Tom Roberts is worried. Thanks to electronic medical records (EMRs), he estimates that over the next couple years his data center environment will double or triple.
"It kind of scares me," he said.
Roberts is not alone. According to recent research from the New England Journal of Medicine only 1.5% of U.S. hospitals have a "comprehensive electronic-records system." The No. 1 barrier, according to the report? Inadequate capital. And according to several data center managers, part of the issue is finding the money to expand their IT facilities.
Game-changing legislation?
Earlier this year, President Barack Obama signed the American Recovery and Reinvestment Act, which, among other things, appropriates $19 billion for health-care information technology. This week, Robert Kolodner, the national coordinator for health IT in the federal Department of Health and Human Services, said that the law is a "game changer" that presents "an unprecedented opportunity [to make] positive changes for health care," according to a story in Health Data Management.
But that has some data center professionals as worried as they are excited.
"Where are you going to get all this capital?" Roberts said. "In five years, if you have all your clinical electronic medical records in the facility, you'll get a rebate. But you have to put that capital expenditure into place."
Alan Howard recommends crunching the numbers before factoring in a potential federal rebate. As the director of IT at Princeton Radiology, he helped oversee the digitization of the company's medical records, which range from x-rays and CT scans to patients' scheduling histories. Before that, the Princeton, N.J.-based company had all its paper-based records stored in a warehouse that had grown to nearly 10,000 square feet. If it needed to retrieve records, it paid couriers, which was an added expense and time-consuming.
"We've effectively transitioned from a huge warehouse to one cabinet in the data center," he said. "We still have film records and we're holding them for retention requirements. But the entire warehouse will eventually disappear. That's a huge transformation."
Metro Health Corp. Wyoming, Mich., is in a position similar to that at Trinity Health but just built a new data center a year ago, which can handle the influx of electronic records. William Lewkowski, the CIO at the company -- which runs a 208-bed hospital and about a dozen outpatient centers -- said it started moving to a "truly integrated medical records system over the last couple years." They've started with physician and ambulatory care and are now working on converting the hospital and outpatient centers, with plans to go live in November.
Lewkowski said they're lucky the data center is new and can handle the new records; that made the IT side of the transition easier. Metro Health has two data centers within 20 miles of one another, backing one another up. It uses VMware server virtualization on HP Itanium and x86 blade servers to pack in the computing power. Since Metro Health has a new data center, it can handle the heat.
"The hard part is the changes in how clinicians do things," Lewkowski said. "It doesn't change patient care, but it changes the process in which they document and access patient information for patient care. I will say it was successful, but it wasn't easy. It was a challenge."
But what about those small doctor's offices, the ones that either have a small server closet or no data center at all? Many will turn to third parties, and even larger operations might do the same.
The health-care industry has not traditionally outsourced IT as much as other sectors, said Tom Deaderick, the director of OnePartner's Advanced Technology and Applications Center (ATAC) in southwest Virginia, the only colocation data center in the country that is certified Tier 3 by The Uptime Institute. But with the new law, Deaderick expects that to change.
There are already plenty of companies focused on health care information technology outsourcing. Inland Northwest Health Services is one. The company works with 35 hospitals, and handles all of the information technology for them out of a 3,500-square-foot data center in Spokane, Wash. Chad Skidmore, the company's director of infrastructure operations, said Inland wouldn't be in that same data center if it wasn't for storage and server virtualization.
"It's not terribly big," he said about the facility. "But it's highly dense."
These companies are also savvy to what health-care organizations need when moving to electronic medical records. The ATAC colo, for example, partnered with Tri-Cities Information Management LLC, which focuses on scanning paper documents and converting them to an electronic format.
"We don't want physicians to have to be IT professionals," Deaderick said.