IBM Software
Thought Leadership White Paper
Healthcare
Transforming service in today’s rapidly
changing healthcare environments
Improve patient care and operational health with service management solutions from IBM
2
Transforming service in today’s rapidly changing healthcare environments
Contents
2 Introduction
2 Taking the first steps to healthcare transformation
applications—and often, IT can resolve problems only after
operations have been negatively affected. Manual processes,
disparate tools and increasing volumes of data are constant challenges, even as physicians and other caregivers require constant
connections to instrumented and intelligent services.
3 Aligning healthcare technology with organizational goals
3 Driving healthcare efficiency with new best practices
4 Application performance management: Improving
healthcare outcomes
5 Network management: Ensuring availability for critical
needs
7 Business service management: Delivering value across
the organization
9 Putting best practices to work with service management solutions from IBM
11 IBM cloud solutions: Charting the way to healthcare
IT’s future
11 Conclusion
11 For more information
Introduction
Technology drives critical business services for organizations
around the world, but when it comes to the healthcare industry,
the stakes are significantly higher than most. Healthcare providers need critical services to work together seamlessly so they can
deliver better quality of care and ensure patient safety. Clinicians
need to access the right information at the right time to develop
treatment plans, while administrators need services that will
help them reduce operational costs and improve the bottom line.
Compliance with the latest government regulations is also a
pressing concern.
Behind the scenes, healthcare IT professionals are challenged
with meeting these exploding demands for service on a limited
budget. They are forced to deliver high performance and availability from a complex mix of legacy systems and evolving
To avoid disruptions in critical services, today’s healthcare IT
organizations require visibility, control and automation across
the entire IT environment—from their data warehouses, clinical
applications and business services to the underlying network
infrastructure that ties everything together. This white paper
explains how to ensure the availability of critical services and
applications by taking a proactive approach to problem resolution. And it looks at how integrating service design and delivery
with end-to-end operations management can provide the crucial
edge in improving patient care, reducing costs and increasing
efficiency across the healthcare environment.
Taking the first steps to healthcare
transformation
Change is in the air for the healthcare industry. Thanks to escalating costs and increasing competition, healthcare organizations
are looking for ways to get more value out of every investment—
without compromising performance or quality of service.
They want to create more collaborative environments, where
providers can work more closely together to deliver high levels
of care. And as they broaden access to information, they need to
ensure compliance with the latest government regulations and
security mandates.
Yet, the information generated and shared within the healthcare
environment is growing exponentially. Electronic health records
(EHR), digitized medical images, digital pathology applications
and other data-intensive information sources are creating vast
volumes of healthcare information. In fact, the amount of data—
much of it unstructured—that is managed by hospitals and
ambulatory providers in North America alone is expected to
quadruple its 2010 levels by 2015.1 As a result, data protection,
availability and management are new issues for concern.
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In addition, more of this vital healthcare information is being
accessed on the go. In a 2011 study of the healthcare industry,
80 percent of doctors reported using smartphones, tablets and
other mobile devices in their everyday medical practices.2
Another survey found that 85 percent of nurses and nursing students would like to access prescription drug guides through their
mobile phones.3 Plus, 71 percent of nursing professionals said
they already use a smartphone for work.3 This means mobile
access and applications are more important than ever within the
healthcare environment.
Aligning healthcare technology with
organizational goals
With a service-oriented approach to managing applications and
infrastructure, healthcare organizations can count on IT as an
essential enabler for clinical and business value. In contrast,
poorly performing IT services can lead directly to reduced
productivity and decreased quality of care. Healthcare organizations need real-time visibility into the discrete elements that
impact service, along with IT solutions that support their key
imperatives to:
●●
●●
●●
Build sustainable healthcare systems: By reducing IT costs
with centralized management—and speeding problem
resolution using proactive analysis—healthcare organizations
can deliver greater value to patients, meet regulatory requirements and ensure greater transparency and accountability.
Collaborate to improve care and outcomes: By proactively
monitoring performance and resolving problems before they
impact operations, IT staff can enable healthcare practitioners
with insights to improve the quality and efficiency of care.
Increase access to healthcare: By improving the performance and availability of critical services, healthcare organizations can enable access to care, with healthcare professionals
having the resources they need at their fingertips to deliver
high-quality care whenever and wherever it is needed to
adequately serve their populations.
3
Imperatives for a new healthcare business model
Collaborate to
improve care
and outcomes
Build sustainable
healthcare
systems
Transform
healthcare
Increase access to healthcare
Driving healthcare efficiency with new
best practices
Traditionally, healthcare IT investments have led to sprawling,
siloed environments that are inefficient to manage and costly to
maintain. Today’s IT best practices, by contrast, are designed to
help healthcare organizations understand and control the interdependencies of IT operations, optimize the delivery of critical
services and improve the economics of IT with an integrated
approach to performance management.
4
Transforming service in today’s rapidly changing healthcare environments
Key best practices for ensuring the high performance and availability of critical services include:
●●
●●
●●
●●
●●
●●
Business service management: Align technology with
business and clinical goals to help managers make
better decisions.
End-user monitoring: Understand the end-user experience
and identify problems before end users are affected.
Transaction tracking: Gain visibility into transactions across
the application infrastructure to identify and isolate issues.
Discovery: Create an accurate and up-to-date topology view
of the application/services environment and the network it
runs on to provide an understanding of the supporting IT
infrastructure.
Diagnostics: Drill down into the details to identify the root
cause of a problem.
Predictive analytics: Leverage IT operational data to be
predictive and preventive.
Best practices for service management
Business service
management
Predictive
analytics
End-user
monitoring
Service availability
and performance
management
solutions
Transaction
tracking
Diagnostics
Discovery
Application performance management:
Improving healthcare outcomes
Medical records management, remote patient monitoring, radiological imaging—these are just some of the critical services in
the healthcare environment that rely upon multiple applications
and infrastructure elements to make them possible. Small delays
in performance can result in big losses of efficiency, while also
increasing the level of end-user frustration. If application
performance is measured only in the data center, it can delay the
delivery of care and create error-prone workarounds that reduce
quality, increase costs and damage the reputation of the entire
organization. Instead, measurements also must be made where
performance matters most—from the doctor, clinician, nurse or
staff perspective.
Enhance the technology experience for healthcare end users
Why does the end-user experience receive so much attention
now? Increasingly, it is because healthcare IT teams are dealing
with IT environments that are more complex than ever—
making the end-user experience harder to ensure. IT has to
manage both legacy and new applications on heterogeneous
platforms, handle the complexity of composite applications and
transactions, and support the move to increasingly dynamic
environments, such as public, private and hybrid clouds.
Monitoring the IT resources alone provides an incomplete view
of application performance; more holistic performance management is needed to deliver the service levels that meet end-user
expectations. Physicians, in particular, require high performance
for their high-demand needs—and often have low tolerance for
slow application response times and page load times.
Within the healthcare IT environment, cross-platform applications may involve a number of systems, still more databases and
various instances of runtime Java applications—so resolving
performance issues when they occur can be anything but
straightforward. Bottlenecks can stem from any number of
potential root causes. And when different IT domains are
managed by different managers or entire teams, pursuing crossteam collaboration to resolve application performance issues can
itself be a challenge.
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Cloud computing is one technique for providing the dynamic
resource allocation and high availability needed to support
clinical and business functions. And while clouds can increase
the complexity of application performance management—
because allocation of cloud-based resources can be difficult to
predict, and policies must be put into place to control cloud
access—many healthcare organizations are finding that
the advantages of the cloud far outweigh the challenges.
A cloud delivers scalability and flexibility with minimal capital
expenditure to meet the needs of both IT environments and
healthcare applications.
●●
●●
Reduce service disruptions with an end-to-end
management approach
To keep critical applications running smoothly and optimize the
end-user experience, healthcare IT organizations need an endto-end management solution that enables them to improve
performance while reducing costs—and enhance IT resource
utilization while minimizing risks. Healthcare IT teams need a
broad array of integrated capabilities, seamlessly working
together, to ensure optimal performance. These key
capabilities include:
●●
●●
Discovery: Gain visibility into application components
and speed problem resolution. Healthcare IT teams need to
quickly find systems that require monitoring or management,
map the systems to corresponding applications, prioritize
problems based on their service impact, and speed the process
of root-cause analysis to improve uptime.
End-user experience monitoring: Track end-user
experience across heterogeneous environments and help
ensure SLA compliance, non-invasively. Integrated
solutions enable healthcare IT teams to understand how an
application looks and works from the end-user perspective, so
that the user experience can be optimized accordingly.
Support for applications running on mobile devices should
also be included.
●●
5
Transaction tracking: Quickly identify and isolate performance problems. With transaction-tracking capabilities,
healthcare IT teams can step through the logical sequence by
which an application works—across variable paths, and virtual
and cloud environments—during a service transaction.
Agentless tracking can be quickly deployed across the entire
IT infrastructure for critical applications and services. IT staff
can also deploy agents for more deep-dive data on specific
resources.
Diagnostics: Facilitate diagnosis and repair of application
performance issues. By viewing performance metrics
through customizable dashboards—such as the mean time
between failures (MTBF) and the mean time to repair
(MTTR)—healthcare IT teams can analyze the root cause of
performance issues and then accelerate the repair process to
minimize the impact on business and clinical operations.
Analytics: Use predictive analytics and capacity planning
for proactive management. Forecasting, trending and
capacity analytics can help healthcare IT teams reduce
outages, improve performance and optimize utilization.
Network management: Ensuring
availability for critical needs
Within the healthcare industry, timely access to information can
make a real impact on people’s lives. Fast and reliable performance of EHR, digital imaging and clinical order-entry systems
directly affects patient care and employee productivity. Yet the
proliferation of end-user devices—from doctors with smartphones to CEOs with tablets—also means IT organizations have
much less control over and visibility into end-user performance.
6
Transforming service in today’s rapidly changing healthcare environments
Application performance management in cloud environments
Discovery
End-user experience
Transaction tracking
Diagnostics
Analytics
Visibility into
components of
composite applications
speeds problem
resolution
End-user monitoring
to ensure SLA
compliance
Rapid problem isolation
through transaction
path analysis
Isolates performance
issues to root cause,
accelerates repair
process and minimizes
business impact
Trends and patterns
of application
performance reduce
outages and improve
business performance
Capacity analytics and
planning optimize
workloads and saves costs
Shared data and common services
Understand
end-user
experience
Optimize
performance
Mobile devices and smart endpoints
Determine
root cause
Follow
changing
workloads
Highly virtualized applications,
storage and networks
Meet the challenges and complexities in
healthcare networks
Around the world, the complexities of network management
are on the rise. One reason is that on today’s smarter planet,
everyone expects to be connected at any time, from anywhere,
using any device. Healthcare IT teams have to manage dynamic
networks that are constantly changing to support the latest cloud
services, mobile applications, virtualized resources, wireless
connectivity, video conferencing, voice-over-IP (VOIP) calling,
cameras and other non-IT devices. What’s more, the healthcare
environment also includes a wide range of legacy systems for
laboratories, pharmacies, imaging and order entry. Ensuring
network availability across these disparate systems is essential
for supporting clinical and business success.
Discover
application
components
Visibility
across hybrid
environments
Private, public and hybrid clouds
Another unique challenge lies in the technology-intensive nature
of the hospital. In an environment where heart monitors and
other medical equipment also send out signals, wireless
connections can suffer interference. Poor WiFi quality can
disrupt access to critical information, such as prescription drug
guides and patient records, and it can limit opportunities for collaboration. By identifying potential conflicts in order to maintain connections, healthcare IT teams can improve service at the
point of care.
Health records digitization and data retention mandates have
also increased organizations’ security challenges, as patient information is required to be always available, constantly accessible
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and never lost. To ensure compliance with government regulations, healthcare organizations must maintain the confidentiality
and integrity of patient information; violations can result in
financial penalties and damage brand reputation.
Prevent network outages where performance matters most
To manage performance effectively and adapt to changing
priorities, healthcare IT organizations need an integrated solution that provides visibility, control and automation across the
entire network. Healthcare IT teams need to be able to:
●●
●●
●●
●●
●●
●●
●●
●●
Discover the network infrastructure in real time, including
employee-owned devices
Visualize the network topology from a “single pane of
glass”—rather than requiring the use of multiple point
solutions
Detect network events that can be proactively resolved before
an outage occurs, based on root-cause analysis
Configure network services automatically, using predefined
templates to reduce errors
Secure the network to ensure compliance with industry
standards and best practices
Activate new services with automated provisioning
Integrate maintenance across platforms with minimal
human intervention
Remediate network issues to automatically correct
common problems
With automated network monitoring and fault management
capabilities, healthcare IT organizations can deliver more
services without adding infrastructure or staff—improving operational cost efficiency. Automation also enhances the quality of
service, as fewer events require human intervention and issues
with achieving the required mean time to repair are reduced. As
a result, network downtime virtually disappears. By streamlining
network management with an integrated solution, healthcare IT
teams can reduce complexity, improve productivity and create a
stable service platform. On the business side, reduced downtime
means organizations can increase revenue by improving the
7
customer experience; meanwhile, for clinicians, the lack of service interruptions means that they can focus on enhancing
patient care.
Business service management: Delivering
value across the organization
Typically, healthcare organizations have managed their IT infrastructures as an outgrowth of specialized medical technologies.
Devices and applications in areas such as X-ray, medical records
or pathology laboratories have operated on their own platforms
and typically have been managed as freestanding elements in
which neither their management processes nor their data integrate with the rest of the environment. The siloed environments
and processes that grew from this practice resulted in high costs
and reduced opportunities for collaboration and information
sharing, whether in IT, clinical or business areas of the healthcare organization.
To help reduce escalating costs and foster collaboration,
however, a new paradigm is required. Healthcare organizations
must move away from an operations-only view of the infrastructure and take a service-level perspective that puts support for
healthcare professionals, patient care and business results first.
In the event of a service failure, for example, how do IT personnel know how to prioritize their repair tasks? With a serviceoriented approach, it’s obvious that IT staff should focus on
the components that affect services with a greater clinical and
business impact.
To manage services at this level, healthcare IT organizations
need better visibility into them and the ability to manage them
based on their clinical and business context—whether the service
provides operational support, helps drive revenue or improves
patient care, for example. The service management solution
should provide a view into the underlying IT infrastructure,
the applications that support it and the business service itself.
The solution should also support roles-based collaboration,
enabling different IT teams to identify and resolve problems
quickly.
8
Transforming service in today’s rapidly changing healthcare environments
Preventing network outages for healthcare organizations
VISIBILITY
CONTROL
AUTOMATION
Discover it
Visualize it
Detect it
Configure it
Secure it
Activate it
Integrate it
Remediate it
Network
By combining a service-oriented approach with the power of
cloud computing, healthcare organizations can create dynamic
infrastructures that can help:
●●
●●
●●
Increase IT efficiency by optimizing and accelerating IT
resource allocation and service delivery
Erase clinical and business boundaries by simplifying access to
information and connecting people and functions across
formerly siloed ecosystems
Improve the economics of IT by optimizing availability and
reducing complexity
Case study: Ensuring services with standardization and
integration
A large healthcare system needed to improve the quality of
patient care, so it purchased a clinical information system
to manage its growing volume of medical records. The
organization previously had developed segmented processes
and IT systems at its 27 facilities—however, that complicated
the rollout of the new platform. With IBM® Tivoli® service
management solutions, the healthcare system was able to
standardize its disparate systems quickly, before the system
launch. And it gained an integrated IT Infrastructure Library
(ITIL) framework for ongoing best practices.
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The service management lifecycle
Monitor
infrastructure
components
Manage
service
quality
Understand
user
experience
Reduce application
management costs
Evaluate
transaction
performance
Reduce
MTTR and
increase
MTBF
Improve business
service availability
Manage risk and
avoid outages
Diagnose
performance
issues
Gain visibility of
service impact
Automated
Discovery
Putting best practices to work with service
management solutions from IBM
IBM solutions for service availability and performance management enable best practices for delivering, managing and
ensuring the operation of critical healthcare IT services.
Built upon leading technologies and proven capabilities,
IBM solutions give healthcare organizations the power to manage multiple layers of the service infrastructure to transform
clinical and business performance.
Infrastructure management
●●
Application monitoring: Working with a composite application manager, system monitoring software enables healthcare
IT organizations to manage enterprise applications such as
those from SAP, operating systems, databases and servers
across complex environments with maximum efficiency. It
helps optimize IT infrastructure performance and availability
by detecting and resolving potential problems automatically.
9
10 Transforming service in today’s rapidly changing healthcare environments
●●
Operations management: Operations management software
reaches across multiple networks and IT silos to help organizations improve the end-to-end availability of critical services.
With the consolidated view of infrastructure events the
solution provides, IT staff can manage performance across
the entire environment from a single location and can help
prevent costly outages with automated event correlation,
isolation and resolution.
This solution provides you with:
With real-time problem detection, diagnosis and repair, IT
staff can optimize the use of key resources and deliver new
levels of efficiency and cost savings. Management capabilities
span physical and virtual servers, applications, databases, transactions, and more. Organizations can also reduce energy costs
with control over energy usage. And the solutions enable
streamlined operations that can eliminate manual processes,
freeing up IT staff to focus on more strategic initiatives.
Business service management
●●
●●
●●
●●
Visibility: Discover, visualize and monitor the network and
reduce service-affecting alarms by up to 98 percent.4
Control: Accurately configure and secure the network and
reduce error repair time by as much as 77 percent.5
Automation: Activate, integrate and remediate the network
and enable “zero-touch” service delivery.
Using service-level tracking and roles-based dashboards,
organizations can monitor key performance indicators (KPIs)
in real time, analyze historical trends and make informed
decisions about resource usage. The solution also delivers the
service management capabilities required for optimizing cloud
investments.
Application performance management
●●
Application dependency discovery: For proactive IT
management, the IBM solution provides real-time visibility
into the application infrastructure with automated mapping
and discovery. It enables IT staff to understand the configurations, topologies and IT dependencies that make up critical
services—so they can more effectively plan for changes and
minimize service interruptions.
In addition, the IBM solution enables organizations to
improve service quality with faster problem resolution. IT staff
can rapidly isolate configuration-related application problems,
which can reduce troubleshooting time from hours and days
to minutes. IT also can prioritize the response to issues based
on application and service impact. And management is
enhanced across physical, virtual and cloud environments.
●●
Composite application management: An IBM family of
solutions empowers IT organizations to optimize performance
and availability with end-to-end application monitoring,
transaction tracking, end-user experience management and
deep-dive diagnostics. The products share a common infrastructure, so organizations can realize a quick return on
investment right out of the box.
Business service management: This proven IBM solution
enables business and operations staff to understand the
complex relationships between critical services and the
underlying IT infrastructure. It provides organizations with
advanced, real-time visualization of services and processes and
deep insight into business data.
●●
Event and alert management: By providing real-time access
to actionable insights, this IBM solution helps organizations
fine-tune the performance of critical applications, processes
and services. IT staff can automate and customize workf lows,
analyze service impact and prioritize corrective actions. The
solution empowers IT personnel to view existing data, events
and operational management tasks in the context of the entire
infrastructure and to correlate information to essential
business functions.
In addition, IBM solutions are tightly integrated, work on heterogeneous platforms, integrate with competitive management
products and are augmented by best practices.
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IBM cloud solutions: Charting the way to
healthcare IT’s future
On a smarter planet, where systems and organizations are more
instrumented, interconnected and intelligent than ever before,
healthcare organizations have new opportunities to use technology to improve their clinical and business performance. From
support for real-time analytics across organizational silos to
cost-efficient management across a sprawling infrastructure,
cloud computing provides a flexible approach for optimizing
operations across the entire organization.
IBM cloud solutions are built on a family of technologies
designed to help organizations quickly adopt private and hybrid
clouds. These solutions enable healthcare IT teams to more
intelligently and dynamically manage the tools, information and
people within their service infrastructure. The offerings can help
improve clinical and business productivity, support regulatory
compliance, speed innovation and delivery capabilities, and
lower capital costs—reaching far beyond traditional IT functions
to enhance the value it provides to the entire healthcare
organization.
Conclusion
Today’s healthcare organizations face significant challenges
related to new technologies, escalating costs and increasing regulations. But IBM can help. IBM solutions enable healthcare IT
teams to improve the performance and availability of critical services by giving them the power to manage the IT environment
for both business and clinical needs. IBM can help organizations
more efficiently manage the infrastructure, applications and
services that support professional efficiency and effectiveness,
enhance patient care and take the next step forward to tomorrow’s advanced capabilities with cloud computing. With service
management solutions from IBM, healthcare organizations can
increase their own operational health as they transform lives
around the world.
For more information
To learn more about the IBM Tivoli solutions for healthcare
organizations, please contact your IBM representative or
IBM Business Partner, or visit: ibm.com/tivoli
Information also is available at the following sites:
●●
IBM families of cloud technologies
●●
●●
●●
Platform as a Service technologies
●●
Application
lifecycle
Application
resources
Application
environments
Application
management
Integration
Infrastructure as a Service technologies
Infrastructure
platform
Management and Availability and
administration
performance
Security and
compliance
Usage and
accounting
http://www-01.ibm.com/software/tivoli/solutions/
application-performance-management/
http://www-01.ibm.com/software/tivoli/products/bus-srv-mgr/
http://www-01.ibm.com/software/tivoli/products/netcool-impact/
http://www-01.ibm.com/software/tivoli/products/
netcool-omnibus/
http://www-01.ibm.com/software/tivoli/solutions/
network-management/
Additionally, IBM Global Financing can help you acquire the
software capabilities that your business needs in the most
cost-effective and strategic way possible. We’ll partner with
credit-qualified clients to customize a financing solution to suit
your business and development goals, enable effective cash
management, and improve your total cost of ownership. Fund
your critical IT investment and propel your business forward
with IBM Global Financing. For more information, visit:
ibm.com/financing
© Copyright IBM Corporation 2013
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Produced in the United States of America
February 2013
IBM, the IBM logo, ibm.com, and Tivoli are trademarks of International
Business Machines Corp., registered in many jurisdictions worldwide. Other
product and service names might be trademarks of IBM or other companies.
A current list of IBM trademarks is available on the web at “Copyright and
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ITIL is a registered trademark, and a registered community trademark of
The Minister for the Cabinet Office, and is registered in the U.S. Patent and
Trademark Office.
1
ESG, “Research Report: North American Health Care Provider
Information Market Size & Forecast,” January 12, 2011.
2
Jackson & Coker Research Associates, “Special Report: Apps, Doctors
and Digital Devices,” July 2011. http://www.jacksoncoker.com/
physician-career-resources/newsletters/monthlymain/des/Apps.aspxB
3
Brian Dolan, “Survey: 71 percent of US nurses use smartphones,”
mobihealthnews.com, May 1, 2012. http://mobihealthnews.com/17172/
survey-71-percent-of-us-nurses-use-smartphones/
4
“ZON Multimedia,” IBM customer experience, December 20, 2012.
http://www-01.ibm.com/software/success/cssdb.nsf/CS/LWIS-8PQK92?
OpenDocument&Site=default&cty=en_us
5
Randy Perry, Eric Hatcher and Elisabeth Rainge, “Profitability and
OSS Support: A Return on Investment Analysis of IBM Tivoli Netcool,”
International Data Corporation, February 2009. http://www-03.ibm.com/
innovation/us/smarterplanet/global/pdfs/IDC_ROI_whitepaper.pdf
Java and all Java-based trademarks and logos are trademarks or registered
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