Are your systems and Asset or a Liability

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  • 1. PRESENTATION OVERVIEW § Hardware § Hardware § New Technologies § Software § Software Functionality
  • 2. ABOUT MEGeoff Boyce- Director at Precision IT-  Specialising in: -  Infrastructure design -  Backup and disaster recovery solutions -  Service delivery
  • 3. WHAT YOU NEED TO IDENTIFYEstablish your needs, not just now but in 5 years’ time?•  Key current requirements •  Mobility •  Multi Site •  Consolidation•  Business direction •  Growth Plans? •  Expansion into other specialties?•  Data storage •  Evaluate current data growth•  Data Compliance requirements •  Statutory, Internal •  ISO Certification etc
  • 4. PURCHASING HARDWARE3 Critical factors of choosing hardware-  White label vs. Mainstream Vendor (HP, IBM, Dell)-  Long term vendor support-  Quality of vendor support-  Proven hardware configurations-  Replacement part availability-  Time to Repair-  Capacity Planning-  Cater for the unexpected-  What are the expansion options-  Consider Performance-  Is the hardware suited to the implementation? -  Database server needs disk speed -  Storage server needs slower larger disks
  • 5. CAN VIRTUALISATION HELP?What is Virtualisation.Separation of the operating system (ie windows) from the physical hardware
  • 6. BENEFITS OF VIRTUALISATIONServer Consolidation-  Better hardware utilisation-  Run more with lessSmaller Footprint-  Reduce running costs with less hardware, less power, less cooling etc-  Reduced Hardware CostsFlexibility and Agility-  Easily run multiple operating systems,-  Simplify system upgrades-  Snapshot technology
  • 7. COMMON MISTAKESDon’t over consolidate-  Over utilisation leads to poor performance-  Larger exposure-  Give yourself breathing space!Make sure hardware is suitable-  Supports virtualisation-  Capacity to run multiple systems-  High speed hard disks etc
  • 8. IS YOUR PRACTICE REALLY PROTECTED?Q: How do you know your systems are protected-  Do you receive any reporting on the success of backup jobs?-  Is you backup data actually valid?-  Is your process suited to the media you are using?-  Does the human factor weaken your backup strategy?
  • 9. HAVE YOU EVER CONSIDERED …Recovery Time Objective- How long is an acceptable timeframe to recover from a server failure?Recovery Point Objective-  What is considered acceptable data loss?Cost Benefit Analysis- Understand how your expectations around recovery will impact cost
  • 10. COMMON PITFALLS OF A BACKUP STRATEGY§  Relying on copy scripts §  To complex §  No reporting §  Prone to failure§  Using desktop/basic backup software on servers §  No support for Database / email applications§  Relying on USB disks / USB dongles §  Most common component to die in a computer is the hard disk §  Moving parts, do not handle being knocked. §  Susceptible to heat / magnetic interference.
  • 11. BUSINESS CONTINUITY IS THE GOAL,DISASTER RECOVERY IS THE PLAN,BACKUP IS THE MEANS TO GET IT DONE.-  If you rely on backups alone, your practice is at risk-  Have a plan in place for difference levels of disasters, including: -  Database corruption -  Server failure -  Major disaster (theft, floods, fire)-  How will your practice continue? -  Temporary practice location -  New/Temporary equipment -  Turn around time
  • 12. ONGOING SERVICE A CRUCIAL ELEMENT TO ANY IT SOLUTIONSystem monitoring - Prevention is the key-  Detect problems before they become headaches-  Clear visibility to the health of your systemsUpdates / Hotfix Management-  Patch against system vulnerabilities-  Update Testing – parallel upgrades & failback strategy-  Version control (MIMS, Clinical/Practice Management Software – same versions)-  Technical Support-  Remote and onsite support levels-  Response and resolution times
  • 13. INVENTORY MANAGEMENTLicensing Maintenance-  Importance of being compliant-  Company Audits occurring more oftenInventory tracking-  Document your equipment-  Hardware lifecycle management, avoid impact of failures-  Procurement plans, suitable hardware (printers, scanners)
  • 14. ACCOUNTABILITY OF SERVICE PROVIDERS- Service Visibility - Don’t be blind to the health of your IT systems-  Decent issue tracking systems -  Issue prioritisation -  Show Assigned Resources -  Clearly defined case status -  Regular Communication / updates-  Clearly defined Service Level Agreements (SLAs) -  service levels should you expect from your providers -  Implications for not reaching targets-  Don’t be afraid to ask! -  Ask for service reports -  Backup failure reports -  Performance reports
  • 15. ABOUT MEGerard BuscombeDirector at Precision ITSpecialising in: §  New and emerging technologies §  Cloud computing §  Integration of Medical applications into the Cloud §  Mobility solutions for doctors.
  • 16. NEW TECHNOLOGIESSo what exactly is Cloud Computing?-  Online Applications - Web based application IE Google docs, Xero Accounting, SalesForce.-  Infrastructure as a service (IaaS) -  Hosted services such as Exchange email, online virtual servers (VPS) etc-  Storage as a service (SaaS) -  Storage providers and online backup solutions IE DropBox, Share file, SkyDrive-  Desktop as a service (DaaS) -  Access your complete desktop in the cloud IE Precision Cloud
  • 17. GENERAL BENEFITS OF CLOUD COMPUTINGHigher Service Availability-  Cloud services are delivered with availability targets-  Expect high service uptimeBuilt on large enterprise scale platforms- As service providers support many customers on the same hardware, systems are built on higher grade hardware, incorporate server and storage farmsSwitch Capitol Expenditure to Operating Expenditure- No more purchasing server hardware- Monthly subscription billing models- Follows the needs of your business
  • 18. USING CLOUD TECHNOLOGY IN MEDICAL PRACTICES Desktop as a service – most suitable for GPs and specialists -  Capable of running most clinical and practice management applications -  Scanning can be fully functional -  Pathology applications -  Cloud Services need to include: -  Software Licensing (all but clinical/PM software) -  Backups & DR Strategy. -  Technical Support Services. -  Service Level Agreement – At least 99% uptime guarantee! -  Increased ROI on equipment -  BYOD – bring your own device – Great for Locums and Part-timers. -  Extend the life of existing desktop equipment -  Bring windows applications to Apple devices and more -  Provides greater mobility for doctors -  iPad/Tablet Access in hospitals / nursing homes (printing can also be setup). -  Access from anywhere – 3G/4G wireless.
  • 19. CLOUD - QUESTIONS THAT NEED ANSWERSYour Data-  who actually owns my data if its stored outside of my business?-  Where is my data physically stored?-  If overseas, what legal implications does this pose?-  How private is my data?Internet Connectivity-  If its on the internet, will it be slow?-  What if my internet goes down?Backup and DR-  How is my data protected?-  What is the RTO and RPO?Support-  What support do I get with a cloud service?-  Will support cost me more?
  • 20. NATIONAL BROADBAND NETWORK + 4G WIRELESS NBN -  one of the largest infrastructure projects to be rolled out nationally. -  Will provide high-speed fibre optic access to 93% of Australian Premises, the remaining 7% to receive satellite and fixed wireless services -  Speed increases of up to 100 time faster than existing ADSL connections 4G wireless -  Speed increases of up to 5 times faster than existing 3G services -  Can achieve higher speeds than ADSL2+ in coverage areas
  • 21. NEW OPPORTUNITIES FOR MEDICAL PRACTICESTelehealth with NBN-  Go beyond the traditional geographical boundaries of your practice-  See patients who are unable to travel / are in remote locations-  Greater patient / doctor accessibility-  Increased patient care with better technologyMobility with Cloud and 3g/4g wireless- Increased access to information from mobile devicesDecentralise your practice- Doctors can consult from virtually anywhere-  Easily expand to new practice locations
  • 22. QUESTION & ANSWERSFeel free to interrogate me…
  • 23. SOFTWARE Cameron Jaffrey§  Development and Testing processes§  Software Architecture§  Data Security and Integrity§  Stability of Systems§  Hidden Costs
  • 24. MODERN SOFTWARE ARCHITECTURECompatibility with latest hardware and OS changes §  Virtualisation §  Cloud computing, both public and private §  Ongoing development with support for the latest Operating Systems and Database Engines §  64bit, large memory availability §  Modern language and techniques to leverage new emerging technologiesGreat opportunities for mobile computing §  Web service based communicationsEnhanced security §  No user access to databases required, all access via Web ServicesLeverage server Clustering for Load Balancing and High Availability
  • 25. DEVELOPMENT AND TESTING PROCESSESISO accreditationRigorous Release Management and Testing § ITIL; Information Technology Infrastructure Library § ISTQB; International Software Testers Qualifications BoardConsistency, personnel independent
  • 26. DATA SECURITY/INTEGRITYEnhanced security model § No users require direct access to databases, all access via Web Services § No need lock practice out of their own data § Unrestricted backup and DR optionsFinancial integrity; accounting standards § Financial transactions cannot be modified or deleted § True date based accounting § True Enterprise accounting model § Full audit trail of changes
  • 27. STABILITY OF SYSTEMS§ Enterprise grade § Enterprise grade Operating System, Database Engine etc. § Scalable §  Scale Up §  Scale Out§ Ease of system Maintenance§ Backup & Disaster Recovery Options
  • 28. HIDDEN COSTSLevels of serviceWho is responsible for installing updates § Monthly data updates § Periodic application updates § Reference data updatesSupport
  • 29. Software Functionality Carla Doolan § Identify the areas of potential risk § Understanding the processes § Automate processes using Action/To Do functionality § Continually improving and optimising your practice efficiencies § Goal – Minimising adverse events
  • 30. POTENTIAL RISK AREAS IN PRACTICES§ Recalls and Reminders§ Diagnostic result reviewing§ Referral Tracking§ Patient compliance with diagnostic test requests
  • 31. PROCESS DRIVEN ENVIRONMENTS Processes Processes Processes!! §  Define the purpose §  How to achieve this §  Expected outcome §  How to measure the outcome
  • 32. EXAMPLE OF A RECENT LITIGATION CASE§ HIV test§ Wrong address on recall letter§ Pathology result overlooked§ Incorrect information to patient§ Patient then infects partner§ Partner sues doctors§ Doctors sue practice§ in-hiv-test-mixup-20110520-1ewra.html#ixzz28sYUR9PT
  • 33. RECALLS + REMINDERS§ Prompts when making and appointment and linking the Recall /Reminder to the appointment§ Prompts when opening and closing the Health Record that a current Recall or Reminder is due§ Ability to automate recall processing, emails etc.§ Provide a list of non actioned Recall/Reminders§ Full audit available on status and when and who actioned recalls§ Recalls should remain on list until cancelled or complied.
  • 34. DIAGNOSTIC TESTS§ Track if your clinicians regularly review results using an alerts system§ Pathology and Radiology Audit§ Define your process for tests which are ordered and have not yet had results returned
  • 35. TASKS/TO DO’S§ Communication variables within a practice§ View or print the list of Actions/To Do’s§ Ability to assign Action or To Do to various staff§ Show a full audit of who has done what and when to that Action or To Do§ Prompts for clinicians if an action or to do is due when opening the Health Record§ Customise for each user§ Record every Action /To Do in patient record
  • 36. REFERRAL TRACKING§ Referrals – what is the process in your practices?§ Action or To Do feature?§ Can you audit this?§ Use the software to help your practice be proactive
  • 37. TO SUMMARISE….§ Software is more sophisticated and smarter now§ Optimise it to work for your business§ Audit your processes and setup§ Continual review and improvement plan in your organisation§ Remove the stress of adverse events occurring