Guest Article: Is your network optimized for EMRs and large document traffic?

In the rush to install EMRs tech folks often forget that you need to make sure that your network can handle the (usually significant) load that medical records automation will add to your network infrastructure. I invited Jon Mills of of Plixer International, Inc., a Maine-based software development company that specializes in network traffic analysis using NetFlow and other flow-based monitoring technologies to talk about network optimization.  Here’s what Jon had to say about optimizing network traffic for EMRs:

As more and more healthcare facilities leave behind the decidedly un-green data storage methods of forms and files for a more 21st century approach, the importance of monitoring and managing that data flow has grown exponentially. Although the adoption rate of such paperless EHR (Electronic Health Record) systems has not exactly been staggering, the American Recovery and Reinvestment Act (ARRA) of 2009 may be enticing an ever growing number of healthcare organizations into taking advantage of this economic stimulus for the Healthcare IT industry.

In a facility like a hospital, many wired and wireless devices pass secure and often time-sensitive information. Traffic monitoring solutions are a necessity for keeping the congestion levels and bottlenecks to a minimum. If the staff can’t get the information they need immediately, it could be the patient who suffers.

Using flow-based technologies make it easier to implement traffic monitoring solutions. Cisco Systems’ NetFlow takes the important information about any given data exchange on the network and delivers the pertinent information about that conversation—which hosts participated in the conversation, how much data was passed, how long the conversation lasted, etc. Several other hardware vendors have introduced NetFlow or a variation of it into their switches, routers and, most recently, firewalls.

Using flow technologies to monitor the health of the network and watch for issues like congestion, bottlenecks, misuse and incorrectly configured hardware and software applications is much easier and more cost-effective than relying on more labor intensive packet analysis. While providing much of the same information, flow devices are typically already found on the network in the form of Cisco hardware, or some other supporting vendor.

Any Electronic Medical Record (EMR) system will certainly demand a good deal of bandwidth to stay at an acceptable level of speed and accuracy. Maintaining that level of available bandwidth starts with knowing how much bandwidth the organization has available to it and where that bandwidth is being dispersed. Just ask Stan DeFreese of Mercy Hospital, who uses a NetFlow analysis solution to receive and display his NetFlow data. “The solution sees disparate applications, top talkers and how much bandwidth each one is using—all from a much more detailed application/packet level perspective. It answers questions like ‘Which device is taking up bandwidth and utilization of application servers?’ Basically, it gives us a level of control and analysis that we’ve never had before.”

There will undoubtedly be times when extra details are required to solve a network issue. But once the high level pictures have been taken by the flow-based systems, a packet analyzer can go even deeper to get to the heart of the problem. Even in these situations, a NetFlow or sFlow application can help narrow in on the problem that much quicker.

Having a patient’s medical records at your fingertips in microseconds could realistically mean the difference between life and death. In a society based on instant gratification, these resources must be made available at little to no cost in effectiveness from past methods. Network latency and stability of course play into this. The healthcare IT organization that invests heavily (using government stimulus funds or not) in making the transition to paperless systems—without protecting the investment with some form of traffic monitoring system—is setting itself up for failure at the expense of its patients. Networks need health insurance, just like the rest of us.

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54 thoughts on “Guest Article: Is your network optimized for EMRs and large document traffic?

  1. Agreed: the large doc traffic, especially high res imaging and video, can be a bandwidth killer. It's something one of clients has struggled with (and they started with a good setup).

    The bottom line: you'd best plan on investing heavily in infrastructure to support your EHR. Adopting one without the other is a recipe for disaster.

    1. Since I am new to this blogging stuff, let me just comment. Four years ago when I designed our network, I put in CAT 6 everywhere with 1,000 gigabit HP switches and ran fiber between my data center and two wiring closets. Presently, we have our own endoscopy center and run digital images across the wire without a problem Do you think I will have a problem in the future?

  2. This article reads like an ad for NetFlow and fails to make a case for why NetFlow is a good product for healthcare. I have no doubts that Netflow is a good product (and my comment does not attempt to discredit NetFlow), but the points presented in here seems to be written by someone with only a fleeting knowledge of healthcare management and a remote passing reference of performance engineering. Both fields of research on their own.

    My concrete points is with the talk of requirements for speed in health. For many clinicians, the bulk of traffic count is of textual nature (though networks don't really care about content). This is not necessarily high in bandwidth demand, but requires low latency (i.e. the time before the first packet arrives). In fact latency and/or packet loss/errors is usually what people consider the biggest problems when stuff takes time.

    Waiting for an endoscopy video to transfer is usually okay, but waiting minutes for a login or medical history is not.

    What all this boils down to is that office-grade network is more than sufficient for most health applications and in fact, if the same precautions are taken as in serious office networking, health is no beast to tackle. This has been done for over 20 years elsewhere!

    One of the few exceptions is radiology and imaging, where the datasets are larger than what is common in a normal office environment. However, imaging is used in many other fields and health isn't especially unique here either. Additionally enterprise PACS can cater for architecture that can mitigate the requirements for high bandwidth by stratified storage and intelligent distribution of imagery.

    This is one of the poorer articles I've read at http://www.healthcareguy.com. Hope it will stay that way…

    1. Thanks for your note, Marius — I always strive for high-quality articles and getting slapped upside the head is most welcome if I've not met the bar so thanks for saying so 🙂

      On the article content itself, it's not really an ad for NetFlow (meaning it's not sponsored by Cisco nor in any way connected with Cisco). However, your point about not making the case why NetFlow is useful in healthcare is valid. So, let me expand — understanding NetFlow and how to use it for healthcare networks (or any others) is important for network professionals and many of my readers are business readers who run networks and they've been asking for advice on what subject areas they should have their IT people look at. So, it was more an introduction to why looking at Netflow is important.

      As far as performance is concerned, you're right that the bulk of total transactions are textual but that images take up most of the bandwidth; images and documents are often unaccounted for when planning the network so this article was about just thinking through and making sure your network is ready before you toss on new clinical applications into the mix.

      You seem to have good networking experience but there are many clinical networks running that have less experienced personnel so they can learn from someone like yourself. Are you interested in writing a guest article? I'd love to post it.

  3. November 1 2010

    what are some names of other companies that offfer this service.How often should a health organization update there flow base technology to prevent traffic congestion.

    Linda Barnes

  4. The solution sees disparate applications, top talkers and how much bandwidth each one is using—all from a much more detailed application/packet level perspective.

  5. I have no doubts that Netflow is a good product, but the points presented in here seems to be written by someone with only a fleeting knowledge of healthcare management and a remote passing reference of performance engineering.

  6. Well As more and more healthcare facilities leave behind the decidedly un-green data storage methods of forms and files for a more 21st century approach, the importance of monitoring and managing that data flow has grown exponentially…this is really a great post worth going through!

  7. Healthcare is  the  most important of life.Healthcare  open of  many hospital and provide many healthcare facilities.

  8. This article reads like an ad for NetFlow and fails to make a case for why NetFlow is a good product for healthcare.

  9. The papers relate to the security of using wifi connection products while generating. The New You are able to Times acquired the research from the Middle for Auto.

  10. IT(information technology is the technology which govern the communication and also business),Now -a- days the whole working of the marketing world,  huge industries are based on the IT.the networking and the communication are held by the many techniques like EMR,EHR.

  11. Many thanks for making the truthful effort to explain this. I feel very strong about it and would like to read more. If you can, as you find out more in depth knowledge, would you mind posting more posts similar to this one with more information.

  12. I came through your each publish and i understand so much from your each. You are professional. Now i am going to search for this website. 

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