Data Storage/Data Management

May 22, 2014

Data Warehousing

Three things healthcare CIOs should know about data warehouses

By Larry Grandia

For the past decade or so, healthcare technology has taken off on a breathtaking sprint to integrate electronic health records and automate essential operational information systems. Today, the goal for most health system CIOs is to produce an analytics capability that will ensure survival in the new healthcare reform environment, including value-based purchasing.

In the race of IT initiatives, it’s easy to lose sight of priorities. Building an enterprise-wide analytics platform should be one of these priorities. It will be a challenge for healthcare CIOs, but it’s a challenge organizations can meet with the aid of a data warehouse.

Here are three things CIOs should know about data warehouses and the imperative that technology brings:

  1. BI/data analytics will be one of, if not the most, compelling IT initiatives in healthcare during the coming decade. Getting started now on a foundational platform will be critical to getting out and staying out in front of this emerging, critical business imperative.
  2. There are critically important reasons why your organization needs an enterprise-wide solution to its analytics needs (as opposed to numerous, single-point solutions). Simplicity in architecture, coupled with lessened resource consumption amid constantly expanding analytics demands, dictates that CIOs implement an enterprise data warehouse (EDW). An EDW minimizes redundancy and isolates reporting to a single source of truth.
  3. Achieving early ROI necessitates a late-binding (highly flexible) data warehousing environment, coupled with a “cleanse your data as you go” operating philosophy. Early ROI will ensure on-going organizational support for the EDW and will facilitate organizational compliance to an enterprise-centric solution.

While CIO at Intermountain Healthcare for more than two decades, I witnessed the automation of a remarkable number of systems and processes. I also realized the need for a flexible EDW fed by operational systems and coupled with advanced analytical tools. This analytics approach yielded insights and allowed us to harvest improvement knowledge. Sharing this knowledge system-wide with clinicians and management, and imbedding this knowledge back into operational systems, took us down a path of real and documented cost, quality and access improvement.

While healthcare technology and the analytics imperatives of healthcare reform advance into the future, CIOs with the foresight to start their data warehouse initiatives sooner, rather than later, will position their healthcare organizations for a successful, efficient transition to value-based care.

Larry Grandia led IT functions for Intermountain Healthcare, Inc. for more than two decades and was Chief Technology Officer of Premier, Inc. before his retirement in 2011. He currently serves on the Board of Directors of Health Catalyst.

Security

Nine key cyber threats identified in Verizon data breach report

Ninety-two percent of the 100,000 security incidents analyzed by Verizon security researchers over the past 10 years can be traced to nine basic attack patterns that vary from industry to industry. That’s the big takeaway from Verizon’s “2014 Data Breach Investigations Report” (DBIR) published this May.

The DBIR identifies the nine threat patterns as: miscellaneous errors such as sending an email to the wrong person; crimeware (various malware aimed at gaining control of systems); insider/privilege misuse; physical theft/loss; Web app attacks; denial of service attacks; cyber espionage; point-of-sale intrusions; and payment card skimmers.

In the healthcare sector, 46 percent of security incidents were the result of lost or stolen assets, with physical theft and loss of assets occurring most often in the office – not from personal vehicles or homes. Insider misuse was the second-biggest threat.

Other key findings in the report include:

  • Cyber espionage is up again in the 2014 report, representing a more than three-fold increase compared with the 2013 report, with 511 incidents. (This is partially due to a bigger dataset.) In addition, these attacks were found to be the most complex and diverse, with a long list of threat patterns. As it did last year, China still leads as the site of the most cyber espionage activity; but the other regions of the world are represented, including Eastern Europe with more than 20 percent.
  • For the first time, the report examines distributed denial of service (DDoS) attacks, which are attacks intended to compromise the availability of networks and systems so that, for example, a website is rendered useless. They are common to the financial services, retail, professional, information and public sector industries. The report points out that DDoS attacks have grown stronger year over year for the past three years.
  • The use of stolen and/or misused credentials (user name/passwords) continues to be the No. 1 way to gain access to information. Two out of three breaches exploit weak or stolen passwords, making a case for strong two-factor authentication.
  • While external attacks still outweigh insider attacks, insider attacks are up, especially with regard to stolen intellectual property. The report points out that 85 percent of insider and privilege-abuse attacks used the corporate LAN, and 22 percent took advantage of physical access.

Verizon analyzed more than 63,000 security incidents and more than 1,300 confirmed breaches in 2013 to compile this year’s report. Get the full report at www.verizonenterprise.com/DBIR/2014/.

Solutions

Hospital integrates PACS, VNA

Thorek Memorial Hospital (Chicago, IL) has integrated Carestream’s Vue for Cardiology PACS and Vue for Radiology PACS with Carestream’s Vue for Vendor Neutral Archive (VNA) solution. The facility has also implemented Carestream’s zero-footprint Vue Motion enterprise image viewer that allows physicians to access imaging studies and reports from any location using laptops or mobile devices. Being able to integrate both PACS systems with a single VNA expedites workflow, enhances productivity and reduces infrastructure expenses. Carestream Health

Near-instant data replication, minimal downtime

Double-Take Availability provides complete flexibility when designing a healthcare data recovery plan. This is the market’s first real-time high-availability (HA) and disaster recovery (DR) solution to offer agentless and agent-based protection options for physical, virtual and cloud servers. This software protects critical data and leverages data for total workload movability for predictable, near-zero downtime migration. Double-Take Availability works with Windows, Linux, vSphere and Hyper-V to provide peace of mind knowing that your data is protected. Vision Solutions

Defend against advanced Web threats

F5 Secure Web Gateway Services enable enterprises to defend against potential malware threats encountered by employees who regularly access Web pages and use Web-based applications, Software as a Service (SaaS) applications and social media sites. F5 Web Fraud Protection reference architecture helps enterprises protect their users and customers from Web-based and mobile threats, regardless of the type of device or browser they use or the location from which they access the Internet and Web-based applications. F5

Go the VNA route courtesy of Novarad, Dell

Novarad and Dell have partnered to create MARZ, a vendor-neutral archive (VNA) to store and manage patient data. This solution combines Dell’s Unified Clinical Archive for on-premise or in-the-cloud data storage and management with Novarad’s zero-footprint viewer, iPad viewer or optional clinical viewer for anytime, anywhere image and report access. MARZ’s XDS/XDSI protocol brings data together from disparate silos and stores it in a non-proprietary, open-standards format, enabling information and images to be shared in an HIE. Novarad/Dell

Safety check for evidence-based medicine

Oracle Health Sciences Empirica Healthcare Analysis enables life science safety organizations, regulatory agencies, healthcare providers and payers to use evidence-based medicine to improve care outcomes and reduce costs while ensuring the safety of emerging treatments and reducing risk. Users of this Web-based application can efficiently explore multiple sources of EMR and administrative claims data to expand insight into outcomes and adverse events, supporting advanced pharmacovigilance, pharmacoepidemiology and comparative effectiveness initiatives. Oracle Health Sciences

Store massive data for pennies per GB

The BlackPearl Deep Storage Appliance enables data-intensive, long-term storage users to save time and money by incorporating low-cost, high-density, scalable tape library-based deep storage into their fast-growth data environments. This solution offers a RESTful, object-based interface to deep storage by leveraging the new DS3 interface and acts as an intelligent intermediary between online and deep storage environments. It was designed for very large data sets that scale from hundreds of terabytes to petabytes and exabytes. Spectra Logic

Get your virtual desktop via the cloud

VMware Horizon DaaS offers the industry’s first hybrid Desktop as a Service (DaaS) solution that gives customers the ability to blend public cloud desktops and on-premise VMware Horizon View private cloud desktops for a seamless end-user experience. Following a few simple steps, IT can provision, deploy and manage high-quality, full Windows desktops to end-users that can be accessed from laptops, desktops, zero/thin clients, Chromebooks, tablets (Apple iOS, Google Android) and mobile devices – all at an affordable price point. VMware

EXAM-PACS gets even better

EXAM-PACS version 3.0 includes a host of back-end upgrades that address medical imaging workflow and security. In this version, filters and searches can more easily recognize patients with multiple medical record numbers. The solution also includes interface utilities that can update an EMR to enable access to a specific patient exam residing in EXAM-PACS, contributing to user qualification for Meaningful Use. Exams reside redundantly in CoActiv’s EXAM-CLOUD archive and are accessed directly and independent of the provider’s network. CoActiv Medical

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