The Ripple Effect of Hardware Choices

When it comes to computer hardware and software applications, hospital CIOs are have more choices than ever to make. And the decisions they make have serious implications for the hospital’s bottom line—for better or for worse.

I recently had a conversation with Albert Oriol, CIO of Rady Children’s Hospital San Diego, about the wide mix of computer hardware and operating environments in hospitals, and the need to widely divergent needs and preferences. Rady Children’s Hospital has about 4,600 computers distributed throughout the organization, he says, including laptops, computers at the patient bedside, and workstations on wheels.

Oriol says the hospital has begun treating clinical workstations as biomedical devices. This involves switching those clinical devices from a traditional Windows device to a Linux device. “In these clinical workstations, we don’t need Word or Excel or the other Microsoft Office tools,” he says, adding that as strictly clinical devices, the applications can be accessed through Citrix or a Web browser.

Oriol says the benefit of going with Linux is twofold: one, the clinical devices, which are hospital-owned, can be “locked down” for security purposes; two, there is a cost savings on licensing fees. With regard to Citrix, the cost factor is more of a wash: updates and maintenance can be done on the server side, rather than on each client, but the robust server architecture gets expensive. But he adds the value of Citrix is that it gives better control. Managing things centrally makes it easier to run from a security standpoint, as well as performance.

That’s just one of the ways in which hardware choices are having a ripple effect that goes far beyond the actual computing device. In a way, computer hardware decisions have a very long tail that has a bearing on operating systems, licensing fees, and infrastructure investments. Stsay tuned for more on hardware choices in the December issue of the magazine.