How Sentara Healthcare is Treating the Surge in Telemedicine

SD-WAN and multicloud is just what the doctor ordered

Tim Waters
Matt Douglas
How Sentara Healthcare is Treating the Surge in Telemedicine

Some great digital solutions for physical problems are just ahead of their time. That was the case with telemedicine. In the late 1960s, NASA and the Nebraska Psychology Institute proposed a project to use telecommunications services to deliver healthcare services to geographically disadvantaged and medically underserved populations, as well as monitor astronauts’ well-being in space. However, the communications technologies and government regulations at the time made wide-spread telemedicine deployment unfeasible.[i]

Even as recently as October 2019, only 10% of U.S. patients surveyed by J.D. Power were using telemedicine services.[ii] That has changed drastically since the beginning of this year as the COVID-19 outbreak has driven unprecedented demand for telemedicine services, with some healthcare providers being caught unprepared to handle the sudden surges in patient usage.

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One progressive U.S. healthcare provider, Sentara Healthcare and Optima Health, was prepared for the two-week 1,455% increase in its patients’ telemedicine usage in April 2020. The Virginia-based healthcare provider had proactively built a robust SD-WAN and hybrid multicloud foundation to integrate its network of 12 hospitals and 300 care centers on Platform Equinix®. As a result, Sentara’s chief enterprise architect, Matt Douglas, said that seamlessly handling its increased patient load in response to the pandemic was just “second nature.”

I recently spoke with Matt about how he and his IT organization were able to meet this new challenge head-on and he shared with us where he is today in his digital transformation journey.

Matt, Sentara Healthcare has a pretty interesting history. Please share a bit of it with us.

Sure, Tim. Sentara Healthcare is a U.S. non-profit healthcare provider that has been around for over 125 years. It was founded in 1888 as a 25-bed retreat for patients in Norfolk, Virginia. Sentara has since expanded to include 12 acute care hospitals and 300 care sites across Virginia and into North Carolina. Sentara also owns Optima Health and other insurance providers, which deliver affordable health insurance to individuals, families and businesses.

What did you want to achieve with your IT infrastructure when you first came to Sentara?

Two years ago, we had a lot of siloed IT at Sentara, whether it was systems, data, applications or the cloud. Since then, we’ve merged those silos into a cohesive, integrated IT infrastructure on Platform Equinix that leverages virtualization, SD-WAN and the cloud for all our business operations. We also consolidated our physical patient records to EPIC electronic medical records (EMR) and are in the process of integrating approximately 22 other EMR systems together.

What are some examples of the digital transformation initiatives that allowed you to consolidate your IT?

I’m a huge proponent of hybrid multicloud. So, we set out on a strategy to move 100% of our business operations to the cloud. A significant part of that digital transformation was moving our on-premises, web-based EPIC EMR and other EMR systems to Platform Equinix. This helped facilitate the secure transfer of patient data to the cloud for data analytics and disaster recovery. Equinix was a key partner in getting us connected to Microsoft Azure via Equinix Cloud Exchange Fabric™ (ECX Fabric™), so we could transfer our data into our data analytics platform. And we’re using those insights to achieve better patient outcomes.

We also leveraged ECX Fabric to connect Alexa personal assistants in our patient rooms to AWS, which has helped us to achieve better patient metrics and also better patient care. There is actually a backlog in our hospitals for those Alexa rooms.

How has moving your IT infrastructure to Platform Equinix benefited your back-office operations?

Leveraging ECX Fabric gives us the ability to connect to cloud- and SaaS-based applications within days versus weeks or months. We’ve also centralized our VMware VeloCloud SD-WAN backbone that connects our 12 hospitals and more than 300 care facilities back to Equinix, which has significantly lowered our latency and improved our resiliency. Working with Equinix over the years, I’ve seen application response times go from 20 milliseconds down to four milliseconds. That’s a huge reduction in latency! And if a network connection were to go down, we wouldn’t lose a single hospital because we are now using a network peering model. But I have to add that since we’ve been on Platform Equinix, we haven’t had a single outage because we’ve gotten rid of the third-party networks in the middle that could potentially go down.

During the recent pandemic, I understand you’ve had a significant increase in the demand on your telehealth and patient portal platforms. What’s that been like?

It’s been incredible and I really think the waiting rooms in hospitals and doctors’ offices are going to be a thing of the past. In just two weeks, we went from 75 providers on our telehealth platform to 2,000. Pre-COVID-19, we may have had 90 total telehealth appointments, but when COVID-19 hit, we had 1,400 patient appointments over two weeks. Most telehealth applications have wait times of up to 4 hours but our patients have no wait times at all.

We’ve also seen up to 60,000 visitors per day accessing our Sentara and Optima Patient Portal via the mobile app to view patient records, billing, insurance and test results. We are seeing 500% more demand from home interconnectivity over our network to that portal. If the global players like Equinix were not in this world, healthcare organizations like ours would not have been able to withstand this epidemic.

What advice do you have for other healthcare organizations in terms of reinforcing their IT infrastructures for today’s and tomorrow’s challenges?

I would tell them to invest in interconnection and cloud sooner than later. Also, I’ve been fortunate to work with great people and great partners over my career. And when you partner with a company like Equinix that also partners with some of the biggest companies in the world, such as AWS, Microsoft and VMware, then scaling up to meet the challenges we’ve faced with the pandemic becomes second nature.

To learn more, go to Digital Healthcare Playbook.

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[i] US National Library of Medicine National Institutes of Health “Crossing the Telemedicine Chasm: Have the U.S. Barriers to Widespread Adoption of Telemedicine Been Significantly Reduced?” – December 2013.

[ii] J.D. Power, “Telehealth: Best Consumer Healthcare Experience You’ve Never Tried, Says J.D. Power Study,” October 28, 2019.

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Tim Waters Sr. Manager, Equinix Research Group for FED, SLED & Healthcare and Life Sciences
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Matt Douglas Guest Author: Chief Enterprise Architect for Sentara Healthcare & Optima Health
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