Mobile technology in healthcare has the potential to make caregiving more convenient for providers. Organizations with cloud-based EHRs and patient information systems — often known as "bring your own device" systems — enable clinicians to use their own personal devices, such as smartphones, tablets and laptops, to access a hospital's clinical information from wherever they are, whenever they need. While this supports an increasingly mobile physician workforce, it also introduces new security risks when a physician's device is lost, stolen or hacked.
One way healthcare providers are strengthening the security of their mobile-enabled IT systems is through virtual desktop infrastructure solutions and hyperconverged technology infrastructures.
John Reeves, solutions development manager of the Data Center for Analytics & Security at Lenovo Health, Andrew Bartley, senior solutions architect for the Health & Life Sciences Group at Intel Corporation, and Adam Sherwood, enterprise data architect at Covenant Health in Tewksbury, Mass., discussed the reemergence and advantages of VDI solutions in healthcare during a webinar hosted by Becker's Hospital Review April 12.
What are VDI solutions?
VDI solutions and cloud solutions use different means to connect digital technologies to clinical and hospital databases. Cloud technology gives end-users remote access to their organization's clinical information systems through a cloud service, which can be accessed through "thin clients" — mobile devices such as laptops, tablets or smartphones.
VDI solutions, on the other hand, use an on-site or cloud-based data center to host an organization's files, data and applications. This means that instead of logging into a cloud service and bringing up a personal user profile stored on the cloud, VDI allows end-users to access a simulated version of the desktop through whatever mobile device they choose. Changes made to the desktop on the mobile device are saved in real-time to the original desktop, and vice versa.
While the technical differences between cloud and VDI technology may seem minor to non-IT professionals, these differences directly affect IT security, interoperability and costs. Specifically, VDI solutions allow providers to continue to use and enjoy the convenience of their mobile devices, but with a greater level of security and at a reduced cost to the organization, according to Mr. Bartley and Mr. Reeves.
Healthcare trends driving VDI adoption
Mr. Bartley outlined three reasons why healthcare systems express interest in VDI solutions.
The need for mobility in collaborative medicine. Having reliable and secure access to EHR and patient data via mobile technology is key in team-based medicine, especially given the increasingly mobile nature of today's clinicians and the evolution of the ACO model, which holds multiple, independent healthcare organizations equally accountable for resource utilization, outcomes and costs.
"The new healthcare workflow requires access to patient data in a digital way on many different devices, in many different places and increasingly with a mobility component to that," Mr. Bartley said.
The importance of seamless access to EHR data across an array of mobile and on-site technology platforms cannot be understated. Rapid consolidation among healthcare entities means different care locations typically have different IT policies and legacy systems, most of which cannot easily connect or share information and are expensive to replace or update. The same is true of ACOs, as they consist of multiple independent organizations.
Cloud services can support team-based care by allowing different end-users to connect and share information by logging in to a cloud platform using different technology systems. But cloud services leave something to be desired in terms of security and compliance.
Mobile technology and the rise of cyberthreats. Providers' increased use of mobile and cloud technology in care has unintentionally contributed to the recent rise in data breaches. The greater number of 'devices at the edge' — mobile or handheld devices connected to an organization's IT systems — has increased the digital 'surface area' through which malicious users can attack or breach an organization's security, according to Mr. Bartley.
The accelerating adoption of digital and mobile technology in healthcare has been linked to increased reports of data breaches by a range of health providers, including payers, hospitals and physicians groups. HHS found nearly 1,800 large data breaches involving at least 500 patients' information occurred between 2009 and 2016, according to a 2017 study in JAMA Internal Medicine.
Besides risking patients' safety and finances, data breaches also have substantial financial repercussions for health systems. "A single data breach costs a healthcare organization $4 million on average," Mr. Bartley said.
Finding ways to fortify patient information systems against cyberthreats is strategic priority for hospital IT leaders, especially as they consider opening new lines of communication and data sharing with external and unaffiliated entities. VDI software has two key functions that can enhance data security: a centralized data center and virtual private networks, according to Mr. Reeves.
Multientity healthcare organizations typically install a server at each of their care settings. IT security employees are challenged with the complex task of managing and protecting patient information across multiple servers at different care sites at the same time. On the other hand, VDI solutions use a centralized data center, either on-site or in the cloud, to manage and store information for the entire enterprise. Rather than installing multiple servers at different locations, VDI would enable a 4-hospital system to use a single server for all of its patient information, data and applications. "This allows an organization to have much better control over their information," Mr. Bartley said.
VDI solutions can also use virtual private networks to connect end-users to the virtual desktop through their mobile devices. VPNs create an encrypted connection for end-users to access files over a less secure network, such as the internet. To ensure security, data travels through secure channels VPN users must provide authentication to access. The benefit of using a VPN is that it ensures the appropriate level of security to the connected systems when the underlying network infrastructure alone cannot provide it. The benefit of using VDI and a VPN together is that the organization achieves a higher level of security.
Pressure to reduce IT costs. VDI uses hyperconvergence infrastructure technology, which is a software-based architecture that collapses computing, storage, networking and virtualization capabilities within a single hardware system, according to Mr. Reeves.
Hypercovergence can help healthcare organizations save substantially in terms of IT expenses. Traditionally, an organization expanding to a second location would have to install additional servers in the satellite location and use a VPN to keep the servers between their two locations in sync.
VDI reduces the need to purchase new hardware and lowers administrative costs since the central desktop is easier to maintain. Furthermore, VDI allows end-users to connect to the desktop using their personal devices. This reduces the need for hospitals to invest in, update and provide devices for clinicians across care sites.
VDI solutions in action: Measurable effects on cost, productivity
Adam Sherwood, enterprise data architect at Covenant Health, has led many organizations through VDI implementation in the last decade. He shared some of the benefits he has witnessed healthcare organizations experience after implementing VDI solutions.
Mr. Sherwood first discussed how hospitals achieved cost savings by either reducing or avoiding the need for IT spending. Specifically, VDI allowed organizations to extend their IT asset lifecycle, cutting down on IT expenses over time.
"We cut the [operating expenses budget] commitment by $800,000 a year. ... That happened due to the devices having a lower unit cost in terms of PCs versus clients and because we got a longer lifetime out of existing PCs rather than replacing them...instead, we repurposed them," Mr. Sherwood said.
Besides financial benefits, Mr. Sherwood said organizations have also seen increases in clinician efficiency and productivity using VDI software. Giving clinicians the ability to instantly access a desktop from various clinical areas is a foundational need for most healthcare organizations. In a non-VDI environment, physicians moving through different clinical areas must spend seconds and minutes logging in and out of different computers and other devices. Added together, a physician's overall time spent logging in and out can be substantial and negatively affect their productivity, Mr. Sherwood said.
VDI helps to make the clinical workflow efficient. By centralizing data and access controls, physicians go through fewer sign-on and authentication processes as they move between different clinical areas.
"We almost didn't believe it. It was our absolute best-case scenario, and data outright supported it," Mr. Sherwood said. "Doctors and nurses increased productivity by 20 percent, mostly due to faster logins, faster application launches and the ability to reconnect to a disconnected session, [which means] it reduced the number of times they had to login each shift."
Conclusion
Mobile technology in healthcare is a major force helping clinicians collaborate across organizations. The use of cloud-based and on-site VDI can play a key role in supporting team-based care while helping to rein in IT department expenses, mitigate risks of HIPAA violations and improve clinician productivity.
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