DSAT was invited to solve some major IT issues for a medium sized medical practice of 12 physicians with nine offices spread across three counties and a staff of 50. The practice had been expanding while their workstations and network had not. Their software was still DOS based and their days were filled with network and system errors.
The basic infrastructure was setup so each computer workstation in the offices would dial into another dedicated computer system at their main office via standard modem connection running a remote PC control program, which was then networked to their failing server. They had 16 dedicated computers, each with its own telephone line providing screen image transfers to the remote offices. Frequently, the dedicated computers being dialed into would crash. The end user at a remote office would have to call the main office and have someone reboot their dedicated computer. It was a hodgepodge network, at best. Because the computer network was not reliable, redundant paper medical records had to be hand carried between the offices and their central medical records library.
The billing department operated much the same way. Frequently, they had to perform data restoration from tape back-ups because when the server went down, the data files would become corrupted. Medical billing information was lost and had to be re-created. Undoubtedly, things fell through the cracks.
DSAT was charged with creating a sound IT solution which would network their clinical offices, administrative offices and billing department. Patient medical records and billing information had be made available to all remote offices. The information had to be secure. Data retrieval had to be fast and reliable. With HIPAA requirements specifying patient data confidentiality, their network had to assure that unauthorized access was not possible, and that the information transmitted between locations was secure and encrypted. New electronic medical records management software had to be implemented and the existing historical data transferred to the system. Other issues were to be addressed which would improve general operations, such as reliable automated data backup, internal and internet email, internal messaging, high-speed Internet access for the physicians and video conferencing capability. Additional features included instant access to lab results for the physicians.
Of course, there were more contemporary capabilities that would be added in the future, such as the introduction of PDAs and tablet PCs with wireless capability, as well as automated prescription writing, but these 21st century luxuries had to wait. Rebuilding the basic IT infrastructure was the immediate goal.
We brought in three servers running MS Windows 2000 Advanced Server, MS Exchange Server, MS Terminal Services and Oracle, provided new or upgraded workstations for all the staff, installed high-speed DSL Internet access at each of the facilities, and started a training program for the staff. The multiple servers at the main office provided for necessary redundancy to assure 24/7 operations. The remote offices had instant access to the servers via the high-speed DSL lines using Terminal Services and a virtual private network (VPN) running IPSec to secure the information as it was in transit. With the newly installed electronic medical records management system, the medical staff and billing department were able to function as they never had.
The results of our basic effort to bring the medical practice into the 21st century were immediately visible. The medical staff had information when they needed it. No more hand-carried medical records from office to office. The medical staff and administrative support staff could communicate as never before. The billing department was able to concentrate on its function and over the first six month period from initial installation, their revenues increased $60,000 to $80,000 per month! All as a result of a properly functioning IT solution. One year later, their ROI on a $300,000 investment was over $500,000.