North Shore Medical Center

Healthcare Provider Cuts Clinical System Costs by 30 Percent, Enhances Quality of Care

North Shore Medical Center in Massachusetts ran its clinical technology system for doctors and nurses on aging computer hardware and software that frustrated medical professionals, cost the IT department precious time and resources to maintain, and inhibited the ability to respond to new business requirements. In its place, the healthcare provider adopted a thin-client solution of desktop and mobile units, which uses Microsoft® technologies. The results: Logon takes seconds instead of minutes, and reliability is improved. Hardware and software costs are cut by 30 percent; help-desk calls are expected to decline 50 percent; and total cost of ownership is down by about 30 percent. Best of all, the solution gives doctors and nurses more time to talk with each other and with patients, enhancing the quality of care.

 

Situation

Some people think immediate access to their computers is a life-and-death matter. For the doctors and nurses at North Shore Medical Center, just north of Boston, Massachusetts, it’s exactly that.

At that 70-facility healthcare system, the largest in its area, computers provide information on patients that doctors and nurses need to ensure quality care. They provide access to other crucial resources within the healthcare system. And they can be powerful tools to assist in the delivery of patient care.

With this thin-computing solution, we can spend more time talking with patients, which translates into a better understanding of how to give them the best possible care. Dr. Nathan Kaufman Medical Director of Information Systems, North Shore Medical Center

But the North Shore computers—especially the PCs used by doctors and nurses to access patient information—were aging. As users downloaded increasing numbers of third-party applications from the Internet, the computers operated with increasing slowness. It could take four to five minutes to log on to the network and access a medical application or patient file—an eternity when busy healthcare professionals are in the midst of providing care.

Because there were at least three healthcare professionals for each computer, and because computers were shared at locations such as nurses’ stations, those professionals often had to wait several minutes or more before they could begin the logon process. If they stepped away from those computers for a moment, a colleague could log on, forcing the first professional to find another computer, perhaps down the hall, and begin the process all over again. Similarly, as doctors and nurses moved through the hospital, they had to repeat the logon process at a nearby computer each time they wanted to access the network.

These were highly significant issues for North Shore Medical Center. For example, the healthcare provider had implemented an order-entry system to record and process any orders a doctor might have for a patient, such as diet, medications, tests, and consultations. But six months after deployment, doctors were revolting against the slowness of the order-entry system and threatening to return to the previous, paper-based system, according to Dr. Nathan Kaufman, Medical Director of Information Systems, North Shore Medical Center.

“It was faster for doctors to use pen and paper than to use the computer system,” says Kaufman. “Private attending physicians have limited time; neither they nor their patients want that time to be consumed accessing technology.”

There was also a competitive aspect to this challenge. Because the medical center’s doctors were not on staff—that is, they were in private practices and admitted their patients to the medical center—a sufficiently high frustration level with the technology could drive them to admit their patients to a competing medical center.

The PCs had been purchased and deployed enterprisewide in a single phase. That meant that they were all ready for replacement at the same time. This was both a challenge and an opportunity for the IT department. The challenge was to minimize the disruption of replacing aging hardware. The opportunity was to move to a solution that would minimize disruption not just at the time of deployment but also throughout the life cycle of the new computer hardware and software. For healthcare professionals, the benefit would be less frustration and more time to devote to patient care. For the medical center, the benefit would be a significant reduction in continuing costs of maintenance and, thus, in total cost of ownership.

Solution

To begin to address these challenges, North Shore Medical Center defined its needs in terms of clinical, business, and technical requirements.

The clinical needs were for a solution that healthcare professionals could access faster, would not disrupt their work to implement support and maintenance, and would have computing sessions that followed professionals as they moved throughout a health-care facility. The business requirements for the new solution were to minimize the upfront cost of hardware and software replacement, as well as the continuing cost of maintenance, and to provide the flexibility to meet new needs. The IT department, meanwhile, defined the technical requirements as facilitating centralized support, reducing the total need for support, and enabling the infrastructure to integrate new technologies.

North Shore Medical Center considered several approaches for a new solution—including multiuser terminals, blade PCs, and a virtual desktop—and decided to adopt them all. The new solution is based on technologies including Citrix Presentation Server 4.5 Platinum Edition application virtualization software, the Terminal Services feature of the Windows Server® operating system, Microsoft® SoftGrid Application Virtualization version 4.0 for Terminal Services, and Windows® XP Embedded.

The new solution enables us to reduce costs, upgrade performance, and provide a foundation for continued growth. Demetrios C. Papayannopoulos Corporate Manager of Technology Support and Operations, North Shore Medical Center

“No single technology met all of our requirements, but technologies from Microsoft, Citrix, HP, and others enabled us to replace standard computing with a thin-client solution that optimizes our core infrastructure,” says Demetrios C. Papayannopoulos, Corporate Manager of Technology Support and Operations, North Shore Medical Center. “The new solution enables us to reduce costs, upgrade performance, and provide a foundation for continued growth.”

The healthcare organization deployed the solution in two configurations: a desktop version for doctors and nurses at nursing stations and other stationary environments, and a mobile version that nurses in particular can take with them as they check on patients, dispense medicine, and perform other healthcare tasks. The mobile part of the solution puts a monitor, keyboard, and specialized input devices, such as a bar code reader, on a cart that nurses wheel from room to room. It connects wirelessly to the enterprise network.

The solution rollout took about a year. Applications run from the central data center, with doctors and nurses interacting with those applications from the desktops and mobile units as though the software was running locally. On the server side, the applications run virtually within isolated areas of the servers, which eliminates conflicts among applications and between the applications and the operating system.

One of the key applications used with the thin-computing solution is called Medication Administration Check, or MAK. A nurse dispensing medications first uses a bar code reader from the mobile unit to scan a bar code on the patient’s ID bracelet, which brings the patient’s record from the central data center to the mobile unit’s screen. The nurse then crosschecks the medication on hand with the prescription in the patient’s record by scanning the medication bar code. After confirming a match, the nurse dispenses the medication and enters the activity into the patient record.

Benefits

The thin-client computing solution meets a variety of goals that North Shore Medical Center set for itself. The solution speeds and streamlines computer access for doctors and nurses, helping increase the quality of patient care. It cuts the costs of new hardware and software, as well as the continuing costs of maintenance. It increases the organization’s ability to respond to new business needs, and it helps attract and retain doctors affiliated with the healthcare system.

Improved Clinical Access Enables Better Patient Care

The thin-client devices cut logon time from five minutes to five seconds, compared with the previous hardware. A doctor or nurse who logs on at one device and uses an application can move to another device and immediately access the same computing session, rather than having to reopen the application and locate the data again. Because the IT department can manage the thin-client solution and its applications from a central location, there is less need for technicians to appear in patient care areas to fix devices manually—and interrupt the delivery of care to those patients.

“Being able to initiate a computing session much more quickly, to move to a different location, and then to bring that session back up on another computer exactly as you left it—that’s a tremendous advantage,” says Kaufman. “It saves the doctor or nurse time, it gets them the information they need when and where they need it, and it enables them to focus on patient care rather than on the use of technology.”

The result, says Kaufman, is that doctors and nurses have more time to talk with patients about their care, and with each other about that care. “When doctors and nurses are rushed, the first thing that goes out the window is quality interaction with patients,” he says. “With this thin-computing solution, we can spend more time talking with patients, which translates into a better understanding of how to give them the best possible care.”

Total Cost of Ownership Cut by About 30 Percent

The solution meets the healthcare system’s business requirements for lower costs and greater agility. North Shore Medical System estimates that the hardware and software for the client side of the solution cost about 30 percent less than replacing the aging PCs with new models.

Beyond the initial savings, the organization sees a range of continuing savings that will contribute to lower total cost of ownership. Centralized software deployment and administration reduces the need to send technicians to the system’s 70 facilities to troubleshoot computers. Because the thin-client computers lack hard drives, they are not subject to infection by viruses, both boosting their reliability and eliminating the need to run antivirus software on them. That in turn eliminates the need for monthly security updates on every client. Papayannopoulos estimates that the healthcare provider will reduce maintenance time and cost by more than 90 percent.

Greater reliability will also help cut the number of help-desk calls to troubleshoot computers. Papayannopoulos estimates help-desk calls will decline by 50 percent. Based on these savings and others, he estimates that total cost of ownership will decline by about 30 percent.

The upfront and continuing savings represent dollars that North Shore Medical Center can reinvest to respond more quickly and effectively to new business needs. For example, the MAK application for medication dispensing replaced a previously manual process. The switch to thin-client computing made MAK both technically and financially possible. “We might have come up with this application before, but we didn’t,” says Papayannopoulos. “We only created MAK after we developed the more technically advanced and cost-effective infrastructure to run it on.”

Solution Helps Attract, Retain Doctors

North Shore Medical Center wanted new clinical technology not only to enhance patient care but also to address the frustrations of the nonresident physicians who admit patients to the healthcare organization’s facilities. The new solution has accomplished that goal, as well.

“The thin-client solution definitely helps attract and retain private-practice physicians who affiliate with, and admit patients to, the medical center,” says Kaufman. “Doctors who trained in large academic settings with up-to-date technology want to work in this type of environment, and other community hospitals don’t offer it.”
 
Microsoft Solutions for the Healthcare Industry
Healthcare and life sciences organizations are under tremendous pressure to meet regulatory requirements, improve patient care, and reduce the time it takes to develop drugs and take them to market. To meet this challenge, Microsoft and its partners have developed cost-effective solutions that enable healthcare organizations to streamline and automate daily processes that improve productivity and deliver information whenever and wherever it is needed. The result is enhanced productivity, safety, and quality.

For more information about Microsoft solutions for the healthcare industry, go to:
www.microsoft.com/healthcare

For More Information

For more information about Microsoft products and services, call the Microsoft Sales Information Center at (800) 426-9400. In Canada, call the Microsoft Canada Information Centre at (877) 568-2495. Customers who are deaf or hard-of-hearing can reach Microsoft text telephone (TTY/TDD) services at (800) 892-5234 in the United States or (905) 568-9641 in Canada. Outside the 50 United States and Canada, please contact your local Microsoft subsidiary. To access information using the World Wide Web, go to:
www.microsoft.com

For more information about North Shore Medical Center, call (978) 741-1200 or visit the Web site at:
www.nsmc.partners.org