A fundamental trend right now for healthcare institutions is the consumerization of medicine.
Both the healthcare industry and patients are embracing it. According to Anthem, 76 percent of patients believe that technology has the potential to help them improve their health. At the same time, the consumerization trend creates a burden that IT needs to address so that it can support the transition and delivery of these new services.
What is the consumerization of medicine? The subject is taking many forms. Three of the top areas that are transforming the healthcare industry consist of:
Expansion of Wi-Fi networks to support personal and distributed device trends (IoT and BYOD)
Modernization of medical payment systems (web-based billing from patient portals, point-of-sale, and Apple pay)
The explosion of Telemedicine and Telehealth services
To be viewed as “cutting edge”, many hospitals have adopted technology like Wi-Fi (for both healthcare professionals and patients) and the deployment of IoT for medical equipment (like electronic pain dispensers and patient vital statistics monitors). However, as the role of Wi-Fi networks expand within healthcare facilities, one of the drawbacks of consumerization is the uncontrolled consumption of bandwidth. Not all consumption is equal, or linear. IT will need to be at the forefront to manage this resource.
As an example, hospitals have embraced BYOD for healthcare professionals and even support the use of patient accessible Wi-Fi. Some examples include: Voice over IP (VoIP)-based medical communication systems (like Vocera badges) for doctors and nurses, data downloads onto healthcare institution laptops and notepads, and guest access by patients for both data and video watching. With all of this happening, IT needs enough bandwidth and prioritization of data types to guarantee real-time medical transactions are passed through the network without delays. Therefore, IT needs to be able to understand who is using the bandwidth and who is abusing it. For instance, are Vocera Wi-Fi badges consuming the bandwidth for hospital staff communications or are patients watching lots of Netflix?
Recent years have also seen an explosion of IoT-based medical devices. One example is the use of infusion pumps that can disburse medication without a nurse being present. Electronic patient monitors are another example. These devices do more than just output data periodically to the nurses’ station. Infusion pumps need to download drug libraries and WLAN-based telemetry transmitters send alarms and waveform data to a central station.
Consumerization is also driving other forms of IP-based communication, like web-based billing, point-of-sale (POS), and mobile payments. Consumers like the multitude of payment options that fit their varied needs. For IT though, this means that besides the standard electronic billing process that needs to be supported, they must support e-commerce engines, credit card processing, and BYOD billing systems. In addition to the complexity of integrating all four types of payment systems, regulatory compliance standards (HIPAA, PCI-DSS, SOX, etc.) must still be adhered to.
The use of telemedicine (and telehealth) is another technology driver. Telemedicine consists of a consultation with a doctor by electronic means – computer, tablet, mobile device, etc. According to Anthem, it could deliver $6 billion in annual savings to U.S. customers and the global market is expected to be larger than $34 billion by 2020. Geographically remote consumers like the convenience and access benefits of telemedicine. Busy consumers like it too as they can get 24-hour, instant access to physicians (like Teladoc, Doctor on Demand, and LiveHealth Online) at a low cost without having to travel to an office. This can be a great option for the flu or rashes. 67 percent of patients say telemedicine increases their satisfaction with medical care. Due to the expanded use of electronic medical records (EMR) promoted in the Affordable Care Act, information collected through telemedicine can be used to update patient records so that the primary doctor is kept in the loop. According to Anthem, 51 percent of doctors use electronic access to clinical information from other doctors while over 91 percent of hospitals have moved to electronic records.
There is also a huge amount of information that is now being collected and made available to mobile and web-based devices. 52 percent of smartphone users gather health information using mobile apps. Over 90 percent of doctors believe that mobile apps can improve health. In addition, 70 million people in the U.S. use wearable health monitoring devices. Certain wearable devices can transmit data to doctor offices that can be included in the EMR for patients to keep their medical records up to data. For instance, activity trackers, pacemakers, and insulin pumps can all send health data to doctors. This wearable technology is expected to drop hospital costs by 16 percent in five years and 86 percent of doctors say wearables increase patient engagement with their own health.
So, how does IT overcome these challenges? From an IT perspective, both front end and back end technologies need to be in place to enable all of these services. Besides deployment of the basic infrastructure, routine testing needs to be performed on the Wi-Fi system and the wired network. Wireless networks can have a multitude of impairments due to: frequency planning issues, building obstructions, use of lead-lined walls in radiology rooms and tile-lined bathrooms, the proliferation of BYOD devices from staff and patients, individual radio performance (as not all radios are created equal), and roaming issues between access points. Because of the traffic intensiveness for wireless LAN connections, IT should perform testing of the wireless LAN network consisting of: frequency interference, traffic generation for load, automated test cases, and performance analysis by quantifying application performance and user perspective.
Once the network is tested for proper operations, a network packet broker (NPB) with application intelligence can assist with determining what applications are running on the network and who’s abusing network bandwidth (e.g. is there a lot of Netflix watching). Other technology can then be used to throttle back usage for network hogs so that telemedicine and IoT devices have enough bandwidth.
Thanks to IoT, there are literally thousands of devices in a hospital. To make it easier for IT to understand what is happening on the network, it is common to separate different device types (infusion devices, patient monitoring, VoIP) based on a VLAN and ESSID. As part of the network and application monitoring strategy (to ensure quality of experience and service validation), these data types can be segmented using an NPB (based upon the VLAN information). The requisite data can then be forwarded to the appropriate application monitoring tools. Proactive monitoring solutions can also be used to observe network performance in real time.
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