Is the Doctor In? Network Design Considerations in Evolving Healthcare Systems

The following is a guest post from Dr. Cahit Jay Akin

Today’s healthcare systems are a far cry from the systems your mother new. Today, healthcare is largely (an increasingly) data-driven, and a patient’s full medical history is fully contained within an Electronic Medical Records (EMR) and Electronic Healthcare Record (EHR). And those records need to be managed and transmitted in an effective and secure fashion between healthcare providers and other entities.

For the purposes of this discussion, ‘EMR’ is a term that refers to the medical data that’s collected in a single provider’s office. Electronic Health Records (EHR) is a more comprehensive set of data that provides a more comprehensive view of the patient and their medical history. But whether we’re talking about EMR or EHR, both are data-sets that are particular to the healthcare information of individual patients, and both benefit from an efficient network for transmitting those records.

The Effects of HIPAA

Of course, any EMR/EHR management system or network needs to be fully compliant with HIPAA policies. HIPAA is the Health Insurance Portability and Accountability Act of 1996. HIPAA mandates the requirements for healthcare information to be portable between different healthcare providers, laying out rules for how healthcare records are standardized, managed, and transferred between healthcare providers, insurance companies, and other third parties.

That means that the network used to transmit those records needs to be configured to support the right encryption levels automatically, so that any records transmitted across it are encrypted right from the start. Requiring manual encryption by clinic or hospital staff at the desktop won’t work – the network needs to do it without any interaction or direction from users.

This encryption, then, introduces overhead that takes additional network capacity, and is another consideration when implementing healthcare networks.

Traffic and Bandwidth Management

If electronic transfer of EMR data is to become truly widespread, then the network will need to be truly available and useful at all times. In fact, this is not only a question of convenience and performance, but potentially has life-saving (or life-threatening) aspects. Because of this, the network connections transmitting that EMR data need to not only be built for availability, but for performance as well.

The size of a patient’s EMR/EHR varies widely, and is determined by the amount of care that a given patient has received, the type of treatments that were given, and the data generated by the those treatments. For a patient with little or no treatment, it’s possible for their EHR to be just 1MB in size, with the average being closer to 40MB in size. And for patients with a significant amount of data and imagery (i.e., x-rays), that number can grow to 3 -5 GB. When you multiply this by the numbers of patients that an average city hospital has in its system at any one time (100,000 is not uncommon), the data requirements can be large.

Costs and the Clinic

EMR and EHR systems are expensive to implement, with large systems running well into the millions, and small clinic-based systems running into the tens of thousands. With those kinds of costs involved for the system alone, network costs can exacerbate an already expensive proposition.

According to HealthIT.gov, the average costs of installing an EHR system is $48,000 for an on-premise EHR system, and $58,000 for a SAAS-based EHR system. And both systems require network access for the accessing and transfer of that data.

More Applications are On the Way

The use of technology is medicine is still, in many ways, quite limited. While there are of course a huge range of technologies involved in the providing of healthcare services, the back-office platforms of most healthcare systems pale by comparison.

But that’s changing as well, as mobile applications, computer-based diagnostics and telemedicine increase in scope and sophistication. These applications have great promise, but they also bring increased overhead to the health provider’s networks.

Meeting the Challenges

All of the requirements and challenges noted above have implications for your network architecture. But there are network management strategies and techniques that can help to address these challenges. By using broadband bonding, for example, multiple smaller network links can be bonded into a single larger network connection. Likewise, efficient WAN orchestration can make efficient use of network resources by prioritizing traffic and ensuring that critical data gets more bandwidth than less-critical applications.

The key is to stay ahead of the changes to come by implementing the right network management now, before the ever-increasing requirements placed on your network overwhelm your ability to keep up with them. It’s only through proactive design and implementation that your network will be able to keep pace with the changes that have not only taken place in the healthcare market, but are certain to keep coming for the foreseeable future.

Dr. Cahit Jay Akin is the co-founder and chief executive officer of Mushroom Networks, a privately held company based in San Diego, CA, providing broadband products and solutions for a range of Internet applications. http://www.mushroomnetworks.com