Lowering The HIT Footprint By Endpoint Modernization

By Simon Clephan, VP, Business Development, IGEL

Healthcare providers, working with tight operating margins, face a classic horns-of-the-dilemma scenario: they must continue to grow their business, and to do so, they must remain competitive in their level of service. This necessitates a refresh of IT technology and a resultant uptick in budget, at a time when overall operational costs continue to rise. All these pressures are felt at the endpoint, and more so now that doctors and nurses are using multiple devices and often traveling to varied locations during a work week. Providing a secure, consistent user experience at the endpoint – one that contributes to quality of care - is now more important than ever.

Despite cost pressures, the healthcare industry is moving toward more adoption of tech initiatives to modernize IT operations, mindful of the need to improve quality of care. An Ernst & Young survey of healthcare executives showed 91 percent of the executives surveyed have begun at least one digital initiative in the last 12 months or plan to do so in the next year. Some 53 percent of executives have invested in technological adoption to improve the patient experience, and 45 percent said they would in the next 12 months, according to the survey.

Not surprisingly, the EY study found insufficient funding topped the list of barriers to further performance initiatives, at 46 percent. This was followed by fear of the unknown (35 percent) and privacy issues and concerns (32 percent).

Endpoint Facelifts

Upgrading IT technology at the endpoint, with limited budget, is a classic example of the challenges facing healthcare providers today. A representative case is Diversicare, a Tennessee-based provider of skilled nursing, long term care services. Diversicare needed to transition from legacy, outdated equipment – notably fat clients – to a companywide, virtualized desktop environment, deploying thin clients. The company had recently acquired 22 centers which were already on a Citrix VDI platform and had a version of thin clients in use. April Marbury, Diversicare CIO, began looking for an endpoint solution that could integrate with Citrix, was turnkey and could enable integration and standardization across a total 76 centers, in 10 states.

Diversicare had two main goals in executing this shift to virtualization: to execute a facelift on old equipment without having to spend heavily on new machine investment, and to lower its IT footprint to enable easier acquisition of additional facilities in the future.

“Margins are tight, so we need to get creative about using technology to ensure the productivity of our skilled nursing staff. We have to continue to move the dial without adding resources and considering new approaches,” said Marbury. At a Citrix Executive Briefing Center event last year, Marbury discussed her goals with colleagues and came back with new insights into available endpoint solutions, which included Raspberry Pi. Diversicare Director of IT Operations, Shanna Persful, then further evaluated the various options and learned about economical, thin client software that could sit on top of the existing legacy machines, transforming the equipment into a modern Linux OS, and working directly within the secure Citrix environment.

Security and simplicity of transition were key factors in Diversicare’s decision making process. “We acquire a new center and literally at midnight we make the switch to Diversicare’s IT infrastructure. The switch has to be fast, secure and seamless,” said Marbury.

To add to the complexity of adding new facilities, Diversicare also was moving from two clinical EMRs to one EMR via the thin client deployment. Working in a distributed model across 76 centers, with kiosks and nursing stations, the healthcare staff needed active daily living (ADL) patient information at their fingertips, without any delays. A thin client solution had to be able to provide nursing staff with a consistent, efficient, secure user experience – to enable optimum quality of care.

Lowering The Footprint And Budget

Mindful of its need to conserve capital, at the same time, moving the organization to a modern VDI platform, Diversicare, with Persful’s recommendation, made the decision to deploy a software driven, thin client solution that could literally be deployed overnight and move the company quickly into a standardized Linux OS environment. “Repurposing the old hardware gave us exactly what we needed, and we began deployment and were in and out within 30 minutes at each center. The shift was basically transparent to the end user as it created a single, homogenous desktop landscape,” Marbury recalls.

To date, Diversicare estimates savings to be $635,000 annually – more than half in eliminating new hardware costs, and the remainder in reducing software expenditures. “Kiosks are a big part of our deployment and the thin client software enabled us to save the costs of having to replace old kiosk platforms,” Marbury explained.

Here are some considerations in looking for solutions to lower IT footprint and modernize the endpoint:

1. Ease of Integration:  There is no time for downtime in healthcare. Executing a lift from a fat client to a thin client, for example, must be seamless and transparent to the end user.
2. Secure Access Controls:  HIPAA and other regulations demand compliance in medical data privacy. An endpoint solution must be able to provide application access control, to prevent unauthorized access to patient files, and to specific devices.
3. Simple Management:  Healthcare organizations are facing a growing nursing shortage, with a projected 1 million nursing job openings by 2024. Nursing staffs are busy and have no time for glitches in their software use at a kiosk or desktop. Therefore, endpoint management to support busy nursing staffs should be a help, not a hindrance. IT staffs should be able to manage endpoints from a centralized console, and with one touch, and one click, make device changes, without disrupting workflow.
4. Saving CAPEX:  Modernizing the endpoint must occur without adding to an already over stressed healthcare provider’s budget. One solution is to repurpose legacy equipment by using advanced thin client technology that converts old OS and equipment into a secure Linux-OS environment.
5. Scalability Friendly: IT needs endpoint solutions that make onboarding simple and saves help desk time. Lowering the IT footprint through seamless integration and one-click management paves the way for healthcare organizations to grow in size and services.  

Modernizing the endpoint is a critical part of healthcare organizations becoming digitally competitive, but the move is occurring in the reality of tight budgets, staffing shortages and increased pressures to protect patient data. Thin client solutions offer a means of improving security at the endpoint with tighter access controls, providing a more efficient and satisfying user experience and protecting budget by repurposing legacy equipment.

About The Author

Simon Clephan is Vice President of Business Development at IGEL, a provider of endpoint management software for the secure enterprise. He has more than 30 years of experience in the enterprise software industry, including solutions for healthcare, and has been in the Endpoint Management marketspace for more than 17 years.