Maintaining IT Health
- From The Confident SMB, July 2010 Issue (Download This Entire Issue in PDF)
When I think of the healthcare industry, I tend to think first of the full-service urban hospital, with hundreds of patient beds, physicians of all specialties, a large data center, and a sizable IT team led by a CIO. But for every such organization, there are hundreds of SMBs that stand on the front lines of healthcare delivery: doctor’s and dentist’s offices, specialty clinics, community health centers, nursing and rehabilitation facilities, and alternative care practitioners.
These organizations are just as vital to patient health as the large hospitals—if not more so. If they’re in the United States, they have the same requirements under the Health Insurance Portability and Accountability Act (HIPAA) to protect patient information. And in many cases, they have similar needs for highly specialized equipment with a corresponding IT infrastructure.
One thing that healthcare SMBs don’t have is a large IT staff. “I’m a one-person operation,” says Meghan Stewart, IT manager at Metrolina Nephrology Associates in Charlotte, North Carolina. “I get everything from server issues to infrastructure problems, from new employee set up to desktop support.”
Building a practice
Metrolina Nephrology traces its roots to 1969, when Dr. Charles Farmer became the first in the region to practice what was then a new specialty, the treatment and prevention of kidney disease. Rapid population growth followed, as the Charlotte area emerged in the 1980s and 1990s as the nation’s second-largest banking center and the home of more than a half-dozen Fortune 500 headquarters. The practice grew along with the city. It moved into a much larger facility in 1975 and opened its first suburban office in Gaston County in 1980. Today, Metrolina Nephrology has seven clinical locations throughout the Charlotte area—including a transplant clinic, an Access center for dialysis patients, and a chronic kidney disease (CKD) clinic. With 27 nephrologists and 120 total employees, it is the largest nephrology practice in the southeastern United States.
Deploying a new infrastructure
Until about six years ago, Metrolina Nephrology was served relatively well by a simple infrastructure: a server running IBM AIX and another running Microsoft Windows Server 2000, with some offices connected to the data center with T1 lines and others with dial-up connections. “The systems needed to be updated, but they were serving us adequately,” Stewart recalls. “Then we decided to deploy an electronic medical records [EMR] system.”
The partners in the practice recognized that such a move would require a full overhaul of IT systems and a dedicated staff person to support the new infrastructure. Stewart was working part time for the practice, and agreed to become a full-time employee and help with the design and implementation of the new architecture.
They chose an Allscripts solution that would not only manage the EMR system, but also centralize practice management and billing. Stewart worked with a number of business partners to deploy new Dell servers at the firm’s data center—about a dozen servers in all to run the Allscripts software, and other new servers to handle other tasks. Suddenly, Metrolina Nephrology had a much more robust IT environment, enabling smoother operations, more efficient billing, and better patient care.
Experiencing growing pains
But this new system was also much more complex to manage. “Once we got the EMR system in place, the data always had to be accessible,” Stewart explains. “And unfortunately, I do have to sleep. “Small things were bringing down our network—IIS logs would get backed up, or a temporary database file would blow up out of proportion,” Stewart describes. “And I would constantly get calls from users about general PC issues. What I really wanted was a single console that would show me everything that I needed across the board—from desktops to servers.”
Finding an appliance solution
For more than a year, Stewart evaluated a variety of endpoint management solutions. “I did a lot of research and looked at almost 20 different products,” Stewart recalls. “Some didn’t have a single console. Others were extremely expensive. For one of them, the installation cost even more than the software itself.”
Stewart determined that Altiris Client Management Suite and Altiris Server Management Suite from Symantec offered all of the functions she needed at the best price. “Once I had decided on the software solution, I talked with a couple of account managers at Dell, and they said, ‘Altiris is now available on an appliance from NetX.’”
So Stewart began to research Symantec Platinum Partner NetX, Information Systems, Inc., maker of the NetX Appliance Server, which ships preloaded with Altiris Client Management Suite, Altiris Server Management Suite, and the Altiris integration components for Symantec Endpoint Protection and Symantec Backup Exec System Recovery. “I really liked what I saw, especially considering how much a conventional installation was going to cost me,” she says.
An easy deployment
Stewart purchased the NetX appliance, loaded with version 7 of the Altiris software, in January 2010. She attached it to the company’s server rack, which was moved two years ago to an unmanned colocation facility operated by tw telecom. A NetX engineer provided minimal setup instructions over the phone, and in a few minutes the system was up and running. “With the NetX appliance, I was immediately able to start doing client discoveries and report on what was in my environment,” Stewart describes.
After five months, Stewart is making extensive use of the Symantec solution. “I absolutely love patch management,” Stewart says enthusiastically. “I would think my endpoints were up to date, but would run a report and realize some of the updates didn’t go in. So I set a policy that any computer without that patch automatically gets it and reboots itself at a time that I specify.”
Stewart recently began using application metering, and she expects to save the company on software license costs. “Some people say, ‘I need Microsoft Office Professional,’ but I can show that all they use is Word, Excel, and Outlook, so all they need is Office Basic,” she says.
She is also using the packaging, inventory, and remote control functionalities of the Symantec software. “The remote control solution has helped me to resolve issues faster. Instead of driving out to a different location to see what a user is seeing, I can see it from my desk, and I can also pull a list of services that are running.”
Stewart plans to use the suite’s software deployment functionality for the company’s migration to Microsoft Windows 7, planned for later this year. “From what I have seen, this functionality should help this migration go quickly and smoothly,” she notes.
Stewart also uses the Symantec Endpoint Protection integration component to pull security reporting information into the Altiris console. Metrolina Nephrology is a longtime user of Symantec AntiVirus and upgraded to Symantec Endpoint Protection in 2008. “We’re using the antivirus, antispyware, intrusion prevention, and firewall technologies that are built into the product,” she notes. “Having good security on our endpoints really makes my job easier.”
The benefit of time
Prior to deploying the NetX/Symantec solution, Stewart wasn’t getting much sleep. “I was working 50 hours or more per week because I had to fix things on an ad-hoc basis when they needed to be streamlined and automated,” she says. “Now that endpoint management is in place, most of these problems are gone. It has saved me at least 20 hours per week.”
As with many SMBs, this time came not from an additional part-time employee, but from extra hours that Stewart worked each week. “I really feel like I have my life back,” she says. “And this has helped me to have the energy to tackle a lot of new projects at work as well.”
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A Planned IT Career, Later Than Expected
Meghan Stewart always enjoyed computers as she grew up. “I’ve always been good with them, and I’ve tended to understand them better than the people around me. I started realizing, ‘I can do something that I really love and get paid for it.’”
After a stint as a physics major, she earned a computer science degree from the University of North Carolina at Charlotte. She had plans to pursue a career in IT—a field that seemed to offer boundless possibilities. Then, just before she completed the degree in 2001, the Internet bubble burst. “I graduated right at the fall of Enron,” she quips.
The scarcity of IT jobs prompted Stewart to return to school to pursue a biochemistry degree, with a new goal of a career in research. But during her first term, a part-time job opportunity arose at Metrolina Nephrology Associates. “They needed a part-time person to do data entry,” she recalls. “But while I was there doing data entry, someone’s computer would break and I would fix it. It snowballed from there.”
When Metrolina Nephrology made the decision to rebuild its IT infrastructure and deploy an electronic medical records system, Stewart jumped at the opportunity to become a full-time employee. “I completed my classes for that term, but I didn’t continue that biochemistry degree,” Stewart says.
While she would have enjoyed biochemistry, Stewart is glad to have landed in her original career field. “I think I’m sticking with IT. I enjoy the challenges. I’m not tied down to a desk. I get to talk with people and help them with issues that are affecting their ability to care for patients. It’s a rewarding career.”
From Customer to Partner
Antwune Gray, vice president of OEM development at Symantec Platinum Partner NetX, Inc., designed the current version of the NetX Appliance Server. The idea for the design came from his former experience as an Altiris customer. “NetX first engaged me as a consultant to deliver professional services,” he remembers. From there, Gray taught training classes for NetX and then moved into development.
“The challenge we’ve faced with our smaller customers is that they don’t have the budget, staff time, or resources to implement Altiris correctly,” Gray explains. “With our appliance, we have integrated best practices from the collective knowledge of our engineering staff to optimize the product and maintain performance. This removes the initial hurdle for getting the product up and running, so we can focus more on teaching them how to use it and making them a happy customer.
“Our appliance is a turnkey solution,” Gray continues. “In most cases, we’re up and running in minutes, saving implementation costs for customers. Our goal is for customers to have usable information by the end of day one so they can immediately begin to realize their ROI.”
Mark L.S. Mullins is a managing editor of The Confident SMB and CIO Digest and senior manager of Symantec’s Global Reference Program team.