Hospital IT Management FAQs

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The world of healthcare information technology (IT) has unique challenges.  And hospital IT managers are under significant pressure to meet these challenges. The pressure originates from many sides-government regulations, the increasing volume of electronic medical records, revenue cycle management, etc.  Determining solutions  to ensure these pressures are relieved is a considerable part of the mission healthcare IT has taken on. 

There are many terms in use by healthcare IT professionals today regarding optimal IT application management. Business transaction management (BTM). Business transaction monitoring. Business transaction performance (BTP). Complex event processing (CEP). Application performance management (APM). Application performance monitoring. All of these terms are interrelated and describe differing sides of the complex process of ensuring IT is effective in its mission to serve the business, regardless of how complex the system is. However, sorting out the differences can be a challenge.

What is the difference between application performance management and application performance monitoring?

Application performance management (APM) software is multi-faceted solution that provides hospital IT managers with multiple tools for evaluating, monitoring and managing the availability, performance, configuration, updating and provisioning of their increasingly complex IT business applications. This can include: application dependency discovery, patch management, change and configuration management, operational resource monitoring, business transaction monitoring, business transaction management and application performance monitoring. Often you will see these terms used almost interchangeably, because their functions often overlap.

Application performance monitoring is a facet of application performance management. It encompasses business transaction management and business transaction monitoring.   Application performance monitoring (also abbreviated APM) includes the use of instrumentation to capture events and metrics and an application performance monitoring database that stores historical application data and enables dynamic queries.  It also provides a dashboard to present the data analysis. Typically, application performance monitoring is used to detect response time problems, bottlenecks, failures and application availability issues.  It also determines the root cause of these failures and degradations, alerts IT about them and sometimes makes automated responses to resolve them.  

 Many application performance monitoring solutions enable application component discovery and provide visualization of the applications that were discovered. In the process, the exact location at which a problem is occurring is presented.  Deep dive application performance monitoring gives 360° visibility into every application crossing through the multiple tiers commonly present in an IT enterprise. It gives a vital health snapshot of how the separate components of the enterprise are interacting with each other. 

How is business transaction monitoring related to business transaction management?

These two terms are frequently interchanged with each other.  But, a management solution would imply that the product actively initiates changes to the IT environment supporting these transactions.  However, in practice most technology vendors providing these solutions are really providing a monitoring only solution with little to no management capabilities.  IT professionals can consider these terms to both mean the same thing - monitoring the performance of the logical units of work in business applications that are referred to as transactions.

How is business transaction monitoring related to application performance monitoring?

In theory application performance monitoring as defined by the Gartner Group includes business transaction monitoring.  Gartner refers to this as transaction profiling.  However, many application performance monitoring solutions do not include business transaction monitoring.   At the same time, many business transaction performance solutions do not provide a complete picture of application performance within the IT enterprise and only focus on the transaction.  The unfortunate side-effect of this is that while the business transaction monitoring solution may detect a problem, it is often unable to explain why this has occurred...

Why is a complex event processing engine needed for application performance monitoring?

Application performance monitoring generates incredible volumes of data that is humanly impossible to correlate. This is why application performance monitoring depends heavily on complex event processing (CEP). A CEP engine can be utilized to perform many different functions, but one of the most important is the ability to rapidly search through a large volume of events and metrics from many sources and detect the patterns that denote an application performance problem. 

This means that not only can each application's performance be monitored; meaning can be applied to the interaction between applications that together realize a business process. A complex event processing engine is the foundation of providing early warnings and alerts that performance is degrading or potential problems are developing.

How important is application performance monitoring to a hospital's bottom line?

Research suggests that 24% of IT time is dedicated to troubleshooting application issues. When an IT enterprise has all applications under constant monitoring, troubleshooting and resolution time, or the MTTR (mean time to repair), is reduced significantly. Rather than wasting 24% of the IT time on resolving application issues which affect the efficiency of the entire hospital (thus causing untold stealth waste costs), these costs can be reduced so low they no longer have a major impact on any aspect of the hospital's operations.  And in this way, IT staff can be available to help grow the business and not just fix the infrastructure.

What makes Nastel's AutoPilot different from other application performance monitoring solutions?

Nastel has designed their application performance monitoring solution, AutoPilot around a complex event processing (CEP) core, rather than adding it as a separate module. Think of it as the "brain".  While some other competing solutions are now offering a CEP engine, they do this as an outboard, add-on module - think "optional brain".  

The reason behind Nastel's approach of building AutoPilot on top of a CEP engine is that this enables expansion of AutoPilot to predict and even prevent problems.  Nastel added a governance layer on top of CEP that can dynamically describe complex sets of events and metrics as situations and prevent them from ever happening again.  AutoPilot is designed to integrate information across all of the separate tiers typical in today's IT configurations, distributed and mainframe from the datacenter to the cloud.

Nastel's AutoPilot monitors and correlates information from all tiers and provides a 360°, fully transparent view of how all the applications, middleware and transactions are performing. Many hospitals have discovered the benefits of using AutoPilot's application performance monitoring capabilities. They have found that installing AutoPilot as part of their IT management strategy has saved thousands of dollars, not only in IT costs, but in other costs related to providing medical care.  More than just saving money, AutoPilot's ability to predict and prevent problems frees up IT staff to work on adding new services and in effect help grow the business.


Denise Rutledge enjoys researching and writing about technology products. She writes on many financial and business topics, including software solutions that impact business performance in the financial industry. In addition to working with clients to develop website content, she writes on how to make a living as a writer on her writing blog.

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