Of the many takeaways that have come from the Covid-19 pandemic, there are two that particularly stand out: the strength and resilience of healthcare workers — including those in IT — and the gaping holes in terms of scalability and agility.
“People in IT can accomplish anything. They can move mountains,” said John Kravitz, CIO at Geisinger Health System, during a recent webinar. “We had all these balls in the air,” but when Covid-19 hit — and the focus shifted to making sure systems were up and information was available — “they rose to the challenge.”
On the other hand, 2020 accentuated just how far behind healthcare is compared with industries like telecommunications. “They do things faster. They’re much more agile in their approach, and we need to be the same way,” he noted.
During the discussion, Kravitz spoke with Jim Brady, PhD (VP of Information Security & Infrastructure and CISO, Fairview Health Services) and Richard Entrup (Managing Director, 5G/MEC Strategy & Innovation, Verizon Business Group), on how healthcare organizations are working to get up to speed with 5G, network-as-a-service and other advancements; what the future holds; and why it’s still just as much about people as it is about technology.
Ready or Not
Although no one could have anticipated just how deeply Covid would impact healthcare, those who had tested the waters of remote work — including Geisinger — were better suited to manage the transition. According to Kravitz, the large IDN was able to move 10,000 workers home within a few days for two reasons: the infrastructure was already in place, and the organization had previously experimented with telecommuting during winter storms. Despite that, Kravitz was still “a little concerned” about how the network would handle the pressure over a long period of time.
He certainly wasn’t alone in that regard, Entrup noted. “Most organizations were not prepared for the extent of the impact on their systems.” Even those with solid disaster recovery and business continuity plans didn’t anticipate having to transition the entire workforce to remote.
The same held true for telehealth. Although some health systems had already begun their digital transformation journeys, most found themselves behind the eight-ball. At Fairview, the decision had been made to adopt a consumer-focused, SMAC (social, mobile, analytics and cloud) model prior to Brady’s arrival in April, but there was still a lot of work to be done.
In addition to the “lights on, doors open” tasks — which occupy a large chunk of bandwidth, even during non-crisis situations — Fairview had to quickly stand up a command center, all while dealing with a legacy network infrastructure. “We recognized that if we want to try to stay a step ahead, we needed to reduce the complexity of our network,” he added. “This accelerated our plans.”
From 5G to the Edge
Before disaster struck last March, Geisinger was also starting to modernize, with plans already in place to move its data centers to the cloud, according to Kravitz. “It will give us the agility to be able to response quickly and enable the business to turn on a dime like other industries have done.” He believes 5G coverage — which is working its way into rural Pennsylvania — will play a critical role in their digital strategy. “We can’t wait for it to get here. We have distributed antenna systems coming into our hospitals, and we’re doing a lot with different kinds of technology, so 5G will be welcome.”
Currently, Geisinger is using a number of technologies, including facial recognition to identify patients, and chatbots to send text messaging. “5G will only make that better in terms of speed and latency,” he said. They’re also leveraging geofencing, which integrates with Epic system to improve the registration process — and, subsequently, the consumer experience; virtual private networks to enable call center agents to connect immediately into the network; and edge computing to communicate with IoT devices and make sure data is analyzed and put through firewalls.
The foundation for all of this, he noted, is the organization’s cloud migration. Not only will it help the organization “become much more agile in supporting applications,” but it will reduce costs stemming from application support, hardware, and personnel.
At Fairview, many of these initiatives are in the exploratory phase as the organization looks to consolidate to a single data center, then migrate to the cloud, according to Brady. And although he believes 5G offers “very large capacity” to increase service levels, he has concerns with connectivity, which is often a struggle in facilities with thick, concrete walls. “It’s always been a problem, no matter what health system I’ve been in, when you get down into the basement and you’re trying to deploy secure text messaging.” As a result, physicians are forced to carry pagers, which come with their own set of challenges. Brady also has reservations about medical devices, some of which are “struggling to keep up with the WiFi,” he noted. “Getting them to be compatible is difficult. I’m hoping there’s forward progress.”
Changing the Game
According to Entrup, there is; Verizon recently increased its C-band spectrum holdings, which will enable it to expand 5G service across the country. Whereas the 5G ultrawide band operates at higher frequencies and can’t always penetrate walls, C-band has the ability to “fill in those gaps and provide currencies like high bandwidth, low latency and high density to address these issues,” he stated. One of the key advantages it offers over WiFi is “less contention on the network for people trying to get an address.” Another is security, particularly when it comes to private networks, one of Verizon’s core objectives.
While the term can take on different meanings, “we see private networking as the ability to take a 5G network or an LTE network, and bring it into your facility, so that you’re running your own cellular network within your premises.”
Edge computing, another key objective, refers to “the ability to integrate the infrastructure, compute, memory, and storage into the fabric of the network, and deliver an AWS cloud in your data center,” Entrup added. “It’s zero hops, which is how you’re going to get to zero to 30 milliseconds in latency.” Finally there’s network-as-a-service, which can enable healthcare organizations to provide “real-time self-service” by bundling services such as 5G, SD-WAN, and WiFi in a “seamless, frictionless way.”
All four components — 5G, private networking, edge computing and network-as-a-service — will play a critical role as organizations moved toward digital transformation. And although they’ve been limited by latency and bandwidth issues, Entrup believes that’s about to change dramatically.
“I believe we are about to see a seismic shift in technology adoption over the next five years that we have not seen in the prior 20,” he noted, with one of the main drivers being the newfound ability to download gigabits in seconds. “That’s going to be game-changing. It’s not just about downloading a Netflix video faster. It’s about the ability to handle large volumes of IOT devices. The ability to have smart cameras in the hospital, monitoring people, patterns, equipment, patients and data in real-time, and providing predictive analytics.”
For Verizon, preparing for that future means continuing to innovate and partner with technology companies, software vendors, and startups to “identify what this technology means,” he noted. “We’re very excited about it.”
“The Right People”
For healthcare leaders, it’s continuing to acknowledge that although technology and process are both critical components, neither are more important than having the right people in place, and providing them with the right guidance.
“In healthcare, we’re very mission driven,” noted Brady. “If you have the right people, they’re going to come together and figure a way to do things, whether they’re prepared or not.”
And whether they already had a full plate, which most IT workers already did, according to Kravitz, whose team went live with three Epic modules while dealing with Covid-19. “They put their heads down and did the work,” he added. “It’s our responsibility as leaders in IT to govern the demand management process and communicate with business owners” to ensure priorities are aligned with the organization’s strategy. That, in turn, will enable health system to “focus on the things that really do move the organization forward and differentiate us. And digital is the way.”
To view the archive of this webinar — Powering the Connected Hospital of the Future with 5G, Edge Compute, and Intelligent Networking — click here.