The changing role of IT in the new healthcare paradigm

IT has a key role to play in improving health outcomes through technologies and functions like analytics, AI and machine learning while also reducing costs through better integration and workflow automations.

During a workshop at the Becker's Hospital Review 12th Annual Meeting, sponsored by Kyndryl, Rajesh Jaluka, Chief Technology Officer of U.S. Public and Federal markets and Distinguished Engineer at Kyndryl, discussed reasons to migrate EHR systems to cloud-based platforms and what it takes to do it.

Four key takeaways:

1. The key imperatives of IT are changing. As the healthcare paradigm shifts, so too must IT's priorities. Now, IT must support clinicians involved in collaborative treatment and remote patient monitoring, while also enabling televisits and supporting digital patient engagement. In this new landscape, IT's imperatives include scale, reliability, security, interoperability and innovation.

2. Migrating EHR to the cloud opens doors to opportunity. The cloud provides high availability with no upfront capital investment. Other opportunities and benefits of migrating EHR to the cloud include a higher degree of reliability, enhanced cybersecurity and increased speed and agility of innovation, as well as increased interoperability and ease of modernization.

3. Choose your highest priority to avoid higher costs and start low risk. "A lot of the time people think [the cloud] is cheaper," Mr. Jaluka said. "It can actually turn out to be more expensive if you don't manage it properly." He advised to "identify and prioritize your critical risks and value drivers" and adopt a model of "crawl, walk, run." He suggested thinking creatively and beginning with a training environment that allows you to first learn lessons about how the system is working before incrementally increasing features and functionality. "Adopt an iterative approach that delivers incremental benefits," Mr. Jaluka said.

4. Organizing teams is critical for success. Traditionally, IT departments were structured into siloes without overlapping knowledge. Development teams built applications and operations teams serviced the infrastructure, with tension between the two.

Mr. Jaluka suggested:

- Step 1: Form cross-functional infrastructure squads. The idea is to replace competency-based structure with cross-functional squads that have the skills necessary to support a business domain and its applications. In forming these cross-functional squads, foster a culture of close collaboration.

- Step 2: Add a site reliability engineer, a concept pioneered by Google. The role of an SRE is to bring an engineering mindset to the IT operations team, making systems more reliable by creating user journey maps, setting realistic expectations of system behavior, scaling operations using automation and removing blame when problems occur.

- Step 3: Adopt DevOps topology that fits for purpose. There are a variety of ways development and operations teams can be structured to work as a single unit instead of traditional single squad model. The structure needs to align with the application delivery model.

This business and application centric collaboration structure also drives the maturity of devOps, devSecOps, modernization, innovation etc. "What you find is it actually accelerates all of these different paradigms because everyone now has an application user centric mindset," Mr. Jaluka said.

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