Still bruised by its Y2K purchases and recovering from this year’s SARS crisis, the CIO of several London hospitals says the current outlook for her IT recovery plan is bright.
A veteran of the oil and gas industry, Diane Beattie, vice-president and integrated chief information officer at London Health Sciences Centre (LHSC), one of Canada’s largest medical teaching facilities and cornerstone of an informal network of regional hospitals, said she faced a steep and unfamiliar learning curve when she assumed her post 18 months ago.
“(The hospital’s) focus is on patients,” Beattie said. When it comes to IT investments, “they’re looking at ROI, but they also say, ‘for $2 million, we could have bought an MRI.'”
Besides grappling with a new mindset, Beattie arrived at a time when the system began to face big challenges. For example, only a tiny fraction of Ontario’s hospitals currently generate surpluses. Baby boomers are entering the years when they will most tax the health care system. And the average age of Ontario nurses is almost 47; Beattie noted that for every five that retire, which many are choosing to do early, on average only one is available to replace them. Thus finding ways to trim IT costs and boost service levels was paramount.
When she initially consulted with her IT staff, she learned that what appeared to be good news on the surface was, in reality, quite different. “As I got here, I said ‘you guys did a good job,'” she recalled, referring to the handling of Y2K. “But they said, ‘we put in a lot of new technology, but it didn’t drive change through at the organizational level.'”
A subsequent audit of the LHSC also revealed that nearly 60 per cent of its 5,500 PCs, including aging HP 486 units, were so old that the warranties had long since expired. That’s when Beattie embarked on an overhaul of the hospital’s internal IT environment, part of a much larger, region-wide effort to bring down IT costs, drive up efficiency and reduce the number of platforms and suppliers, all with the goal of having one single record for every patient.
As part of the project, she commissioned Peter Gilbert, coordinator of technology solutions at LHSC, to improve the desktop environment and tighten up access to legacy systems.
Gilbert’s first reaction was to think thin. “We were already in that mindset,” he said. “We were…trying to keep (our platforms) common.”
So he oversaw a rollout of MetaFrame Presentation Server, central management software from Citrix Systems Inc., at LHSC and St. Joseph’s Health Care. With it, Gilbert said he is able to push out application upgrades for the hospital’s clinical software, Cerner Millennium, as well as an array of business applications, including PeopleSoft HR and Financial, Microsoft Office, WordPerfect and Groupwise. He can also begin the process of locking down user desktops and devices and keep patient data flowing to medical staff regardless of their location.
“And from a hardware point of view, it has given us the time window we need to make…transitions,” Gilbert added.
For instance, LHSC is now able to live with its aging fleet of desktops until a suitable leasing agreement can be hammered out. Second, it’s able work around a decision from one of its medical applications providers to end support for Windows 95, which is still pervasive throughout the organization. “We (would have) had a big deal on our hands,” Gilbert said.
And though the upfront costs were relatively high – it cost nearly $2 million to implement the solution at LHSC – rolling out the software in the other facilities would be less costly. For example, it cost only $400,000 to repeat the process at St. Joseph’s.
Locking down the desktop has long appealed to IT departments, but in many cases the risks appeared daunting. Uptime on the management server becomes paramount, printing can become problematic and users often rebel at the prospect of giving up free access to fully loaded PCs. Gilbert said he weighed and dealt with those very issues. He installed seven, two-processor Intel rackmount servers to run the infrastructure, “and that’s before touching any application,” he added, “and that’s been rock solid, along with a good SQL database.”
Together the cluster supports 100 application servers. “Also, we put a lot of discipline on how we put code into that environment.” And user buy-in hasn’t been an issue so far, Gilbert said. “The user population is maturing, for sure. They know that with flexibility comes vulnerability.”
Today, staff can upload patient files from anywhere in the hospital, and via any device.