Dana Gardner's BriefingsDirect: Need for quality and speed powers Sentara's applications modernization journey

Wednesday, October 9, 2013

Need for quality and speed powers Sentara's applications modernization journey

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The next edition of the HP Discover Performance Podcast Series highlights how Virginia Healthcare provider Sentara Healthcare has improved its IT operations and services delivery at higher quality and higher speed.

As part of its modernization journey, Sentara improved its IT service management (ITSM) maturity, making IT an internal business-service provider, and thereby deployed better monitoring of app services.

To learn more about how Sentara Healthcare excelled at application and data delivery and has progressed toward an automated lifecycle approach for high-performance applications management, join Jason Siegrist, Manager of Enterprise Management Technologies at Sentara. The discussion, which took place at the recent HP Discover 2013 Conference in Las Vegas, is moderated by Dana Gardner, Principal Analyst at Interarbor Solutions. [Disclosure: HP is a sponsor of BriefingsDirect podcasts.]

Here are some excerpts:

Gardner: Apps, of course, are always important, but in your business, healthcare, getting those apps so the people seems to be more important than in the past. How has the very notion of an application been changing for your users?

Siegrist: At Sentara Healthcare, and actually most healthcare organizations, the interest has been trying to get to electronic medical records (EMR) to make it easier and to reduce risks associated with caring for patients.

Patients are looking to get access to that data quicker, be able to see lab results in a timely manner, and be able to schedule appointments with doctors. We're trying to make those systems available to them in a secure way so that they're confident that their personal information is safe and protected.

Gardner: Tell us why maturity and progressing toward better application culture and behavior has been important for you.

Better healthcare decisions

Siegrist: In healthcare, the face of healthcare is still our doctors, nurses, and technical staff. However, we're trying to make sure we can enable those doctors and nurses to make better healthcare decisions and allow them to work interactively among each other, even when they're not in the same building.

Siegrist

Our environment has grown so significantly, even with things like X-rays being all digital these days. Now, a doctor can go back and review case studies, without having to wait to request those images and have them shipped. If someone is sitting in their office and they have an X-ray, they can go to priors very quickly.

So all these systems -- in Sentara there are about 17 of them -- have to be integrated in such a way that we guarantee that their work being collected and going to the right patient, and at the same time, when they're requesting information, they're getting the right patient data back.

Previously, every organization always looked at IT as being a very expensive cost center. We've been working very hard internally to change that discussion to be that we're enabling the business.
We've done that by doing some creative and unique processes. We bring in the pharmacist, for example. We make him the owner of the pharmacy app. Now, we have direct buy-in from a pharmacist who is a part of the IT process that selects the application and figures out how to integrate it.

We're trying to make sure we can enable those doctors and nurses to make better healthcare decisions.

Through that process, he's able to act as our champion in the pharmacy space and talk to his fellow pharmacists, saying "We have selected this, and I've been a part of that process." So we're involving them in the process, and at the same time, it's not an IT-focused or IT-forced initiative. We really are enabling business.

Gardner: Tell us about Sentara, how big it is, how many apps you have.

Siegrist: In the healthcare space, you measure it by hospitals. I think we're at 11 hospitals these days. We're always looking to expand and grow. We're out on the western edge of Virginia in the Blue Ridge Parkway area, as well as Hampton Roads and up to DC. So, we're in Virginia and a little bit in North Carolina.

Having these maturities in these processes has enabled us to include the business in the IT decisions. As we start building the monitoring, we start building the proactive analysis, in the troubleshooting. Our mean time to repair has gone down. We support larger populations with fewer staff, whether that's with internal systems or internal hardware. We built these automation processes and we built these systems with the idea that we want to be as lean as possible, and at the same time, deliver quality healthcare services.

Maturity roadmap

Gardner: It’s impressive to me too that you have charted out a maturity roadmap for yourselves and you've been in it for several years. Tell me where you evaluate yourself now and where you came from.

Siegrist: Like anybody, this really is an organizational learning process as well as a cultural shift and change. Several years ago, my boss, Betsy Meadows, had started the process about how we want to deploy ITIL. It all started around measuring network performance.

Ultimately, that grew into the idea that in order to do that, we have to do with network monitoring. We have to capture incidents and we have to capture that downtime, and by the way there is downtime that’s legitimate because we are doing maintenance.

Then, we had to think about how to capture maintenance events as downtime? So this process grew and grew. Over the last 8 to 10 years, we went from being very new in the process to where we are today. This is something every company goes through as far as maturation process.

As more and more young people under the workforce, they are coming with a predefined set of skills.

Today there is a scale out there. It says, 1 to 5. I’d say we are solidly 4-point something, if you do the math. But we have adopted a lot of processes at level 5 and at level 4. It’s allowed us to make smart decisions and make smart financial decisions as well.

Gardner: What have been some of the important tools that you've used to get there and what do you look to in terms of getting to that higher level of maturity? What are some of the ways that technology can come to bear on that?

Siegrist: Well, the reality is the workforce. As more and more young people under the workforce, they are coming with a predefined set of skills. I'm still young at 40, but my son can operate an iPad and he is three. He has no problems at all navigating that space.

The reality is that a younger workforce has an expectation of services and delivery. To that end, we're trying to enable our customers to have the ability to go out and do some of these things themselves. It's like an a la carte process, where they can say, "I want this level of monitoring. I want my application monitor this way. I’d like to see this dashboard here."

The application performance management suite that’s available from a software-as-a-service (SaaS) solution, has given us one more tool in our arsenal of solutions that allowed us to pass that out to the customer and say, "If you want to go make your monitor and you have a synthetic transaction or you want diagnostics-level knowledge about your application, here is a delivery channel to do that."

Gardner: You're a big user of HP. Tell us a little bit about the HP Business Services Management (BSM) suite, your involvement, and also the performance.

Several iterations

Siegrist: Ten years ago, we started out with HP Network Node Management (NNM), which is the network monitoring solution, and then moved into HP Open View (OVO), which is now called Operations Manager. So it’s been through several iterations, but over the last 10 years, we made lots of decisions about what tools to use.

We've always tried to go with best-of-breed where appropriate, and it happens to be that for us, the best-of-breed for us has been the HP solution set. It’s enabled us to get deeper into the applications and given us multiple ways to solve different problems.

Nothing is free in life. So we always want to try and give our customers options for which path they want to take and what level of the knowledge they want in the application space.

To this end, with the APM SaaS solution, it’s an operational expense. They don’t have to buy it in whole. They don’t have to deploy everything. They can just start. So, as I said It's an a-la-carte model. It let’s them just choose just a little or a lot, and then you can bite off the bigger pieces of pie that they're willing to tolerate.

The value is that the face of customer care in healthcare is still doctors and nurses.

Our customer base is interested in trying to have a way to interact with the doctors, and as more-and-more tablets and PCs and smartphones hit the market, we're looking for delivery solutions that provide that.

Our partner for our EMR is Epic. We use their solution for contacting and working with the doctors. It's called MyChart, and that tool gives them the ability to do that. As more-and-more of these devices get out there, the population gets younger. They have an expectation of service delivery through that channel, and Sentara is working to meet that expectation. This gives us the ability to monitor that application to make sure it's working properly.

Gardner: You mentioned earlier that it’s about SaaS and the ability to pick and choose the type of deployment model for your apps, services, and even infrastructure. Do you have any thoughts about where you're heading in terms of more choice in hybrid or cloud models?

We're trying to make sure that, as we move forward with monitoring these things in the data landing in the cloud, we are protecting patient data.

Siegrist: For most health organizations, and I'm probably in line here with my peers as well, there's always a concern about HIPAA. We're trying to make sure that, as we move forward with monitoring these things in the data landing in the cloud, we are protecting patient data. We are moving tentatively into that space and doing a little bit at a time to prevent and avoid any risk associated with patient data loss.