PHOTO - Leon Jackson, Head of Healthcare IT, UMSC.
A virtualisation transformation project has helped clinicians make critical medical decisions with instant mobile access to patient data, according to University of Malaya Specialist Centre (UMSC).
In a recent interview with Computerworld Malaysia, UMSC head of healthcare IT Leon Jackson said information technology provided the key to affordable, quality care. "We needed a cost-effective, agile infrastructure to boost the performance and availability of hospital and clinical IT systems. This would in turn enable ubiquitous access to mission-critical clinical information systems for clinicians using various devices around the hospital and campus. i.e., securing robust business continuity and disaster recovery to ensure the availability of its clinical systems while reducing technology operating expenses to enable further investment opportunities."
"The short term goal for UMSC was to provide clinicians with efficient and meaningful decision support, while giving the management insights to business and clinical analytics," said Jackson. "The long term goal is to get our patients to participate in the management of their care by allowing them access to their relevant clinical information."
"When UMSC begun a process of consolidation in 2010, we moved towards consolidating various silos of infrastructure to a single virtual server farm supported with newer smarter virtualised storage," he said "The driver for this design was to spend less and yet get the availability and data protection we needed to run mission critical systems."
"Our virtualisation project helps UMSC to respond quickly to clinicians' need to access various clinical information systems, by basically making 'desktops available via mobile devices and fixed terminals.'," said Jackson. "It also simplifies the provisioning and management of servers and computing resources. In addition, VMware allows UMSC to make computing resources available to all other operational staff quickly and efficiently.
Established in 1962, the University of Malaya has about 30,000 students, 1,700 academic staff and 3,000 support staff. The university also operates a publicly funded, 1,300-bed teaching hospital called the University of Malaya Medical Centre (UMMC) as well as a private medical centre within UMMC, known as University of Malaya Specialist Centre (UMSC), with the aim of keeping its clinical talent in the Malaysian public health system and giving the public access to world-class specialist clinical services. UMSC supports about 200 clinicians and another 250 nursing and support staff.
Jackson said the solution process started in 2009 while setting up the technology infrastructure. "We faced a specialised set of infrastructure and end-user requirements to support the digitisation of biomedical imaging and other medical information, and electronic workflows to enable/ease basic clinical processes. We also had to provide personal desktop environments that could be accessed on mobile devices, and via terminals throughout UMSC including in sterile and electronically sensitive areas such as operating theaters."
What was needed was a cost-effective, agile infrastructure to boost the availability of systems needed to treat patients effectively, the encouragement of clinicians to embrace digitisation, and meet demand for new medical services applications, he said.
"After evaluating options, UMSC decided on VMware due to the company's experience in the market and the product's superior features," said Jackson. "The mature ecosystem surrounding its products-including its close integration with the storage products of a range of vendors-also played a very significant role in the company's decision. We found deploying VMware vSphere would make it easier to manage resources, consolidate its hardware and balance workloads across its infrastructure."
"We also need to roll out a unified infrastructure spanning both of our datacentres and started implementing VMware vSphere in January 2011, finishing the deployment six months later," he said. "We then combined tools such as VMware vMotion, which allowed us to move running virtual machines between physical servers with no interruption to users, using storage virtualisation to deliver this unified infrastructure."
"For immediate access to data, we employed thin-client architecture based on VMware View desktop virtualisation," said Jackson. "This was designed based on the varying job requirements of the surgical team and clinical staff. By early 2012, we were running about 100 VMware View desktops, and expect this to increase over the following year to support about 300 concurrent users."
Jackson said the organisation planned to use VMWare View to provision virtual desktops to support future expansion by the end of the third quarter of 2012, together with new mobile applications for its hospital information systems. "Training for end users was minimal as the technology has a very small footprint to the end users. IT staff has already been up skilled in virtualisation."
VMware Malaysia's country manager, Laurence Si said VMware vSphere has helped UMSC to rationalize and consolidate datacentre server infrastructure and to deliver IT as a service over a private cloud to build a flexible infrastructure, "While VMware View is used to offer a standardised clinical follow-me desktops (VDI) to improve mobility, workflow and security for clinical staff."
Si said the key lay in the holistic vision of the portfolio of solutions from the datacentre to the desktop. "VMware remains adaptive to the specific needs of each customer. Each individual business will approach cloud computing with unique goals, assets, timelines and budgets."
USMC's Jackson said the virtualisation project has helped speed up clinicians' access to various clinical information systems across different devices, including mobile and fixed terminals. "This has helped deliver business benefits through providing the continuous availability necessary to clinicians delivering tertiary care, and to all delivery units using IT to improve patient management. An automated and efficient ubiquitous IT system provides better decision support to clinicians and increases efficiency that will lead to reduced waiting times and UMSC being able to see more patients."
Other benefits include:
- cutting server hardware and infrastructure spending to 60 percent of the cost of an all-physical infrastructure;
- enabling the clustering of two retro-fitted Tier 2 datacenters to serve metrics equivalent to a Tier 3 datacentre.
"We can now deploy new virtual machines in minutes to support staff requirements, rather than waiting weeks or months to procure and implement new physical servers," he said. "We have a system that responds quickly to clinicians' requirements and helps provide a better service to patients; minimising unplanned downtime; and redirects IT spending to support new application delivery. VMware View allows us to easily customise desktops to support the different functions within the center. The VMware View desktops are ideal for environments such as operating theaters, where the sterility of the environment requires IT staff to scrub down before going inside to perform maintenance tasks and where equipment needs to be medical-grade."
Minimal cultural, behavioural and workflow changes were need by staff to adapt to the new solution, said Jackson. "The only real adaptation the end users have to make is to move towards the concept of the 'follow-me-desktop,' where your desktop is persistent and on the network and accessible over multiple devices."
In an era of increasing mobility, including BYOD [bring your own device], the new project has helped UMSC, he said. "The VMware View desktop virtualisation provides the surgical team with a ''follow-me desktop' that helps them access the same data from multiple devices within the private network. When the systems are launched later this year, clinicians will be able to consume and contribute information to and from the patients records at the point of care, improving efficiency, reducing errors and our need for clerical support plus time wasted treasure hunting for information."
VMware's Si said VMware solutions change fragmented, legacy IT systems into agile computing environments, which in turn accelerate quality connected healthcare. "Patient care happens everywhere-bedsides, remote offices, homes, labs and in the cloud. These varied locations require providers to manage a variety of unique desktop environments, ranging from workstations on wheels to high-traffic nursing stations to inpatient room computers."
Advice to other healthcare organisations
UMSC's Jackson said other healthcare organisations considering similar moves would be well-advised to first design and consolidate IT. "Otherwise the cost will be unfeasible. In any case, as other healthcare organisations transform their delivery with IT upgrades, patient expectations will demand the same quality of care."
"Design robust IT that can deliver uptime and continuous availability when needed because as your care becomes more dependent on IT, the impact of downtime becomes more severe," he said. "Capture and aggregate all clinical and relevant information to a consolidated patient profile to provide clinicians with meaningful decision support. The added benefit to this is that this automation with result in a more efficient and accurate billing which reduces waiting time, and it gives the operators better insight to revenue, demand and clinical trends and statistics."
"We envision a future of active Malaysian patients who have ownership of their healthcare and are able to work towards making healthier choices and understanding their risk profiles, etc.," said Jackson. "These are some of the emerging promises of Clinical and Bio Informatics on the horizon that have to be built on solid and sustainable IT platforms. With these steps UMSC is making the initial steps towards these lofty but achievable goals."
"VMware is looking to free healthcare IT from more than two decades of complex, device-centric computing," said VMware's Si. "By delivering a more user-centric, higher quality on-demand experience for connected care infrastructure, healthcare providers can leverage hybrid cloud resources, while maintaining a managed, secure environment. VMware allows new ways for clinicians to collaborate across applications and data from any device, where and when they need it. With more clinicians and healthcare consumers using their applications and services, healthcare providers are able to deliver better services at lower costs."
Sign up for CIO Asia eNewsletters.