October 1, 2018

MEDITECH Expanse & the Network

One of the things I do as a consultant is reviewing our customers’ physical infrastructure and help them prepare for change – moving workloads to the cloud, refreshing on-premises technology, implementing or migrating to a new MEDITECH platform. While working with our customers, I’ve had several conversations lately centered around a common theme: Is it necessary to perform a comprehensive network assessment when preparing for a migration to MEDITECH Expanse? It’s an interesting question.

Expanse changes things. From a network perspective, it changes things for the better. Prior to Expanse, there were very stringent network requirements for things like bandwidth, utilization, round trip latency, segmentation, and hop counts (physical, logical, and virtual). Depending on how the existing network measured up to the design specifications, hospitals needed to make decisions on fat vs thin clients and two-tier/three-tier design requirements.

How does Expanse change all that? Most significantly, users access MEDITECH via a web browser. MEDITECH screens can now be presented natively on tablets and smartphones. There are use cases for the MEDITECH client, but the need is greatly reduced. The metrics that drove previous network designs such as bandwidth, latency, and hop count requirements are all but eliminated.

So, if network demands have eased, why do you need to assess the network? The answer to the question is complex. Expanded support for tablets and smartphones, by the very nature of what they are, drives the shift towards expanded wireless networking. What is the impact of an increase in wireless requirements? There are already dedicated wireless networks for telemetry systems, tracking systems, phones, internal users, guest users, and more. And here’s where it gets complicated…

What happens if the number of internal users doubles, triples, or more? After all, Expanse can be the beginning of users moving from desktops to hospital-wide mobility via tablets and smartphones. How will access be controlled, both physical and logical? Will there be support for internal wireless networks and 3G/4G LTE cellular network(s)? What happens if a doctor authenticates to a guest network and tries to access rounding information? Can you use the cellular network(s) as a backup for the internal wireless network? By logical extension, internal and external security mechanisms will need to be reviewed. And what about browser versus MEDITECH Client access? For those users requiring full client access do you run the client natively, or in a 3-tier environment? Maybe it’s a full deployment, maybe it is a hybrid of all the above. I’ve been involved in debates on the benefits of Citrix/VDI even with browser-based access and I’ve learned there can be a good case made for it. And finally, it makes good business sense to perform a periodic network review to make sure there are no underlying issues that could impact performance, security, or availability.

Given the above, can you migrate to Expanse on your existing network? Yes, you absolutely can. But the migration to Expanse presents a golden opportunity to take a holistic look at the network. Expanse is truly an enabling technology – it will simplify access, expand capability, increase flexibility, and ultimately improve user satisfaction. You want to be sure that your network allows your organization to take full advantage of all the benefits Expanse offers.

Joe Kelly is a Sr. Principal Consultant at CloudWave. Joe has been working with Healthcare providers and/or payers since the mid-1980s and focused solely on MEDITECH and MEDITECH hospitals since 1997. Joe has provided technology consulting, architecture, design, and planning services while at organizations such as EDS, JJWILD, Perot Systems, Dell Services, and now CloudWave. Joe’s overall goal is to bring the leveraged, cloud-based virtual universe down to earth to most effectively meet real-world objectives for MEDITECH hospitals. Joe has a BS in Computer Information Systems from Bentley University.