HOW ATERNITY WORKFORCE APM FULFILLS THE PROMISE OF DIGITAL HEALTHCARE DELIVERY
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1 HOW ATERNITY WORKFORCE APM FULFILLS THE PROMISE OF DIGITAL HEALTHCARE DELIVERY ENABLING HEALTHCARE ORGANIZATIONS TO OPTIMIZE THE BENEFITS OF CONVERGED TECHNOLOGIES
2 CONVERGED TECHNOLOGIES ARE REVOLUTIONIZING HEALTHCARE Mobility, cloud, interconnected systems, and virtualization are changing the practice of medicine, the structure of healthcare organizations, and the role of the patient in his or her own care. Mobility, cloud, interconnected systems, and virtualization are revolutionizing healthcare, just as they have in other industries like manufacturing, financial services, and retail. These disruptive technologies are changing the practice of medicine, the structure of healthcare organizations, and the role of the patient in his or her own care. With interconnected systems, all of the healthcare practitioners involved in patient care instantly access Electronic Health Record (EHR) information for better diagnoses and close collaboration across departments or geographies. Cloud and virtualization extend anywhere, anytime access to critical systems, not just for medical staff in hospitals, but also for a host of care extenders such as case managers, pharmacists, and non-licensed community health members in remote locations. Wearables, mobile devices, and mobile apps empower patients to participate actively in their own care, and enable medical staff to attend to patients half a world away. Enhancing Patient/ Doctor Interaction Remains a Key IT Focus These methods of digital healthcare delivery have the potential to improve patient outcomes, medical staff productivity, and financial results. As they implement these technologies, healthcare IT staff face the same challenges that their colleagues in other industries have faced. One aspect of healthcare remains central to success the critical interaction between patient and medical staff. What customer interactions can evolve to a self-service model? How to securely roll out mobile devices and apps to the workforce? Which applications should be run in-house, and which should be run in the cloud? Will virtualization really improve control, flexibility, and operational costs? However, unlike industries that have leveraged converged technologies to facilitate customer self-service, one aspect of healthcare remains central to success the critical interaction between patient and medical staff. For the consumer, healthcare is not like booking a flight, ordering a sweater, or trading a stock. Patients will always rely on the guidance of a medical practitioner for their care. Converged technologies will deliver the expected benefits to healthcare organizations based on the extent to which they enhance, not replace, the patient/medical staff interaction Aternity, Inc. All other trademarks or trade names are properties of their respective owners. All rights reserved. 2
3 BEYOND SECURE ACCESS THE NEED TO MEASURE, MANAGE, AND IMPROVE MEDICAL STAFF PRODUCTIVITY Improving patient care, financial results, and medical staff efficiency only begins with providing secure interconnected applications. Breaking down silos between patient history, clinical results, and treatment guidelines is only a start to streamlining the delivery of worldclass care. Converged technologies provide fundamental capabilities for achieving the vision of digital healthcare delivery. However, improving patient care, financial results, and medical staff efficiency only begins with providing secure interconnected applications. Breaking down silos between patient history, clinical results, and treatment guidelines is only a start to streamlining the delivery of world-class care. These capabilities are absolutely critical pre-requisites. However, by themselves, converged technologies don t enable healthcare organizations to measure, manage, or improve medical staff productivity. To complete the vision, healthcare organizations must move beyond access and control to actually measuring and improving the end user experience of the medical staff as they interact with patients. After all, what improves patient interactions is not whether care givers have access to applications, patient data, and treatment recommendations. What counts is usage and performance, as experienced by care-givers in the field. To improve productivity, healthcare IT must ensure their applications deliver the quality of service and responsiveness the medical staff require as they interact with patients. Collaboration across departments doesn t work if the teams are unable to access treatment history and the latest test results. A home healthcare provider can t properly treat her patient if she is unable to look up her patient s record. And a telemedicine practitioner in a remote area won t be able to consult with the treatment team if mobile app performance prevents an accurate diagnosis Aternity, Inc. All other trademarks or trade names are properties of their respective owners. All rights reserved. 3
4 ATERNITY WORKFORCE APM FULFILS THE PROMISE OF DIGITAL HEALTHCARE DELIVERY Aternity Workforce APM enables healthcare organizations to fulfill the promise of digital healthcare delivery with usercentric, proactive IT management capabilities. Fulfilling the promise of digital healthcare delivery requires the ability to assure the reliability and quality of the entire range of applications relied upon by medical staff, as experienced by the practitioners themselves. Aternity Workforce APM monitors any application on any physical, virtual, or mobile device, providing a user-centric vantage point that closes the visibility gap existing with network- and server-centric application performance management tools. By effectively transforming every device mobile, physical, or virtual into a self-monitoring platform that is user experience aware, healthcare organizations fulfill the vision of digital healthcare delivery with user-centric, proactive IT management capabilities that dramatically reduce business disruptions and increase medical staff productivity Aternity, Inc. All other trademarks or trade names are properties of their respective owners. All rights reserved. 4
5 FIVE WAYS ATERNITY WORKFORCE APM ENHANCES DIGITAL HEALTHCARE DELIVERY Some doctors project that their productivity has decreased 20-25% after implementing EHR systems. They re spending more time doing administrative tasks in the EHR interface than they are interacting with patients. Leading Healthcare IT organizations have leveraged Aternity Workforce APM to add value to their digital healthcare delivery initiatives in five key areas. 1. Ensuring EHR Implementations Actually Improve Productivity Healthcare providers look to EHRs to improve collaboration, quality of care, patient participation, diagnosis accuracy, and medical staff productivity. In fact, Juniper Research projects that EHRs will save the global healthcare industry as much as $78 billion between 2014 and Aside from the projected benefits, U.S. healthcare providers qualify for increased Medicare and Medicaid payments by adopting certified EHR technology and achieving Meaningful Use criteria, objectives, and measures established by the National Quality Forum. While the first two stages of meaningful use criteria focus on data capture, tracking, and secure transmission, the third stage focuses on improved patient outcomes delivered through quality, efficiency, and safety. 2 Despite widespread adoption, feedback from doctors shows that EHRs are not yet enhancing the quality of the doctor/patient interaction. As reported in Healthcare IT News, some doctors project that their productivity has decreased 20-25% after implementing EHR systems. They re spending more time doing administrative tasks in the EHR interface than they are interacting with patients. 3 Doctors expect EHR vendors to move beyond security and interoperability to focus on task-oriented design that supports their interactions with patients. As the comments from doctors show, simply providing certified EHR applications won t increase productivity. What will is ensuring those applications actually enable medical staff to execute patient care activities quickly and flawlessly. And that means that healthcare IT needs the ability to define and monitor the activities that are most relevant to patient encounters. 1 Juniper Research Digital Health, Remote Monitoring, Smart Accessories & EHR Cost Savings , 7/10/ HealthIT.gov EHR Incentives and Certifications, How to Attain Meaningful Use 3 Healthcare IT News, Docs Say How They Really Feel about EHRs, Frank Erving, 11/13/ Aternity, Inc. All other trademarks or trade names are properties of their respective owners. All rights reserved. 5
6 LOADING SUCCESSFULLY LOADED Patient Record LOADING SUCCESSFULLY LOADED Aternity enables healthcare IT to define user interactions with EHR applications in the context of a patient care workflow, to measure, manage, and improve medical staff productivity. EHR applications may be part of a single step activity, such as record vitals, or part of a more complex workflow, consisting of a sequence of activities, such as admit a patient. Unlike APM products which require tagging to instrument applications, or that primarily report application diagnostic data like SQL and code level execution times, URL response and page load times, or HTTP and TCP errors, Aternity enables healthcare IT to define user interactions with EHR applications in the context of a patient care workflow, to measure, manage, and improve medical staff productivity. Monitoring and reporting on business activities, not just application diagnostic data, will indicate the success of an EHR application enhancing the interaction between patient and care provider. User Interactions Business Activities Patient Record LOADING START Click Submit Order Patient Record IDENTIFICATION Submitting SUCCESSFULLY LOADED UNAVAILABLE Transaction Failed COMPLETE Successfully Submitted INCOMPLETE Click Submit Network Interactions Reporting Requests PNxuGScWpagHbAj9RtYu3oFD0EhXlMTieMvSstlmXqtIGXwSoQZCYqWCmoaX1Y89Mfb&retURL=%2Fhome%2 Fhome.jsp&apv=1&cshc= RIzW sly&display=touch SELECT * FROM TAB1, TAB2 WHERE TAB1.KEY=TAB2.KEY AND TAB1. NAME=:mynameUPDATE RECORD SET VAL= WHERE KEY=AA SS1213INSERT INTO TAB1 (VAL, NAME, ID, RES) AS SELECT * FROM TAB Healthcare IT can define user interactions with applications in the context of patient care workflow 2014 Aternity, Inc. All other trademarks or trade names are properties of their respective owners. All rights reserved. 6
7 2. Guaranteeing Excellent End User Experience for All Teams Involved in Patient-Centered Care The challenge for healthcare IT is to ensure that each of these groups of care providers receives excellent end user experience for the entire portfolio of applications on which they rely, no matter where they are, or what devices they use to access the applications. For stage 1 Meaningful Use, the primary goal is to enable interoperability of the systems, devices, and organizations that coordinate patient care. EHRs enable a broad range of care extenders to deal with patients not just doctors and nurses in hospitals, but also physician assistants, case managers, pharmacists, and non-licensed community health members, who may see patients in smaller clinics, retail outlets, or in patients homes. By enabling immediate, secure access to the health records of patients, care providers can collaborate across departments, organizations, and geographies to provide speedier, higher quality care to patients. EHRs enable a care delivery model with the patient at the center, surrounded by medical practitioners who rely on a variety of devices and applications. The challenge for healthcare IT is to ensure that each of these groups of care providers receives excellent end user experience for the entire portfolio of applications on which they rely, no matter where they are, or what devices they use to access the applications. Thick Client SaaS Laptop Desktop Productivity Web Apps Tablet Virtual Desktop Smartphone Desktop Virtualization Application Virtualization Mobile 2014 Aternity, Inc. All other trademarks or trade names are properties of their respective owners. All rights reserved. 7
8 Unlike traditional APM or systems management products, Aternity Workforce APM has a deep understanding of the enterprise end user their identity, role, department, office location, and the full range of business activities for which they are responsible. To support patient-centered care, this understanding includes not just practitioners in the primary organization, but also the extended care team. Healthcare IT Ops and the line of business must also have this extended context of the enterprise end user to prioritize service assurance response and to validate the business impact of strategic IT initiatives. Monitor the end user experience of any application used by any team involved in patient-centered care 3. Extending Mobile Health Beyond Device Management and Security The interest in leveraging mobile devices and apps is widespread within healthcare, just as with other industries. Mobility has the potential to transform medical practice and the engagement between providers and patients. The benefits of mobile health initiatives include: Wider collection of health data Faster delivery of healthcare information Real-time monitoring of patients Direct, remote care provisioning Mobile health is particularly important in developing countries, where mobile penetration is high and populations are not well served by traditional healthcare structures. But it is also a priority for physicians in developed countries who want to use their own devices in clinical settings Aternity, Inc. All other trademarks or trade names are properties of their respective owners. All rights reserved. 8
9 Provisioning, configuring, inventorying, and securing devices and apps are necessary first steps for mobile health initiatives. However, by themselves, they don t enable healthcare organizations to transform patient care and medical staff productivity. Like colleagues in other industries implementing Bring Your Own Device (BYOD) policies, healthcare IT teams must address issues around the management and security of devices, apps, and data. But privacy regulations covering personal health information (PHI) raise the priority of data security even further. Enterprise Mobility Management (EMM) solutions enable healthcare IT to develop and implement policies that treat mobile health apps separately from the personal apps that medical staff run on their devices. Provisioning, configuring, inventorying, and securing devices and apps are necessary first steps for mobile health initiatives. However, by themselves, they don t enable healthcare organizations to transform patient care and medical staff productivity. Widespread mobile app adoption is the key to achieving the goals of mobile health. To drive adoption, a mobile app must be well-architected, compatible with multiple operating systems, secure, and intuitive to use. App developers and EMM vendors play key roles in these steps. But ensuring excellent mobile user experience only begins there. It continues with the app s usage and performance in the field. That s where Aternity Workforce APM comes in. Aternity Workforce APM augments the domain-specific metrics and analytics provided by EMM vendors with app performance and the business context of the enterprise end user, necessary for healthcare organizations to measure, manage, and improve medical staff productivity. Adding mobile end user experience management to enterprise mobility management arms healthcare organizations with what they need to ensure the success of their mobile health initiatives. The User Experience dashboard captures the key business activities executed by the user on any app and any device, analyzes their response time relative to performance targets, and enables drilldown for investigation 2014 Aternity, Inc. All other trademarks or trade names are properties of their respective owners. All rights reserved. 9
10 Without comprehensive visibility into application performance as experienced by their clinical staff, healthcare IT lacks the critical insight needed to effectively plan, manage, and troubleshoot VDI environments. 4. Adding Performance Visibility to VDI and Virtualized Apps Healthcare IT organizations have turned to Virtual Desktop Infrastructure (VDI) and Virtualized Apps as a way of reducing operational and management costs through centralized control of the desktop environment. Running desktops running virtually in the data center helps raise IT productivity for routine tasks such as patching operating systems and applying application updates. In addition, these technologies increase data security by storing PHI centrally in the data center, instead of on practitioners devices. Virtualized apps enable anywhere, anytime access for medical staff as they migrate between hospital, clinic, and home. But improved flexibility, operational efficiency, and control won t matter if healthcare organizations cannot maintain excellent application performance. The challenge is that virtualization disrupts the traditional relationship between applications, physical hardware, operating systems, and presentation layers. Without comprehensive visibility into application performance as experienced by their clinical staff, healthcare IT lacks the critical insight needed to effectively plan, manage, and troubleshoot VDI environments. By monitoring the performance of any business transaction within any packaged or custom application, and correlating it with the key performance indicators of the underlying desktop virtualization, Aternity Workforce APM empowers healthcare organizations to achieve successful VDI outcomes. Aternity enables application owners to prove that their EHR application performs as well or better on virtual infrastructure as it does on different physical desktop configurations 2014 Aternity, Inc. All other trademarks or trade names are properties of their respective owners. All rights reserved. 10
11 Metrics monitored from the perspective of the cloud provider s infrastructure don t reflect the actual end user experience as cloud-hosted applications render on their devices. 5. Confirming Cloud Providers Meet Their SLA Commitments Use of cloud services by healthcare providers is pervasive. According to the 2014 HIMSS Analytics Survey, 83% of healthcare IT executives report they are using cloud services today, primarily for SaaS-based applications. 41 The benefits of cloud services to healthcare IT are clear: Faster time to deploy for critical apps Staff augmentation for resources or technical skills Reduced operational and capital expenses However, these benefits won t mean much if cloud-hosted applications don t deliver a quality end user experience to the medical staff relying on them. Although cloud providers offer Service Level Agreements (SLAs) governing availability goals, incident response time commitments, and penalties, these metrics are insufficient to guarantee excellent end user experience. Penalties paid at the end of the month don t help a telemedicine practitioner who is unable to access her patients records in the course of treatment because of a service reliability issue. Even cloud providers which share infrastructure performance metrics fail to capture end user experience. The problem is that metrics monitored from the perspective of the cloud provider s infrastructure don t reflect the actual end users experience as cloud-hosted applications render on their devices. Even when cloud providers use JavaScript Injection to embed code into a web application in order to get timings of what is occurring within a user s browser, they do not obtain any correlating metrics about what s happening on the user s device. Without this complete picture, providers and healthcare IT lack information critical to rapid problem resolution. Aternity Workforce APM provides a powerful combination of a user-centric view, realtime performance analytics, and business activity analytics. This enables healthcare IT to monitor critical patient care activities performed by medical staff and get immediate alerts when expected performance deviates from SLA targets or baselines. By correlating application performance, user experience, and key performance metrics of the underlying device and network, Aternity Workforce APM enables IT to rapidly isolate the cause of problems to the cloud provider s infrastructure or their own. 4 Source: Forbes article 83% Of Healthcare Organizations Are Using Cloud-Based Apps Today, Louis Columbus 7/17/ Aternity, Inc. All other trademarks or trade names are properties of their respective owners. All rights reserved. 11
12 The majority of Allscripts business activities meet performance targets 2014 Aternity, Inc. All other trademarks or trade names are properties of their respective owners. All rights reserved. 12
13 CONCLUSION To complete the vision, healthcare IT must take the next step actually measuring and improving the end user experience of medical staff as they interact with patients. With Aternity Workforce APM, healthcare IT can measure, manage, and improve clinical staff productivity for any app delivered on any device, mobile, virtual or physical. Aternity Workforce APM Key to Fulfilling the Vision of Digital Healthcare Delivery Aternity Workforce APM arms healthcare IT teams with the capabilities they need to fulfill the vision of digital healthcare delivery. Transforming patient care and improving financial results begins with implementing converged technologies like mobility, cloud, interconnected systems, and virtualization. To complete the vision, healthcare IT must take the next step - actually measuring and improving the end user experience of medical staff as they interact with patients. With Aternity Workforce APM, healthcare IT can measure, manage, and improve clinical staff productivity for any app delivered on any device, mobile, virtual or physical. Some of the largest healthcare organizations in the world use Aternity to ensure excellent end user experience of applications like these: Allscripts Cerner Sunquest Vista CPRS Epic McKesson GE Centricity Meditech eclinicalworks Orthoview Xcelera APTA Connect Caris ScriptMed BabySentry Pro CattailsMD Implement as SaaS or On-premise Aternity Workforce APM provides a SaaS or on-premise platform for ensuring the reliability of any business-critical application running on mobile, virtual, and physical devices. Request a free product evaluation: Aternity, Inc. All other trademarks or trade names are properties of their respective owners. All rights reserved. 13
14 United States (HQ) 200 Friberg Parkway Suite 1004 Westborough, MA Europe Standard House Weyside Park Catteshall Lane Godalming GU7 1XE United Kingdom ABOUT ATERNITY Aternity monitors any application on any physical, virtual, or mobile device, providing a user-centric vantage point that closes the visibility gap existing with network- and servercentric application performance management tools. By effectively transforming every device physical, virtual, and mobile into a self-monitoring platform that is user experience aware, enterprises are empowered with user-centric, proactive IT management capabilities that dramatically reduce business disruptions and increase workforce productivity. Visit to register for a free product evaluation today. Find AternityInc on: 2014 Aternity, Inc. All other trademarks or trade names are properties of their respective owners. All rights reserved.
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