Healthcare IT Paradox: The Cost of Technology vs. Saving Lives

Making the right investments at the right time is a balancing act Dr. Zafar Chaudry performs every day to allow his hospital to run more efficiently and scale to meet the growing needs of clinicians and patients.

A physician by training, Dr. Chaudry is senior vice president and chief digital and information officer at Seattle Children’s Hospital, one of the top pediatric treatment centers in the world. His experience with upgrading end-user IT services ahead of the COVID-19 crisis underscores how medical providers are adapting to a new world of telehealth and remote care.

“The interesting thing about being in healthcare IT and also being a physician is that every dollar does impact patient care,” Chaudry said in a live video interview in July during a Nutanix IT Unplugged event.

“For every $250,000 I spend on a technology solution, that could be one less cancer patient’s treatment we can cover.”

Seattle Children’s covers the cost of treating young people whose families lack financial resources. In 2020, Seattle Children’s paid nearly $240 million in medical expenses not covered by insurance, government programs or philanthropy.

“I have to be very careful about the technology solutions, software and hardware I buy because I'm always thinking about how many more children could we have helped versus paying for a piece of hardware,” Dr. Chaudry said.

Upgrading End-User Computing for an Expansive Pediatric Care Provider

Founded in 1907, Seattle Children’s evolved into an expansive pediatric enterprise over the ensuing century. Today it delivers world-class service to ailing children like a 3-month-old baby with a failing heart who got a second chance with a transplant and a young woman who graduated from Harvard five years after surgeons removed a golf-ball-sized tumor from her brain.

It's also a leading center of research, where scientists do things like figure out how to accelerate COVID-19 testing. Seattle Children’s includes a 400-bed main hospital plus multiple clinics in the Seattle area and associated facilities in Alaska and Montana, plus telehealth services extending to Idaho.

In 2020, Seattle Children’s handled more than 375,000 patient visits. Its staff of more than 8,400 includes over 1,800 nurses and 1,000 doctors in training. These professionals work in nearly 60 pediatric subspecialties, delivering inpatient, outpatient, diagnostic, surgical, rehabilitative, behavioral, emergency and outreach services.

These services require reliable technology for placing real-time physician orders, digitizing healthcare records and granting access to medications, prescriptions, medical histories and complications like allergies, genetic defects and chronic illnesses.

“All of that information has to be available at the point of care,” Dr. Chaudry said. “Having a stable infrastructure and continual access at the bedside at one of our 46 sites in any of the four states that we operate in is mission-critical for the services we offer.”

Embracing Virtual Desktop Infrastructure

In 2019, Dr. Chaudry and his colleagues launched an initiative to ensure that everybody in the Children’s Hospital system who needed access to the IT network would have it. They chose a Nutanix virtual desktop infrastructure (VDI) solution, which hosts a Citrix presentation layer that streams an operating system and applications from the cloud to users’ personal computers. 

“We wanted to build a platform where our end users could consume their virtual desktops anywhere, anytime,” Dr. Chaudry recalled. “The model was simplify, standardize and consolidate.” The system had to be able to scale quickly, running hardware storage in a single plane. The goal: supply VDI to 13,000 users, divided by work shifts.

The Nutanix technology uses hyperconverged infrastructure (HCI), which combines virtualization and automation to emulate the operations of a traditional data center. Compute, storage and networking run in virtualized instances on commodity hardware, which improves scalability and reduces total cost of ownership. 

“When we embarked on that journey and were building it out, the pandemic hit,” Dr. Chaudry said. 

These preparations paid off when Seattle Children’s responded to the COVID-19 threat.

“We were able to scale within 24 hours to about four and a half thousand virtual desktops in real time per shift,” he said. “And I'm pleased to say that in the last 18 months, that virtual desktop infrastructure has consistently delivered 99.998% uptime.”

Services had to be reinvented on the network front end as well.

“We had to restrict the number of visitors by the bedside to one parent,” Dr. Chaudry said in a January 2021 Bloomberg Business podcast. “We deployed iPads at the bedside so that children can talk to their caregivers remotely.”

Digital Transformation Comes to Children’s Hospital

Dr. Chaudry said the caregivers and patients he serves agree on one point: they’re less interested in visiting a hospital or clinic. 

“We've had to pivot the process to involve physicians communicating and working with and treating patients remotely using telehealth,” he said during a September 2020 Nutanix .NEXT video conference. 

“We've gone from a hundred telehealth visits prior to COVID to 15,000 telehealth visits on a weekly basis during COVID.”

The hospital system’s IT infrastructure shifted to a hybrid cloud model. 

“We eliminated our data centers, so we're about 90% private cloud and 10% public cloud,” Dr. Chaudry said. “We use the public cloud to run our research environment as well.”

Shifting to a cloud-based model that ramps up telemedicine services poses unique challenges. 

Employees, patients and visitors must be trained to use new devices and software. And there are equity issues because many patients and parents lack laptops and home computers.

“To help those patients and parents who don't have access to the right technology, we've set up kiosks in our clinics where they can come, socially distance and use the technology we provide to gain access to those consults,” Dr. Chaudry said.

Where Hospital IT is Going Post-Pandemic

“The consumer wants more remote capability and access,” Dr. Chaudry said. “They want to be able to ask clinicians questions in real time. They want to be able to have apps available when they visit our campus.” 

Of course, everything must be secured to protect patient data and reduce the risk of ransomware and other cyber threats.

“Post-COVID, we're only going to continue to ramp up virtual capability,” he said. “That's everything from a virtual desktop to email to mobility.”

“Phase two is leveraging hyperconverged infrastructure to deliver high performance against some of our critical clinical and nonclinical applications.”

Dr. Chaudry noted that the pandemic created a financial squeeze for hospitals like his. 

“Every healthcare organization in the United States, if not globally, has taken a massive financial hit in terms of revenue and keeping up the numbers of beds filled and staff employed,” he said. He called on vendors in the technology space to provide more flexibility to hard-hit medical providers.

“That's what we need to make it through to the other end of post-COVID,” he concluded.

Editor’s note: Learn how you can support Seattle Children’s Hospital Foundation.

Tom Mangan is a contributing writer. He is a veteran B2B technology writer and editor specializing in cloud computing and digital transformation. Contact him on his website or LinkedIn.

© 2021 Nutanix, Inc. All rights reserved. For additional legal information, please go here.