Moving Mission-Critical Electronic Health Records to Hyperconverged Infrastructure

Coastal Medical CIO transformed his IT to deliver eClinicalWorks and healthcare services to more patients.

By Damon Brown

By Damon Brown December 05 2019

Coastal Medical Chief Information Officer Mice Chen faced what he calls “the moment of truth.” The healthcare provider’s IT team encountered challenges in servicing a growing number of patients, managing multiple service and data systems needed to support the work of the organization and planning for management’s long-term business growth strategy.

Founded in 1995, Coastal Medical is a physician-owned and governed accountable care organization (ACO) that now has over 20 locations across Rhode Island, servicing well over 120,000 patients. 

Quality of patient care, access to care and cost optimization are critical business imperatives. Maintaining these things and running mission-critical eClinicalWorks electronic health records (EHR) require robust, reliable data technologies. When leaders of Coastal Medical decided it was time to expand their services to a lot more patients, Chen knew his IT team needed to take a new approach.   

“We knew our legacy infrastructure approach was not sustainable in the long-term,” said Chen.

While researching new technologies, Chen built a mental blueprint for replacing Coastal Medical’s existing legacy infrastructure. That’s when he discovered hyperconverged infrastructure (HCI), an IT framework that combines storage, computing and networking into a single platform. He knew that was the way to modernize the IT system’s foundation and manage future growth.

[Read the case study: Coastal Medical Moves Mission-Critical eClinicalWorks EHR to Nutanix]

HCI would give Coastal Medical the ability to create pools of shared data processing and storage resources, while simplifying and speeding up everything necessary to maintain the system. Chen saw that HCI would also shrink the amount of space needed for IT equipment. This would enable his IT to operate like a hybrid cloud system, to easily scale its private cloud and tap into public cloud services whenever that made business sense.

“In healthcare, people usually take a conservative approach to avoid uncertainties that could potentially jeopardize patient care or our business operations,” said Chen.

E-Health Heart Beat

To modernize his IT, Lehr and his team moved to hyperconverged infrastructure, which combines storage, computing and networking capabilities into one system. They did this to reduce data center complexity and increase their ability to meet growing needs.

“The hyper-converged infrastructure allows us to manage workloads on a single, cost-effective solution,” he said.

[Related: Enterprise Cloud Index Report – Healthcare Industry Findings Webinar]

Being able to use private and public cloud technologies is helping healthcare providers like AAMC manage applications and data, take advantage of automation, and create new services like telehealth or remote monitoring. These benefits are critical for improving patient engagement and competing with industry upstarts.

Moving to Cloud with Careful Purpose

Great thought needs to go into any decision about moving to public and private cloud computing, according to Cheryl Rodenfels, Nutanix Customer Success Executive.

“Don’t go to the cloud for the cloud’s sake,” she said. “Go because you have a business objective or because it helps provide things you need to deliver. Align it with the business goal. Align it with a strategy or a technology road map.”

[Related: Business Continuity Depends on Your Disaster Recovery Plan]

Rodenfels previously served as CTO and CIO of large healthcare organizations. She said there must be a business driver, better service for patients or a requirement to meet physician needs before cloud can be a cost-effective solution.

Not Just Cloud, But a Better Way

To adhere to strict industry privacy standards, hospitals and health-related services often rely on complex, sometimes proprietary systems to manage health records, according to Jon Kohler, Nutanix Technical Director of Engineering and Health Solutions. Those systems and applications need to speak to each other without burdening the cost of patient care.

“The overriding goal of any health system is to deliver excellent patient care and quality at a cost-effective rate,” said Kohler.

Concerns about security and cost of cloud technologies can be overcome with education and acceptance, according to Rodenfels. She said many healthcare organizations have Microsoft enterprise software agreements that provide an allotment of Azure cloud services.

“They don’t have a lot of structure,” she said. “So their $100,000 grant turns into a $300,000 bill because they didn’t know how to manage the service.”

Kohler added it would help if technology experts spoke in ways that were more appealing to healthcare experts. When talking to healthcare IT managers, he said he learned not to use the word ‘cloud,’ because it’s distracting.

“It’s not something that is on the customer’s mind when you’re talking about poor clinical experiences.” Kohler said.

“The more popular term would be ‘hosted solution,’ not ‘cloud solution.’ That resonates with customers today. This will open more discussions that lead to effective use of cloud.”

Improving Technical Prowess

Ultimately, thinking creatively allows the many advantages of cloud to flourish, said Kohler. When healthcare IT pros are dissatisfied with their current systems, they will be open to exploring new options.

Big hurdles remain, however. Healthcare leaders often don’t have the platform APIs or deeper technical access necessary to fully adopt another cloud provider, so it’s ultimately up to the vendors, according to Rodenfels.

[Related Podcast: NCHICA Annual Conference Podcast featuring Cheryl Rodenfels of Nutanix]

She said the proprietary nature of their applications they use, along with privacy and regulatory concerns, hold back healthcare IT from unlocking the value of new technologies such as hybrid cloud systems.

“They don’t yet have all the keys to the kingdom.”

Damon Brown is a contributing writer. He writes a daily column for Inc. Follow him on Twitter @browndamon.

© 2019 Nutanix, Inc. All rights reserved. For additional legal information, please go here.

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