WASSER Studios Reduces Long-Term Costs With a Consolidated, Virtualized Infrastructure

We went with leading edge hardware so that we could grow into it over time and then focus on minimizing our management. Over time, that pays for itself.”
– Trevor Koop, IT Manager, WASSER Studios

A Change in IT Strategy

WASSER Studios decided to change its IT strategy in an effort to better support the business. It transitioned from a near-term focus on acquisition cost to a broader, long-term emphasis on ease of management, high asset utilization and low total cost of ownership. As a result, it was able to deliver a more reliable and functional IT infrastructure that cost the company less over time.

Headquartered in Seattle, Washington, WASSER Studios creates technical documentation and content for clients such as HP, Sony, Microsoft and Weyerhaeuser. It employs a variable number of people based on project demand – some are contractors hired on temporary basis. At the main office, the number of workers at can range from about 50 to 125 people, plus project managers and writers working remotely and at client sites. Its computer systems must be able to support a fluctuating number of local and remote users.

“WASSER Studios previously had taken an approach where we would buy previous-generation technology and then support that over time with parts from various places,” said Trevor Koop, IT Manager of WASSER Studios. “It was a very low cost method for us to keep everything up and running.” While they were able to support the business reasonably well with this approach, it required a significant amount of troubleshooting and reactive problem solving to maintain the infrastructure. Savings on hardware were eventually consumed by the cost of managing it. Occasional downtime of secondary applications would also slow down office productivity. “It’s never that we had work stoppages, but we had definite bottlenecks or pinch points,” he said.

To a Consolidated, Virtualized Infrastructure

Rather than continue with the status quo, WASSER opted to consolidate and virtualize the server infrastructure and employ more sophisticated management tools. “We decided to do that in an effort to consolidate and get off of the older, faultier server hardware that we had. In doing so, the hope was to minimize management and mitigate hardware failures, which we did,” said Koop.

The company deployed Microsoft Windows Essential Business Server (EBS) initially as a beta customer in late 2006.  This solution, which has since become generally available, bundles and integrates several Microsoft technologies for IT management, messaging and security at a discounted price. These include Microsoft Windows Server 2008, System Center Essentials, Exchange Server and Forefront Threat Management Gateway. Windows EBS targets midsize enterprises.

The software ran on an HP BladeSystem c3000 with five HP ProLiant server blades running AMD multi-core Opteron processors, two disk storage blades and an LTO tape blade. The BladeSystem c3000 is a flexible, all-in-one infrastructure in a single enclosure. Three of the server blades ran the Windows EBS components for management, messaging and security, respectively. The fourth blade supported multiple applications in a Microsoft Hyper-V virtual environment, and the fifth was a Terminal Services Gateway Server for remote users to securely access to internal corporate resources.

“We have typically used AMD chips,” said Koop. “We’re very comfortable with the performance and the reliability of them, so we tend to stick with them. And it’s worked out really well for us.”

Easier Management and Lower TCO

“So with this new deployment,” he continued, “we went from having all these disparate hardware platforms to having most everything in the blade server. We went with leading edge hardware so that we could grow into it over time and then focus on minimizing our management. Over time, that pays for itself.”

In particular, System Center Essentials helped ease the management burden for clients and servers with its monitoring, alerts and automation. “It really allowed us to be more proactive in maintenance, patching clients, monitoring applications. We know something is going to happen before an end user reports something going haywire on their desktop,” he said.

Hyper-V boosted server utilization by running multiple applications in a virtual environment. “This enables us to maximize the capacity of the hardware and also minimize the cost of the hardware that we have to purchase, whether replacement parts or whole servers,” he said. “From an energy efficiency standpoint, I know that Hyper-V runs a lot cooler than if we had all these older physical servers still in the room. Although I don’t have metrics, I can make a safe assumption that we’re being a lot more energy efficient.”

When asked what he liked most about this new solution, Koop responded: “I like the fact that in my current situation I can really be proactive in management. I can see something may be a problem and take care of it before it becomes a larger problem. But it also gives time to focus on the future. Because I’m not running around putting out fires, I have more time to think about what I can do with our infrastructure in the future to be more productive and to allow WASSER to provide more services to potential clients. So I think in my small ways, I’m able to do that, helping contribute to the growth of the company.”

 

 Copyright © 2009 Apropos LLC. All rights reserved.

Oliver Family Healthcare Finds Electronic Health Records Are a Win for Patients and Clinic

I really felt the future was going to be electronic health records.”
– Dr. Greg Oliver, Oliver Family Healthcare

Out With the Old – Paper Charts

Dr. Greg Oliver, head of Oliver Family Healthcare in Indianapolis, Indiana, was early to see the benefit of electronic health records for health care providers. “I had been in practice the first twelve years of my career and then I sold my practice to a hospital and went to work for them,” said Dr. Oliver. As medical director for multiple clinics, he kept abreast of new technologies for computerized healthcare. “I thought the future was going to be electronic health records from what I was reading. So the hospital gave me the assignment to try to find a product for all their clinics. I narrowed it down to a couple of products, and about that time, the hospital decided not to go forward with it due to costs.”

When this project stalled, Oliver saw an opportunity to buy back the family practice and run it more efficiently using new IT systems. “I decided to go back into private practice for several reasons,” he said, “but one was I really felt the future was going to be electronic health records.” The hospital allowed him to keep the practice in the same location since it was a larger referrer to the hospital.  He and a nurse practitioner worked together to go back into private practice.

Having used charts for so many years, Oliver knew the limitations and costs of a paper-based system. “There wasn’t a day that went by where one of my staff didn’t say the unfortunate thing, ‘Your chart is lost.’ I’d always tell a patient that it’s really not lost. It’s here. Someone just can’t find it,” he said. Electronic health records seemed a more reliable and cost-effective solution. “I knew that it was expensive to handle charts and keep them stored. I just thought this has to be cheaper to do, which it definitely was. We were doing transcription at the time, and I wanted to save on transcription costs.”

At the time, he did not anticipate that electronic health records would add significantly to the quality of patient care. “That wasn’t really one of the things I thought I would gain from it. That now turns out to be one of the greatest benefits of it,” he said.

In With the New – Electronic Health Records

Oliver chose Allscripts Professional EHR for electronic health records and Allscripts Professional PM for practice management (known at the time as the A4 HealthMatics System and HealthMatics Ntierprise). After considering many aspects of the competitive solutions, one feature in particular made Allscripts stand out: “The reason I chose that over the other was it seemed to provide a very easy-to-use physician interface with a computer,” he said.

Dr. Oliver took an aggressive approach to rolling out the new system. He and the nurse practitioner took a week’s vacation from their hospital employment and traveled to Allscripts’ offices in North Carolina to learn the new system and make customizations to the software. After returning, they trained the staff and made preparations. On July 1, 2003, they went live with the new system and started the private practice on the same day. “We had a trainer from Allscripts here on site with us. The first day we went live in our practice we saw 60 people. They told us we shouldn’t do that. I know a lot of practices will say, ‘Stay with your charts and just do three or five on the system.’ We just went live,” he said.

In advance of a scheduled appointment, a worker entered key details into a patient’s electronic record. They also carried the patient’s chart into the room in case it was needed. Oliver continued, “I remember being in an exam room and telling a patient, ‘Hang on, I don’t know what I’m doing here,’ and would walk out. The trainer would say do this, this and this. And I would go back in the room and take care of it. The first few days we were in the office very early, six-thirty or seven a.m., and didn’t leave until probably nine or ten p.m. But very quickly within that first week, having seen hundreds of patients on the new system, we were rolling. It was fine. So my thought on it was if there’s going to be pain, let’s get it over with quickly, and it turned out, I don’t think we had a lot of pain.”

By the end of the year, they rarely needed the paper charts, and by the end of the second year, they no longer used them.  The old charts were stored for compliance purposes and for rare instances when they need to see an old test result.

More Efficient, More Productive, Better Care

The Allscripts Professional EHR and Professional PM solutions helped the practice to operate more efficiently and cost-effectively and improved patient care. Merely having access to timely, reliable records and reports enabled medical workers and staff to accomplish more each day. They were able to see more patients. At the end of the day, every patient visit was ready to send to the insurance companies. Collections were much higher than before, and revenues also climbed. The system notified patients automatically to schedule routine exams and tests, such as for hypertension, diabetes and high cholesterol. “Not only has it increased our ability to get the patients in for things that we think are important for their healthcare, but because of that, it increases our revenue also,” said Oliver.

More recently, Oliver Family Healthcare implemented online visits. For current patients experiencing minor issues, they can go to the website, enter symptoms and request an online visit. This generates an email that is sent to the on-call doctor’s iPhone. The doctor views the patient request, symptoms and medical history from their iPhone or PC. With this information, the doctor can address the health issue, send a prescription, request the patient come into the office the next day or refer to an emergency room. The benefit to patients is they can access their own doctor who is aware of their medical history from home. They do not have to drive to a walk-in clinic. From Oliver Family Healthcare’s perspective, the online visits are chargeable, though only if they can address the problem, and not if it requires further evaluation or a referral. The patient visit is also documented and becomes part of their medical history. “So we have implemented that in the last couple months,” said Oliver, “and without an electronic health record, you couldn’t do that.”

Just jump in, you’ll be okay. Because there is no way that with a paper chart you can take as good care of a patient as you can with an electronic health record.”
– Dr. Greg Oliver

Advice for Healthcare Providers

When asked for his advice to other medical practices and clinics that may be considering electronic health records, Dr. Oliver responded: “I would tell anybody, especially a small practice, just jump in, you’ll be okay. Because there is no way that with a paper chart you can take as good care of a patient as you can with an electronic record. And most of it is because you can’t do anything with the data that’s in a chart in a file. This software is doing things and inviting patients to come back for their regular screenings and checkups and blood tests while I’m sleeping. It’s doing this automatically. There is no way you can practice that type of medicine with a paper chart. Is there an expense to getting involved? Yes. But we noticed that for the last five years, our practice revenue has gone up between twenty-five and thirty percent every year. A lot of is just because we strategically look at how we can ladder technologies in our practice and link them to our electronic health records and practice management system to, number one, take better care of the patient and, number two, become more efficient over time and be able to capitalize financially on our ability to take better care of our patients.”

 Copyright © 2009 Apropos LLC. All rights reserved.