Brian Lee, Vice President of IT, FastMed Urgent Care

Jan 12 2021

EHR Expansion in Healthcare Demands a Focus on Storage

Healthcare providers modernize to address present needs and to better handle future challenges involving clinical data.

In late 2019, leaders at FastMed Urgent Care decided to replace its cloud-based electronic health records service with an on-premises Epic system for greater control, setting off a sprint to modernize the healthcare network’s data infrastructure.

The journey required marathon-level preparation.

By early spring, the Raleigh, N.C.-based organization and its partners had built two data centers, deploying Cisco servers, a NetApp storage system, VMware virtualization, Veeam back-up and recovery software, and Red Hat software.

“Because we had been relying heavily on cloud services, we had a very small existing infrastructure footprint,” says Brian Lee, vice president of IT for FastMed, which operates facilities in Arizona, North Carolina and Texas.

“We set an aggressive deadline to go live with Epic in our Arizona clinics in September,” he adds. “To do that, we had to meet Epic’s technology recommendations, as well as our own requirements for an infrastructure that could scale quickly and provide the best experience for providers and patients.”

A guiding objective informed all parts of the project: safe and speedy access to FastMed’s growing pool of important clinical data.

Hospitals Rely on IT to Move ‘From Data-Rich to Data-Driven’

Even before the COVID-19 pandemic began to overshadow other IT priorities, healthcare organizations faced myriad challenges to their infrastructure, says Mutaz Shegewi, an IDC research director.

These hurdles include EHRs and digital transformation; the rise of medical consumerism; and complex merger and acquisition deals that bring separate groups of people, platforms and tools under the same umbrella.

“Providers have data flooding into their systems, and now the question is what do they do with it,” says Shegewi, who leads IDC’s provider IT transformation strategies practice. “They’re trying to make the switch from data-rich to data-driven.”

The rise of telemedicine, greatly accelerated by the pandemic, has put pressure on providers to optimize their data infrastructure, Shegewi says. But healthcare organizations are historically slow to adopt new data center technologies, and COVID-19’s impact on budgets has further limited modernization initiatives.

Proactive, forward-thinking organizations will see a host of benefits, Shegewi says, including improved employee efficiency, ease in automating services, elimination of data silos and stronger security.

“A modernized infrastructure provides a more agile environment,” he says. “At the heart of it is being able to take action and deploy new capabilities to the workforce.”

How FastMed’s Data Center Initiative Got Going Quickly

Starting from close to scratch at data center sites in Arizona and North Carolina, FastMed leaders saw early challenges in establishing third-party relationships with vendors and service providers, Lee says.

A partnership with CDW removed those hurdles.

“We leaned on CDW services to match Epic’s requirements with our business requirements for storage — like ease of management, scalability, performance, resilience and, obviously, time to deploy,” Lee says. “Then, CDW acted as a gatekeeper between us and the vendors, making our life easier.”

CDW also worked with FastMed IT teams to produce a project playbook with supporting data to generate fundamental buy-in from executives for the project to move forward, says Neil Marlowe, the organization’s CTO.

“Executive support was crucial for us; they were heavily involved from the get-go,” he adds. “Correct team composition and incentives are also critical for a project like this.”

By late January, FastMed had 34 people working on the project — up from an IT staff of eight — and had established 21 new relationships with vendors and service providers. Working with CDW and other partners to build the data centers on consecutive April weekends, the team’s first scheduled Epic rollout to Arizona clinics launched on schedule in September.

With the EHRs of 1.7 million patients, along with other streams of data from FastMed’s clinical and business operations, the NetApp FlexPod storage system is the backbone of the overhaul.

“Now that we’re part of the Epic world, that data has to be readily and rapidly available,” Lee says.

Brian Lee
We leaned on CDW services to match Epic’s requirements with our business requirements for storage — like ease of management, scalability, performance, resilience and, obviously, time to deploy.

Brian Lee Vice President of IT, FastMed Urgent Care

Better Storage Improves User Experience in Healthcare

Planned adoption of an Epic EHR system also spurred Atlantic Health System to reassess its data infrastructure — but it was far from the only reason to upgrade, says Sunil Dadlani, CIO of the five-hospital network serving northern New Jersey.

“Thanks to 5G and IoT technologies, the data generated within Atlantic Health System doubles every 18 to 24 months,” says Dadlani.

To handle it all, the organization deployed four FlashArray//M70 storage systems from Pure Storage, using the evergreen subscription upgrade model. Atlantic was looking to build an infrastructure that could provide scalable storage capacity and a foundation for tools such as artificial intelligence and predictive analytics, says Dadlani.

Strengthened security, improved resilience and end-user experience also informed the process.

Those criteria were met: Two years after the Pure installation, the number of end users on Atlantic’s Citrix XenApp virtual desktop infrastructure running on the FlashArrays had jumped from 1,000 to almost 20,000 — with uninterrupted access to data.

Atlantic leaders saw notable performance improvement with various processes and reports, increased overall responsiveness of the applications running on the platform, and better uptime with mission-critical applications.

“Our key objectives were to make sure our clinicians could have fast and reliable access to information and applications to deliver quality care to our patients,” Dadlani says.

Hospital Data Centers Support Forward-Looking Growth Plans

Growth and scalability have always driven IT decisions at Steward Health Care, says Michael Hale, Steward’s executive director of enterprise architecture.

Launched a decade ago with the buyout of six struggling hospitals in the Northeast, Steward’s network now includes 34 hospitals in nine states, as well as the operation of three national hospitals in Malta.

“We know that our data capacity needs will continue to expand, and we look to deploy solutions that will handle that growth,” Hale says. “Now that we have all our hospitals running off the Meditech EHR platform hosted in-house, the demands for performance and uptime have never been greater, so we’ve implemented Dell PowerMax to host our data. We cannot afford any downtime and risk patient care.”

Michael Hale, Steward Health Care
By increasing resiliency and having the ability to dynamically shift loads, we’re finding ways to eliminate downtime, which provides real-life benefits to our providers and our patients.

Michael Hale Executive Director of Enterprise Architecture, Steward Health Care

In 2018, as part of a continuing push toward consolidation and standardization, Steward built two new data centers around the Dell EMC VPLEX flash platform. Steward deployed the vendor’s PowerMax 8000 flash-based storage arrays and Isilon PowerScale flash-based network-attached storage, which allows users to add nodes that augment both capacity and compute power as needed.

More than 90 percent of Steward’s systems and underlying storage are virtualized on VMware’s vSphere hypervisor, with the remaining physical systems being clustered database solutions. The combination of clusters and virtualization provide for easier failover and mobility, says Hale.

Beyond better input/output per second, advanced compression and deduplication capabilities, and out-of-the-box encryption, Steward’s optimized data infrastructure supplies caregivers with the data they need when they need it, says Hale.

“By increasing resiliency and having the ability to dynamically shift loads, we’re finding ways to eliminate downtime, which provides real-life benefits to our providers and our patients,” he says.

MORE FROM HEALTHTECH: Better backup solutions reduce costs while increasing productivity.

Hospitals’ Data Center Upgrades Enhance Speed and Security

Pure Storage solutions also helped St. Joseph’s Health address data center challenges. Headquartered in Paterson, N.J., St. Joseph’s operates two hospitals as well as a rehab center and community clinics in the northeastern part of the state.

The organization deployed Pure Storage FlashArray//X blade arrays in an active-active configuration over two data center sites, a design that serves I/O at the same volume to each site, thereby reducing latency and enhancing disaster recovery capabilities.

Data can now be accessed far more quickly than IT teams could via legacy architectures. That’s key not only for daily operations but also to support AI and machine learning.

“With the new data infrastructure, we’re able to deliver information faster, we have redundancy, and the technology provides added security from ransomware and other threats,” says Jesse Fasolo, director of technology infrastructure and cybersecurity at St. Joseph’s.

In choosing a storage solution, Fasolo’s team evaluated factors such as hardware lifecycle lengths and integration with the provider’s Veeam backup solution and the AWS cloud. They might eventually opt for a Storage as a Service iteration of Pure Storage technology, Fasolo says.

For now, they’re swiftly ahead in the race.

“Everything to do with data and applications is faster for providers and patients — there’s no downtime or latency or performance degradation,” he says. “For IT, there’s more space in the data center because of a smaller hardware footprint, less power consumed and much less maintenance.”

Photography By Charles Harris

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