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This article is part of a VB special. Read the full series here: The Future of the Data Center: Dealing with Growing Demands.
When Jesse Fasolo came along St. Joseph’s Health Nine years ago, the medical institution in Paterson, New Jersey was easily 10 to 20 years behind when it came to digital transformation.
“In healthcare in general, budget is always a concern,” said the healthcare company’s information security officer and head of technology infrastructure and cybersecurity. “That led to the environment being so outdated: the lack of implementation, lack of investment in new technologies.”
Eight years later, St. Joseph’s has undergone two complete transformations, completely overhauling its data center and dramatically improving compute and storage capabilities (not to mention leveraging AI and exploring a hybrid cloud future).
“We had spinning disks, a large footprint, a large energy-consuming infrastructure that we have since consolidated,” Fasolo said. “Now I could put the data center in my dining room.”
A complex, cobbled-together data infrastructure environment
Fasolo needed to take St. Joseph’s Health into the 21st century and began immediately analyzing all of its network technologies.
The biggest problem, he said, was the complexity of the data infrastructure environment. There were multiple storage areas from multiple providers, some supported, others unsupported.
“Technology in general should be easy for people to manage,” Fasolo said.
Of course, downtime is a big problem in healthcare as it has a direct impact on patient care. In this context, he likes to say that ‘minutes matter’.
Day-to-day system performance issues delayed clinicians and IT staff, he explained, and it was nearly impossible to use real-time data for patient care. In addition, Fasolo estimated that it would take 247 days to recover from a ransomware attack.
“We fought fires every day to keep the systems running,” he said. “Something as simple as a mass email with a PDF can degrade performance, leaving patients waiting to be admitted or doctors waiting for lab results.”
Flash forward, active-active
After his initial assessment, Fasolo began exploring tools that could increase uptime and provide flexibility while also being cost-conscious – because, as he put it, “How do you buy and acquire technology if you don’t have a lot of money?”
He eventually settled down Pure storage. The data storage hardware and software vendor helped St. Joseph’s upgrade its storage and computing environments and eliminate all spinning disk storage. “We’re now a completely flash-forward, flash environment,” said Fasolo.
The facility also did an “active-active” implementation five years ago. This data resilience architecture distributes workloads across two or more nodes in a cluster to keep data safe and available in the event of an unexpected component failure.
In addition, St. Joseph’s can now use AI. In radiology, for example, AI reads images, identifies abnormalities and makes recommendations to specialists to improve reading accuracy and speed up treatment. On an operational level, the healthcare facility can query live data to track revenue trends, hospital utilization rates, and patient status.
Fasolo pointed out that the St. Joseph’s-Pure Storage partnership has enabled the healthcare facility to source smaller quantities and drive purposeful, ongoing growth. St. Joseph’s typically conducts a major annual expansion of data storage and capabilities based on trends. It is currently undergoing another iteration of compute and server upgrades.
A security-conscious data center
When it comes to cybersecurity, “being aware is key,” Fasolo said.
It is critical to understand what could be happen and plan accordingly, he said. Pure’s cybersecurity tools allow for a lock and two PINs, and St. Joseph’s uses “MFA (multi-factor authentication) for everything we can.”
Should an attack occur, the healthcare facility can recover using immutable snapshots. The facility performs daily backups and snapshots every 15 minutes; the latter can easily be referenced when a malicious person tries to do something malicious.
“We have multiple layers of security,” Fasolo said.
Improving performance and reliability – and most importantly, patient care
Across the board, St. Joseph’s has seen improvements in performance and reliability for clinical applications. Interruptions to hospital operations and patient care are kept to a minimum, and clinicians can access medical data in seconds to reduce waiting times.
Email backups take two hours instead of four days, and user login time has been reduced from minutes to seconds.
Fasolo pointed out that “most clinicians and health professionals on the front lines are not concerned with technology in the back-end data center.” However, they are aware of significantly less downtime and downtime, and they appreciate that technology supports them and enables them to work efficiently.
Using hybrid cloud
Fasolo plans to move some workloads to the cloud in the future, particularly to archive data for compliance purposes.
The healthcare trend is toward “cloud-enabled, cloud-hybrid” tools, he noted. With hybrid storage and cloud block storage, St. Joseph’s can continue to use on-premise storage and compute, while also having the option to move to the cloud to reduce costs (compared to migrating all workloads to the cloud). Ultimately, this would provide an additional layer of recovery if the facility had a problem and needed storage to recover.
“Management and migration is something we’re looking for,” says Fasolo. “We have to keep it as simple as possible, allowing automation where possible. If you introduce something too sophisticated, you will need more staff, more training and development, all of which will lead to burnout, breakdowns and maintenance issues.”
Get buy-in: Focus on business results, not technologies
The healthcare industry has been notoriously slow when it comes to digital transformation, due in part to data privacy and compliance concerns. Getting support from senior leadership is crucial, but it must be approached the right way, Fasolo said.
“Each technology, infrastructure and security leader should align with the business, befriend senior leaders and explain in business terms what the investment will mean for the entire company,” he said.
A new data center tool can’t just be viewed as a hardware or software product or explained technically. Instead, IT leaders need to outline how technology can support strategic roles.
“Once you start changing the tone of a hardware IT purchase to enabling a company’s purpose, people start listening,” he said.
From there it is important to show tangible performance, sustainability and efficiency improvements to build trust. That can snowball into support for future initiatives.
Fasolo also advised IT leaders to review multiple vendors and go through proof-of-concept and implementation planning with the vendors themselves, not resellers. The best partners not only provide technology tools, but also provide quick responses and turnaround times and remote and in-person support, he said.
Ultimately, in healthcare, it all comes down to expanding patient care options, Fasolo stressed. That means improving time efficiency, eliminating shortcomings and reducing the time it takes to maintain IT environments.
“Obviously if I can get a doctor’s or clinician’s capabilities faster, that helps me sleep at night,” Fasolo said, “and it also allows me to help the facility maintain its mission.”