Hospitals and healthcare facilities are an integral part of our society. Hospitals treat patients and keep us healthy using the best medical knowledge and practice. Hospitals are increasingly embracing advanced technologies from operations management to record keeping and even diagnostics, and IT systems are helping doctors and nurses achieve feats.
Digital transformation changed everything
In healthcare, as in many other industries, digital transformation has been rapid. Modern medical equipment is connected to the network, making the IT infrastructure inextricably linked with the day-to-day processes in the healthcare sector, including the treatment of patients. This has increased the effectiveness and quality of treatment. However, digitalization is fraught with new pitfalls. Today’s hospital IT networks with so many new connected devices have more potential points of failure than ever before.
Healthcare and pandemic
When coronavirus patients were added to the regular flow of patients, the burden on health systems increased. According to the report ONS due to limited access to treatment or lack of treatment, 42% of patients were affected.
Now we are not talking about long-term development plans or transformations by 2030 or 2040. – everything is needed here and now. Outdated hardware, including IT systems, prevents healthcare professionals from focusing on core tasks. Many systems support key processes from clinical research to therapy follow-up. Therefore, network failures in healthcare facilities are unacceptable.
Anatomy of a modern medical infrastructure
At the heart of all healthcare IT systems, like any other, is the storage and transmission of data. Most, if not all, IoT medical devices use data and information available through various points in the hospital network. For example, a radiologist typically needs access to a patient’s X-ray results in order to view images that have been automatically uploaded to the system by an MRI machine.
To ensure this degree of integration, most hospitals have a so-called integration center. It is a central communications center that securely stores information and data and makes it available on demand. This center can be compared to the central nervous system of a hospital, which provides all communications over the network. In larger hospitals, the Integration Center works with several other independent data systems such as Image Transfer and Archiving System (PACS), Radiological Information System (RIS) and Laboratory Information System (LIS). Integration with these systems ensures that information is stored in the correct network segments.
What is PACS
Basically, PACS is a platform for storing and sharing images. Imaging devices (English-speaking medical technicians call them modality) allow you to do all types of visual examinations: X-rays, ultrasounds, computed tomography, etc. These images are stored for a long time in a central repository, from where they can be obtained, transferred to other workstations and devices. This central repository is called PACS.
Imaging is essential for the diagnosis and treatment of all types of disease and injury, which is why PACS is a critical tool for the modern physician. Read more about this in our Health IT Monitoring Report…
In a typical hospital network, the PACS connects to imaging devices, a radiology information system, and an integration center. PACS is at the center of many radiology workflows, which means that PACS issues can be critical to patient care.
In the event of problems with the storage of images or access to them, many processes in the hospital are disrupted. IT Professionals should organize the system monitoring and warning about potential problems PACS… There are four aspects of PACS to track.
Since PACS is primarily a storage system, it requires disk space. You need to watch out for this: set thresholds, generate alerts if storage space is low. It is necessary to monitor the operating parameters of servers and storage systems: monitor the signs of hardware failures (overheating, lack of RAM, etc.)
2. Read / write latency for PACS and storage
PACS permanently saves images to storage and downloads them. This includes tasks such as preparing for download, short-term transfer, long-term transfer, and more. PACS storage read and write latency should be kept to a minimum so as not to slow down the entire system. It is recommended that you monitor this delay and set thresholds.
3. API and PACS log files
Many PACS provide APIs for accessing health and health information for components, and nearly all such systems generate log files. Typically, the PACS API can provide data on current application performance and metrics such as the number of DICOM requests received, the number of errors, and the status of internal requests processing. You can get these metrics through the corresponding API in the network monitoring system (for example, using REST requests if the API provides a RESTful interface), you can generate an alert when the values are out of range.
The logs contain details of failures such as failed authentication attempts or internal PACS failures. It is recommended that you regularly check the logs with the monitoring system for potential problems.
PACS is central to the IT infrastructure of a typical hospital and has interfaces to interact with a variety of systems and devices such as a radiological information system, imaging devices, and more. You need to keep a close eye on these interfaces.
There are two main protocols for communication between medical systems that can be used to monitor interfaces.
· DICOM (Digital Imaging and Communications in Medicine): used to store, retrieve and transfer digital medical images, for example between PACS and imaging devices, workstations. To check the status of the DICOM interfaces, you can use the C-STORE function to check if the image can be stored, and C-MOVE and C-FIND queries to check the transfer of images.
· HL7 (Health Level 7): The exchange of other data between systems, such as patient data, test results, etc., is mainly done using HL7. If HL7 messages are not properly or completely transmitted, it can cause delays or problems in other systems. It is recommended to send HL7 test messages and check the success of their transmission and completeness of the information. This can be done using monitoring software that supports HL7.
· User interface: A workstation often uses web interfaces to request data from the PACS. To provide a better user experience, administrators must control the responsiveness and availability of these interfaces.
How do IT administrators deal with all of this?
Correct troubleshooting is essential when it comes to hospital operation and patient care. However, this does not mean that absolutely everything must be controlled. It is more accurate to argue that IT administrators should focus on four key components of the hospital infrastructure.
1. Digital medical equipment
Many medical devices are now connected to the network and can send and receive data. This has advantages: these devices can be monitored on the same network. What’s the catch? The point is that medical devices do not offer the same monitoring capabilities as other IoT devices, so you need a dedicated monitoring tool for them.
2. Integration center
The Integration Center is the communication hub for the entire network. Therefore, it is imperative to follow it carefully. Fortunately, most of the Integration Center servers offer APIs that are useful for getting data about server performance and monitoring it.
3. Interaction between medical systems
If the connected devices cannot communicate with the integration engine, they are completely useless. IT administrators need to closely monitor how devices communicate and ensure they are using the correct protocols.
In hospital IT infrastructure, this requires a monitoring tool that is capable of understanding medical protocols such as DICOM (Digital Imaging and Communications in Medicine) and HL7 protocols.
4. Traditional IT systems
When purchasing new medical devices, it is important not to overlook conventional devices such as routers, switches, and servers. Server failure or network failure can have the same disastrous consequences as medical device failure. For this reason, it is important to be able to quickly analyze data from traditional devices along with indicators from medical devices. In the event of a failure, this allows the IT staff to localize and resolve the problem as quickly as possible.
Maximum reliability at all times
When it comes to healthcare IT, administrators are required to provide the highest degree of reliability 24/7. Human lives and the protection of confidential information depend on it.
Fortunately, with the right tools, experience, and equipment, the hospital’s IT staff can handle all the challenges. Let doctors and nurses focus on what matters most. Preserving our health.
PRTG Network Monitor from Paessler AG: https://paessler.softline.ru/