Eileen Haggerty, senior director enterprise business operations, NETSCOUT
Eileen Haggerty, senior director enterprise business operations, NETSCOUT

Much like other enterprises, healthcare groups, hospitals, and pharmaceutical companies have all seen the benefits of digital transformation (DX). Healthcare is changing, and these organisations are becoming more and more dependent on technology. Whether it is ease in delivering fast, secure higher quality patient care, or greater business efficiency, the small and incremental DX-related changes have created wonders. 

Now healthcare providers are seeking to improve their patient care quality by adopting a plethora of applications that require trouble-free and real-time access from their IT networks. Electronic health records, imaging, electronic prescriptions, Unified Communications (UC) coupled with telemedicine are all being deeply linked to the healthcare service delivery chain, and this is complicating matters greatly whilst stretching network resources to capacity. Unfortunately, as was evidenced very recently with high profile ransomware attacks on the NHS, they also seem to be stretching security resources to capacity too. 

There is no denying the positive effects that DX is having on the hospital IT ecosystem, but it's the challenge of increasingly complex IT networks that power today's healthcare organisations that may present a new set of challenges as well. Every new application, every new connected device, every new end-point added to the network not only increases complexity, but also requires business assurance.  That means service assurance from slowdowns or problems with the applications' availability as well as security assurance from the vulnerabilities of today's threatening nefarious incursions. In an area where success and failure is very much measured in life and death, the need for greater visibility into the traffic that is crossing a healthcare network has never been more crucial. 

Securing safe patient care 

For hospitals in particular, improving patient care is one of the primary driving forces behind DX. But this is only one piece of a puzzle that is becoming very large. Digital services are already integral to healthcare; from Electronic Medical Records (EMRs) and Electronic Health Records (EHRs), to Picture Archiving and Communications Systems (PACS) Imaging, and telemedicine, right down to the very revenue cycle management and enterprise resource planning systems, digital transformation is enhancing and refining operational process, improving patient care and reducing cost. 

However DX is a double-edged sword, and hangs precariously above the heads of those involved in the adoption of digital services. Investments in these application services, new software defined networking (SDN) and datacentre projects, or migration of services to the Cloud are significant and have the attention of the CIO.  Securing and monitoring these networks should be one of the main tasks for healthcare IT professionals. One example could be the continuous monitoring of EHR transactions. Assessing performance and availability metrics and even transaction status activity (such as response time analysis) is crucial to a successful clinical practice, and also for clinical practice. Within some countries it's a regulatory requirement, making the ability to monitor these transactions efficiently and completely transparently all the more important. 

But who needs to take the lead here? CIOs in healthcare organisations are faced with a need to keep up with the pace of innovation, whilst making their healthcare technologies – often multi-vendor – interoperate in a seamless fashion, while keeping them secure and compliant with regulations. Health Layer 7 or HL7 is one such example of a good technology helping to improve efficiency, speed, and also security of networks. When it comes to data governance in the UK, healthcare data needs to be compliant with the Data Protection Act. In the EU the Data Protection Directive will come into action next year, further complicating matters for those who may need to transfer patient data internationally. 

Increasing demand on healthcare networks is a reality!  New data centre buildout has followed with more capacity than ever before.  Now is the time to capitalise on application and network monitoring in real-time, to gather real-time insights into the healthcare networks already in deployment. The data exfiltrated from their network traffic will give a powerful and useful view on how their network and applications are performing. They may even discover traffic flow discrepancies from previous trends. These can mean security breaches, which can then be dealt with accordingly before the end user, or the patient, is aware of them, before any effects are felt, sometimes before they are even launched.  New application services can be introduced with confidence as any impact they may have on the network can be planned for based on an understanding of performance and traffic trends (as much as they can be predicted in a hospital environment). As we move towards increasingly virtual, public and hybrid networks, holistic network and performance service assurance is becoming a foundation upon which efficient software defined networking must be built. 

In practice: Application and network visibility is no longer a “nice-to-have” 

With a constantly changing environment such as healthcare, there is never a “typical” day, so visibility into your network on a constant basis is crucial. Regular users don't exist: schedules are infinitely varied, patient type changes every day, and this leads to a demand on network and services being unpredictable…and that's on a good day. 

Consider one world-renowned healthcare provider that treats patients in North America and in the Middle East and leads the industry in digital transformation. It has a broad, complex environment of dozens of facilities including hospitals, healthcare centres, ambulatory surgical centres and medical offices. Network and application service demands for safe, efficient treatment of more than five million out-patients and half a million ER patients every year makes service assurance a priority. 

For this, and any other, major healthcare provider, maintaining always-on availability to patient care-related services like EMR and medical imaging is essential to vital operations, and directly impacts the quality of patient care throughout the organisation. As the IT team migrated their EMR Citrix Server environment from a legacy mainframe infrastructure to a new software defined network (SDN) platform, issues with slow logins, application freezes, and system bottlenecks arose. Staff at this healthcare organisation were experiencing limited availability during peak times which was seen as hampering caregivers' ability to improve patient care and negatively affecting the patient experience. 

IT recognised the need to quickly and accurately triage its network and applications whenever problems occur. Tackling visibility into “virtualised” environments was a new challenge when it came to troubleshooting vitally important services. As the datacentre traffic has evolved, IT has implemented a solution that can validate and monitor EMR Citrix-related traffic, proactively alert the IT team when it detects response time issues, reduce the time to troubleshoot reported problems, and ultimately to ensure high-quality patient care experience. Running a highly available, 24/7 global network for a healthcare organisation is no small feat, but made much more achievable with service and security assurance visibility. 

High availability is crucial for healthcare, especially with the adoption of new digital services. Healthcare has a driving and desperate need for complete network visibility and service assurance unlike ever before. But digital transformation is not a one-time thing; visibility and assurance will be needed during and after implementing these changes. Only through this will healthcare be a more secure environment, and patient experience and care remain as good as we expect them to be. 

Contributed by Eileen Haggerty, senior director enterprise business operations, NETSCOUT 

*Note: The views expressed in this blog are those of the author and do not necessarily reflect the views of SC Media or Haymarket Media.