Electronic Health Reporter

By Marcio Saito, CTO, Opengear. 

In the past few months, telehealth services have helped many to obtain medical services and avoid exposure to COVID-19 while freeing up resources for those facing graver conditions. This is a great example of an unexpected circumstance quickening the adoption of new technology that will remain after the crisis has passed, but the rapid adoption has also overwhelmed telehealth services, illustrating the importance of network resilience.

Telehealth is just one relatively new application of technology that’s part of a constantly growing repertoire of connected tools. To provide optimal patient care, healthcare ecosystems require constant connectivity to many other bandwidth-intensive applications, such as IoT devices, systems to process patient data via electronic health records (EHR) and picture archiving systems (PACS). With experts predicting the Internet of Medical Things (IoMT) market to be worth $158.1 billion USD by 2022 (Deloitte), we can only expect this trend to grow.

With all these new advancements come new risks. Healthcare systems are comprised of multiple facilities, such as hospitals, labs and urgent care units that all have multi-point connectivity requirements. This requires higher capacity wide area networks (WAN) – often in the form of software-defined wide area networks (SD-WAN). If one of these points loses connectivity for reasons like a cyber-attack, an interoperability issue or a bad SD-WAN router update, the entire network could go offline.

To keep healthcare networks running, organizations need intelligent systems and processes to monitor every piece of equipment, prevent issues, and recover from incidents quickly. This will ensure the secure, always-on availability needed to decrease costs, meet strict regulatory requirements, and improve patient experiences.

Top challenges that can bring your healthcare network down

Three large challenges healthcare organizations face are protecting data, staying online during network consolidations, and unexpected incidents like natural disasters or physical equipment disruptions. These could all bring the primary network offline.

Cyber criminals constantly seek to breach data networks and harvest patient data. In this regard, ransomware attacks, which are primarily transmitted through spam/phishing or other manipulations of unprepared users operating in the primary data plane, cause many healthcare enterprises to shut down computer systems, including their EHR. No topic is off limits to hackers, and even in the past few months, research has revealed phrases like “corona” or “covid” have been featured in spam emails (RiskIQ).

Weather a health system is seeking to modernize its infrastructure or a merger has led to a large transformation, consolidating networks can also be a challenge, requiring the migration of a multitude of apps and hardware components that must stay online at all times and integrate with one another in a cohesive system.

Lastly, unexpected outages from physical events can bring a system offline by disrupting vulnerable points like last mile connections. In this regard, a wide range of network components, such as cable interconnects, switches, power supplies, storage arrays, or chillers could present problems. To support new technologies, network environments are only becoming more complex, which means more software stacks that are frequently updated and susceptible to exploits, bugs and cyberattacks.

To ensure business continuity despite these challenges, healthcare organizations must incorporate end-to-end resilience into their network planning. The effectiveness of resilience is measured by an organization’s ability to resume normal operations after an outage and their ability to rapidly anticipate, prevent and react to problems based on visibility into all equipment in a core data center or edge site.

Overcoming challenges with a unified approach to end-to-end network resilience

Issues will inevitably occur, so organizations must be prepared to recover from them and prevent problems when possible. Installing redundant equipment or purchasing more space in a data center or colocation facility may not be enough to save a network if anything other than a redundant element is brought down. Luckily, ensuring end-to-end network resilience becomes more manageable with the right tools and processes. These tools can provide essential benefits, such as remote monitoring and management, continued Internet connectivity if an ISP or physical problem occurs and minimized need for human intervention.

There are many methods to help achieve resilience. One is to institute an alternate link path with failover to a high-speed cellular 4G LTE network. Another is to split network management from the main production network on a separate management plane, which can also be coupled with automated rules for out-of-band management and monitoring.

The best option, however, is a smart approach that incorporates network resilience elements into a unified platform. Such a single-source solution can provide automated self-healing capabilities and remote paths for engineers to manage operations outside of the data and control planes.

Maintaining service availability despite multiple threats

With a unified network resilience platform, healthcare organizations can vastly improve their ability to prevent cybersecurity threats. A few benefits that can help with this include advanced security and encryption features for out-of-band administrators and full visibility into network devices to detect faults and prevent failures. These tools will ensure prevention and quick recovery, even if users are prone to errors.

An intelligent system for resilience can also help in consolidation efforts by providing automation, remote configuration and troubleshooting, as well as a central hub for network management. Smart out-of-band solutions can automate certain labor-intensive tasks – this will enable functions like continuous equipment monitoring, instantaneous alerts to prevent issues, and automated recovery states to fall back to if updates or changes cause disruption.

Additionally, functions like zero touch provisioning can enable a way to ship network management equipment to new, remote sites and configure them without the need of highly skilled engineers. Once networks are connected, a centralized management system can then enable healthcare providers to manage hundreds of devices at various locations and have comprehensive visibility in a single window.

When an unexpected outage does occur, a network can be made to automatically failover to an alternative cellular network – enabling admins to connect to the main site during an outage and troubleshoot equipment. This automated failover to cellular can be configured to ensure critical applications still run using the router bandwidth while management remotely remediates network issues. This places organizations in a stronger position to ensure uninterrupted service, even if the primary network is brought down.

Prepare for business continuity now and build a future foundation

Whether it’s a network at one of the nation’s leading health systems or a smaller medical group, the right system for network resilience can provide a critical lifeline and a method to monitor and manage IT infrastructure in all locations – hospitals, labs, clinics, data centers or colocation facilities, telehealth hub, and other facilities.

When implementing network resilience, organizations should consider housing network management on a wireless connection that can also serve as a failover for critical applications. Additionally, an ideal solution should be easily scalable, be manageable from a central location by even a small group of IT admins that can work remote, automate labor-intensive network management tasks, and be less expensive than legacy solutions like back-up telephone lines or unnecessary 5G infrastructure for lower intensive management processes.

We are seeing many trends, such as telehealth relying on users to access networks on their own devices as well as an increased use of IoT tools like wearable technology that constantly collect valuable data. When updating or adopting this technology, network resilience should be incorporated into planning network architecture as soon as possible.