In 2013, Alameda Health System (AHS), a large public healthcare system in Alameda County, California, committed to making major improvements to its outdated technology. This initiative was largely inspired by the appointment of a new CIO and CTO who were eager to manage, measure and improve system performance.
AHS, with more than 750 inpatient beds and 1,000 physicians, is spread over nine distinct physical facilities. It sees 20,300 inpatient admissions, more than 300,000 outpatient visits and some 127,000 emergency room patients annually. It incorporates Oakland’s only Level II adult trauma center, Highland Hospital, where the emergency room alone sees 90,000 patients each year.
The technological challenge in the healthcare environment is immense, and the needs of AHS are distinctly greater than those of organizations, even similarly large organizations, in other fields. The IT requirements are extensive to say the least:
• The systems must operate on a large scale in terms of both data storage and retrieval and in communications capacity.
• They must provide completely reliable, long-term data retention.
• They must incorporate state-of-the-art security in light of the sensitivity of patient data and the mandates of government frameworks like HIPAA.
• They must be fast. In an environment where seconds matter, speed is essential.
• The systems must always be available, 24/7/365, with no downtime for patches, upgrades or maintenance. System redundancy and ease of management are imperative.
• The system must be one that users, including clinical staff, will adopt, and deliver clear benefits to motivate users – users with multiple competing demands on their time – to embrace the technology.
• The rollout of any new system must be flawless.
• Communication systems must be robust. They must allow for the speedy transmission of large amounts of data – like medical imaging files– without
Advantel had an existing 15-year relationship with AHS, but its role was seen as limited. In the eyes of some at AHS, Advantel was simply the provider of a handset on their desk. In order to upgrade, AHS would have to rip and replace – essentially starting completely from scratch.
However, much of the power of the existing system had never been fully utilized, making the necessary upgrade within arm’s reach. This was largely due to Advantel’s capabilities of future-proofing the system when it was first installed.
When it became clear that the system had much more capability than expected, discussions turned to other aspects of the AHS technical infrastructure.
One example was Advantel’s ability to support AHS with their growing storage needs. AHS began analyzing storage vendors, and subsequently determined Nimble Storage was a better solution than its existing NetApp arrangement. AHS had budgeted for NetApp contract renewal, but it did not see new purchases as financially feasible. If AHS wanted to upgrade, NetApp offered a $200,000 head-end upgrade, but that change would necessitate 12 hours of downtime.
For AHS, that alone was a fatal flaw. In the end, moving to Nimble eliminated a $180,000 operating expense for annual NetApp support. With Nimble, AHS would get increased performance and increased diagnostic and maintenance capabilities, all without a second of downtime and all within budget – including a much more cost-effective service contract.
Advantel’s approach involved much more than equipment installation. Its engineers worked in conjunction with AHS staff every step of the way. Nimble was up and running in a single day, with servers moved to the new environment that same night.
The approach extended to the transition of phone service to Voice over IP (VoIP) and the implementation of remote technologies that would bring major improvements in performance and flexibility and significant savings for AHS.
In addition, Advantel’s role as the central provider of new capabilities allowed AHS to decrease its reliance on multiple vendors, a burden that had formerly taken up large amounts of AHS administrative time.
- The results of Advantel’s approach were cost-effective increases in performance and reliability. The system is more secure. Privacy is protected. Speed is increased. Users are happy, and they’re taking advantage of the system’s greatly enhanced potential.Since installation, four patches, in the form of regular maintenance upgrades, have been done. None have required downtime.The system is dramatically faster. In medical records, for example, with millions of scanned pages, access times dropped from five seconds to one second. That difference adds up quickly when spread over an institution the size of AHS.Where system bottlenecks had been hard to track down and equally hard to remedy, the new system is easy to monitor and diagnose. Clinicians simply won’t use a slow system, but that is no longer a concern as bottlenecks can be identified using tools to monitor SQL latency and access times, resolving bottlenecks as they occur.
With VoIP, staff can easily move locations without disrupting communications, and the number of technicians involved in any move is cut in half.
With the move to VoIP and the addition of Skype for Business, AHS has been able to move away from a system that required flying in technical consultants from all over the United States. Now, employees can work remotely, doing the jobs that once were done by consultants. As a result, AHS has saved $2 million in staffing costs.
“Advantel is an extension of my own department in many ways. They’ve been very easy to work with. As a customer, I don’t feel like I’m getting the slick sales guy that’s just really looking out for himself. I feel like they care about us and it’s a win-win. We have other vendors and partners. Some of them we’ve said our goodbyes to because it seems like it’s one-sided. They’re not really looking out for our best interest. Advantel understands what our mission is as a county hospital and clinic serving the community of Alameda County. I think they help embrace that mission with us.”
Nick Volosin, Chief Technology Officer for Alameda Health.