This document proposes an architecture blueprint for healthcare in emerging countries with three key points:
1. It establishes the need for business and technology linkage to provide benefits like quality information sharing and flexible IT support through cloud and managed services.
2. It examines healthcare solutions like EHR, telemedicine, and middleware and their impact on national networks, with a focus on standards to enable collaboration across organizations.
3. It presents a technology architecture with elements like data centers, transport networks, security, and a hierarchical national/regional/local view to improve access to care, quality of care delivery, and address rising costs.
Methodology:Technical Architecture must be derived from Business Requirements, as of today, and moving into the future.Content is first delivered with a deck to promote concept, discuss rationales, and fine-tune. Full text document will follow.First release will be adapted to Saudi HC status, to be then generalized.A sanitized version is required, easily customizable to various countries
Make it Cisco independent to show the benefits of a collaboration architecture.Real-time and always-on collaboration across the entire country.Cisco’s collaboration architecture not only powers our product portfolio, it is also our most important differentiator. From the ground up, it is constructed to enable boundary less collaboration – breaking down silos between content formats, between individual tools and devices, between companies, and ultimately between people working towards a common goal.At Cisco, we recognize that it requires a combination of both great software and purpose-built hardware to deliver the experiences that most effectively bring people together. Yet at the same time, we recognize that heterogeneity is a fact of life and that interoperability, openness and customer choice are paramount. These principles are actively embraced throughout our architecture.We also realize that it’s neither all about the desktop nor all about the cloud – it’s about recommending the right option to empower individuals, teams and communities to get their work done. But whether it’s an on-premise in-room solution, a hosted PC-based solution, or a combination of the two – it’s an intelligent network that’s the foundation that makes it all possible.It is the converged network that binds together today’s infrastructure domains of virtualized computing, network resources and persistent storage to enable unmatched agility, resiliency, scalability and quality of experience – and that allows an organization to securely span beyond its corporate firewall in order to collaborate with customers, partners and suppliers.With MediaNet, the network will be able to dynamically route rich media traffic along the path of least resistance to deliver the fastest and highest quality voice, video and data experiences to end users.With the Service Advertisement Framework we’re building into MediaNet, devices will automatically be able to advertise what services are available to them so that things like the configuration of dial plans can be automated… changing the experience for those working in IT behind the scenes as well.And there’s much more - so when you hear competitors talk about the network as “just plumbing”, you can respond with confidence that it’s actually an intelligent platform for rich and effective inter-company collaboration.Our collaboration architecture is our most important differentiator. From the ground up it is constructed to enable boundary less collaboration—breaking down silos between content formats, individual tools and devices, companies, and between people working towards a common goal. 9a. The bottom layer of the network binds together today’s infrastructure domains of virtualized computing, network resources, and persistent storage. It provides unmatched agility, resilience, scalability and quality of experience. It allows an organization to securely expand beyond the firewall to collaborate with partners, customers, and suppliers. 9b. On top of this foundation lies a comprehensive set of network-based services that enrich collaborative applications. These services can: Turn data into information by providing associated context Construct social graphs of who you know—and need to know—to build a product, close deals faster, or spot market opportunities. Let you know who’s available. This is presence beyond the boundaries of instant messaging. It goes across different tools and devices and individual application silos by using standards-based protocols Locate people for you, whether in the office or on the road, and can manage collaborative sessions for you. These services operate consistently and reliably, with both Cisco and non-Cisco collaboration applications and they are consistently secured and managed via network-based policy.9C. On top of this layer are communication and collaboration applications. Applications on this layer leverage these services to help companies deliver against the top line business imperatives they are facing today—such as saving on travel costs, improving employee productivity, increasing customer intimacy, and facilitating innovation.9D. Lastly, aforementioned layers of the collaboration architecture enable the development of industry-specific solutions, such as Cisco HealthPresence==========================================================Our collaboration architecture is our most important differentiator. From the ground up it is constructed to enable boundary less collaboration—breaking down silos between content formats, individual tools and devices, companies, and between people working towards a common goal. The bottom layer of the network binds together today’s infrastructure domains of virtualized computing, network resources, and persistent storage. It provides unmatched agility, resilience, scalability and quality of experience. It allows an organization to securely expand beyond the firewall to collaborate with partners, customers, and suppliers. On top of this foundation lies a comprehensive set of network-based services that enrich collaborative applications. These services can: Turn data into information by providing associated context Construct social graphs of who you know—and need to know—to build a product, close deals faster, or spot market opportunities. Let you know who’s available. This is presence beyond the boundaries of instant messaging. It goes across different tools and devices and individual application silos by using standards-based protocols Locate people for you, whether in the office or on the road, and can manage collaborative sessions for you. These services operate consistently and reliably, with both Cisco and non-Cisco collaboration applications and they are consistently secured and managed via network-based policy.On top of this layer are communication and collaboration applications. Applications on this layer leverage these services to help companies deliver against the top line business imperatives they are facing today—such as saving on travel costs, improving employee productivity, increasing customer intimacy, and facilitating innovation.
HIE are critical to optimal efficiency of the entire HC ecosystem:Single patient view across the country to get the highest level of quality of careReduction of analysis and scans for patients, reducing costs to insurance and social servicesPossibility to define new models to optimize costs and payments.
These be characterized by their ‘profile’ on the network, so as to prepare for proper nw support.These applications have proper sense in a hospital environment. When we take it from a national perspective what becomes interesting is:The aaS potential nature of these, so as to optimize costs, increase flexibility, promote standards.The potential exchange of information at national levelThe storage strategy at national levelThe collaboration potential, therefore leveraging standard communications means.The ‘profile’ of the application on the network (application awareness).CLINICAL SYSTEMS – Hospital Information SystemsElectronic Medical RecordPatient database with entire patient history, clinical diary, radiographies, analysis, diagnosis, medicines, ..Patient registrationPaperless and mobile system to register new patient. Includes bed and room allocation.Physician Order systemPhysician can place order online any time. Total mobility and secure remote access required.Patient Tracking and MonitoringAll patients are tracked and monitored via RFID in-house or remotely (through Internet). All vital parameters are made available.Emergency e-monitoringDisplay status and facilitate patient flowCaregiver searchAutomatic system to search for caregiver on the base of proximity and skills. Integrated with telephony system.Radiology Information SystemA RIS is a computerized database used by radiology departments to store, manipulate and distribute patient radiological data and imagery. The system generally consists of patient tracking and scheduling, result reporting and image tracking capabilities. RIS complements HIS (Hospital Information Systems) and is critical to efficient workflow to radiology practices. Picture Archiving $ Communication SystemStore and manage all type of medical images (x-ray, scans, …). Secure access is allowed over Internet.Telemedicine/ Tele CareCollaborating system to support remote consultancy, in a synchronous (video capability is key) or asynchronous way (ex: store and forward).Robotic SurgeryRemote robot control for surgeryOnline operating roomRemote access to operating room to attend an operation with learning purposes.Lab management systemSystem to securely place lab orders from anywhere. Secure access to lab results on Internet. Integration with EMRPharmacy Management systemSolution to remotely place orders to pharmacy from anywhere. Includes a pharmaceutical handbook. Product is delivered by robot or automated delivery and is tracked via RFID or similar. System is integrated with procurement system.Excellence centerBest practice and knowledge management. Content can be offered externally.Ambulance managementCoordinate ambulance operations in real-time. Ambulances are connected to the hospital for exchange of first emergency information.IHE middlewareMiddleware to set up interoperability between HC systems, using standards and scenarios.BEDSIDE SERVICESPatient portalPatients have online access to: 1) Hospital General information, 2) Schedule an appointment with a Physician, 3) schedule a hospital procedure, such as Radiology or Lab work, 4) view their full Medical Record via secure Internet access; 5) Health calculator (Body Mass Index, diet calculator, life expectancy); 6) directions (end-to-end interactive map), facility navigation, and ability to pre-purchase parking; 7) Personal Health Organizer (support for the whole illness experience, including remainder for visits, medicine assumption, tracking results)Internet accessFor employees, patients, and guests.Digital SignageHospital IP based network is used to deliver TV, Education, Entertainment, generic information. STAFF EFFICIENCYHospital PortalsRole-centric portals for Physicians, Employees, Nurses, Executives. Information delivery is based on multimedia capabilities. Integrated with e-learning system. Physicians can also access their decision making support system. An online agenda is available .Communication and CollaborationBaseline tools: E-mail, vmail, IM, calendar, meeting organizer, remote presentation tool, Video Conferencing, Audio conferencing, web seminar, etcVideo Conference and TelephonyIP-based Video and audio systemsWorkflow ManagementEnables the definition of workflows and procedures in the hospital, including the automation of messages to staff when any critical events happens.BACK OFFICE & HOSPITAL EFFICIENCYDevice TrackingAll hospital devices, staff and patients are tracked via RFID.Paying systemSystem to pay for any services delivered in the hospital (not only clinical), securely accessible from anywhere.E-procurementAutomated system for hospital procurementContact CenterHospital Contact Centers, leveraging integration between all different channels (phone, e-mail, fax, web, ..)External portalCitizens (potential patients) have online access to: 1) Hospital General information, 2) Directory hospitals locations with interactive map 3) Directory of Physician profiles, 4) Interactive site with online operator and Internet call me feature 5) job posting 6) Health campaign and support materialINTELLIGENT BUILDINGVideo SurveillanceIP-based Video surveillance systems.Intelligent SystemCentrally manages all hospital systems: machinery sensors, heating/cooling systems, lighting, …Access managementManages all info from badge readers to provide access right to various hospital areas. Key to track all employees’ movements in the hospital.
The next few slides we highlight the Vblock and its core components. Highlight the key components of the solution – application & management, VMware virtualization, Cisco Unified Computing, Cisco networking, and EMC storage
Components:PACS serverPACS storage (LTS, STS)PACS backupPACS viewing station (Diagnostic wkst)PACS web serverPACS web viewing stationRIS serverRIS dbHIS serverHIS dbModalitiesNW:SITAMPLS WANSITA hosting sitesMDESWAAS
Cisco’s collaboration architecture not only powers our product portfolio, it is also our most important differentiator. From the ground up, it is constructed to enable boundary less collaboration – breaking down silos between content formats, between individual tools and devices, between companies, and ultimately between people working towards a common goal.At Cisco, we recognize that it requires a combination of both great software and purpose-built hardware to deliver the experiences that most effectively bring people together. Yet at the same time, we recognize that heterogeneity is a fact of life and that interoperability, openness and customer choice are paramount. These principles are actively embraced throughout our architecture.We also realize that it’s neither all about the desktop nor all about the cloud – it’s about recommending the right option to empower individuals, teams and communities to get their work done. But whether it’s an on-premise in-room solution, a hosted PC-based solution, or a combination of the two – it’s an intelligent network that’s the foundation that makes it all possible.It is the converged network that binds together today’s infrastructure domains of virtualized computing, network resources and persistent storage to enable unmatched agility, resiliency, scalability and quality of experience – and that allows an organization to securely span beyond its corporate firewall in order to collaborate with customers, partners and suppliers.With MediaNet, the network will be able to dynamically route rich media traffic along the path of least resistance to deliver the fastest and highest quality voice, video and data experiences to end users.With the Service Advertisement Framework we’re building into MediaNet, devices will automatically be able to advertise what services are available to them so that things like the configuration of dial plans can be automated… changing the experience for those working in IT behind the scenes as well.And there’s much more - so when you hear competitors talk about the network as “just plumbing”, you can respond with confidence that it’s actually an intelligent platform for rich and effective inter-company collaboration.Our collaboration architecture is our most important differentiator. From the ground up it is constructed to enable boundary less collaboration—breaking down silos between content formats, individual tools and devices, companies, and between people working towards a common goal. 9a. The bottom layer of the network binds together today’s infrastructure domains of virtualized computing, network resources, and persistent storage. It provides unmatched agility, resilience, scalability and quality of experience. It allows an organization to securely expand beyond the firewall to collaborate with partners, customers, and suppliers. 9b. On top of this foundation lies a comprehensive set of network-based services that enrich collaborative applications. These services can: Turn data into information by providing associated context Construct social graphs of who you know—and need to know—to build a product, close deals faster, or spot market opportunities. Let you know who’s available. This is presence beyond the boundaries of instant messaging. It goes across different tools and devices and individual application silos by using standards-based protocols Locate people for you, whether in the office or on the road, and can manage collaborative sessions for you. These services operate consistently and reliably, with both Cisco and non-Cisco collaboration applications and they are consistently secured and managed via network-based policy.9C. On top of this layer are communication and collaboration applications. Applications on this layer leverage these services to help companies deliver against the top line business imperatives they are facing today—such as saving on travel costs, improving employee productivity, increasing customer intimacy, and facilitating innovation.9D. Lastly, aforementioned layers of the collaboration architecture enable the development of industry-specific solutions, such as Cisco HealthPresence==========================================================Our collaboration architecture is our most important differentiator. From the ground up it is constructed to enable boundary less collaboration—breaking down silos between content formats, individual tools and devices, companies, and between people working towards a common goal. The bottom layer of the network binds together today’s infrastructure domains of virtualized computing, network resources, and persistent storage. It provides unmatched agility, resilience, scalability and quality of experience. It allows an organization to securely expand beyond the firewall to collaborate with partners, customers, and suppliers. On top of this foundation lies a comprehensive set of network-based services that enrich collaborative applications. These services can: Turn data into information by providing associated context Construct social graphs of who you know—and need to know—to build a product, close deals faster, or spot market opportunities. Let you know who’s available. This is presence beyond the boundaries of instant messaging. It goes across different tools and devices and individual application silos by using standards-based protocols Locate people for you, whether in the office or on the road, and can manage collaborative sessions for you. These services operate consistently and reliably, with both Cisco and non-Cisco collaboration applications and they are consistently secured and managed via network-based policy.On top of this layer are communication and collaboration applications. Applications on this layer leverage these services to help companies deliver against the top line business imperatives they are facing today—such as saving on travel costs, improving employee productivity, increasing customer intimacy, and facilitating innovation.
MoH can leverage e-Centers created by Government programs to produce and distribute content for training and educational purposes to remote/rural workers in various industries. Health workers can go into e-Centers on the scheduled days for HC, and get training over different types of media, either on-Demand or attending scheduled live training sessions.The content is hosted in a government-orchestrated Knowledge Cloud, where every minister can pay its contribution for the hosted content and the number of sessions hold.Connectivity is based on existing coverage as provided by local/national SPs. Knowledge Cloud need to have large bandwidth available to sustain a large number of connections.
MoH can create HC Cloud to provide support to rural areas. Remote Health workers can collect vital signs from patients in rural areas with no access to primary care and send those to the centralized eHR over 3G using a smartphone to access eHR. Doctors and specialist can then interpret signs and provide with specific directions to patients over phone, SMS or email. eHR is also investigated for early signs of medical outbreaks or epidemics.Citizens in rural areas with no access to primary care can get support over the phone. The contact center can intelligently route the call to the specialist according to symptoms, and early screening can be provided over the phone. Citizens with Internet access can also browse the National HC social site, for investigations, Q&A, or to look for latest newsletter from MoH.