Catering for a ‘New Normal’: Why Healthcare Needs to Rethink its Digital Infrastructure Strategy

In May 2020, just after the first wave of COVID-19, I was reading an interesting story regarding NSW Health, who found itself at the centre of Australia’s response. You could imagine it might have felt like the world was caving in for the public health body during the crisis, however it seems there was one area they knew they could rely on to ease the burden; the area of digital services.

That’s because NSW Health spent the five or six years preceding the pandemic investing in digital infrastructure, digitising existing applications and building a modernised hybrid multicloud architecture.

This enabled them to rapidly scale up their digital and remote tooling – to support a physical working exodus – and further lean on public clouds to cater for increased demands. The result was a “world-class” public-facing digital health services platform, spun up to full capacity shortly after COVID-19 hit.

NSW Health is more of the exception to the rule, rather than the rule itself. Historically the healthcare industry has tended to avoid cloud adoption and digital transformation due to data regulations and security concerns, creating limitations in security and flexibility. As hospital staff continue to work remotely and patients start engaging more digitally, the limitations of on-premise IT will continue to hold institutions back.

COVID-19 has driven a necessity for healthcare providers to embrace hybrid multicloud architectures, as they often deliver agility, flexibility and the greatest level of innovation.

Building smarter digital infrastructure

There are three main elements of digital infrastructure pertinent to healthcare providers, which are digital core, digital edge and digital exchange.

The digital core typically includes a multi/hybrid cloud architecture, which is often made up of six to eight different public or private cloud platforms. This approach allows flexibility to pick the right clouds for the right workloads and the ability to deploy and scale infrastructure on-demand.

By deploying their infrastructure adjacent to public cloud providers, healthcare institutions can establish direct and secure low-latency connections to all their preferred cloud partners. This will provide the innovation and flexibility of public cloud, whilst enabling them to retain performance-optimised private infrastructure to satisfy compliance obligations.

Secondly, healthcare providers are looking to extend their core capabilities through digital edge. Deploying infrastructure at the edge – closer to the users, patients, partners and devices – improves user experience and meets the low latency requirements of certain applications. Institutions can also scale their edge computing infrastructure to build local analytics capabilities, supporting local data management and analytics for real-time decision making. This drives operational efficiencies and improves patient care.

Sheraz Bhatti, CIO at cloud solutions provider 3verest (an Equinix partner that builds cloud deployments for healthcare providers), says edge and IoT are becoming increasingly important factors to consider in healthcare.

“Traditionally, as a cloud provider, we tried to do everything in the cloud,” Bhatti says. “Although we’re now finding some deployment types and projects where we’re actually sending IoT devices to our customers, which essentially act as caches and local buffers.

“There’s a heavy reliance on ultra-low latency, especially with imaging devices. In trauma cases, time is of the essence, so we’re providing local compute nodes to customers to offset some of the processing the central cloud would normally do, then feed that back to our cloud.”

The third and final aspect is around digital exchange, which is about developing a digital ecosystem strategy. API-based digital services and exchanges empower healthcare providers to innovate and collaborate and build new digital capabilities by tapping into these rich ecosystems.

By accessing a digital infrastructure platform with high density of connection to rich global ecosystems, healthcare service providers can innovate and generate new value.

Bhatti says healthcare solution providers who were traditionally competitors are even joining forces to take on joint procurement contracts.

“You’ve got companies who, in some spaces, may be complete competitors saying, ‘hey you’ve got a good voice recognition solution, you’ve got a great AI module and we’ve got a good picture and archive service, let’s come up with a rounded offering to provide customers with best-of-breed’,” he explains.

Transforming patient engagement models

Using this three-pronged approach (encapsulating digital core, edge, and exchange), healthcare institutions can ensure they’re keeping up with digital innovation and extending their strategic advantage while improving patient outcomes. This is of fundamental importance, as there has been a notable shift in how doctors and patients have been engaging with each other.

The pandemic has accelerated what were already rapidly shifting patient engagement and care models. Patients are more informed than ever, and this is creating a bit of a shift in the power dynamic. Digital health experiences have taken a preferred status for not only the savvy younger generations but also across the broader population demographics.

COVID-19 has even spurred older generations to become adept at using digital platforms where they weren’t before. Institutions need to realise that these shifts aren’t entirely temporary, and they will likely have permanent ramifications for their IT infrastructure.

“There’re challenges around network loads,” Bhatti says. “We have a radiology customer that rolled out a platform that puts the patients’ medical imaging in their own hands, so they can see it.

“We found that people were looking at these images repeatedly throughout the day because it was this interesting, new thing.  This obviously adds extra load to the network when you could have 10,000 users looking at imaging all at the same time.”

This shift isn’t totally patient-centric, either. Practitioners are also finding themselves fully kitted out and working from a home office, something that was previously unheard of. Bhatti recalls his work with a group of NHS trusts in the UK where radiologists were being sent home over the course of the pandemic, ultimately creating the ‘new normal’.

“There was a group of NHS trusts in the UK, where we had a small image-sharing network that we power for them,” Bhatti explains. “They had a finite number of radiologists working from home connecting to our cloud and reporting on diagnostic images for their hospitals.”

“There was originally supposed to be 30 radiologists working this way, but at the peak of the first wave of the pandemic we had to enable an additional 70 radiologists, and have them kitted out with full diagnostic workstations. They’ve now got almost all their radiologists working from home. This just wouldn’t have happened naturally at the start of 2020 without this crisis.”

These seismic shifts within the industry will not completely revert to a pre-covid state once the virus has been contained – eventually. Digital infrastructure enabled by core, edge and exchange components will not only enable healthcare institutions to effectively respond to dynamic trends, but also maintain a strategic advantage through continued innovation and collaboration.