When technology meets medicine

The General University Hospital (VFN), one of the largest and most important healthcare facilities in the Czech Republic, has undergone massive changes.

With patients from all over the country travelling to the hospital for specialized care, and a large number of staff specializing in different fields and clinics, smooth operation is absolutely essential – and technology is the game changer that’s making all the difference.

Currently, more than 7,000 people at the hospital are using Microsoft’s 365 Enterprise cloud-based services, ranging from storing medical data, to sharing notes, and allowing staff to work remotely, increasing their flexibility while reducing costs and increasing efficiency – all benefits of the hospital’s willingness to embrace digital transformation.

This move to the cloud took place last year, resulting in a tremendous positive impact for both staff and patients – all without the former requiring the skills of an IT expert to take advantage of the new system. Technology, in this case, has become a powerful enabler.

The unchained office

The move to the Microsoft cloud has brought with it a wave of change that has improved the service of the hospital for patients and staff alike.

“As a regular user, I mainly appreciate the option of storing all files on an online server. This way I don’t have to fear loss of data from a computer hard disk,” says Hana Špačková, lead radiology assistant, who works at the Radiodiagnostics Clinic of the Charles University 1^st Medical Faculty and the VFN.”I like the option of being able to get to my files via my smartphone or my tablet; or any computer that is connected to the internet,” she explains.

“Today, we can no longer imagine that we would keep documents on our patients solely in paper form,” describes Professor Vladimír Tesař, head of the Nephrology Clinic at the Charles University 1^st Medical Faculty and VFN. “Just that fact that a doctor from any work site can access patients’ e-documents and results without having to contact colleagues from other departments is a huge simplification of our work.”

Professor Tesař’s passion for the benefits of technology allow him to spend more of his time looking after his patients – even when travelling abroad and his colleagues need a remote consultation.

The benefits of migrating services to the cloud go beyond simply saving time. Thanks to electronic documentation and cloud data storage, it’s possible to monitor how a patient’s health status is developing, how test results from examinations are changing and how best to handle critical situations.

“We often have to deal with a patient’s health taking a turn for the worse or further health problems arising and their being hospitalized at a clinic other than the one at which they are normally treated. The doctor on call can quickly access information about them,” explains Professor Tesař.

This results in improved, quality healthcare, allowing to quickly and easily share information. Doctors can easily use the cloud-based system to find out what medicines their patients are taking, for example, allowing them to better decide how to adjust their treatment to avoid undesired interactions between certain types of drugs.

Thanks to the cloud, staff have also access to a unified communications platform that allows for team work using shared inboxes, shared storage, shared notepads, reports and online discussion forums. This solution is scalable and accessible from anywhere and from any device, which results in less wastage, increased efficiency, and reduced cost –  all with a 24/7/365 support setup.

Safe and sound

The storing of data and remote connectivity would be worthless, however, without security – especially when sensitive data such as medical records and notes are concerned.

With unrivalled security and compliance with the most stringent of data protection laws (including the upcoming General Data Protection Regulation in 2018), the use of Microsoft’s cloud services ensures that confidential information remains private.

When a doctor or any other medical worker wishes to check something in a patient’s documentation, they also have to confirm their identity using multi-factor authentication. Since the new system was implemented, a username and password are no longer enough.

Now, security measures include multi-factor authentication via text message, phone calls, emails or an app, putting an end to the days of insecure passwords scribbled down on scraps of paper.

“In the healthcare sector, we manage the most sensitive data and thus we have very strict security requirements. Nonetheless, we have to let our doctors and experts work and collaborate without them noticing any significant limitations on their work”, states Vlastimil Černý, Deputy Director for Informatics at VFN.

The hospital is taking security one step further by testing biometric security systems such as retina and fingerprint scanners. It is also testing auto-lock software for computers if a user leaves their PC with a connected smartphone. Mobile devices themselves can also be wiped remotely, ensuring that sensitive data is kept secure.

“Now we have auto-watch functions to check if there have not been breaches of sensitive information. A doctor merely sending patient data, i.e. their civil ID numbers, via email is a security risk. We are able to monitor this well though,” explains Vlastimil Černý.

In practice, this means that users can disable the forwarding or printing of sensitive documents via Microsoft Outlook, or even preventing the copying of sensitive data or configure document expiration dates.

Leaving the past behind

Previously, the hospital had a random mix of applications, based on both physical local machines, and on their own on-premise servers. These gradually became outdated, and it was increasingly difficult to maintain them.

The hospital management had to make a choice whether to continue to rely on this existing solution (running on its own servers) or to move to the cloud:

“Outdated technology slowed our further development; something we were aware of. We became a system maintenance team and could not spend time on conceptual issues,” says Černý.

Relying on your own servers runs the risks of losing everything if there is a catastrophic failure. In addition, the responsibility is on you to ensure that everything is updated – a particularly important exercise when it comes to security patches. Moving to Microsoft’s cloud service leaves all of these responsibilities with Microsoft, who can take care up updates, scaling, security, backups and more, allowing organisations like the VFN to focus on their primary objectives – in this case, providing world-class healthcare.

Speedy transfer
The move to the cloud had to happen relatively quickly, so that the hospital could continue its important role without any delay or limitations.

“For us, the binding factor was the fastest implementation possible. We needed to create new infrastructure and integrate it with ours, which was a relatively big task; one we managed to complete within six months,” summarizes Rostislav Babarík, a Microsoft manager responsible for healthcare.

“Use of cloud technologies as part of modernization meant that there was no need for initial investment in infrastructure. Realization of the project was noticeably faster and cheaper than if the hospital had implemented its own environment,” Babarík continues.

Big Data

The move to the cloud also resulted in another benefit for the hospital – big data analysis.

Through its Enterprise 365 cloud platform, VFN has mailbox space exceeding 500TB in size at its disposal. The mailboxes are protected by robust anti-virus and anti-spam software. In practice, this means that hospital workers never encounter a situation where their mailbox is not large enough.

The total space set aside in the cloud affords the hospital access to more than 20 petabytes of data – that’s around 68 years’ worth of full HD video footage. In total, the hospital currently operates 133 team sites and websites on which, in addition to internal applications, 32,000 documents are stored.

Azure’s ability to store immense volumes of data, combined with its powerful data analytics tools which can identify patterns using machine learning, offers a whole new world of possibilities.

The hospital can now analyse not only the purchase of healthcare and medical materials, but can also compare the length of hospital stays with regard to individual diagnoses, while comparing the levels of serious complications after various surgeries.

This allows hospital to make better, more informed decisions on both investments and the quality of healthcare. “You cannot run a hospital without well-functioning information technology. We see IT as a strategic asset, while also being an opportunity for further growth. Moving to the cloud is a big step forward in this regard,” says Vlastimil Černý.

Moving to the cloud has also resulted in significant progress in the analysis and evaluation of patients’ image documents, increasing the precision and speed with which x-ray images, CT scans, MRI scans and ultrasound exams are carried out.

Microsoft Azure’s machine learning capabilities – such as those found in Cortana Intelligence Suite are able to identify possible anomalies that a human could not notice in the given timeframe. This results in more accurate information that simplifies doctors’ ability to make a correct diagnosis and then plan treatment.

Hospital director, Dana Jurásková states that “We want to be a hospital for the 21^st century; one that provides patients top-level healthcare. This includes having the ability to use information technology efficiently.

“Meanwhile, it is important for us that people working in the hospital have good conditions for their work; the move to the cloud had a positive influence on this,” she summarizes. “Management also gained better analytical tools, which is very important for the hospital’s healthy functioning.”