Solutions for the rural healthcare technology gap

A recent Navigant report about the alarming number of rural hospitals in danger of closing attributes a large part of the problem to a technology gap. Rural hospitals are struggling financially, unable to make IT investments necessary to stay afloat. Other findings from the Navigant study include:

· Closure of 275 of the endangered hospitals—64 percent of the at-risk total—would represent a significant detriment to the health and economic well-being of the communities those hospitals serve.

·  Roughly 20 percent of Americans live in rural areas, including more than 13 million children, according to the last U.S. Census. Rural communities rely on these hospitals for essential healthcare.

· Rural populations are declining, but those that remain have more complex health needs and are more likely to be on government programs, meaning reimbursements are lower.

These issues leave rural hospitals in a tough spot if they don’t have the capital necessary to keep up with healthcare IT demands at a time when adoption of new tools is critical to survival.  The growing amount of data that hospital IT systems must process and analyze exacerbates the problem which includes information transmitted via electronic health records as well as that from the increasing use of advanced predictive analytics, precision medicine, and wearable devices.  A recent report from International Data Corporation suggest the volume of data processed in the overall healthcare sector is projected to increase at a compound annual growth rate of 36 percent through 2025, significantly faster than in other data-intensive industries.

Why IT systems start to drift

Processing and analyzing large amounts of data are dependent on the overall system’s input/output (I/O) performance, also known as throughput. Data analytics requires a computer system to access multiple and sometimes widespread databases, pulling information together through millions of I/O operations. The system’s analytic capability is dependent on the efficiency of those operations, which in turn relies on the efficiency of the computer’s operating environment.

In the Windows environment especially, I/O performance degradation progresses over time. This degradation, which can lower the system’s overall throughput capacity by 50 percent or more, happens in any storage environment.  This happens because Windows penalizes optimum performance due to server inefficiencies in the handoff of data to storage. As the storage layer has been logically separated from the compute layer and more systems are being virtualized, Windows handles I/O logically rather than physically, meaning it breaks down reads and writes to their lowest common denominator. This creates tiny, fractured, random I/O that results in a “noisy” environment that slows down application performance. When left untreated, these problems worsen over time.

The sensible solution

Even experienced IT professionals mistakenly think that new hardware will solve these problems. Since data is so essential to healthcare organizations, they are tempted to throw money at the problem by buying expensive new hardware. However, given the financial infeasibility of doing a major system upgrade, it is essential that cash-strapped healthcare organizations find ways to maximize the performance of their existing IT infrastructure.

Buying new hardware is not practical across the entire healthcare spectrum, let alone for beleaguered rural hospitals. This is a software problem that can be solved by software, substantially improving overall system throughput with no added investment in hardware. For example, when Indiana’s Hancock Regional Hospital implemented a software solution it was able to improve response time by 67 percent, eliminating slow data loads and sluggish applications without changing the hardware infrastructure.

Hancock Regional’s IT center supports a large user base accessing MEDITECH software and was experiencing an unacceptable level of data loading delay which prompted IT management to consider an upgrade in storage area network hardware. On the advice of MEDITECH support, however, the hospital opted instead to implement a software solution that automatically and transparently increases the throughput of Windows-based platforms. Here’s what’s important to remember: While additional hardware can temporarily mask IT degradation, targeted software can improve system throughput by 30 to 50 percent or more and should be part of the IT toolkit for any large-scale healthcare organization.

Rural hospitals face many challenges, and their IT systems are at the forefront.  Improving systems performance economically could help to enhance service significantly while contributing to the organization’s overall survival plan.