Connected Healthcare part 2:

Moving from a Basic Network to an Innovative Network

Healthcare organizations desire a seamlessly Connected Healthcare system, with all of an individual’s health-related information available to every care team member at each patient encounter. This may seem beyond reach, but healthcare organizations can take practical steps toward this goal, whether they are starting with the basics or at the forefront of innovation. In this article, the second in our Journey to Connected Healthcare series, we will begin providing a picture of a new, attainable Connected Healthcare network approach, or reference architecture, discussing enabling Network as a Service (NaaS) technologies and use cases. We will start at the beginning, with moving from a basic network, the challenges it poses, and the means for healthcare organizations to overcome them.

To start, what does a basic, or traditional, healthcare network look like, and what are some examples of its challenges? 

Connectivity:

• Physical access points, switches, and routers (Customer Premise Equipment) Internet Dedicated Services, Private IP (Multi-Protocol Label Switching)
• Challenges: limited versatility and optimization for variety of cloud services/apps, changes require updates to, and possibly movement of, individual physical network components, replacement cycles

Management/Operations: 

• Performed by the healthcare organization without a partner or managed services provider
• Challenges: acquiring, training, maintaining staff with network and security expertise, keeping up with these increasingly complex fields

Security: 

• A focus on perimeter defense with physical firewalls, intrusion detection systems (IDS), and antivirus. 
• Challenges: timely detection, response, recovery from incidents and breaches, as well as correlation across variety of user and network devices, and limited control over devices themselves 

Visibility: 

• Network performance monitoring and diagnostics 
• Challenges: application performance and end-user experience insights (understanding clinical value).

Automation: 

• Limited, not centrally-managed
• Challenges: timely detection, response, recovery from faults and outages, lengthy provisioning and policy update processes

This basic network has likely been pieced together over time, with various components rolled out to coincide with the introduction of new service lines, administrative functions, and technologies. It has likely been updated through re-alignments and changes to clinical practices and business processes, each time with great effort from the organization’s IT team and with great impact felt by network users.

A healthcare organization must move beyond maintaining a basic network with its own IT team, as this approach is not sustainable: expectations from stakeholders are high, advances in networking are rapid, requirements for security and privacy are great, and the talent needed for them is scarce.

When building a new Connected Healthcare network, care organizations should strive for the network to have two key attributes:  

• The network should be invisible to the user, something s/he does not have to think about, regardless of device or location. Most importantly it should be reliable and deliver secure connectivity.
• The network should be easy for the organization to manage. It should be flexible, programmable, scalable, reliable, and, of course, cloud-centric. 

Primarily, all information relevant for patient care should flow through the network across the ecosystem of participants, care models, processes, systems, and devices, both inside and outside facility walls, with appropriate security and privacy controls. Secondly, the network should facilitate basic uses, like data entry for admission, through to advanced uses, such as intelligent video to monitor for patient falls, with a combination of wired, Wi-Fi, and cellular connections. And finally, the network should allow for regular changes to the ecosystem, smoothly expanding and reconfiguring to accommodate them. 

This is what a high-level view of this network would look like: