IBM Health Innovation Forum 2013 - Smarter Healthcare

IBM Smarter Healthcare

How healthcare players could benefit from new service models
implemented in the market around cloud computing
Stefan Henze, Director Public Sector Industry IT Consulting DACH
Rüschlikon, 05.11.13

12.11.2013


© 2013 IBM Corporation


Forward-thinking companies are redefining their
business strategy with cloud

http://www.youtube.com/watch?v=8qoRSBTuC_k&feature=youtu.be

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12.11.2013




Agenda

Typical situation and challenges in a larger clinical IT environment

(Cloud-) Sourcing as an appropriate solution

Governance model as prerequisite for successful sourcing

Use Case: eFA (electronic patient record) UK Aachen

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12.11.2013




Agenda

Typical situation and challenges in a larger clinic IT environment




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12.11.2013




Status quo –
What does a typical IT infrastructure look like?

Devices
Server
Standard-software
....

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12.11.2013




Today's IT areas
Monitoringsystems

Deviceprovisioning

Systemmanagement

Archive

Clinical Applications
Databaseprovisioning

Virtualization

Groupware

HIS

Maintenance
Med. Databases
Backup

IT-Security

CITIRX

Mobility

LIS
Electronic patient record

Monitoringsystems

12.11.2013

SAP

EPA
Intensivedocumentation

6

Ticketsystem

Telemedicine

Cablemanagement
Businessintelligence

Storage




Devisions & tasks in a typical
IT-department (FTE distribution)
Datacenter

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12.11.2013




IT Sourcing could be a solution to overcome the current
issues. The following areas are primarily in focus:

Standard applications without clinical relation

Operation and administration of a data center

Device support

Hotline & ticket-system service

Multimedia telecommunication
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12.11.2013




Areas with a need for action in a typical hospital

Significant backlog demand for “hardware”
investments of approximately 3 times the annual IT
budget.

Annual maintenance fees for the current inventory eat
up almost entire IT budget assigned
New hardware investments cannot be financed any
longer
Lack of skills, reduced headcounts in IT and overall
high average age of employees leads to a critital
situation to constantly meet quality of service
requirements

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12.11.2013




Agenda





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12.11.2013




Important challenges for companies are cost issues,
service-portfolio optimization and reduction of business risks
Costs

High

Low
Low

High

Low

High
IT Environment

Business risks

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12.11.2013

Service portfolio




The need to control business risks and maintain service quality under
existing cost pressures lead to a focus on core competencies
Costs

High

Low
Low

High
Low

High
IT Environment

Business risks

Provisioning

External

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12.11.2013

tial
n poten
ovatio
igh inn
H

Service portfolio

Operation

Optimization

Technology
Mgmt.

Internal

Business Mgmt.

en t i al
rgy pot
ne
High sy




The role of corporate IT continues to evolve
2011 – 2015

IT as service integrator
2006 – 2010

2000 – 2005

IT as application
implementer

IT as head of virtualization
and standardization

Widespread SaaS and cloud
adoption
Highly standardized and
virtualized, delivered as
a service
Even less staff, many more
suppliers and new modes
of delivery

Early SaaS and cloud adoption
Acceleration of virtualization and
standardization
Less staff, multiple suppliers

Expansive, on-premise
applications
Highly customized, with dedicated
hardware
Internal staff and external trusted
advisor
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12.11.2013




IT sourcing market has changed dramatically
in recent years
IT Selective Sourcing Market
SAP Hosting

Fullscope Outsourcing
(new Business) – often combined
with Asset + Employee takeover)
2nd + 3rd generation outsourcing
(Contract-extension / provider
exchange)

High standardization,
contents entirely cross and
international

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12.11.2013

Changes in
the market

Cloud Services

Data Center
Services
(IaaS / PaaS)

SO Outsourcing Market

Managed
Converged
Communication

ASP Hosting
(SaaS)

Managed
Security

Selective
Service Desks

DR / Data Center
Housing




Vertical sourcing offerings are driven by Cloud and
Managed Services Models and have changed the way
services are tailored
Typical sourcing candidate
areas of the last years:

Vertical sourcing as Cloud
or Managed Service
Business Units
Vertical x

Plan

Build

Development &
Deployment

Run
Systems
Operations

Command

Center

User Help
Desk

BPaaS

App1

App2

App n

SaaS

Application

AaaS

Platform /
Middleware
…

PaaS

Infrastructure

IaaS

Command
Center
Internal IT

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12.11.2013

Candidate for ext. Sourcing




A layered, open Cloud Architecture is emerging
Software Services
Business
Applications as
components
Service Oriented
Architecture

Open Standards / Source
Driven by customer
use cases
Cloud
Interoperability is
key for adoptance

Platform Services
Operational (OSS)
and Business
(BSS) Support
Services

OSLC

Infrastructure
Services
Compute, Storage,
Network

Backplane
Specialized
implementations
and “drivers”
“Fit for purpose”
workloads
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12.11.2013




A successful service integration starts with a
well defined governance model
Many expert opinions regarding internal
and external service delivery…
but no „End to End“ statement

User-Incident:
„Application XY is non performant
“
Or „Network is slow!“
Client LAN:
„OK“

User

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12.11.2013

Service
Provider 1

„Host transactions
below 1 Sec.“
WAN Provider:
„No WAN
issue“

Service
Provider 2

„Middleware
?
Moderately
utilitzed“

„No problem in
the Server LAN
environment“

Internal
IT-X

Service
Provider 3


Internal
IT-Y



Service integration covers an important portion of the
processes required to manage the interface between
business units, end users and IT
Business Units / End Users

Retained IT
Processes as an interface between business & IT

-BU 1
-BU 2

…
End Users

Project Portfolio
Management
Service Portfolio
Management
Service Catalogue
Management
Service Performance
Monitoring & Service
Level Management
Security & Compliance
Management

Requirements
Management
Architecture
Management
Financial
Management /
Chargeback
Service Desk /
Incident
Management

Provider Management
(Portfolio, Coordination, etc.)

Sector …

Overall Governance

Sector …
-BU 1
-BU 2

Service Delivery
Internal IT
Service
Delivery

Service
Provider 1

Service
Provider 2

...

Service Delivery

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12.11.2013




Service integration is a mandatory core competency of
IT organizations with multi sourcing strategies
Retained IT Organization
Service Integrator

Contract

Supplier 1

Contract

Supplier 2

Contract

Supplier n

Service Integration capabilities:
Internal
Services

Coordination and orchestration of Service
Providers
End to end services representation
Escalation Management

*) OLA = Operational Level Agreement

Appropriate skills
Cultural Change

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12.11.2013




Agenda





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12.11.2013




Accident and emergency care



Filetranfser with DICOM-Send

X-Ray image

PACS
Stolberg



Integrated access to electronic patient record
medico
UKA
PACS
UKA

PACS
Stolberg
FallAkte Plus
X-Ray image



Transfer to University Hospital Aachen



Integrated access to electronic patient record
Medication

AIS
Medistar
jesaja.net

medico
UKA

EKG
PACS
UKA

PACS
Stolberg
FallAkte Plus
X-Ray Image
Transfer Report
CT
OP-Reports
Results
X-RayThorax



Transfer-Report

OP-Report

Integrated access to electronic
patient record

medico
X-Ray-Result UKA
PACS
X-RayThoraxUKA

PACS
Stolberg
FallAkte Plus
X-Ray image



Medication review & customization
with focus on specific patient

Medicationsrules

medico

ID Diacos
Pharma

UKA

AIS
Medistar /
jesaja.net

PACS
UKA

PACS
Stolberg
FallAkte Plus
X-Ray Image
Medikatio
Transfer Report
Medication
n
OP-Reports
Results

EKG
X-RayThorax


Transfer to Düren for rehabilitation treatment



Integrated data acquisition
medico

AIS
Medistar /
jesaja.net

ID Diacos
Pharma

UKA
PACS
UKA

Physician Letter

PACS
Stolberg

i.s.h.med
Düren

SonoResult

FallAkte Plus
X Ray Images Medication
Transfer-Report
CT
EKG
OP-Report
Results
X-RayThorax


Integrated data acquisition
medico

AIS
Medistar /
jesaja.net

ID Diacos
Pharma

UKA
PACS
UKA

PACS
Stolberg

i.s.h.med
Düren

FallAkte Plus
Transfer-Report
EKG
OP- Report
Results
X-Ray Thorax


Transfer for additional surgery (skull) back to University Hospital Aachen



Acquisition of relevant documents in the primary systems
medico

AIS
Medistar /
jesaja.net

ID Diacos
Pharma

UKA
PACS
UKA

PACS
Stolberg

i.s.h.med
Düren

FallAkte Plus
Skull
Medication
Transfer-Report
CT
EKG
Physician Letter
OP-Report
X-Ray Result SonoReport
X-Ray-Thorax


Access to electronic patient record
medico

AIS
Medistar /
jesaja.net

ID Diacos
Pharma

UKA
PACS
UKA

PACS
Stolberg

i.s.h.med
Düren

FallAkte Plus
Transfer-Report
EKG
OP-Report
Physician Letter
SonoX-Ray Result
Result
X-ray Thorax


Solution Outline

Duria

PVS

KH4 KIS
KH1 medico

EFA-Box
medatixx

Jesaja.
CGM-AIS

Soarian

Net

KH2 i.s.h.med

Integrated Care

CompuGroup

Siemens
KH3 iMedOne

CGM-AIS

IBM Private Cloud
(PaaS)



IBM basis
IBM basis

IBM options
IBM options

Hospital/
Siemens

Service portfolio of private IBM Cloud
Customizing of the Soarian
Application,
App-development and support

CommunicationMonitoring
Database
Management
Storage and BackupManagement
Operating-System and
Server- Management

Installation and configuration of new
servers
Maintenance of CMDB
Daily Housekeeping
Log File analysis
Start, Stop and Relocate of VMs
Image-Service
Incident Management
2nd and 3rd level support

Hospital

Capacity Management
Hosting Center- and
Network-Management

Patch Management
Service Management

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12.11.2013




Service portfolio of private IBM Cloud
Operating and scaling options

Providing of a private cloud on the hospital
campus
Protected private cloud with computing
resources required for the eFA
What is performed by IBM? Hardware,
software, operation, maintenance, monitoring
Scaling options depending on the load and
storage requirements
Optional use for other applications
Test- and migration-environment
Architecture planning with the hospital and
Siemens Healthcare

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12.11.2013

Technology and processes

High Performance IBM System x Server
IBM cloud services with virtualization platform
Server, storage and network based on System
X VMware, IBM V7000 and Cisco technology
Secure VPN through separate management
and data networks
Certified operation team to manage data with
high protection needs




Your Contact

Stefan Henze
Stefan Henze
Senior Manager Industry Sales Public & CSI – DACH
Global Technology Services
Location: Düsseldorf, DE
49-(0)1717844057
stefan.henze@de.ibm.com

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12.11.2013




Thank you

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12.11.2013



IBM Health Innovation Forum 2013 - Smarter Healthcare

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