Are your systems and Asset or a Liability
- 2. PRESENTATION OVERVIEW § Hardware § Hardware § New Technologies § Software § Software Functionality
- 4. ABOUT ME Geoff Boyce - Director at Precision IT - Specialising in: - Infrastructure design - Backup and disaster recovery solutions - Service delivery
- 5. WHAT YOU NEED TO IDENTIFY Establish your needs, not just now but in 5 years’ time? • Key current requirements • Mobility • Multi Site • Consolidation • Business direction • Growth Plans? • Expansion into other specialties? • Data storage • Evaluate current data growth • Data Compliance requirements • Statutory, Internal • ISO Certification etc
- 6. PURCHASING HARDWARE 3 Critical factors of choosing hardware - White label vs. Mainstream Vendor (HP, IBM, Dell) - Long term vendor support - Quality of vendor support - Proven hardware configurations - Replacement part availability - Time to Repair - Capacity Planning - Cater for the unexpected - What are the expansion options - Consider Performance - Is the hardware suited to the implementation? - Database server needs disk speed - Storage server needs slower larger disks
- 7. CAN VIRTUALISATION HELP? What is Virtualisation. Separation of the operating system (ie windows) from the physical hardware
- 8. BENEFITS OF VIRTUALISATION Server Consolidation - Better hardware utilisation - Run more with less Smaller Footprint - Reduce running costs with less hardware, less power, less cooling etc - Reduced Hardware Costs Flexibility and Agility - Easily run multiple operating systems, - Simplify system upgrades - Snapshot technology
- 9. COMMON MISTAKES Don’t over consolidate - Over utilisation leads to poor performance - Larger exposure - Give yourself breathing space! Make sure hardware is suitable - Supports virtualisation - Capacity to run multiple systems - High speed hard disks etc
- 10. IS YOUR PRACTICE REALLY PROTECTED? Q: How do you know your systems are protected - Do you receive any reporting on the success of backup jobs? - Is you backup data actually valid? - Is your process suited to the media you are using? - Does the human factor weaken your backup strategy?
- 11. HAVE YOU EVER CONSIDERED … Recovery Time Objective - How long is an acceptable timeframe to recover from a server failure? Recovery Point Objective - What is considered acceptable data loss? Cost Benefit Analysis - Understand how your expectations around recovery will impact cost
- 12. COMMON PITFALLS OF A BACKUP STRATEGY § Relying on copy scripts § To complex § No reporting § Prone to failure § Using desktop/basic backup software on servers § No support for Database / email applications § Relying on USB disks / USB dongles § Most common component to die in a computer is the hard disk § Moving parts, do not handle being knocked. § Susceptible to heat / magnetic interference.
- 13. BUSINESS CONTINUITY IS THE GOAL, DISASTER RECOVERY IS THE PLAN, BACKUP IS THE MEANS TO GET IT DONE. - If you rely on backups alone, your practice is at risk - Have a plan in place for difference levels of disasters, including: - Database corruption - Server failure - Major disaster (theft, floods, fire) - How will your practice continue? - Temporary practice location - New/Temporary equipment - Turn around time
- 14. ONGOING SERVICE A CRUCIAL ELEMENT TO ANY IT SOLUTION System monitoring - Prevention is the key - Detect problems before they become headaches - Clear visibility to the health of your systems Updates / Hotfix Management - Patch against system vulnerabilities - Update Testing – parallel upgrades & failback strategy - Version control (MIMS, Clinical/Practice Management Software – same versions) - Technical Support - Remote and onsite support levels - Response and resolution times
- 15. INVENTORY MANAGEMENT Licensing Maintenance - Importance of being compliant - Company Audits occurring more often Inventory tracking - Document your equipment - Hardware lifecycle management, avoid impact of failures - Procurement plans, suitable hardware (printers, scanners)
- 16. ACCOUNTABILITY OF SERVICE PROVIDERS - Service Visibility - Don’t be blind to the health of your IT systems - Decent issue tracking systems - Issue prioritisation - Show Assigned Resources - Clearly defined case status - Regular Communication / updates - Clearly defined Service Level Agreements (SLAs) - service levels should you expect from your providers - Implications for not reaching targets - Don’t be afraid to ask! - Ask for service reports - Backup failure reports - Performance reports
- 18. ABOUT ME Gerard Buscombe Director at Precision IT Specialising in: § New and emerging technologies § Cloud computing § Integration of Medical applications into the Cloud § Mobility solutions for doctors.
- 19. NEW TECHNOLOGIES So what exactly is Cloud Computing? - Online Applications - Web based application IE Google docs, Xero Accounting, SalesForce. - Infrastructure as a service (IaaS) - Hosted services such as Exchange email, online virtual servers (VPS) etc - Storage as a service (SaaS) - Storage providers and online backup solutions IE DropBox, Share file, SkyDrive - Desktop as a service (DaaS) - Access your complete desktop in the cloud IE Precision Cloud
- 20. GENERAL BENEFITS OF CLOUD COMPUTING Higher Service Availability - Cloud services are delivered with availability targets - Expect high service uptime Built on large enterprise scale platforms - As service providers support many customers on the same hardware, systems are built on higher grade hardware, incorporate server and storage farms Switch Capitol Expenditure to Operating Expenditure - No more purchasing server hardware - Monthly subscription billing models - Follows the needs of your business
- 21. USING CLOUD TECHNOLOGY IN MEDICAL PRACTICES Desktop as a service – most suitable for GPs and specialists - Capable of running most clinical and practice management applications - Scanning can be fully functional - Pathology applications - Cloud Services need to include: - Software Licensing (all but clinical/PM software) - Backups & DR Strategy. - Technical Support Services. - Service Level Agreement – At least 99% uptime guarantee! - Increased ROI on equipment - BYOD – bring your own device – Great for Locums and Part-timers. - Extend the life of existing desktop equipment - Bring windows applications to Apple devices and more - Provides greater mobility for doctors - iPad/Tablet Access in hospitals / nursing homes (printing can also be setup). - Access from anywhere – 3G/4G wireless.
- 22. CLOUD - QUESTIONS THAT NEED ANSWERS Your Data - who actually owns my data if its stored outside of my business? - Where is my data physically stored? - If overseas, what legal implications does this pose? - How private is my data? Internet Connectivity - If its on the internet, will it be slow? - What if my internet goes down? Backup and DR - How is my data protected? - What is the RTO and RPO? Support - What support do I get with a cloud service? - Will support cost me more?
- 23. NATIONAL BROADBAND NETWORK + 4G WIRELESS NBN - one of the largest infrastructure projects to be rolled out nationally. - Will provide high-speed fibre optic access to 93% of Australian Premises, the remaining 7% to receive satellite and fixed wireless services - Speed increases of up to 100 time faster than existing ADSL connections 4G wireless - Speed increases of up to 5 times faster than existing 3G services - Can achieve higher speeds than ADSL2+ in coverage areas
- 24. NEW OPPORTUNITIES FOR MEDICAL PRACTICES Telehealth with NBN - Go beyond the traditional geographical boundaries of your practice - See patients who are unable to travel / are in remote locations - Greater patient / doctor accessibility - Increased patient care with better technology Mobility with Cloud and 3g/4g wireless - Increased access to information from mobile devices Decentralise your practice - Doctors can consult from virtually anywhere - Easily expand to new practice locations
- 25. QUESTION & ANSWERS Feel free to interrogate me…
- 26. SOFTWARE Cameron Jaffrey § Development and Testing processes § Software Architecture § Data Security and Integrity § Stability of Systems § Hidden Costs
- 27. MODERN SOFTWARE ARCHITECTURE Compatibility with latest hardware and OS changes § Virtualisation § Cloud computing, both public and private § Ongoing development with support for the latest Operating Systems and Database Engines § 64bit, large memory availability § Modern language and techniques to leverage new emerging technologies Great opportunities for mobile computing § Web service based communications Enhanced security § No user access to databases required, all access via Web Services Leverage server Clustering for Load Balancing and High Availability
- 30. DEVELOPMENT AND TESTING PROCESSES ISO accreditation Rigorous Release Management and Testing § ITIL; Information Technology Infrastructure Library § ISTQB; International Software Testers Qualifications Board Consistency, personnel independent
- 31. DATA SECURITY/INTEGRITY Enhanced security model § No users require direct access to databases, all access via Web Services § No need lock practice out of their own data § Unrestricted backup and DR options Financial integrity; accounting standards § Financial transactions cannot be modified or deleted § True date based accounting § True Enterprise accounting model § Full audit trail of changes
- 32. STABILITY OF SYSTEMS § Enterprise grade § Enterprise grade Operating System, Database Engine etc. § Scalable § Scale Up § Scale Out § Ease of system Maintenance § Backup & Disaster Recovery Options
- 33. HIDDEN COSTS Levels of service Who is responsible for installing updates § Monthly data updates § Periodic application updates § Reference data updates Support
- 34. Software Functionality Carla Doolan § Identify the areas of potential risk § Understanding the processes § Automate processes using Action/To Do functionality § Continually improving and optimising your practice efficiencies § Goal – Minimising adverse events
- 35. POTENTIAL RISK AREAS IN PRACTICES § Recalls and Reminders § Diagnostic result reviewing § Referral Tracking § Patient compliance with diagnostic test requests
- 36. PROCESS DRIVEN ENVIRONMENTS Processes Processes Processes!! § Define the purpose § How to achieve this § Expected outcome § How to measure the outcome
- 37. EXAMPLE OF A RECENT LITIGATION CASE § HIV test § Wrong address on recall letter § Pathology result overlooked § Incorrect information to patient § Patient then infects partner § Partner sues doctors § Doctors sue practice § http://www.smh.com.au/national/healthcare-giant-must-pay-300000- in-hiv-test-mixup-20110520-1ewra.html#ixzz28sYUR9PT
- 38. RECALLS + REMINDERS § Prompts when making and appointment and linking the Recall /Reminder to the appointment § Prompts when opening and closing the Health Record that a current Recall or Reminder is due § Ability to automate recall processing, emails etc. § Provide a list of non actioned Recall/Reminders § Full audit available on status and when and who actioned recalls § Recalls should remain on list until cancelled or complied.
- 39. DIAGNOSTIC TESTS § Track if your clinicians regularly review results using an alerts system § Pathology and Radiology Audit § Define your process for tests which are ordered and have not yet had results returned
- 40. TASKS/TO DO’S § Communication variables within a practice § View or print the list of Actions/To Do’s § Ability to assign Action or To Do to various staff § Show a full audit of who has done what and when to that Action or To Do § Prompts for clinicians if an action or to do is due when opening the Health Record § Customise for each user § Record every Action /To Do in patient record
- 41. REFERRAL TRACKING § Referrals – what is the process in your practices? § Action or To Do feature? § Can you audit this? § Use the software to help your practice be proactive
- 42. TO SUMMARISE…. § Software is more sophisticated and smarter now § Optimise it to work for your business § Audit your processes and setup § Continual review and improvement plan in your organisation § Remove the stress of adverse events occurring
- 43. QUESTIONS