Healthcare Adopts Virtualization, But Slowly

All of the big virtualization vendors — VMware, Citrix and Microsoft — are pushing the technology as a way to solve problems in healthcare, and more healthcare providers are trying it out.

But they are still in the minority, according to speakers at VMware’s annual conference in San Francisco this week. Despite the pressure on healthcare providers to cut costs – which virtualization, if it’s implemented correctly, could help them do – they still have the usual concerns about the privacy and security of their data, especially with federal and state regulators looking over their shoulders.

[login]Also, IT has been structured differently in healthcare than in other industries, which makes it more challenging for the industry to adopt any new technology, according to Jim Fitzgerald, CTO of Meditech Solutions Group, a captive integrator and consultant for Dell.

“It’s a tale of two cities,” Fitzgerald said. “We deal with hospitals running Meditech software in several large, integrated delivery networks, and those folks are the equivalent of giant commercial IT organizations – they’re centralized. On the other end, we’re in 1500 standalone, small community hospitals with very different sets of problems.”

Until recently, Fitzgerald added, especially in the U.S., IT has been treated as an “afterthought” in healthcare — not as a way to improve patient care. Also, almost all IT in healthcare has been home-grown, according to James Philbin, senior director of medical imaging and bioinformatics research at Johns Hopkins, and “since medical people can’t tell the difference between good IT and bad IT, salaries for IT were not as high.”

Now all that is changing, thanks partly to various funded and unfunded mandates from regulators and the government, and partly to the growing popularity of mobile devices, which need infrastructure to function. But more changes are coming.

Ironically, healthcare’s particular challenges mean that virtualization could be especially helpful once it’s widely adopted, several people said.

The types of data errors that occur in healthcare tend to be different than in other industries, Fitzgerald said. Nearly half are “infrastructure accidents” caused by human error — lost backup tapes, missed storage area networks and so on — and virtualization could give IT workers “a central management toolkit that they’ve never had before, so they have a fighting chance.”

Applications to improve customer service and data to satisfy regulators can also be turned out more quickly, which helps with compliance and lowers costs, several people said.

CVS Caremark, for instance, which fills prescriptions online for pharmacies and patients, is using virtualization to improve performance and customer service – IT resources can be dedicated to different categories of service, like pay-as-you-go.

(Caremark also settled with two federal agencies last year — the FTC and HHS — over charges that it failed to protect personal medical and financial information. It paid HHS $2.25 million).

The big traditional healthcare IT providers – EPIC, Cerner and Siemens, among others – are also adapting their products to virtualization, although they are taking different approaches and customers are advised to get involved.

“The vendors are trying to lock you in to their solution — they like to sell expensive hardware as well as software,” Philbin said. “We told them we don’t buy hardware from software vendors anymore, and we succeeded in getting Siemens to virtualize. We run five PACS (picture archiving communication system) vendors, and four are virtualized and show good performance.”

As networks keep getting faster, Philbin added, 3-D images will be zipped all around the world to be diagnosed, an application he called “game-changing.”

Whatever healthcare providers do with virtualization, though, had better be done well, or hospital workers will find ways around it.

“Shared workstations in hospitals are like hummingbird feeders,” said David Ting, the CTO of Imprivata, a vendor that works with VMware on security and user access. “Doctors and nurses buzz in for 30 seconds, log off and go on to the next one. The more layers of security you have, the more inefficient they become. That’s one of the key advantages of a virtualized desktop – you can move from one station to the next and still have a continuity of experience. It’s more productive, and it’s better for patient care.”

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