Long before IT departments heard the term 24/7, it was the typical workweek for medical professionals and was known more commonly as being on call. An on-call physician would receive phone calls and go to the hospital center to deal with patient emergencies—to verify test results or lab work, order new medication, or conduct surgery—at all hours of the day.

While doctors still have to be in the operating room for surgery, advancing technologies—from cell phones with Web access to home desktops linked to medical center databases—are helping many medical professionals avoid late-night trips to work.

The idea of accessing patient data from any location at any time is obviously a welcome advancement for doctors and patient care and medical facilities, such as the Catholic Health System (CHS) in Buffalo, NY.

“We had to get clinical information into the hands of the people who needed it fast, and easily,” said Doug Torre, director of networking and technical services for CHS.

CHS wanted physicians to be able to log in to the system for consultations on x-rays or lab results—from potentially any PC in western New York, at any time.

Establishing such a connectivity network posed several challenges before CHS found ultimate success.

Point-to-point problems
CHS’s 8,000 employees and 1,200 physicians serve more than 200,000 patients throughout a network of five hospitals, nine primary care centers, nine diagnostic and treatment centers, and a freestanding surgery center. In addition to acute-care facilities, CHS runs 11 long-term care facilities, adult homes, home care agencies, counseling services, social service, and behavioral health programs.

Torre’s first tack in April, 2002, to solve CHS’s networking challenge was to install a point-to-point virtual private network (VPN) that physicians could use to access data either from the external clinics or from home.

The value of a VPN, of course, is its security features; CHS wouldn’t be broadcasting private patient data over the Internet, explained Torre.

With the VPN, time wouldn’t be wasted on travel, and quicker patient care would be achieved. The system, which was to be rolled out to 500 doctors, would also allow physicians instant access to lab results, transcribed reports, and patient health-care information at any time from any place.

User issues hurt deployment
A VPN installation requires software to run on the client machines. That’s not a big deal if all the users have laptops that can be dropped off at the IT shop for system setup and implementation. It’s not a great scenario if most users will access the medical network from home-based PCs.

“People were unhappy because we couldn’t come out to their house and install software on their PC. They just wanted access—they didn’t want to configure a PC,” explained Torre.

While some sophisticated users were able to install the VPN software on their home machines, others required visits by a third-party system integrator—which brought additional costs into the project.

In addition, members of Torre’s team had to develop support documents, procedural manuals, and self-install CDs to help the deployment. In some desperate cases, the IT team even configured PCs and gave them to doctors to take home. That clearly wasn’t a good solution, for cost or manpower, said Torre.

“That doesn’t scale well unless you have deep pockets,” said Torre. “There may be some hospital systems with deep pockets, but we’re not one of them.”

It was at that point that Torre realized the solution was causing more pain than the original access problem, and that the VPN effort wouldn’t be viable for physicians’ off-site access needs.

Torre reset his sights on finding a better, more workable solution. Stay tuned for the second chapter of the CHS effort, and find out why a Web server system was chosen as the right networking prescription.