Glendale Adventist Medical Center has successfully installed SUSE Linux-based thin clients in 65 rooms, using technology from IBM, NoMachine, and Novell, say the companies. Meanwhile, Midland Memorial Hospital is touting cost savings from deploying Red Hat Linux-based OpenVista electronic health record software, says Forbes.
U.S. hospitals are woefully behind corporate America in technology deployments, and when they do purchase computer systems, Unix and Windows are the typical platforms. In recent years, however, healthcare IT software is increasingly supporting Linux, led most notably by McKesson, which switched to Red Hat Linux for its server software in 2007.
Meanwhile, patients are increasingly demanding their own web access from the bedside. Linux thin clients may offer a low-cost way for hospitals to remain competitive while keeping costs low, says IBM. The Glendale, Calif.-based Glendale Adventist Medical Center (GAMC) has already enjoyed significant savings in IT maintenance and energy costs using the new Linux-based thin clients, according to the computer giant, which helped GAMC design the system.
SLED virtualization and a "NoMachine"
An IBM System x3650 server sits on the back end of the thin client system, feeding 65 IBM thin clients deployed in patient rooms in the hospital's new West Tower. Novell's SUSE Linux Enterprise Desktop (SLED), which has added virtualization features in recent versions, especially SLED 11, is used to offer virtualized operating systems for the thin clients.
In the middle sits NoMachine's NX remote access technology. NX, which is bundled with Xandros server, reduces the bandwidth required to run X Window applications over a network by placing caching proxy servers at either end of the connection. The servers work to limit network transfers to "differential" data, such as cursor movements and menu expansions. In the GAMC deployment, NX's data encryption is said to allow secure transfer of confidential information and patient records.
GAMC estimates it has enjoyed a 60 percent savings in electricity costs versus using stand-alone PCs, according to IBM. Meanwhile, IT cost savings compared to overseeing individual PCs are estimated at 98 percent, and patients have responded enthusiastically, claims the company. The virtualized Linux desktops offer a high level of privacy and security, as no data is left on the local client monitor after the patient has checked out of the hospital room, says IBM.
Patients use the computers to communicate with friends and family, investigate medical sites, or blog about their hospital stay. They can also update their web-pages on CarePages, a site where chronic illness patients can report on their condition, FaceBook-style.
In the future, GAMC plans to extend its use of virtual desktops for employee and clinical use. Stated Roger Pruyne, senior programmer/analyst and project manager for the GAMC Patient Computing project, "Just as easily as the hospital provides patients with TVs in rooms, now we provide personal computing. Considering our patients' positive feedback, we're looking to expand the project to other Adventist Health hospital locations."
Midland saves big on open source Linux
Switching to electronic health record (EHR) systems is one of the few approaches to improving the U.S. healthcare system that enjoys bipartisan support. EHR spending is part of the Obama administration's stimulus plan, and it is likely to be prominently featured in the latest bill being formulated in Congress. Cutting costs is also a high priority, which should give a boost to open source medical software in the coming years.
One successful experiment in Linux-based EHR appears to be well underway at Midland Memorial Hospital in Midland, Tex., according to a recent Forbes story. The Ed Sperling story interviews Midland CEO David Whiles on a five-year old project to replace Midland's aging healthcare system. The legacy system covered only front-office and pharmacy departments, but Midland wanted to move into clinical operations and improve patient safety via a barcode-enabled EHR system, complete with computer-assisted physician order entry (CPOE).
Shocked by the price of commercial healthcare IT systems, which ran about $20 million at the time, Whiles was quoted as saying that Midland chose the VistA (Veterans Health Information Systems and Technology Architecture) system, which was developed by the Veterans Administration. VistA, which long predated the infamous Windows OS, is used by all 160-plus VA hospitals in the U.S., as well as their outpatient ambulatory clinics.
Although VisTa is typically run on Windows, Midland chose the open source Linux OpenVista version (pictured above), which is supported by Medsphere Systems Corp. The software runs on Red Hat Linux installed on Hewlett-Packard servers. The Midland system also depends on a database system from InterSystems Cache, which Whiles says is the only proprietary component.
According to Whiles, Midland spent $6.3 million to install the EHR system, including hardware, with Medsphere acting as the main consultant. The system comprises 600 wireless workstations, including 80 mobile cart workstations, and encompasses nursing care, physician care, and electronic documentation. It also extends into lab, pharmacy, respiratory therapy, and other hospital departments, Whiles told Sperling.
Since moving to the new system in early 2007, Midland has seen considerable savings in paper storage costs, as well as improved patient safety. "It certainly improves patient safety in a number of areas," Whiles was quoted as saying. "Medication is a big one. It's certainly more foolproof than paper. It's a complete record of the patient care."
