Need for Quality and Speed Powers Sentara's Applications Modernization Journey
Need for Quality and Speed Powers Sentara's Applications
Transcript of a BrieﬁngsDirect podcast on how a healthcare provider is deploying and
monitoring IT operations and services for better patient care.
Listen to the podcast. Find it on iTunes. Sponsor: HP
Dana Gardner: Hello, and welcome to the next edition of the HP Discover Performance
Podcast Series. I'm Dana Gardner, Principal Analyst at Interarbor Solutions,
your moderator for this ongoing discussion of IT innovation and how it’s
making an impact on people’s lives.
Once again, we're focusing on how IT leaders are improving their services'
performance to deliver better experiences and payoffs for businesses and end
users alike, and this time we're coming to you directly from the HP Discover
2013 Conference in Las Vegas. [Disclosure: HP is a sponsor of BrieﬁngsDirect podcasts.]
Our next innovation case study interview highlights how Virginia Healthcare provider Sentara
Healthcare improve its IT operations and services delivery at higher quality and higher speed.
We'll learn how it’s improving the IT service management (ITSM) maturity, making IT an
internal business-service provider, and how that’s helped them in deploying better
services, but also monitoring those services to oversee their applications’
To learn more about how Sentara Healthcare excelled at application and data
delivery and has progressed towards an automated lifecycle approach for high
performance management, please join me in welcoming our guest. We're here with
Jason Siegrist, he is Manager of Enterprise Management Technologies at Sentara. Welcome.
Jason Siegrist: Glad to be here.
Gardner: Let’s paint the picture. Apps, of course, are always important, but in your business,
healthcare, getting those apps so the people seems to be more important than in the past. Is there
a shift here, where the emphasis is on speed and access to data? How has the notion of an
application been changing for your users.
Siegrist: In Sentara Healthcare, and actually most healthcare organizations, the interest has been
trying to get to electronic medical records (EMR) to make it easier and to reduce risks associated
with caring for patients.
Patients are looking to get access to that data quicker, be able to see lab results in a timely
manner, and be able to schedule appointments with doctors. We're trying to make those systems
available to them in a secure way so that they're conﬁdent that their personal information is safe
Gardner: Of course, as end users, they just see the apps but there's a lot going on behind the
scenes to make sure that they are performing properly and that they get to where they are
supposed to be. Tell us why maturity and progressing towards better application culture and
behavior has been important for you.
Better healthcare decisions
Siegrist: In healthcare, the face of healthcare is still our doctors, nurses, and technical staff.
However, we're trying to make sure we can enable those doctors and nurses to
make better healthcare decisions and allow them to work interactively among
each other, even when they're not in the same building.
Our environment has grown so signiﬁcantly, even with things like X-rays being
all digital these days. Now, a doctor can go back and review case studies, without
having to wait to request those images and have them shipped. If someone is
sitting in their ofﬁce and they have an X-ray, they can go to priors very quickly.
So all these systems -- in Sentara there are about 17 of them -- have to be integrated in such a
way that we guarantee that their work being collected and going to the right patient, and at the
same time, when they're requesting information, they're getting the right patient data back.
Gardner: Those are the requirements, that’s the goal, but what about inside your IT
organization? How have you been able to change and adapt so that you can deliver these and
improve? What's the underlying shift internally.
Siegrist: Our big secret isn't really a secret anymore. Previously, every organization always
looked at IT as being a very expensive cost center. We've been working very hard internally to
change that discussion to be that we're enabling the business.
We've done that by doing some creative and unique processes. We bring in the pharmacist, for
example. We make him the owner of the pharmacy app. Now, we have direct buy-in from a
pharmacist who is a part of the IT process that selects the application and ﬁgures out how to
Through that process, he's able to act as our champion in the pharmacy space and talk to his
fellow pharmacists, saying "We have selected this, and I've been a part of that process." So, we're
involving them in the process, and at the same time, it's not an IT-focused or IT-forced initiative.
We really are enabling business.
Gardner: It’s impressive to me that you're doing this at signiﬁcant scale. Tell us a little bit about
Sentara, how big it is, how many apps you’ve got, the fact that you distributed over fairly large
geographic area in Virginia.
Siegrist: In the healthcare space, you measure it by hospitals. I think we're at 11 hospitals these
days. We're always looking to expand and grow. We're out on the western edge of Virginia in the
Blue Ridge Parkway area, as well as Hampton Roads and up to DC. So, we're in Virginia and a
little bit in North Carolina.
Having these maturities in these processes has enabled us to include the business in the IT
decisions. As we start building the monitoring, we start building the proactive analysis, in the
troubleshooting. Our mean time to repair has gone down. We support larger populations with
fewer staff, whether that's with internal systems or internal hardware. We built these automation
processes and we built these systems with the idea that we want to be as lean as possible, and at
the same time, deliver quality healthcare services.
Gardner: It’s impressive to me too that you have charted out a maturity roadmap for
yourselves and you've been in it for several years. Tell me where you evaluate yourself now and
where you came from.
Siegrist: Like anybody, this really is an organizational learning process as well as a cultural shift
and change. Several years ago, my boss, Betsy Meadows, had started the process about how we
want to deploy ITIL. It all started around measuring network performance.
Ultimately, that grew into the idea that in order to do that, we have to do with network
monitoring. We have to capture incidents and we have to capture that downtime, and by the way
there is downtime that’s legitimate because we are doing maintenance.
Then, we had to think about how to capture maintenance events as downtime? So this process
grew and grew. Over the last 8 to 10 years, we went from being very new in the process to where
we are today. This is something every company goes through as far as maturation process.
Today there is a scale out there. It says, 1-5. I’d say we are solidly 4-point something, if you do
the math. But we have adopted a lot of processes at level 5 and at level 4. It’s allowed us to make
smart decisions and make smart ﬁnancial decisions as well.
Gardner: What have been some of the important tools that you've used to get there and what do
you look to in terms of getting to that higher level of maturity? What are some of the ways that
technology can come to bear on that?
Siegrist: Well, the reality is the workforce. As more and more young people under the
workforce, they are coming with a predeﬁned set of skills. I'm still young at 40, but my son can
operate an iPad and he is three. He has no problems at all navigating that space.
The reality is that a younger workforce has an expectation of services and delivery. To that end,
we're trying to enable our customers to have the ability to go out and do some of these things
themselves. It's like an a la carte process, where they can say, "I want this level of monitoring. I
want my application monitor this way. I’d like to see this dashboard here."
The application performance management suite that’s available from a software-as-a-service
(SaaS) solution, has given us one more tool in our arsenal of solutions that allowed us to pass
that out to the customer and say, "If you want to go make your monitor and you have a synthetic
transaction or you want diagnostics-level knowledge about your application, here is a delivery
channel to do that."
Gardner: You're a big user of HP. Tell us a little bit about the Business Services Management
(BSM) suite, your involvement, and also the performance.
Siegrist: Ten years ago, we started out with Network Node Management (NNM), which is the
network monitoring solution, and then moved into Open View (OVO), which is now called
Operations Manager. So it’s been through several iterations, but over the last 10 years, we made
lots of decisions about what tools to use.
We've always tried to go with best-of-breed where appropriate, and it happens to be that for us,
the best-of-breed for us has been the HP solution set. It’s enabled us to get deeper into the
applications and given us multiple ways to solve different problems.
Nothing is free in life. So we always want to try and give our customers options for which path
they want to take and what level of the knowledge they want in the application space.
To this end, with the APM SaaS solution, it’s an operational expense. They don’t have to buy it
in whole. They don’t have to deploy everything. They can just start. So, as I said It's an a-la-carte
model. It let’s them just choose just a little or a lot, and then you can bite off the bigger pieces of
pie that they're willing to tolerate.
Gardner: How do these tools support your drive towards greater mobility and development of
applications so that there is a lifecycle where the development, the deployment, and then the
operations can relate to each other for a higher efﬁciency, productivity, and beneﬁt of the users?
Siegrist: Our customer base is interested in trying to have a way to interact with the doctors, and
as more-and-more tablets and PCs and smartphones hit the market, we're looking for delivery
solutions that provide that.
Our partner for our EMR is Epic. We use their solution for contacting and working with the
doctors. It's called MyChart, and that tool gives them the ability to do that. As more-and-more of
these devices get out there, the population gets younger. They have an expectation of service
delivery through that channel, and Sentara is working to meet that expectation. This gives us the
ability to monitor that application to make sure it's working properly.
Gardner: I visit the doctor from time-to-time. Are the doctors welcoming these technology
shifts? Has there been any change because you have been able to do this with delivery, services
orientation, and service bureau types of beneﬁts? Do you see a reaction in terms of their
acceptance of it?
Siegrist: Well, the value is that the face of customer care in healthcare is still doctors and nurses.
Where we often have run into problems is when you start doing things like transcription or
prescription order writing.
Today, the doctors are doing those themselves and they are documenting their own notes. There
was initially some pushback because it's different than what they were used to. The reality is that
they're able to make the notes and to do it very quickly, and they are able to review those.
Perception of savings
In the past, they had to go to a transcriptionist, and transcriptionist would type it. Then, they’d
have to validate what the transcriptionists wrote, so they really didn’t save any time through that
other process. All they had was the perception of time savings.
The adoption rate has been pretty high. Again, we have younger doctors hitting the market.
They're looking for similar types of behaviors, and it allows them to be able to provide better
customer service as well.
Gardner: You mentioned earlier that it’s about SaaS and the ability to pick and choose the type
of deployment model for your apps, services, and even infrastructure. Do you have any thoughts
about where you're heading in terms of more choice in hybrid or cloud models?
Siegrist: For most health organizations, and I'm probably in line here with my peers as well,
there's always a concern about HIPAA. We're trying to make sure that, as we move forward with
monitoring these things in the data landing in the cloud, we are protecting patient data. We are
moving tentatively into that space and doing a little bit at a time to prevent and avoid any risk
associated with patient data loss.
Gardner: Well, great. That makes a good sense, and I appreciate your spending some time with
us. We've been learning about how Virginia healthcare provider Sentara Healthcare has improved
its IT operations and services delivery for higher quality and speed, and we have seen how
Sentara gained an IT service management maturity and deployed monitoring dashboards to better
oversee and advance their applications.
Please join me now in thanking our guest, Jason Siegrist, Manager of Enterprise Management
Technologies at Sentara. Thanks, Jason.
Siegrist: Thanks, Dana.
Gardner: And thank you too to our audience, for joining us for this special HP Discover
Performance podcast, coming to you from the HP Discover 2013 Conference in Las Vegas. I'm
Dana Gardner, Principal Analyst at Interarbor Solutions, your host for this ongoing series of HP-
Thanks again for listening, and come back next time.
Listen to the podcast. Find it on iTunes. Sponsor: HP
Transcript of a BrieﬁngsDirect podcast on how a healthcare provider is deploying and
monitoring IT operations and services for better patient care. Copyright Interarbor Solutions,
LLC, 2005-2013. All rights reserved.
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