Some hospitals are joining the electronic health records movement late, especially those in remote, rural areas. Others, having already installed an EHR, have grown disenchanted with their system and are ripping and replacing in time for meaningful use stage 2.
Without the appropriate IT systems and supporting infrastructure in place, a new EHR solution -- no matter how highly ranked by users -- cannot deliver the stable and effective clinical data platform a provider needs.
Five primary IT infrastructure areas must be evaluated and likely upgraded as part of the core infrastructure supporting an EHR. IT needs to ensure its readiness and stability prior to an EHR's installation.
Wireless network: For most caregivers, "wireless infrastructure" means the ability to connect their tablets, mobile devices, mobile carts or even laptops to the network. It becomes critical to prepare the wireless infrastructure to handle the additional load it will receive once the EHR goes live. Begin with site surveys and network assessments to ensure that there is adequate coverage. This process helps ensure that there is enough bandwidth to withstand the increased demand on the network.
Data security: With the continuous regulatory pressure and patient demand to ensure all clinical data stay protected, the implementation of a new EHR poses new demands on IT. New EHRs will likely bring more data access points and servers, as well as increase the volume of information and diversity of data that must be protected. This also means that with the constant demand for remote access to patient health records, IT will likely enable remote connectivity through patient portals. These raise the stakes for IT, requiring a security evaluation of all existing systems on top of new modifications they're making to the network infrastructure. This ensures the EHR and infrastructure upgrades don't increase security risk for the organization and that all the appropriate measures are taken into consideration to ensure all systems stay protected.
System stability: When an organization is ready to implement a new EHR solution, the vendor typically provides system requirements for its application. These comprise hardware (unless virtualized) and software specifications that their system requires. The documents outline minimum requirements with which the system has been tested and provide best practices to ensure that the EHR application can function appropriately. In order to maximize performance of the system, it is highly recommended IT consider all the system requirements highlighted by the vendor -- even when it means purchasing newer equipment to meet the requirements.
Network infrastructure: Many of today's organizations have significantly increased data traffic on their networks from just a few years ago. Existing networks now support wireless, VoIP, guest traffic and standard wired device traffic. Having the appropriate configuration and setup is a critical component to the success of the implementation and performance of the new EHR system. As larger data points are captured and transferred over the network -- such as dictation, scanned documents, high resolution imaging -- the speed at which the health information is delivered becomes crucial to patients and the success of the EHR.
Disaster recovery/business continuity planning: While risk assessment and risk management as well as disaster recovery and business continuity planning are part of the HIPAA rules and Joint Commission standards, each must be considered individually. In the past, health organizations that have not fully implemented an EHR or are paper-based have been more accepting and forgiving of some limited downtime associated with computer outages. However, as more providers begin to use EHR systems, IT must ensure that system continuity and high availability is on top of their list, as it could impact patients' health when these outages occur.
As part of EHR implementation planning, technology assessment readiness provides the organization with a gauge of where they are in terms of infrastructure. These assessments can provide a list of infrastructure changes and improvements needed to ensure an enterprise is ready to host the new EHR system and provide the adequate reliability and performance so that caregivers can continue to support the adoption of the new system. In the end, patients reap the benefits.
About the author:
Reda Chouffani is vice president of development with Biz Technology Solutions Inc., which provides software design, development and deployment services for the healthcare industry. Let us know what you think about the story; email firstname.lastname@example.org or contact @SearchHealthIT on Twitter.
This was first published in October 2013