B.C. Interior Health Authority switches server software

B.C. is beautiful, but when the snow starts to fall on the main arteries connecting its interior communities, it becomes something else: dangerous.

The potential problems are a big concern for many of the Interior Health Authority

(IHA) doctors, nurses and home health care workers who work in the field, often travelling long distances to see patients.

To reduce the amount of time spent on the road and improve employee access to information, the IHA recently implemented Microsoft Server 2003.

Roy Southby, director of technology services for the IHA, said before the health authority was amalgamated in December 2001 — a move which brought together 19 small regional organizations — it used a combination of Citrix thin-client technology, dial-in via modem and VPN access. The new authority, which employs 1,200 doctors, 16,000 others and serves 690,000 patients, has 183 locations and covers pretty much all of central B.C.

“”The dial-in system first of all wasn’t very secure,”” Southby said. “”The servers that do the work reside on our local servers, and your remote PC or workstation becomes a terminal, something like in the old mainframe days. When you hit your keyboard you are actually keying data to that remote server, so all applications and data can remain within our data centre. Citrix was the way to do this in the past — but Citrix is not inexpensive.””

Southby estimated the organization has saved roughly $400 per user through Windows Server 2003. There are roughly 1,700 users.

The IHA wanted to give employees easier access to Meditech, the hospital medical information system it uses, which is an integrated system comprising admissions, radiology, lab, HR, financials and materials management modules. It also wanted to provide e-mail and a number of productivity and database applications, he said. Doctors frequently need remote access to the electronic health records module so they can look up lab results and X-Ray reports, Southby explained.

“”We wanted to get a system that could do this as easily as possible without installing any applications on laptops or desktops.””

One of the reasons the IHA was interested in Windows Server 2003, Southby said, is its ability to load-balance servers.

“”Server 2003 has a component called Windows Terminal Server — they had this in Windows 2000 as well, but it wasn’t very good,”” says Southby. “”When you’ve got a lot of users you can’t put them all onto one server.You’ve got to balance the load over lots of different servers, With Windows 2000 you could not load-balance, so we would have to assign server A to 150 users and server B to a different 150 users. You might have a situation where you’ve got 100 users all coming in on server B and none on server A, so server A is underused and B is overloaded.””

To make address security, the IHA has designed the system so that users can’t do split tunnelling. In other words, if they’re doing a session through the IHA’s .Net servers, they can’t be on the Internet at the same time.

In addition, no one is allowed to place orders remotely.

“”We’ve blocked them out of that,”” he said. “”For instance, in our Meditech system the doctors order X-rays, drugs and procedures to be done. You can imagine if some hacker got in they could order somebody to be put on a certain drug. If doctors want to still do that order they can go into any hospital, because any hospital order must be done over a secure network and we don’t consider the Internet a secure network.””

B.C.’s health authorities are also participating in a working group that is trying to decide on the best combination of hardware and software for two-factor logon, he added.

But while Southby is enthusiastic about the Server 2003 implementation, he said it’s only because his IT organization had done so much research prior to the decision.

There are still bugs to be worked out — like remote printing, which can be a problem if the drivers on the user’s computer don’t match those on the server -– but that’s a minor issue, he said.

“”We liked it so much I was pretty certain it would work,”” he said. “”The fantastic thing is we had the whole system up and running in three days, which is unbelievable. Citrix took over a month, and we’ve managed to put new applications as well. We can set up a client in under five minutes; we tell them how to do it and there’s no training involved.””

That research is essential to a successful Server 2003 rollout, says Kevin Hunter, senior product manager, servers, at Microsoft Canada Co.

“”If you’re not architecting in an enterprise directory, a security strategy and a management strategy, you’re still going to have some of those problems once you’re done,”” he said. “”They’re not an afterthought, they’re one of the top two things people should be doing today.””

The IHA is also planning ahead for future server expansion needs by adopting IBM’s blade server technology, which allows the organization to put more servers in a much smaller space, Southby said.

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Jim Love, Chief Content Officer, IT World Canada

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