Today modern IT equipment is necessary in order to provide high standards of healthcare for the general population. However, the establishment of a modern IT infrastructure requires the ability to implement and manage both traditional IT and medical systems. IT professionals working within a healthcare environment are often faced with a unique challenge: they have the “traditional” IT elements of firewalls, routers and switches to take care of, and then on top of that, there are the specialised healthcare systems with their associated data formats, communication protocols, and medical devices. All of these elements and systems co-exist in the same infrastructure, and this brings with it some challenges.
Infrastructure and network monitoring is not new to IT professionals, and most medical environments are probably already monitoring at least parts of their traditional IT infrastructure. But what is good monitoring software supposed to do, and how should it be applied to medical environments?
Put very simplistically, monitoring software should do the following:
- Monitor the network speeds and check for bottlenecks, etc. It should do this using common network protocols like SNMP, Netflow, WMI, and so on.
- Monitor devices such as routers, servers and storage.
- Provide alerts and notifications when certain thresholds are reached, like when bandwidth is running low or when a device becomes overheated.
- Display the status of the infrastructure in a single dashboard view.
This last point is an important one for any environment: to be able to see what the overall health of your IT infrastructure is at a glance. This applies to healthcare environments as much as any other. And while there is a lot of information out there about how to monitor your IT, it becomes a bit more difficult when considering healthcare IT. This is because a typical hospital environment includes many disparate devices, systems, and protocols.
Tips on monitoring software and what to look for
The network monitoring solution for healthcare IT environments needs to monitor both traditional and healthcare IT-specific network elements. Here are some things to look out for when considering monitoring software:
Traditional Network Monitoring
This includes the ability to monitor routers, switches, firewalls, storage devices, and support for common protocols like SNMP, NetFlow, and others.
Healthcare IT Elements
Make sure the monitoring software has the ability to monitor the systems specific to a healthcare environment (such as HER, EMR, PACS etc.) using the DICOM and HL7 protocols.
You need to be able to visualise the IT infrastructure, and preferably see it all on one screen: This means including both traditional elements and healthcare IT elements into the same view, with the ability to drill down if you need to.
For example, at the very top level, you could have the status of all your modalities shown on the overview dashboard. If there is a problem with one of the modalities, the status will show that there is an issue. You can then drill down to see which modality has the issue.
Alerts and Notifications
Since you can’t watch dashboards all the time, you need to be alerted when problems arise. The infrastructure monitoring solution you select should let you set thresholds for certain parameters, and notify you when they are exceeded.
For example, a rising number of worklist entries for modalities could mean that worklist items are not being cleared - probably due to a network issue. In this case, when monitoring the number of worklist items, you would set a specific threshold.
When this threshold is exceeded, the status is set something like “Warning” and a notification can be triggered.
Realistically, the infrastructure in a hospital supports a series of workflows that consist of all kinds of devices and protocols. For example, a radiology workflow makes sure the patient goes from registration at reception, through their scans, to a diagnosis at the end. If any of the systems or interfaces fail, the workflow breaks down.
The monitoring solution you choose should let you build overviews of entire workflows, such as radiology workflows, laboratory workflows, and so on. Building an overview of the entire workflow, helps to see if there are problems with any individual step and if the workflow status shows a warning, you can then drill down to each step to identify where the problem is.
Technology plays a vital role in managing a large healthcare IT environment and sometimes requires state of the art solutions managed by IT professionals who have a deep understanding of how to manage and optimise the software. Successful IT solutions should be designed to empower healthcare systems to effectively manage their workforce to help reduce labour costs, improve quality of care and deliver operational efficiencies.
It is abundantly clear to hospital management that without the deployment of the appropriate IT infrastructure, it will not be possible to monitor and improve the important efficiency reserves in hospitals and the healthcare system as a whole.
Steven Feurer, CTO, Paessler