When and how to deploy e-health records tech

By , Computerworld |  Business, healthcare, healthcare IT

Paul Sikora, vice president of IT at UPMC, said his hospital shares its data center with 27 other hospitals in the region, including Children's Hospital of Pittsburgh, which opted to run its EHR applications on discrete servers in UPMC's facility.

In 2009, the Healthcare Information and Management Systems Society honored Children's Hospital with its HIMSS Analytics Stage 7 award in recognition of the fact that the hospital had an advanced patient record environment. "One reason they were able to do it is they didn't have to worry about infrastructure," Sikora said.

UPMC, which itself won an HIMSS Analytics Stage 7 award this year began to rip and replace its outdated data center infrastructure five years ago at an unspecified cost of millions of dollars -- and it was worth every penny, said Sikora. An IDC evaluation of UPMC showed that the hospital avoided $80 million in expenditures that it would have incurred if it had stuck with its legacy infrastructure, Sikora said.

Apart from the $80 million in cost savings, Sikora said he was also able to avoid the need to build a new $85 million data center in order to keep up with server sprawl.

"A lot of that savings was because of the virtualization we rolled out," he said. "When you can pack 24 rows of servers [we formerly had] in to one server rack, that's savings. When you cut 100 Unix servers down to 14, that's savings." UPMC runs its new virtualized environment at one-fifth the cost of its legacy data center, he added.

UPMC runs 1,300 Windows virtual machines on 22 physical servers, allowing it to add capacity for hosted hospitals in hours through strokes on a keyboard instead of building out additional infrastructure. And I/O loads are matched with the most cost-effective computer service in the environment.

UPMC not only virtualized its servers with VMware; it also virtualized its storage with IBM's SAN volume controller appliance, which sits in front of storage arrays and makes them appear to application servers as a single pool of available capacity.

"When you get all of your enterprise systems in a standardized environment, you can start to manage it differently. You start to see load characteristics ... and then you can determine that you can take this data and put it on Tier 3 storage with a lower cost," he said.

UPMC, which has an IT staff of 197 people who support 4,000 physicians, began its data center consolidation and upgrade in 2005, long before the government began formulating its requirements for meaningful use. Sikora said the technical complexity behind EHRs just from an infrastructure standpoint is "enormous." A midsize hospital starting up an EMR project could devote more than half its effort just to getting the new infrastructure operational. "And that hinders the ability to do the task at hand, which is the health record itself," he said.

Originally published on Computerworld |  Click here to read the original story.
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