Medical imaging and document management in hospitals both represent challenging use cases for cloud deployments. Why? Traditionally there have been two reasons:
- Their information systems are highly regulated.
- Their legacy information systems exist as distributed IT silos.
These silos were often built to satisfy the use cases for specific departments. Distributed silos make it difficult to comply with government regulations. It also makes it nearly impossible to broadly communicate institutional policies and procedures (IPPs). Each IT silo might provide a customized document workflow configuration, but the hospital as a whole runs the risk of violating various government mandates.
One of EMC’s customers (MD Anderson) faced an even more complex problem: individual departments began outsourcing their IT needs to cloud service providers. Their CIO realized that the best way to comply with regulations and satisfy audits was to bring everything back in-house and attempt to consolidate into a private “document cloud”. This document cloud had two fundamental requirements:
- The ability to centrally ingest, manage, and audit documents at massive scale (with high availability).
- The ability to offer customized workflow portals to each department.
MD Anderson is building their internal cloud offering using Documentum ECM (Enterprise Content Management) as their foundational content repository, and Documentum xCP as their multi-tenant customization strategy. To date the hospital has already implemented several use cases.
The Compliance Department
One of the first departments to reap the benefits of the new architecture was the Compliance Department responsible for the management and communication of hospital policies and procedures (IPPs). The old system was a legacy Lotus Notes configuration that lacked lifecycle capabilities and automatic routing (for review and approval). The department was able to leverage Documentum’s central repository and also use Documentum xCP to create their own “look and feel” for their workflow.
In addition, they created a centralized portal with efficient search capabilities for roughly 10,000 users. These users now have one location on the MD Anderson intranet to find the most up-to-date policies (via a shared IT infrastructure). In addition to the improved user interface and centralized IT, the system achieves one of the overriding goals of the new architecture: auditability.
Electronic Medical Records
The challenges of storing and securing patient EMRs had caused MD Anderson to outsource document management to a hosting provider at considerable cost. In addition to the yearly hosting fees, access to these critical records was at the mercy of external internet connectivity. A shared, private document cloud offered the ability to not only cut costs but to improve the availability of mission critical access to patient records.
MD Anderson migrated 75 million outsourced documents and images into their private document cloud.
The next step was to create a customized workflow portal for the internal scanning of new documents and records. For this task they created customized xCP workflow via an integration with EMC Captiva. This solution handles 60,000 documents per day (Captiva is fast).
The in-sourcing to a shared private document cloud also satisfied the privacy requirements required by HIPAA and strengthened their ability to satisfy an audit. The cost savings in hosting fees totaled nearly $2 million.
Clinical Research
MD Anderson has been ranked (U.S. News and World Report) as the top hospital in the nation for cancer care. One of their departments captures and stores the medical records of patients enrolled in clinical trials. This research center is one of the lead protocol investigators for these trials. They create medical guidelines for new treatments.
The customization for this particular department involved the integration of Documentum xCP with a fax server. The workflow is also customized to meet with FDA regulations for tracking and auditing clinical data.
Hospital Facilities Department
Yet another group that has leveraged the document cloud is the engineering team that manages changes to the facility itself. The MD Anderson facility occupies nearly 11 million square feet. Without a central document repository, the engineers had to hire outside consultants to redraw their blueprints any time a change to the facility was desired. Through a partnership with McLaren, the hospital now centrally stores all blueprints for the facility, and has created workflow software to make changes and approvals to said blueprints.
Design For Audit
One of the tougher aspects of multi-tenant private clouds is the creation of the “uber-GRC” tool that can govern the sea of bits on a per-tenant basis.
What I find interesting about the MD Anderson use case is that tenants, through the use of Documentum xCP, can design their auditing workflows in parallel with solving their business problem.
If you’d like to dive further into this use case, the writeup can be found here.
Steve
Twitter: @SteveTodd
