Roger Burnett – InFocus Blog | Dell EMC Services https://infocus.dellemc.com DELL EMC Global Services Blog Thu, 13 Dec 2018 11:38:05 +0000 en-US hourly 1 https://wordpress.org/?v=4.9.7 Data Integration Is the Cure to Increasing IoT Adoption in Healthcare https://infocus.dellemc.com/roger_burnett/data-integration-is-the-cure-to-increasing-iot-adoption-in-healthcare/ https://infocus.dellemc.com/roger_burnett/data-integration-is-the-cure-to-increasing-iot-adoption-in-healthcare/#respond Mon, 01 Jan 2018 10:00:10 +0000 https://infocus.dellemc.com/?p=33474 In a recent Verizon report on the adoption of IoT in various industries between 2016 and 2017, healthcare came in last with only an 11% increase. This is compared to manufacturing as the far-and-away leader at 84%, followed by utilities/energy (41%) and transportation/distribution (40%). Why is there such a low IoT adoption rate in healthcare? […]

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In a recent Verizon report on the adoption of IoT in various industries between 2016 and 2017, healthcare came in last with only an 11% increase. This is compared to manufacturing as the far-and-away leader at 84%, followed by utilities/energy (41%) and transportation/distribution (40%).

Figure 1: Industry Comparison IOT Adoption Rate

Why is there such a low IoT adoption rate in healthcare? HealthcareITNews author Bill Siwicki believes that it’s a combination of 3 main factors: cost, security, and data integration.

Of the 3, I find one in particular requires a unique perspective for healthcare: data integration.

What about cost and security you ask?

They are no doubt important, however, their solutions are further along in maturity.

Cost becomes a sticking point when there is no business justification. In evaluating IoT initiatives, there needs to be an examination of the potential benefit compared to the cost. For healthcare, an IoT use case can increase revenue or reduce/eliminate other costs. It does not have to be a long drawn out evaluation process. Take a look at Bill Schmarzo’s blog [The #1 IOT Challenge: Use Case Identification, Validation and Prioritization] on prioritizing IoT use cases as a framework for quickly assessing the business value of IoT.

Once there is business justification, you also need to consider security. The key isn’t to look at security as an issue in which to solve because you’re introducing a new and innovative IoT solution. Your environment is already loaded with vulnerable connected devices for bad guys to exploit:

Figure 2: The State of Interconnection

From this perspective, security is an existing and critical issue that needs to be addressed with or without your new IoT initiative.

Security is a topic to its own, and while I am not deep diving into it here, there is one technique I’m seeing as an emerging solution. It consists of using virtual networks and micro-segmentation to keep potentially risky devices from having open access to your network. Check out the whitepaper, “Micro-Segmentation Builds Security Into Your Data Center’s DNA“, for more information.

So many devices, so much data

Assuming the IoT use case has business justification and security is being addressed, your IoT initiative still has to be integrated – the biggest hurdle for healthcare providers in my view.

The challenge is the devices on the market are all proprietary and the data they crank out (in mass quantity) doesn’t always align to the core data sets in the electronic medical record and other healthcare applications. Now you have a problem that needs some new thinking.

Why?

For years we have been trained in IT to take data, normalize it and neatly file it into data warehouses where we can access it later. This approach has shown to have 2 problems: it takes too long and doesn’t adapt well to changes like the introduction of new data sources. Your IoT business case doesn’t allow for a 9-month cycle of data modelling to come up with an elegant schema that will be broken as soon as you introduce another device.

Big data to the rescue

This would be a serious obstacle, however, the good news is it’s being addressed in the big data arena. Big data has been defined as an environment comprised of volume, variety and velocity of data inputs. This is exactly what we are dealing with when adopting IoT solutions.

With IoT, the data lake approach shifts:

The key concept is that a data lake is well-suited for taking data from any source, including IoT devices, that produces data in various formats (e.g., HL7, SQL, proprietary, etc.). The data is then resolved at run-time taking advantage of modern technologies like Hadoop. The benefit to that is the ability to be both flexible and responsive in adding new sources and devices.The article, “The Data Lake: What It Is, What It’s For, Where It’s Going” explains the concept in more detail and you can also find for more information on data lakes here.

When you look at it this way, the issue of IoT data integration for healthcare is essentially the same as the data aggregation being addressed by data lakes. Case in point is a solution provided by one of our partners, Medical Informatics Corporation (MIC). Using a data lake approach, their solution takes all the data streams from all the connected devices in an ICU setting and creates a single view with predictive analytics that help clinicians spot trends early.

Figure 3: MIC Transforms Patient Data into Actionable Clinical Intelligence Using a Data Lake Approach.

Looking ahead

So, what will the IoT uptake in healthcare be over the next 12 months?

Time will tell but I’m expecting it to be a more significant jump than the 11% from last year. There are IoT uses that are simply too profitable to ignore and my bet is on IoT solutions for chronic condition management as a game changer. Early adopters are already seeing the benefits and disrupting the industry as they go. For those just getting started, there is plenty of opportunity and a clearer path to get there.

At Dell EMC, our experienced consultants and industry specialists work with healthcare providers around the world on their digital transformation journeys. Visit our Healthcare & Life Sciences website to learn more.

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For Healthcare, Big Data Analytics Isn’t an “Out of the Box” Purchase https://infocus.dellemc.com/roger_burnett/healthcare-big-data-analytics-isnt-box-purchase/ https://infocus.dellemc.com/roger_burnett/healthcare-big-data-analytics-isnt-box-purchase/#respond Tue, 25 Oct 2016 09:00:59 +0000 https://infocus.dellemc.com/?p=29228 It may sound odd to those outside our industry, but one of the things I truly enjoy about my role as a presales engineer is that I get to meet healthcare IT executives from all over the US. While our conversations cover a wide range of IT challenges, one topic that comes up often is […]

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It may sound odd to those outside our industry, but one of the things I truly enjoy about my role as a presales engineer is that I get to meet healthcare IT executives from all over the US. While our conversations cover a wide range of IT challenges, one topic that comes up often is Big Data. Most executives don’t need to be sold on the importance of big data analytics; the “how” is much murkier.

To simplify things (perhaps even over-simplify things), I tend to classify IT decision makers into one of two categories: the buyers and the solvers. The buyers look to their EMR vendor of choice and follow their lead. If they can’t answer a question using the vendor’s standard reporting database and tools, they work around it, and move on. If you are a buyer (and happy being so), good luck, I wish you all the best. Stop reading now.

The solvers, on the other hand, realize that not every question of interest can be answered by an EMR vendor and decide that something else, something overarching, is needed if they really want to answer their key business and clinical questions.

The most surprising example I have encountered comes from a relatively small hospital in a ski town. What was surprising is that smaller hospitals traditionally have trouble with basic reporting. For most organizations of their size, advanced analytics seems like a stretch. Not these guys. They had already been using the latest and greatest Epic reporting solutions, but they kept running to unanswerable questions.

For example, they noticed that they had a much higher than average incidence of deep vein thrombosis (DVT) compared to other hospitals. They looked into it and determined that they followed best practices for diagnosis and treatment, but the questions remained: why? Altitude? Are these patients sitting still on planes, trains and automobiles more than normal?

Maybe the truth is the data isn’t in the EMR to tell you this. If you want to answer this kind of question you’re going to need something more comprehensive than the EMR reports. But what do you need? Do you really need real-time analytics? Data visualization? Machine learning? You might, but how do you know? For more examples of how healthcare is working through these challenges, check out our new video below.

There is a solution that I’ve seen work really well and is actually fun (in a nerdy way). The exercise is to list out every analytics problem you’d like to solve, evaluating potential use cases. Because I like to keep things simple, I like to outline this process in 5 steps:

  1. The first step is to capture some high-level information. No more than what would fit onto a 3×5 notecard. Remember those? No? Ok, well, then just jot down a description of the question, where the data comes from and who cares about solving the problem.
    • Ask around about who has unsolved problems. Ask the CMIO. Ask the nursing leadership. Ask finance and patient accounting. And yeah, ask IT too.
  2. Take a look at the note cards and staple together the ones that have the same information on them. This is a good thing. It means more than one stakeholder sees the same problem.
  3. Get the stakeholders together in the same room (bring food) and show them a blank matrix that looks like this:Business Alignment/Implementation Feasibility Index
  4. Take the stack of use cases and have a collaborative discussion placing the cards on the board. The more valuable to the business, the higher it goes on the chart. The easier it is to collect the data, the further right. This will be fun and sometimes heated. Don’t worry about breaking ties too much. This isn’t a precision exercise. The goal is to get something that looks like this:goal matrix
  5. The idea is to identify about three analytics problems that are widely recognized as unsolved, valuable and doable. This should be where you start. In addition, you should have another few that you really think you need to do in a second iteration.

Once you know this, you can start to decide what analytics technology you need to own now and in the next year or so. Use this information to guide your plans for building out capabilities beyond the EMR reporting features. BTW – this technique works for any industry. It just seems to help healthcare shops in particular, given the history of looking for strictly off the shelf pre-built reporting.

Don’t want to go it alone? Dell EMC Services offers the Big Data Vision Workshop that can help you and your stakeholders find the best possible use case and solve a big data challenge.

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Are You An IT Service Fast Food Junkie? https://infocus.dellemc.com/roger_burnett/it-service-healthcare-fast-food-junkie/ https://infocus.dellemc.com/roger_burnett/it-service-healthcare-fast-food-junkie/#respond Thu, 28 Jul 2016 12:44:25 +0000 https://infocus.dellemc.com/?p=28409 Ask any doctor and they will tell you that one of the biggest challenges we face as a society is our love of fast food. We want what we want and want it now. Funny thing is, if you asked that same doctor how long it took to get setup with a computer and access […]

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Ask any doctor and they will tell you that one of the biggest challenges we face as a society is our love of fast food. We want what we want and want it now. Funny thing is, if you asked that same doctor how long it took to get setup with a computer and access to systems when they joined the health system you will likely get an earful. When it comes to consuming IT services, we’re all fast food junkies and waiting doesn’t improve our satisfaction.

In this blog I’d like to talk about ways IT services can be delivered in a way that satisfies the hunger.

In my role as a consultant providing services to healthcare clients, I often have to have access to client applications and many times that requires using a client provided laptop as well. I’ve learned through painful experience that if I need it any time soon, I should have asked for it weeks ago. In fact, one project that required access to some old EMR applications had a TWO MONTH lead time for getting a login. When I asked what do they do if it were a clinician they just hired, they said “we get yelled at a lot.”

“There has to be a better way” you might say. And there is. What if you could simply go to an internal website, click a button that says something like “Add New Resource.” Clicking the button asks you a few simple questions like the resource name, what kind of user they will be and what department they will work in, start date and so forth. After you submit, a desktop or laptop magically appears that has all the software they need installed and user accounts we already setup.

In my previous post, I talked about just getting started, being an IT Hero, not a superhero, and creating service portals and service catalogs. The “nirvana” outlined is an example of this idea. It starts with a well-defined service. In this case, it is a desktop service. Not only is it a desktop service, it is a desktop for a specific kind of user. For example, a cardiologist. The service definition includes some key bits of information such as the desktops needs:

  • A browser that is compatible with your EMR hyperspace
  • A copy of the cardiology RIS and PACS application client software
  • Email client setup with a user account
  • User accounts created for the associated applications and a network login

Of course, there is more to this scenario than the end user device itself. The addition of a new user triggers:

  • Creating requests for user accounts
  • Routing requests to approvers
  • Nagging approvers for approval
  • Nagging the approver’s manager about a late approval
  • Billing the appropriate department budget for the device and the fractional consumption of resources for the use of the EMR, PACS, RIS and so forth.

In a well-defined service, these elements are detailed. They are detailed for a cardiologist and they are detailed for a billing office user and they are different for each one.

Is that enough? Of course not. The service definition needs to be added to the list of other services IT provides called a service catalog. The catalog contains all the service definitions for all the services IT provides. Each service in the catalog also has a service implementation. In the case of our cardiologist desktop, the service definition is going to be a standard virtual machine image that is created from a template. A request for the service triggers automated processes that creates the image and also initiates workflows for creating the needed application and network accounts. The workflows send emails with links to the approvers to approve the new accounts. And it sends it again if needed and copies a manager if it doesn’t get completed fast enough.

The concept that ties it all together is the self-service portal. This is where the hiring manager can see that there is such a thing as a cardiologist desktop and can request a new one for the newly hired doctor. It also shows the user how much the service will cost and gathers the information needed to create the service request.

The key enablers to being able to do this are:

  • Modern infrastructure that supports virtualization and automation
  • Implementation of automation, both at the infrastructure and process workflow levels
  • Transformation to use defined services that are manifest in a self-service portal

Chances are you already have some of the pieces in place. For example, a recent tech refresh may have introduced infrastructure that supports automation, whether that was the reason for the purchase or not. Likewise, you might have deployed a help desk ticketing solution that has portal features you haven’t used yet. Either way, start taking a look at how to create the value chain of Modernize, Automate and Transform. If you do, you’ll be the IT Hero your company needs you to be. If you don’t they will find another way to get services that we call “Shadow IT.” More on that in another blog post.

Continue Reading the Series:

Best Places to Start in IT Transformation – What CIOs Are Telling Us
IT Service Strategy: Catalogs and Portals
State of IT Transformation – CIOs Want More Automation
IT Execs Plan to Reduce Software Development Release Cycle Times by 75-90%
State of IT Transformation – Solving the Operating Model Challenge
How Do You Determine if Your Legacy App is Suitable for a Public Cloud?
Be a Healthcare IT Hero….Not a Superhero……

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Be a Healthcare IT Hero….Not a Superhero…… https://infocus.dellemc.com/roger_burnett/healthcare-it-hero/ https://infocus.dellemc.com/roger_burnett/healthcare-it-hero/#respond Wed, 08 Jun 2016 09:00:14 +0000 https://infocus.dellemc.com/?p=27666 As we roll into the warmer weather, all things are turning to the familiar sights and sounds of summer. One of my favorite signs of summer, aside from the rising mercury, is the arrival of the big budget summer blockbusters. The key to a good summer movie, besides the explosions and potential worldwide catastrophe, is […]

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As we roll into the warmer weather, all things are turning to the familiar sights and sounds of summer. One of my favorite signs of summer, aside from the rising mercury, is the arrival of the big budget summer blockbusters. The key to a good summer movie, besides the explosions and potential worldwide catastrophe, is the hero. Fast, strong, dependable, nothing is better than a hero; except maybe a team of superheroes.

Sadly, as healthcare IT professional, we lack laser vision, and the ability to fly, but we can help those that depend on us by being faster, stronger, and available (without the need of a roof-top spotlight with a copyrighted logo).

Most of the IT leaders I speak with feel like IT can and should be more aligned with the business and be able to provide services faster, with cost transparency, all while protecting patient and business sensitive data, also serving users who work inside the healthcare system facilities but do not work for the system directly as employees. What I tell them is that to be an IT hero, cataloging what you deliver as a “Well-Defined Service” is the first step.

According to a study by EMC and VMware 52% of healthcare IT professional do not have a self-service portal or service catalog in place. That number balloons to 92%, when we include those that have just started to develop a service catalog but have not fully implemented one.

self-serve

A well-defined service in most cases is based on what you already offer today, just more carefully cataloged. For example, if you offer a clinical desktop today using VDI, a well-defined service may involve:

  • Creating a standard definition for a clinical desktop (or a set of clinical desktops if applications vary). This includes determining the applications to be delivered.
  • Calculating the storage, network and compute resource needed to support a clinical desktop.  For example, an individual desktop is expected to consume X amount of storage, Y% of virtual server CPU, Z amount of network bandwidth and a single thin client device.
  • Defining the process for delivering a clinical desktop including approval cycle and delivery of the thin client device and the roles and associated.
  • Defining the support model including roles and associated labor.

Once you have these pieces in place the IT organization can define expectations, and offer a more consumer-like service. Let’s look at a quick example of where having a well-defined service improves IT response time and user-experience.

One of our major healthcare clients has a very large presence in the grant funded clinical research community. They noticed that their grant win rate was dropping off and investigation revealed that they had a reputation for having trouble meeting grant objectives due to cost and schedule overruns associated with assembling data and making it available to researchers.

The solution was to create an analytics sandbox service that allowed users to access a portal and select the data sets and tools they needed for their research. The selections in the portal are automatically provisioned and resource consumption is tracked, allowing for a better charge back model. In this case, creating a well-defined service turned a competitive weakness into a strength.

Over the next few weeks I will post additional blogs on how EMC’s Global Services has partnered with healthcare organizations worldwide to deliver IT as a Service. Future blogs will focus on:

  • Fast Food Nation – Ordering up a clinical desktop with specific services for the cardiac department should take hours, not weeks or months.
  • Eliminating Shadow IT- Work with, not against the solution providers who market to your organizations’ departments
  • Cost Transparency – Know how much of the budget is going where, so the budget isn’t based on a % of what you got last year, it is an accurate look at what is being used, or better yet will be used.

By taking a step by step approach to creating well-defined services you can reconnect with your users, making IT accessible, easier to user, and enable them think more about their job, then the IT service they are using to complete it. It might not make you a superhero, worthy of a summer blockbuster, but you will have taken the first step to something much greater – and done so without a mask.

For information on how Dell EMC Services can help, check out our IT Transformation Workshop healthcare.

Continue Reading the Series:

Best Places to Start in IT Transformation – What CIOs Are Telling Us
IT Service Strategy: Catalogs and Portals
State of IT Transformation – CIOs Want More Automation
IT Execs Plan to Reduce Software Development Release Cycle Times by 75-90%
State of IT Transformation – Solving the Operating Model Challenge
How Do You Determine if Your Legacy App is Suitable for a Public Cloud?
Are You An IT Service Fast Food Junkie?

 

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