This content is part of the Essential Guide: A guide to application performance management

Using application monitoring software for health IT systems

Most application monitoring software tends to be siloed. This may suffice in certain situations, but when one application’s performance is tied inextricably to another’s, a more horizontal approach is required. This is especially true for health care IT environments, where electronic health record (EHR) systems must be able to share data, and server downtime is simply out of the question.

Compuware Corp. is one vendor whose application monitoring software takes that horizontal approach. Its Vantage product uses dashboards to display system performance data, isolate problems and drill down to a programmatic level to determine what needs to be fixed and who is responsible for doing so.

Application performance monitoring is crucial to health care providers, said Michael Wilson, Compuware’s senior IT director for clinical information systems in a brief meeting at the HIMSS10 annual conference in early March. If IT cannot guarantee an application’s reliability, then already skeptical doctors will be even more reluctant to use it.

The monitoring process takes on added importance as health care providers consider the federal government’s criteria for the meaningful use of EHR. Wilson noted that Vantage will let CIOs verify whether the IT systems are in place to meet a particular meaningful use criterion and, if so, whether clinicians are in fact using those systems. This helps CIOs decide whether resources should be allocated to clinical or IT operations in order to achieve meaningful use.

At HIMSS10, spoke to two Vantage users about the benefits of application monitoring software in a health IT setting. In this video, Avery Cloud, vice president and CIO at New Hanover Regional Medical Center in Wilmington, N.C., discusses how monitoring mission-critical applications has boosted physicians’ confidence in IT.

Let us know what you think about the video; email Brian Eastwood, Site Editor.

Read the full transcript from this video below:

Using application monitoring software for health IT systems

Brian Eastwood: Hi, this is Brian Eastwood, the Site Editor with at HIMSS 2010. I am with Avery Cloud, the Vice President
and Chief Information Officer of New Hanover Regional Medical Center in
Wilmington, North Carolina. Thank you for joining us.

Avery Cloud: Thank you. It's good to be with you.

Brian Eastwood: My first question, I just wanted to get your general
impression of the HIMSS10 so far. What have your highlights been and what
have you been focusing your attention on?

Avery Cloud: I think the whole conference has been really great. It has a
whole lot of energy. The subjects have been focused and very helpful to attendees.
Most importantly, because of the stimulus package that this administration has
created and the need to move into a more high tech realm in health care, tThe
attendees are here to learn more about how to be successful, and I think the
conference is measuring up and delivering a lot of answers.

Brian Eastwood: That's great. I know that one of the ways your organization
is working on achieving meaningful use, you've been using a couple of Compuware
products - Vantage and ChangePoint. What kinds of applications are you monitoring,
using that technology?

Avery Cloud: Well, we essentially have tiered our applications in terms of importance
to the organization, so we have tier one applications which will be equivalent to
mission critical apps, so we started there. Our full intention is to monitor all applications
because we believe as IT professionals we have the responsibility to deliver high levels
of service for everybody or every customer that uses [our facility]. In order to get started
putting the most important things first, we use a prioritization scheme and focus on
mission critical apps. In healthcare, those would be your clinical apps, certainly with
payroll. A lot of people would be surprised that payroll would be a mission critical app,
but you don't want a nurse working on you who didn't get paid.

Brian Eastwood: Yeah.

Avery Cloud: Then even our e-mail system is considered a tier one mission
critical app, so we're focusing on monitoring those, but we're giving special attention
to our clinical apps because that's the focus of healthcare right now. It's
beginning to move into a state of meaningful use and, frankly, trying to improve the
health of the communities we serve. For a lot of years we talked about the fact that
medical errors and poor quality of care kills thousands of patients a year, and it's really
good that we're beginning to address that through electronic systems and decision
making. It's the responsibility of the IT department to build the sub-structure on
which those various sophisticated apps ride to also protect the patient, because
if you have patients and  doctors and nurses dependent on information technology,
then that technology needs to perform where it's available, [because]life is still at risk.

beginning to address that through electronic systems and decision making. It's the
responsibility of the IT Department to build the sub-structure on which those various
sophisticated apps ride to also protect the patient because if you have patients and
doctors and nurses dependent on information technology, then that technology
needs to perform where it's available, then life is still at risk.

We really moved out of the realm because of healthcare automation. We
moved out of the realm where you lose money with systems down to where
you actually lose life. So, that's the importance of our ChangePoint and Vantage
products is to give us a strong sub-structure in our IS service model, to make
sure that the platform is solid, stable, and can produce the kind of stability
that is necessary to protect our patients and to enhance the caregivers' jobs.

Brian Eastwood: Now that you've been using this monitoring technology,
what is different within your organization in terms of using those mission
critical applications?

Avery Cloud: Well, I think one of the most important things that's different is
there's a much higher level of confidence in IT, basically. Before we did not
have insight into how our applications were performing. We were slow to
resolution because we didn't have the tools to detect problems, and even
worse we had no predictive capabilities. So the way we operate today we
can actually see a problem developing and solve it before our customers
even know about it. It gives us the opportunity to get rid of anecdotes which
is really destructive to process improvement because if you base your actions
on what people perceive to be the reality, you can quite often find yourself
running in rabbit holes. But with this technology we can actually see what is
going on in the applications and focus on the right things.

An example I like to frequently give is: One of our critical areas is our PACS
workstations that our radiologists use to read images. We were getting mixed
messages on how stable those platforms are. We actually implemented
monitoring to send automatically an email to my desk if a PACS work station
is rebooted, and that same email is also sent to the technical staff so we can
actually know that something has taken place that shouldn't without the radiologist
even having to call. Our ability to predict failures, our ability to prevent failures,
our ability to get objective clear performance data is light years ahead of where
we used to be.

Brian Eastwood: Well, thank you for sharing this insight into the use of
monitoring technology, and thank you for spending some times with us at
HIMSS. I know you're having a busy conference, but we do appreciate your
time and your insights.

Avery Cloud: My pleasure and I hope you also have a good conference.

Brian Eastwood: All right. Thank you. This is Brian Eastwood from

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