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Better Than a Silver Bullet

March 1, 1998
by Alan Joch
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After a decade of PC proliferation and custom software, many healthcare IS managers have nagging doubts about the economic benefits of their computer systems. "If someone says they’re reducing costs, they’re probably lying," says Roger Grimes, regional director of networks and technology for Bonsecours/Hampton Roads, a Virginia healthcare system. "Hospitals may be changing where they’re spending their money--switching from mainframes to PCs. But what they’re saving on mainframe costs is being eaten up on more training and more support for the people using PCs."

Last year, The Gartner Group (Stamford, Conn.) crystallized these doubts with its estimates of "total cost of ownership" or TCO, the maintenance and administration costs for PCs after installation. The research firm said large organizations spend $8,000 or more per year to support each PC. Healthcare technologists quibble with the number--some say a more realistic figure is $1,000 annually--but no one argues that support costs are significant and can sink an IS budget if they go unchecked.

Fortunately, you don’t have to watch TCO expenses spiral out of control. Healthcare organizations can take cost-cutting steps today, some that don’t require any additional expenses but can save as much as 20 percent in support costs. Just don’t rely yet on initiatives like Zero Administration Windows, from Microsoft, or Novell’s code-named ZEN strategy, no matter how many headlines they grab. Healthcare IS managers say these TCO solutions are still too immature to work as advertised. The "thin client" movement, centered around stripped down network PCs that run applications off of a central server, isn’t ready to replace traditional PCs in most healthcare organizations yet, either. "No one is sure a network PC will result in savings," says Steve Ditto, vice president of the network integration services practice for First Consulting Group, Long Beach, Calif. "They’ll require a lot of communications capabilities that would overwhelm most healthcare networks."

Instead of "silver bullets," the real support savings come from a mix of techniques, like standardizing on a limited variety of hardware and software, and tools, like software that lets you monitor PCs and networks from a central workstation. Apply the following five measures judiciously, and you can cut your admin costs by 20 percent to 30 percent--or $200 to $300 per PC per year, experts say.

Step 1

Conduct a comprehensive technology audit
First, gather detailed information about your organization’s hardware and software resources. If you’re like most healthcare organizations, prepare to be shocked by the results. "Our experience shows that most hospitals underestimate by at least 30 percent the actual number of PCs, printers and network ports they have," Ditto says. One First Consulting client thought it had 450 PCs, while an inventory turned up 1,450 computers. The problem: A large amount of hardware and software comes into organizations outside the formal IS purchasing mechanisms, from research grants, for example. But when these systems crash, the IS department is still called to fix them.

Even more glaring is when an inventory reveals an organization is throwing away money in unnecessary software licenses. "One hospital we worked with had 2,000 PCs for 3,000 people, but was paying for 6,000 Novell Netware licenses," Ditto says. "Every time a department bought a server it automatically purchased a multiuser license."

A comprehensive inventory will help you keep these cost drains in check. First, purchase asset-management software, such as IBM Tivoli, Microsoft SMS, Novell ManageWise, or Tally Systems NetCensus, which let you centrally count each networked computer and create a system-resource profile for each box. Next, walk through your organization to count and profile any systems that aren’t connected to the network.

Once you’ve gathered the information, create a central database accessible by your help desk staff that stores a list of applications and system resources for each PC. This information will give help desk people a jump start when a support call comes in and may avert sending a technician to physically inspect the problem PC.

One caution: Many hospitals avoid budgeting for an audit. Doing the job right, however, requires about $100 per PC, whether you hire an outside consultant to do the work or take IS staff away from its regular work to do the count. Either way, look at the cost as an investment. If configuration information exists in a central database, and help desk staff don’t have to physically go to a PC to fix a problem, "it’s like putting $100 back in your pocket each time there’s a problem," says Ditto.

Step 2

Control hardware and software proliferation
Second in importance to a comprehensive inventory is limiting the variety of hardware and software your organization uses. Lack of standardization springs from a cultural attitude that many people have toward the PC on their desktop: It is fair game to be customized with any hardware or software they see fit. To get support costs under control, you’ll have to change this attitude. "I know one organization that has stopped referring to desktop computers as PCs," says Bob Warren, senior manager for First Consulting Group. "Instead, it uses the term ’workstation’ because there’s nothing ’personal’ about the computers."

The issue, he says, is that when a doctor, nurse, or support staff member "customizes" a system with his or her own hardware or software, the IS department inherits a support problem it didn’t expect if there’s a compatibility conflict or a system crash.