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Streamlining Healthcare Processes with Nimble
By Samuel Fershteyn
Director of Information Technology, Streamline Health, Inc.

The Digital Impact of Your Doctor Visit

When you visit a doctor, a lot of activity happens behind the scenes that you may not know about. The medical form you fill out and the driver’s license you present at check-in get scanned and organized into a digital patient folder. Documenting this and other information is extremely important as it becomes the evidence behind the bill that is sent to your insurance company for payment. Streamline Health provides revenue cycle optimization for healthcare enterprises. Our integrated solutions, technology-enabled services and analytics help providers better manage the middle of their revenue cycle—from charge capture to bill drop— to drive optimal reimbursements in a value-based world.

Our technology drives improvements in electronic documentation of patient charts and billing processes, which is crucial in ensuring that the provider is accurately reimbursed and with fewer delays. For example, if our system sees that a certain drug was prescribed to a patient that is typically given to diabetics but there’s no diagnostic code for diabetes within the patient’s EMR, it enables an alert to be sent to the doctor to ensure that this gets addressed accordingly. Proper coding can translate into more accurate and appropriate revenue at billing time. Most importantly, it helps to ensure that the details regarding the care encounter are accurately reflected in the documentation.

Medical centers have teams of people focused on this digital effort. They have to be extremely organized and need to know what’s next in their work queue to improve their performance when processing patient information. When these systems are slow, resulting in a backup of their workflows, the Client Support and Enterprise Information Technology (EIT) group at Streamline Health are the first to hear about it.

The Dark Side to Poor Performance

I joined the organization in October 2015 as Director for our EIT functions, and my first focus was on quickly driving improvements in our systems architecture to improve the quality in services our customers expect and require. The database transactions and ETL run times could be improved, and the footprint of the snapshots and replication operations were very resource intensive, which put real-time system processes at potential risk.  Our team also identified certain bottlenecks and latency issues relating to maintenance and upgrades. I realized we weren’t going to solve this issue with the data management solution and environment we had been using.  However, upgrading our previous SAN solution meant a potentially painful “forklift” upgrade, which represented a risky and costly step.  And, since our test and development environments would be affected as well, we would need to act rapidly in any such undertaking.

Action Plan:

We have taken some time to build trusting and reliable relationships with the Nimble Storage team. As a result, we were able to stage and deploy a new SAN with a CS-Series Adaptive Flash array in a matter of hours (less than 10 days to production). The testing, as previously done during the proof of concept (POC), has shown solid performance outcomes, which instantly led to increased performance across all database platforms. We can easily scale vertically or horizontally, without overprovisioning of resources.

Streamline Health constantly looks to improve SaaS offerings and architectural design to provide our clients with the quality and support they expect. Investing in long lasting and scalable infrastructure is key to success, where hospitals can rely on our solution during the hours they need. We chose storage that is application performance centric, “self-aware”, and complements a certified smart compute stack.

A Bright Future with Nimble

Based on technical expertise and as part of the POC, we researched Nimble, Pure, NetApp, EMC and others. Nimble was the only vendor that offered the precise balance of performance, capacity, cost efficiency and resources. After meeting with their CEO, I found his hands-on approach— backed by a strong belief in his company strategy, vision and product capabilities— to be a powerful combination.

Immediate Benefits:

  • Simplicity and ease of use. The entire migration to Nimble took less than 10 business days and was so intuitive that I could teach my kids how to do it. There was an effortless knowledge transfer between Nimble SMEs and Streamline Health’s EIT staff.
  • InfoSight predictive analytics and support. Other competitive offerings require that we have a dedicated resource managing our network. InfoSight does an amazing job of identifying and resolving issues proactively and automatically. The level of support so far is outstanding. It feels like an extension to our internal EIT Team. We can now focus more resources on supporting new product development and cutting edge improvements that are beneficial to our customers.
  • Data protection. The ability to use snapshots is allowing us to maintain better service level expectations with our customers. When we perform testing or customer upgrades, we can easily rewind to see any issues that happened during the process and resolve them quickly. We are addressing system integrity and reliability from one place. As we continue to evolve our business continuity and disaster recovery strategy, we’re confident Nimble will take us to the next level in that area as well.
  • Performance, capacity and a foundation to scale. After transferring all SaaS workloads from our previous product to Nimble, they are barely making a dent in our Nimble arrays. As application use grows and consumes more of our resources, Nimble gives us the flexibility to move to any of their Predictive Flash arrays over the next few years with a non-invasive upgrade path.

Thanks to Nimble, Streamline Health now benefits from storage that’s an integrated and smooth-running foundation that underpins our network. Legacy networks can sometimes feel like an intricate maze of cobbled-together technology that requires constant attention. Having more stable and smart storage performance has given my whole team more time to focus on providing the best possible SaaS solutions to health care providers. As we move into the next phase of our infrastructure evolution, we look forward to doing it with the support of the team at Nimble.