Imagine this: a patient has arrived at A&E with severe symptoms, and immediate access to their medical history is vital. In moments, the doctor pulls up the patient’s electronic health records, instantly accessing a full overview of their health background. Thanks to secure and dependable databases, the doctor can make well-informed decisions swiftly, potentially saving the patient’s life.
This is just one example of how unified, reliable databases are essential to hospitals providing critical care. The databases that store and manage patient information are – or at least should be – the backbone of healthcare institutions, helping ensure that patient data is accessible, accurate and secure.
Putting databases at the heart of the NHS
There are many reasons for focusing on the database over other elements of an IT environment.
One of the most significant is the simple fact that the NHS is, rightly, subject to rigorous regulations designed to protect patient data. As a result, it is critical that databases are designed, built and maintained correctly to align with cybersecurity regulations.
Additionally, reliable and secure databases foster accountability and transparency within an organisation. By maintaining accurate and consistent records, the NHS can not only demonstrate compliance with regulatory requirements but also build trust with patients. In the event of a data breach or other security incident, a reliable database can provide a clear audit trail, helping to identify the source of the problem and then address it.
Finally, health data concerning human beings must last the many decades of a human lifetime. Whilst other elements of the IT stack may come and go according to the prevailing technology and architectural best practices of the day, the NHS and other healthcare providers need to retain records about any given patient for a very long time. That requirement alone puts additional emphasis on reliable, secure and recoverable databases in ways that, say, a simple retail database application would not.
Reliable databases support hospital systems
A reliable database system, particularly in a large NHS trust, helps ensure that if a patient is admitted, their medical history is instantly accessible at any facility within the network. Managing databases across an often incredibly dispersed network presents significant challenges, particularly in regard to ensuring data consistency and synchronisation. Disparate systems can lead to fragmented patient data, which can make it difficult to provide a unified view of a patient’s medical history.
An effective database will offer a single source of visibility – one way to see everything – rather than having important data and information stored across several locations. Thus, healthcare providers can access comprehensive patient records anytime, anywhere.
Seamless access to patient data can help improve the quality of care, reduce the risk of medical errors and enhance overall operational efficiency. High-speed, highly available and reliable databases are crucial for successful interoperability between locations within distributed systems.
Creating highly functional databases
The question is: what can NHS leaders do to improve the quality of their database infrastructure?
It may not grab the headlines, but one of the best things NHS organisations can do to maintain the high availability of their data is to ensure that the database itself remains healthy and functions properly. It sounds simple, but it is much more difficult in practice.
Databases have historically been black boxes that are difficult to understand in terms of internal processes and behaviours. That lack of understanding leads to many development teams making architectural choices that lead to poor performance, scalability and reliability. However, modern database observability solutions are changing the game.
These new solutions allow users to actually see what’s going on inside the system in case of any issues or bugs. With proper observability features, a modern database can provide the IT staff with a comprehensive view of the health of the system to help ensure consistent and stable functionality.
Beyond relying on observability capabilities to maintain database performance, large healthcare organisations like the NHS should ensure high availability by implementing failsafe mechanisms, processes and redundancies. Critical databases should utilise fully redundant availability groups in which a failure on any primary server seamlessly fails over to its secondary server waiting on standby. Additionally, automated backup procedures and frequently tested disaster recovery plans are essential to minimise downtime and data loss.
Without a reliable backup and failover system, a hospital could lose access to critical patient data – leaving a patient at risk, which could end up being critical. With a robust database and effective processes in place, hospital IT staff can act quickly, helping to ensure that patient data remains accessible.
Digital transformation at work today
Clearly, the NHS’s digital transformation is vast. In its entirety, it is one of the world’s most complex information systems and its success hinges on multiple factors. It’s something that NHS South, Central and West (SCW) knows all about. With offices across the south of England, it provides advanced technical support and transformation services to NHS trusts, hospitals and GP surgeries. That means keeping a watchful eye on more than 51,000 endpoint devices, 2,100 servers, 1,300 routers and 800 firewalls.
Monitoring their customers’ infrastructure is central to SCW’s work. SCW must ensure that systems and connectivity are available during core operational times while maintaining GPs’ daily operations, patient visits and processes. ‘We can’t live without our dashboards’, says Martin Russell-Raymond, Observability Systems Manager and Technical Operations Service Delivery team member at SCW.
To this end, Martin and his team have invested in the SolarWinds® platform. It lets them quickly detect, diagnose and resolve network performance problems and outages. ‘I have made the main status dashboard so clear,’ he says, ‘it shows which devices are down, which are up, which have been set to unmanaged and which devices are unreachable.’
This single-pane-of-glass clarity is essential for maintaining the operational integrity of NHS services. For instance, in 2022, SCW completed a project enabling 97% of its 563 GP practices and 30,017 GP staff to consult patients online.
While this has helped GPs see more patients, greater reliance on such systems inevitably leads to an uptick in clinicians remotely accessing medical data to deliver virtual consultations/telehealth services, increasing network traffic. By the same token, more remote workers means additional effort is needed to maintain security and performance for the underlying databases.
NHS’s digital transformation relies on its IT systems and databases
To summarise, secure and reliable databases support regulatory compliance, facilitate interoperability in distributed systems and help ensure uninterrupted access to patient data. By investing in robust database solutions, the NHS can protect patient privacy and improve operational efficiency leading to better healthcare outcomes for its patients. In an industry where the stakes are incredibly high, the importance of secure and reliable databases cannot be overstated.
By Kevin Kline, SolarWinds Database Technology Evangelist
