© 2013 IBM Corporation
How healthcare players could benefit from new service models implemented in the market around cloud computing
Stefan Henze, Director Public Sector Industry IT Consulting DACH
IBM Smarter Healthcare
12.11.2013
Rüschlikon, 05.11.13
IBM Smarter Healthcare
© 2013 IBM Corporation
IBM Smarter Healthcare
Forward-thinking companies are redefining their business strategy with cloud
2 IBM Smarter Healthcare12.11.2013
http://www.youtube.com/watch?v=8qoRSBTuC_k&feature=youtu.be
© 2013 IBM Corporation
IBM Smarter Healthcare
Agenda
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Typical situation and challenges in a larger clinical IT environmentTypical situation and challenges in a larger clinical IT environment
Governance model as prerequisite for successful sourcing Governance model as prerequisite for successful sourcing
Use Case: eFA (electronic patient record) UK AachenUse Case: eFA (electronic patient record) UK Aachen
IBM Smarter Healthcare
(Cloud-) Sourcing as an appropriate solution(Cloud-) Sourcing as an appropriate solution
© 2013 IBM Corporation
IBM Smarter Healthcare
Agenda
4 12.11.2013
Typical situation and challenges in a larger clinic IT environmentTypical situation and challenges in a larger clinic IT environment
Governance model as prerequisite for successful sourcing Governance model as prerequisite for successful sourcing
Use Case: eFA (electronic patient record) UK AachenUse Case: eFA (electronic patient record) UK Aachen
IBM Smarter Healthcare
(Cloud-) Sourcing as an appropriate solution(Cloud-) Sourcing as an appropriate solution
© 2013 IBM Corporation
IBM Smarter Healthcare
Status quo –What does a typical IT infrastructure look like?
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DevicesDevices
ServerServer
Standard-softwareStandard-software
........
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IBM Smarter Healthcare
Today's IT areas
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Monitoring-
systems
Device-provisioning
System-
management
Ticket-
system
SAP
CITIRX
Cable-management
Business-
intelligence
Archive
Database-provisioning
Virtualization
Groupware
Monitoring-systems
StorageBackup
HIS
EPA
Intensive-documentation
LIS
IT-Security
Electronic -patient record
Maintenance
Med. Databases
Mobility
Tele-
medicine
Clinical ApplicationsClinical Applications
© 2013 IBM Corporation
IBM Smarter Healthcare
Devisions & tasks in a typical IT-department (FTE distribution)
7 IBM Smarter Healthcare12.11.2013
Datacenter
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IBM Smarter Healthcare
IT Sourcing could be a solution to overcome the currentissues. The following areas are primarily in focus:
8 IBM Smarter Healthcare12.11.2013
Standard applications without clinical relation
Operation and administration of a data center
Device support
Hotline & ticket-system service
Multimedia telecommunication
© 2013 IBM Corporation
IBM Smarter Healthcare
Areas with a need for action in a typical hospital
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Significant backlog demand for “hardware”investments of approximately 3 times the annual IT budget.
Annual maintenance fees for the current inventory eat up almost entire IT budget assigned
New hardware investments cannot be financed any longer
Lack of skills, reduced headcounts in IT and overall high average age of employees leads to a critital situation to constantly meet quality of service requirements
© 2013 IBM Corporation
IBM Smarter Healthcare
Agenda
10 12.11.2013
Typical situation and challenges in a larger clinic IT environmentTypical situation and challenges in a larger clinic IT environment
Governance model as prerequisite for successful sourcing Governance model as prerequisite for successful sourcing
Use Case: eFA (electronic patient record) UK AachenUse Case: eFA (electronic patient record) UK Aachen
IBM Smarter Healthcare
(Cloud-) Sourcing as an appropriate solution(Cloud-) Sourcing as an appropriate solution
© 2013 IBM Corporation
IBM Smarter Healthcare
Important challenges for companies are cost issues, service-portfolio optimization and reduction of business risks
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Low
Low
High
Low
High
High
IT Environment
Costs Costs Costs
Business risksBusiness risksBusiness risks Service portfolioService portfolioService portfolio
© 2013 IBM Corporation
IBM Smarter Healthcare
The need to control business risks and maintain service quality under existing cost pressures lead to a focus on core competencies
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Low
Low
High
Low
High
High
IT Environment
Costs
Business risks Service portfolio
ProvisioningProvisioning Operation Operation OptimizationOptimizationTechnology Mgmt.
Technology Mgmt.
Business Mgmt.Business Mgmt.
External
Internal
High synergy potential
High innovation potential
© 2013 IBM Corporation
IBM Smarter Healthcare
The role of corporate IT continues to evolve
13 IBM Smarter Healthcare12.11.2013
2000 – 2005
2006 – 2010
2011 – 2015
IT as applicationimplementer
� Expansive, on-premise applications
� Highly customized, with dedicated hardware
� Internal staff and external trusted advisor
IT as head of virtualizationand standardization
� Early SaaS and cloud adoption� Acceleration of virtualization and
standardization� Less staff, multiple suppliers
IT as service integrator
� Widespread SaaS and cloud adoption
� Highly standardized and virtualized, delivered as a service
� Even less staff, many more suppliers and new modes of delivery
© 2013 IBM Corporation
IBM Smarter Healthcare
IT sourcing market has changed dramatically in recent years
14 IBM Smarter Healthcare12.11.2013
Fullscope Outsourcing
(new Business) – often combined
with Asset + Employee takeover)
2nd + 3rd generation outsourcing
(Contract-extension / provider
exchange)
SO Outsourcing MarketSO Outsourcing Market
High standardization,
contents entirely cross and
international
SAP HostingSAP Hosting
Data Center Services
(IaaS / PaaS)
Data Center Services
(IaaS / PaaS)
ASP Hosting(SaaS)
ASP Hosting(SaaS)
Selective Service Desks
Selective Service Desks
Cloud ServicesCloud Services
DR / Data Center Housing
DR / Data Center Housing
Managed Converged
Communication
Managed Converged
Communication
Managed Security
Managed Security
Changes in the market
IT Selective Sourcing MarketIT Selective Sourcing Market
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IBM Smarter Healthcare
Vertical sourcing offerings are driven by Cloud and Managed Services Models and have changed the way services are tailored
15 IBM Smarter Healthcare12.11.2013
Internal IT Candidate for ext. Sourcing
RunRun
User Help Desk
…
Command Center
PlanPlan Build Build
Systems Operations
Development & Deployment
Infrastructure
Application
Platform / Middleware
Command Center
BPaaS
SaaS
AaaSAaaS
PaaSPaaS
IaaSIaaS
Business Units
Vertical xVertical x
App1 App2 App n
Typical sourcing candidate areas of the last years:
Typical sourcing candidate areas of the last years:
Vertical sourcing as Cloud or Managed Service
Vertical sourcing as Cloud or Managed Service
© 2013 IBM Corporation
IBM Smarter Healthcare
A layered, open Cloud Architecture is emerging
16 IBM Smarter Healthcare12.11.2013
Platform Services
InfrastructureServices
Backplane
Software Services� Business
Applications as
components� Service Oriented
Architecture
� Specialized implementations and “drivers”
� “Fit for purpose”workloads
� Operational (OSS) and Business (BSS) Support Services
� Compute, Storage, Network
Open Standards / Source� Driven by customer
use cases
� Cloud Interoperability is key for adoptance
OSLC
© 2013 IBM Corporation
IBM Smarter Healthcare
A successful service integration starts with a well defined governance model
17 IBM Smarter Healthcare12.11.2013
User-Incident:„Application XY is non performant
“Or „Network is slow!“
WAN Provider:„No WAN
issue“Client LAN:
„OK“
„No problem in the Server LAN environment“
„Middleware ?
Moderately utilitzed“
„Host transactions below 1 Sec.“
Many expert opinions regarding internal and external service delivery…but no „End to End“ statement
Service
Provider 1
Service
Provider 2
Internal
IT-X
Service
Provider 3
Internal
IT-Y
User
© 2013 IBM Corporation
IBM Smarter Healthcare
Service integration covers an important portion of the processes required to manage the interface between business units, end users and IT
18 IBM Smarter Healthcare12.11.2013
Internal IT Service Delivery
Internal IT Service Delivery
Sector …-BU 1-BU 2 Project Portfolio
ManagementService Portfolio ManagementService Catalogue Management
Security & Compliance Management
Service Provider 1
Service Provider 1
Service Provider 2
Service Provider 2
......
Pro
vid
er M
anagem
ent
(Portfo
lio, C
oord
inatio
n, e
tc.)
Service PerformanceMonitoring & Service Level Management
Requirements Management
Architecture Management
Financial Management / Chargeback
Service Desk / Incident Management
…
Business Units / End Users Retained IT Service Delivery
Processes as an interface between business & IT
End Users
Service DeliveryService Delivery
Overa
ll G
overn
ance
Sector …-BU 1-BU 2
© 2013 IBM Corporation
IBM Smarter Healthcare
Service integration is a mandatory core competency of IT organizations with multi sourcing strategies
19 IBM Smarter Healthcare12.11.2013
*) OLA = Operational Level Agreement
Retained IT OrganizationRetained IT Organization
Supplier 1 Supplier 2 Supplier n
Contract
Internal Services
Internal Services
Service IntegratorService Integrator
Contract Contract
�Coordination and orchestration of Service
Providers
�End to end services representation
�Escalation Management
�Appropriate skills
�Cultural Change
Service Integration capabilities:Service Integration capabilities:
© 2013 IBM Corporation
IBM Smarter Healthcare
Agenda
20 12.11.2013
Typical situation and challenges in a larger clinic IT environmentTypical situation and challenges in a larger clinic IT environment
Governance model as prerequisite for successful sourcing Governance model as prerequisite for successful sourcing
Use Case: eFA (electronic patient record) UK AachenUse Case: eFA (electronic patient record) UK Aachen
IBM Smarter Healthcare
(Cloud-) Sourcing as an appropriate solution(Cloud-) Sourcing as an appropriate solution
© 2013 IBM Corporation
IBM Smarter Healthcare
PACS Stolberg
Filetranfser with DICOM-Send
X-Ray image
© 2013 IBM Corporation
IBM Smarter Healthcare
FallAkte Plus
PACS
UKA
medico
UKA
X-Ray image
PACS Stolberg
Integrated access to electronic patient record
© 2013 IBM Corporation
IBM Smarter Healthcare
FallAkte Plus
X-Ray ImageCT
PACS
UKA
medico
UKA
Transfer Report
OP-Reports
Results
X-RayThorax
PACS Stolberg
AIS Medistarjesaja.net
Integrated access to electronic patient record
Medication
EKG
© 2013 IBM Corporation
IBM Smarter Healthcare
FallAkte Plus
X-Ray image
PACS
UKA
medico
UKA
Transfer-ReportOP-Report
X-Ray-Result
X-RayThorax
Integrated access to electronic patient record
PACS Stolberg
© 2013 IBM Corporation
IBM Smarter Healthcare
FallAkte Plus
X-Ray Image
PACS
UKA
medico
UKA
Transfer Report
OP-Reports
Results
X-RayThorax
PACS Stolberg
Medication review & customizationwith focus on specific patient AIS
Medistar /jesaja.net
ID Diacos Pharma
Medikation Medication
Medications-rules
EKG
© 2013 IBM Corporation
IBM Smarter Healthcare
FallAkte Plus
Medication
EKG
X Ray Images CT
PACS
UKA
medico
UKA
Transfer-Report
OP-Report
i.s.h.med Düren
Physician Letter
PACS Stolberg
Sono-Result
Results
X-RayThorax
AIS Medistar /jesaja.net
Integrated data acquisition
ID Diacos Pharma
© 2013 IBM Corporation
IBM Smarter Healthcare
FallAkte Plus
Medication
EKG
X Ray Images
PACS
UKA
medico
UKA
Transfer-Report
OP- Report
Results
X-Ray Thorax
i.s.h.med DürenPACS
Stolberg
AIS Medistar /jesaja.net
Integrated data acquisition
ID Diacos Pharma
© 2013 IBM Corporation
IBM Smarter Healthcare
Transfer for additional surgery (skull) back to University Hospital Aachen
© 2013 IBM Corporation
IBM Smarter Healthcare
PACS
UKA
FallAkte Plus
Medication
EKG
SkullCT
medico
UKA
Transfer-Report
OP-Report
i.s.h.med DürenPACS
Stolberg
Acquisition of relevant documents in the primary systems
Physician Letter
Sono-Report
X-Ray Result
X-Ray-Thorax
AIS Medistar /jesaja.net
ID Diacos Pharma
© 2013 IBM Corporation
IBM Smarter Healthcare
FallAkte Plus
Medication
EKG
X Ray Images
PACS
UKA
medico
UKA
Transfer-Report
OP-Report
i.s.h.med DürenPACS
Stolberg
Access to electronic patient record
Physician LetterSono-Result
X-Ray Result
X-ray Thorax
AIS Medistar /jesaja.net
ID Diacos Pharma
© 2013 IBM Corporation
IBM Smarter Healthcare
EFA-Box
Jesaja.
Net
Soarian
Integrated Care
KH1 medico
KH2 i.s.h.med
KH3 iMedOne
Duria PVS KH4 KIS
medatixx
CGM-AIS
CGM-AIS
CompuGroup Siemens
IBM Private Cloud(PaaS)
Solution Outline
© 2013 IBM Corporation
IBM Smarter Healthcare
Service portfolio of private IBM Cloud
35 IBM Smarter Healthcare12.11.2013
� Installation and configuration of new
servers
� Maintenance of CMDB
� Daily Housekeeping
� Log File analysis
� Start, Stop and Relocate of VMs
� Image-Service
� Incident Management
� 2nd and 3rd level support
� Capacity Management
� Patch Management
� Service Management
Operating-System and
Server- Management
Operating-System and
Server- Management
Storage and Backup-
Management
Storage and Backup-
Management
Database
Management
IBM
basis
IBM
basis
Hospital/
Sie
mens Customizing of the Soarian
Application,
App-development and -
support
IBM
options
IBM
options
Communication-
Monitoring
Hospital
Hosting Center- and
Network-Management
© 2013 IBM Corporation
IBM Smarter Healthcare
Service portfolio of private IBM Cloud
36 IBM Smarter Healthcare12.11.2013
� Providing of a private cloud on the hospital
campus
� Protected private cloud with computing
resources required for the eFA
� What is performed by IBM? Hardware,
software, operation, maintenance, monitoring
� Scaling options depending on the load and
storage requirements
� Optional use for other applications
� Test- and migration-environment
� Architecture planning with the hospital and
Siemens Healthcare
� Providing of a private cloud on the hospital
campus
� Protected private cloud with computing
resources required for the eFA
� What is performed by IBM? Hardware,
software, operation, maintenance, monitoring
� Scaling options depending on the load and
storage requirements
� Optional use for other applications
� Test- and migration-environment
� Architecture planning with the hospital and
Siemens Healthcare
Operating and scaling optionsOperating and scaling options
� High Performance IBM System x Server
� IBM cloud services with virtualization platform
� Server, storage and network based on System
X VMware, IBM V7000 and Cisco technology
� Secure VPN through separate management
and data networks
� Certified operation team to manage data with
high protection needs
� High Performance IBM System x Server
� IBM cloud services with virtualization platform
� Server, storage and network based on System
X VMware, IBM V7000 and Cisco technology
� Secure VPN through separate management
and data networks
� Certified operation team to manage data with
high protection needs
Technology and processesTechnology and processes
© 2013 IBM Corporation
IBM Smarter Healthcare
Your Contact
37 12.11.2013
Stefan Henze
Stefan HenzeStefan Henze
Senior Manager Industry Sales Public & CSI – DACHGlobal Technology Services
Location: Düsseldorf, DE
49-(0)1717844057
IBM Smarter Healthcare