Welcome to the third entry in our blog series, “Enterprise Integration: Considerations for Healthcare Organizations”. In our previous post, we talked about the need and considerations for a high performance integration engine. We also showed off some impressive performance stats from our own integration engine, Iguana. Today, we will shift our attention to ensuring an organization’s integration engine is available to process messages in the first place, specifically in the event of a service disruption. Of course, we are talking about High Availability.
It’s About Business Continuity
In simple terms, business continuity refers to the processes and procedures that ensure mission-critical services can continue to operate with as little disruption as possible during a disaster or serious incident. So, first and foremost, when we talk about high availability, we are really talking about an integral component of business continuity planning and preparation.
The basic idea of high availability is to build an architecture that can continue to operate with as minimal disruption or downtime as possible, ideally so minimal that end users don’t even know a problem or incident has occurred.
Keep in mind, disasters or serious incidents include much more than natural disasters such as hurricanes, floods, and earthquakes. The vast majority of service disruptions are primarily caused by hardware failures, network issues, operating system problems, and, quite often, human error.
The crucial driver of the implementation of a high availability solution is, of course, risk. In any of the causes of downtime mentioned above, the result is critical patient, financial, and administrative data stops flowing through systems and is no longer available to the end users who need it. It is important that healthcare providers and vendors accurately assess the following risks that occur when data stops moving through their organization:
Lower Revenue – With so many workflows and processes reliant on the automation of data exchange, the downtime of an integration engine can significantly impact an organization’s revenue. Consider the financial implications of the following scenarios:
- Providers: lost or incomplete billing claims for services rendered.
- Labs and Imaging Centers: unable to receive orders and return results.
- Vendors: application becomes severely limited in functionality or even unusable.
Lost productivity – When essential information stops moving between mission-critical applications, once automated processes now become manual and extremely time-consuming. All of the inefficiencies that an integration engine addresses immediately resurface in the face of downtime, not to mention the extra effort of manual data entry once the service is restored.
Patient safety and satisfaction – Beyond significant and costly manual intervention, the downtime of an integration engine can lead to inaccurate and outdated information, which can result in increased risk of misdiagnoses and medication reconciliation issues. Patient safety and satisfaction issues will directly compromise an organization’s reputation and once again, revenue.
Cost to recover from downtime – The cost of downtime can be as difficult to predict as the cause for the downtime itself. Even once an organization’s integration engine is brought back online and information is flowing again, there is often still work to be done. What about the lost and missed messages that resulted from the downtime? The prospect of having to request messages be resent from a number of different vendor applications can prove to be a costly and time consuming endeavour.
Tolerance for downtime varies significantly from organization to organization. To make an informed decision, organizations need to accurately weigh the risks of downtime (outlined above) versus the cost of implementing a highly available solution.
Highly Available Iguana
Highly Available Iguana is a proven architecture solution designed to maximize the uptime of our Iguana integration engine. Like any high availability solution, Highly Available Iguana adheres to three core design principles:
- Eliminate single points of failure. Identify single points of failure and add redundancy to ensure that the failure of a single component does not bring down the entire system.
- Failure detection. Incorporate failure detection so that the redundant components in the system know when the primary component has failed.
- Reliable failover. Set up redundant components for automated failover so that the redundant component takes over as soon as the primary component fails.
Additionally, we designed our solution with three specific goals in mind:
- To deliver a reliable solution that makes Iguana highly available and removes the complexity for our customers.
- To deliver a highly available solution that works in any existing network topology and Iguana installation.
- To deliver a highly available solution whether Iguana instances are running on Windows or Linux.
Highly Available Iguana has been implemented in a number of different environments and on several platforms much like Iguana itself. Let’s take a closer look at one of those implementations.
Highly Available Iguana in Action
Rush Memorial Hospital is a general medical and surgical hospital located in Rushville, Indiana. One of the most forward-thinking hospitals in the country, Rush Memorial was named Most Wired by Hospitals & Health Networks magazine for the fifth year in a row in 2017.
As is the case with many healthcare organizations using Iguana, Rush Memorial has large amounts of critical information flowing through their systems, applications, and medical devices on a daily basis. With this in mind, Jim Boyer, VP of Information Technology and CIO at Rush Memorial, knows that network failures and downtime are not an option.
“We send information from telemetry, PACS, and pharmaceutical information to our EMR and other ancillary clinical systems and none of those can ever be down,” Boyer says.
To ensure that Iguana is always able to process messages coming from Rush Memorial’s various systems, iNTERFACEWARE’s professional services team implemented a high availability solution for all of the Iguana instances running at Rush Memorial.
Since configuring their Iguana instances for high availability over a year ago, Rush Memorial has experienced 100% uptime. That piece of mind is invaluable according to Boyer.
“We never have to worry about any components failing because there are backups in place at every stage,” Boyer says.
To read the rest of our high availability case study with Rush Memorial, click here.
We’re always interested in hearing how different healthcare organizations plan for business continuity; what measures does your organization take? Let us know the comments.
If you’re interested in Highly Available Iguana, or just want to chat about healthcare integration, don’t hesitate to get in touch with us.
Next up in our “Enterprise Integration Considerations” blog series: SecurityEnterprise Integration Series