A recent Healthcare IT News article discusses how hospitals want to invest in emerging technologies – all of which have implications to the network. In fact, the foundation of all digital information exchanges in healthcare is a robust and dependable data network. Functions that are central to the processes of delivering quality healthcare such as electronic medical records access, digital image sharing, appointment scheduling functionality, billing solutions, medication dispensing, and financial reimbursement depend minute-to-minute on the ability to connect to systems on the network.
According to Network Computing, “managing systems, data centers, and infrastructures keeps getting more challenging as complexity grows. As a result, network, data center, and IT managers face a constant stream of problems that lead to outages, disruptions, and unhappy users.” Yet in a March 2023 online survey of College of Healthcare Information Management Executives (CHIME) members, 22% named limited employee bandwidth/capacity to manage/execute on IT initiatives a top area of concern.
Network Management Strategy Matters to Patients, Clinicians, and the Bottom Line
When staffing inadequacies happen on the network management team, the implications can be dire – up to and including impact to patient safety. While other consequences are not so dire, they are nothing HIT teams want their clinical users or patients to experience:
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Potential impact
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Direct impact on patient experiences
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Indirect impact on patient experiences
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Cost
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Return on HIT investment
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Unplanned downtime
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Outages requiring fail over to paper-based processes
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Duplication of effort to record data on paper and then perform data entry into a system when access is regained
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Increased risk of cybersecurity-related event
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Decreased physician satisfaction
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Reduced productivity
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Inability to attract and retain top HIT talent
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Technical debt
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Fortunately for patients everywhere, HIT leadership teams know the problem. They understand that change in healthcare IT methodologies, tools, support models, etc. comes with the territory of continuous improvement for users of HIT — clinical teams and patients. When asked to rank three most important areas for improvement in their healthcare organization, the majority responded with these as their highest priority:
- 72% Reduce cybersecurity risk
- 56% Improve physician/clinician satisfaction with IT services
- 52% Optimize EHR/EPR for clinical workflow productivity—a priority concern for the past four consecutive years
More than half of those surveyed reported improvements in infrastructure and scale as second in importance to improving IT:
- 57% ranked improve or modernize infrastructure/network
- 52% ranked scale IT operations to meet demand/future growth
What’s harder to quantify and garner support from decision makers and stakeholders outside IT is a network management strategy that solves known problems and mitigates the risk of any new problems. What we do know, per research collected by Netscout, is that the cost of downtime in healthcare can be up to $9,000 per minute on the financial side and up to and including negative patient impact from a quality of care perspective. Managing EHRs, accessing images for diagnostic purposes and decision support/patient identification for dispensing medications are all dependent on network availability.
Operating a network efficiently, securely, and to user expectations in a world where remote services are widely accepted and preferred is tough – especially when combined with hiring challenges, economic considerations, and the obligation to rally your network and resources around functionality required by an organization’s strategic priorities.
And that begs the question – how good is your network management strategy? Is it adequate? Is it better than most? Is it among the best? Answer these questions for some insight.
1. Do your downtime and planned outage policies consider the implications to telemedicine, clinical decision support, image access, and information protection as well as the patient and care team experiences that are impacted?
2. Is your network monitored 24/7 by administrators with knowledge of what to do when diagnostics, troubleshooting and problem resolution are in order?
3. Does your strategy include experts on the local and cloud-based data warehouses you employ?
4. Do you feel confident in your team’s ability to enable 24/7 access to data and connectivity for positive patient experiences (ex: lab results, appointment scheduling functionality, ER waiting times information, and mental health professionals)? Does your confidence vary depending on who is on call or on vacation?
5. Does your resident network management team hold many or most of the following professional certifications?
- Aruba Certified Mobility Associate (ACMA)
- AWS Certified Solutions Architect - Associate
- Certified Ethical Hacker (CEH)
- Certified Information Systems Security Professional (CISSP)
- Cisco Certified Network Expert - Enterprise Infrastructure (CCIE)
- Cisco Certified Network Professional - Collaboration (CCNP)
- Cisco Certified Network Professional - Enterprise (CCNP)
- Cisco Certified Network Professional - Security (CCNP)
- Google Cloud Professional Cloud Architect (GCPCA)
- Google Cloud Professional Network Engineer (GCPNE)
- IT Service Management (ITIL Foundation)
- Palo Alto Networks Certified Network Security Administrator (PCNSA)
- Palo Alto Networks Certified Network Security Engineer (PCNSE)
- Project Management Professional (PMP)
6. Have members of your team developed a solid three-to-five-year plan for network technologies that minimizes outages, prioritizes recovery, and builds or protects a competitive advantage?
7. Are some members of your network team dedicated to providing “keep the lights on” services while others lead your organization’s strategic imperatives?
8. Are your customers satisfied and are your employees engaged?
Network Management Strategy Improvement Options
Given your answers to these questions and what they indicate about your network team’s capacity and skill set, you have likely identified some areas for improvement. The path to dramatic change will involve at least one of these options:
- Deliver on a plan. Developing a 3–5-year plan that details which work your current team can prioritize and when. This plan should include work you cannot support so that there are no surprises when progress isn’t made on work you have documented as beyond your current team’s capacity. For IT organization reputation and position justification purposes, it’s important to present your plan and to report on the progress you have committed to in addition to what you can’t affect without additional support.
- Add to your FTE staff. Making a few key hires to address skill gaps and building a pipeline of candidates to quickly recover after key employee resignations, etc. You may also feel it necessary to review turnover and open position recruitment efforts so there’s appreciation for how difficult highly skilled HIT positions are to fill.
- Hire for special projects. Supplementing your staff with short- or long-term resources to do high-profile project work or to assume responsibility for networking tasks to avoid risk, delays, or even downtime. These proactive tasks could include:
- Addressing network performance, lifecycle management, and modernization efforts
- Managing on-premises and distributed architectures including public and private cloud environments
- Providing project-based and network operations center (NOC) capabilities for the entire network lifecycle, from design, build and assessment, to consolidation and migration
- Monitoring and maintaining a healthcare-ready network
Addressing Network Management Concerns with Talent and Tools
- Persevering with finite talent pools. Bandwidth and staffing shortages have been a consistent pain point for the past three years according to CIOs surveyed. CIOs and IT departments continue to strive to do more with fewer resources and the inability to locate specialized IT talent makes it even more difficult to deliver transformational IT solutions. Gartner predicts that by 2025, lack of talent or human failure will be responsible for over half of significant cyber incidents.
- Implementing the right tools. A reduced budget or lack of funding for IT initiatives was a top concern with insufficient employee bandwidth following closely behind. With many CIOs also reporting that their organization’s resistance to change was a barrier, we see that implementing the right tools and implementing tools at all is a pressure and a priority for HIT teams. Although budgets may be rebounding, change remains difficult – making the role of CIO as a champion for change, for the right change, and an effective manager of change even more important.
- Assessing and revisiting your plans. All good networking designs and support models account for cybersecurity as it is a well-documented area of focus for CIOs. What’s less understood is that effective designs and support models start with getting the fundamentals of networking right. Security should be “baked into the cake” and not simply the “icing on top.” Furthermore, when network management and governance plans are initially made, they account for the situations of the moment. Revisiting the plans ensures they evolve with your organization’s structure, tool choices in other areas, and in accordance with your company’s plans for growth.
What’s Next for Network Management
As tools to manage, monitor, and detect anomalies on networks become more sophisticated, command of those tools, and experience administrating them will continue to be an important element of network management strategy for HIT organizations. Addressing issues before they cause widespread problems will be the opportunity and the expectation. Network management teams will fare like so many other industries who are vying for a small pool of talent and augmented staff may come into even broader favor given that network management priorities can be accomplished remotely on or off the cloud. On location experts will still be required to conduct on-premises support and to drive strategic priorities of local leadership teams.
In short, network management is and will continue to be an all-hands-on deck effort using organizational creativity and budget stretching skills to orchestrate a customized solution for each HIT organization. Keep these questions in mind as you plan your team’s responsibilities and consider partners to ensure quality patient and clinician experiences.
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