation, for example, will allow providers to reach non-rule-based processes too.
We are already seeing steps towards this being taken by NHS Shared Business Service, for example. The organisation, which provides non-clinical services to around two-thirds of all NHS provider trusts and every clinical commissioning organisation in the UK, is working to create an entire eco-system of robots. It believes that no automation should be looked at in isolation, but rather the technology should stretch across departments and functions. As such, inefficiencies in the care pathway can be significantly reduced, saving healthcare providers a substantial amount of time and money.