Denver Health has developed a thin client strategy that has significantly improved PC user experience, and in some cases, has increased revenue through improved workflow directly attributable to better computing practices. No additional or new budget was required for the implementation, PC refresh dollars were primarily used to fund the effort ($250,000) and existing professional services dollars were used to augment staff ($72,000) for rapid deployment.
Given a general directive to speed up logon times and provide the end user with a more consistent and productive computing experience, the desktop services manager at Denver Health began investigating various technologies.
The primary requirements of this system were:
- Work with the Denver Health smart card implementation (cannot be forced to change the card solution to the vendor’s proprietary cards).
- Authenticate with active directory for user permission and policy management.
- Work within the Denver Health Citrix implementation and provide a feature-rich desktop, to include persistent and consistent sessions from anywhere on the Denver Health wide-area network.
- Eliminate the build up of adware and spyware which rapidly impairs a PC’s performance.
- Emulate the current PC environment.
- Provide accurate and reliable printing to appropriate systems using both Windows print and 3270 printers, while roaming.
- Rapid, consistent logon times, resulting in improved workflow.
- Handle the Denver Health screen saver communication protocols while not using network bandwidth.
- Provide out-of-the-box installation with no hardware configuration.
- Implement a gradual migration strategy not requiring wholesale replacement of PCs.
- Develop a protocol for PCs to emulate the vendor environment, without the expectation of extremely rapid logons.
- Provide a familiar user experience that requires no new training.
- Remove all reliance on the vendor’s certificate server while maintaining the two-factor authentication protocol already in place.
- Remove the need for PIN and associated management, allowing the hospital to start using strong passwords without causing confusion.
- Generate power consumption savings.
- Require no new operating expenses or capital expenses to fund the project.
There are several parts of the solution that are noteworthy:
- First logon to the vendor takes approximately 15 seconds and subsequent logons are virtually instantaneous.
- Integration with active directory is seamless, and the user database is dynamic in that it is created daily, no database management is required.
- Printer queue builds are dynamic—created when required, without administrative overhead.
- Screen savers are loaded as the thin client polls the network, with no impact on network bandwidth.
- No complicated setup is required for the thin client device. The equipment goes from shipping carton to production in a manner of minutes.
- Denver Health’s team developed a script to provide two-factor authentication, allows strong password enforcement, and removes the necessity for certificate management.
- A team of three people manages the entire system, from the thin client (over 1,500) to the other vendors environments (over 50 servers).
Denver Health’s implementation of server-based computing using a highly efficient thin-client strategy has been a huge success.
The improvements in clinician workflow directly and positively affect revenue. Overall, this technology has had a revolutionary effect on the computing environment of Denver Health. The approach will continue to get better and will drive additional savings and cost avoidance as other technologies develop in the area of application distribution.
Strategy for seeking funding for the health information technology or system adopted from the ARRA.
Denver Health is planning on leveraging this technology to facilitate more rapid implementation of an electronic health record that will assist in meeting the “meaningful use” criteria required in the American Recovery and Reinvestment Act of 2009. This will help ensure receipt of both Medicare and Medicaid payment incentives for EHR adoption.
In addition, as a novel new-use technology we hope to apply for information technology grant funds both from the Office of the National Coordinator and from potential state grants.
Lastly, we are exploring a partnership with a local small business to further develop this technology with funding from the Small Business Administration.
Jeff Pelot
Chief technology officer
Denver Health Hospital
Denver
