A functional and reliable IT infrastructure is very important, especially in the healthcare sector, because cost-conscious patient care, workflow management and administration can be ensured only through modern data processing technology. At the same time, the effects of the healthcare reform are one reason hospitals and healthcare providers are facing tight budgets. These considerations were vital when Gesundheit Nordhessen Holding AG decided to migrate to server-based computing architectures with Thin Clients.

Creating a network of health and social services facilities for the greater North Hesse area and providing quality services at the highest level under costeffective conditions - this is the goal of Gesundheit Nordhessen Holding AG. Therefore, modern medicine and the welfare of guests and patients are top priorities for the more than 4000 employees of the holding company whose subsidiaries currently include three hospitals, a rehab center, an assisted living facility, and a service company.

The core unit of the healthcare group is the Klinikum Kassel. With a capacity of 1200 hospital beds, 45,000 patients annually and a total of 24 affiliated specialty clinics and institutes, the facility is the largest municipal hospital in all of Hesse. Klinikum Kassel houses the central computer center of the holding company, and this is where the extensive restructuring of the complete IT infrastructure for all entities and institutions of the company began in June of 2003. The existing client/server architecture, consisting of 1000 PCs and 65 Windows 2000 servers, was replaced by a server-based computing infrastructure with Thin Clients from IGEL Technology, a manufacturer in Bremen. Excessive maintenance and support expenses for standard PCs were the reason for the change. The 15-member data processing support team was no longer able to provide cost-effective assistance and management.


The Client

• More than 4000 employees
• 1200 hospital beds, 45000 patients annually
• 24 affiliated specialty clinics
• Largest municipal hospital in Hesse
  

Compelling know-how and professionalism

Andreas Weiss, Department Head Data Processing of Gesundheit Nordhessen Holding AG, initiated the project. He had already worked with Thin Clients in a previous position in another hospital. Due to the positive experience, he believed this would be an ideal solution to efficiently restructure the holding company's IT environment.


Andreas Weiss talks about his considerations leading up to the project

'Our stated goal was to significantly reduce the costs for overall system support. Some know-how with respect to the special IT requirements in a hospital environment was particularly important to us. A referendum by the Klinikum Bremen Mitte added weight in persuading the decision-makers.'


The Challenge

• Replacing 1000 PCs and 65 Windows 2000 servers by a server-based computing infrastructure
• Reducing high maintenance and support expenses
• Efficiently restructuring the IT environment
• Know-how regarding special IT requirements in hospitals
• Integrating a chip card reader for health insurance cards
  

'IGEL Technology is obviously experienced in the healthcare sector, because our co-workers in Bremen have been very successfully working with IGEL Thin Clients for quite some time', said Andreas Weiss, explaining the decision to work with the Thin Client specialist. Direct contact with the IGEL design team in Augsburg was another critical factor, which allowed highly individualized solutions and actual participation in the development process. This was the only way to ensure that every detail of the new system would meet the particular needs of a hospital. A special request from the project team in North Hesse involved an integrated chip card reader for health insurance cards. IGEL Technology is the only manufacturer of Thin Clients to offer this product. The design team in Augsburg developed keyboard-supported chip card readers specifically for Gesundheit Nordhessen Holding AG. IGEL.


The implementation phase begins

A budget of around 100,000 Euro was approved for the initial investment in servers and terminals. First, the necessary server environment was established in the central computer center of the holding company in the Klinikum Kassel. In cooperation with IT-SysTeam, an IT service provider from Bauntal, a high-capacity Citrix server farm of 12 application servers on Windows 2000 was installed based on the existing server environment consisting of 65 Windows 2003 servers and 10 additional Unix servers, which resulted in a clearly structured server environment compared to the original situation.

This was followed by a 3-month test phase during which 300 Thin Clients, model IGEL-316 Compact were used. These models from the flexible Compact series made by the manufacturer from Bremen offer a great variety of configuration options. The slim terminals communicate with the server via ICA protocol. They are very flexible and therefore ideally suited to expand the Thin Client infrastructure as needed. Another plus of the new system, because, as Weiss explained, it accommodates the highly decentralized structure of the company, which is spread all over the North Hesse region. Especially noteworthy is the fact that the initial investment was below the originally budgeted 100,000 Euro.

Since the trial operations ran so smoothly project expansion began within a short time. The assisted living facility, a subsidiary of the holding company, was integrated into the project and equipped with IGEL thin clients.


Convincing benefits

The migration to Thin Client technology quickly produced the expected results. The combination of a server-based infrastructure and Thin Clients considerably optimized workstation management. Previously, time-consuming on-site support represented a significant cost factor, which is a thing of the past due to central Thin Client management. The existing 15-member team is now able to provide cost-effective maintenance for the IT infrastructure. The slim terminals also work entirely without hardware components that are susceptible to mechanical problems, such as hard disks and fans, and therefore, they are generally less likely to break down. For the IT environment of Gesundheit Nordhessen Holding AG, this means considerably higher system availability and application stability. Andreas Weiss, the Project Manager, is pleased: 'Overall, we can say that our administrative expenses are about 80 percent lower.

Since we are able to handle maintenance and support in our central computer center, our employees no longer need to travel to the individual operating facilities. The time we are saving can be effectively used to manage the server environ- ment and allows us to ensure maximum availability of the entire system for all facilities at all times.

A particular highlight for Andreas Weiss is the quicker distribution of software to the other operations. For the dynamic and growing Gesundheit Nordhessen Holding AG, this is a key criterion, as Weiss explained: 'New institutions and facilities are being added to the holding company virtually every month. Installing the required IT infrastructure and providing the necessary assistance through the existing data processing support team would be out of the question under normal circumstances.'


The Result

• 12 application servers on Windows 2000
• 300 IGEL-316 Compact for the test phase
• Communication via ICA protocols supporting the decentralized structureFar below the budget of 100,000 Euro
• 80 % lower administrative expenses
• Maximum availability of the entire system ment and allows us to ensure maximum availability of the entire system for all facilities at all times.'
  

The future is Thin Clienting

Approximately 300 of the slim IGEL thin clients are currently being used throughout the holding company's operations. By the end of the year 2006, a total of 1000 IGEL thin clients are expected to fully replace the classic workstation PCs, except for some isolated special cases.

When asked about his opinion of the development of Thin Client applications in the healthcare market, Weiss summarized his experience as follows: 'If hospitals and healthcare facilities intend to continue having cost-effective computer systems in the future, there is no way around server-based computing with Thin Clients.'


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