Opinion Article: Establishing the EMR Infrastructure

Dell Healthcare and Life Sciences EMEABy Renzo Taal, Director of Dell Healthcare and Life Sciences EMEA.
Since the launch of the Community eHealth Action Plan in 2004, the European Commission has encouraged member countries to move from paper-based to electronic medical records (EMRs). From 1990, research has been carried out by the European Community on the implementation and efficacy of eHealth, and by 2000 the concept of a unified European electronic medical information plan played a clearly delineated role in the Lisbon European Council's eEurope strategy.

While many countries have prioritized EMRs as fundamental to increasing the efficiency and reducing the cost of healthcare, digital patient information is also foundational to improving the coordination and management of patient care, of transitioning from episodic care to managing wellness and ultimately to the delivery of personalized medicine. To make this transition, GPs, hospitals, insurance providers and pharmaceutical companies must be able to access, exchange and analyze patient information and that process must start with the digitization of patient information at the point of care in the GP's office.

The drive for such a shift in record keeping and information management, however, does not come solely from the European Commission. The Obama administration's stimulus plan should boost US conversion to EMRs dramatically. Nevertheless, both Europe and North America share common challenges associated with accelerating the use of EMRs and sharing and managing the influx in data resulting from digitization.

Recent industry reports by Forrester and IDC highlight the slow up-take in healthcare digitization practices across hospitals and surgeries, noting that in the US, only 20% of healthcare providers have comprehensive EMR and computerised physician order entry (CPOE) systems. Cost and complexity have been the primary barriers to EMR adoption for GP practices.

Digitizing patient information is only part of the equation; we must be able to share and exchange data between healthcare providers and organizations. Sharing patient EMRs requires interoperable information systems within hospitals and across the healthcare system as a whole. Because of their central role, hospitals must prepare their data centres for the growth in digital data and to support interoperability within their four walls and intraoperability for information exchange across the healthcare system. Effective storage and management of patient data and improved IT processes via virtualization play large roles in the effective execution of ambitious e-health plans.

Additionally, the growing adoption of electronic health records systems and the steady accumulation of patient data at hospitals and GP surgeries place an ever-increasing demand on digital storage and associated security issues. Administrative data, such as patient addresses, billing and insurance details is incidental in comparison to the amount of medical data generated for each patient. Furthermore, there is the challenge of managing unstructured data like that from imaging and related tests. The average hospital generates between 60,000 and 500,000 new imaging studies a year requiring approximately 60 terabytes of storage. Hospitals must plan now how to manage and archive this information in the most efficient and secure manner possible. Thus, a new perspective on IT infrastructure is more critical than ever before.

Improving storage
A recent survey by Forrester1 investigated IT trends in hospitals across the US, highlighting the key challenges to managing storage in line with data growth. In particular, survey respondents cited EMRs and diagnostic imaging systems as the primary sources of growth in storage demand and also pointed to two activities - sharing and retention - as contributing factors. Forrester survey respondents expect their storage needs in 2012 to be roughly three-and-a-half times what they were in 2009. Half of the survey respondents reported to be in the building or planning stages of handling additional data demand and even those with active systems expressed they would be adding more departmental modules, clinical decision support engines, and quality reporting tools. Despite the availability of numerous storage solutions to manage increasing data demands, users indicated they struggle to determine which solution represents the best fit for their institution.

Moving towards electronic-based record keeping means that lab results, patient vitals, GP orders and notes, and medication data will require more IT storage capacity and a much higher and faster level of availability. For the 90% of patient information that is rarely accessed, secure, scalable, and affordable archival storage alternatives must be considered. Key recommendations derived from this research include using storage as a strategic healthcare resource that facilitates the management of organisational and technology complexity.

Virtualizing healthcare
Improving and simplifying data storage within a complex infrastructure can also be dramatically improved through virtualization. Additionally, the ability to access data quickly and securely when needed is not a simple feet and virtualization is central to enabling this process.

In its industry report, IDC2 explained how the increasing use of digital information in healthcare will undoubtedly change IT requirements within hospitals and across the healthcare system. Budgets for such expansion, however, remain small, and thus improving access to information at the point of care, and improving the productivity of IT and medical staff efficiency with client or desktop virtualization is an important tool to assist with growth challenges.

Dell's Mobile Clinical Computing (MCC) solution is a tool that addresses these virtualization needs, providing access to patient information at the point of care to medical clinicians and the benefits of virtualization to hospital IT staff. MCC's benefits of client and desktop virtualization along with additional features that reduce the time and effort necessary to access information from clinical systems enable better care and better outcomes. Clinicians can improve productivity by entering and accessing data as they move around the hospital. Single sign-on gives medical professionals fast and easy connectivity to numerous virtualized clinical applications across hospital systems - disparate data can be accessed from any location. The solution also secures data and applications in the data center and eliminates time-consuming desktop trouble shooting for the hospital's IT staff.

According to the IDC report, EMR and CPOE system adoption is estimated to increase from 20% at present to 50%-60% in the US by 2016. Such majority adoption will undoubtedly increase the load on hospital IT departments to offer support for the increasing use of technologies. Storage solutions will be critical for managing the increase in data, and virtualization of servers, storage and clients will be necessary in order to maximize the performance and efficiency of IT investments.

A solution such as Dell's MCC will be important to helps hospitals and healthcare providers achieve compliance with impending standards and improve business efficiency and patient care. Primary care trusts such as the mid-Yorkshire NHS Trust are adopting this solution to facilitate better management and use of clinical data. Electronic medical data is invaluable to patient treatment. Harnessing medical information digitally and managing it effectively with the help of storage and virtualization solutions will be the key to success.

A comprehensive IT infrastructure facilitating EMR data capture, storage and retrieval will undoubtedly contribute to more efficient patient care in the years ahead. The EMR will gain momentum as a critical tool in treating patients by offering patient information at hand whenever and wherever it is needed. Indeed, the future is looking bright for healthcare.

Related news articles:

About Dell Healthcare and Life Sciences
Today's healthcare CIOs are already dealing with the IT complexities of an overburdened healthcare system, yet the pressure on IT will only grow as the trend toward personalized medicine advances. While interoperability is the goal, most CIOs are struggling with intraoperability within their four walls - all while facing budget cuts. How do you solve the problems of today while preparing for the IT demands of tomorrow? Simply adding technology to the current system is not the answer. Health IT must be transformed, and Dell is leading the transformation with DellHealth.

For further information, visit www.dell.com/healthcare.

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