| Real world case study: Linux thin client savings exceed 37% in just 8 months |
(Jun. 2004)
When an Albany-based cardiology practice announced their move to Linux last year, headlines touted the move as an affirmation of the use of open source software. Having a large medical practice with locations in Massachusetts and New York entrust medical records to Linux was a resounding nod to the cost savings and security that has become increasingly associated with the Linux platform.
But the real story -- the one that is even more important to end users and IT managers -- is the ROI (return on investment) that CCA has realized in their move from proprietary Windows to open source Linux.
Dr. Martin Echt and Jordan Rosen reveal the details of CCA's Linux implementation in the full presentation, from their talk at April's Real World Linux trade show held in Canada.
Among their key findings, summarized in the article below, Echt and Rosen found that CCA's Linux thin client savings exceeded 37% in just 8 months. They provide a detailed cost analysis of their migration to Linux . . .
Linux thin client conversion in a large cardiology practice: initial experience
Martin P. Echt, M.D., PhD, CEO, Capital Cardiology Associates
and
Jordan Rosen, President, Lille Corp
Description of the Medical Practice
Capital Cardiology Associates (CCA), is a single specialty cardiology practice with offices located in both New York (Albany, Troy, Oneonta, and Latham) and Massachusetts (Pittsfield). In 2003 CCA converted there IT system from a Microsoft based network to a Linux network employing Linux thin client technology.
CCA consists of over 40 physicians, surgeons & providers, practicing in 7 offices and 7 hospitals in New York and Mass., employing approx. 200 employees. In 2003 activity stats were: 128,000 patient visits (office & hospitals), 92,000 diagnostic tests, 6,000 catheterizations & interventions, 800 open heart surgeries, over 380,000 billed services with yearly revenue over $22 million.
CCA is “highly wired” with extensive MIS dependency. Applications include eScribe, an Oracle driven Internet based electronic patient record (www.escribeonline.com), billing and patient data collection (Medical Manager, AIX based), pacemaker monitoring application (PACEART), cardiac catheterization and procedure imaging applications, patient services tracking (via spreadsheets), financial and business applications (MAS 90, FRx), analytical software (Touchpoint), payroll and employee time monitoring (Kronos, ADP), word processing and general spreadsheets, physician & employee shared time schedules, shared Intranet based daily hospital rounds and procedure activity lists, hospital patient data access (via Citrix), e-Mail, calendaring, address books.
Business Situation in 2003
Rapid network expansion due to rapid (>15%) yearly growth over the previous 7 years necessitated extensive upgrading of the entire network, which was installed in 1997 and was a mixed environment of Windows 95, 98, and 2000. Upgrading everybody to Windows 2000 or going with a Linux solution were the options. We operate out of 7 different offices and an additional 7 different hospitals so we are heavily dependent on fast and simple access to our office systems from all locations. Having an enterprise wide stable environment that could be centrally managed to eliminate expensive remote desktop support was one of the major business goals in this transition.
We analyzed the core IT network features really needed for optimal business conduct and agreed on the following:- Easy and fast inter-networking via broadband Internet where available
- Shared file access environment
- Low incremental cost of network expansion
- Need for minimized remote on-site IT support
- Complete integration of key business apps (billing, business records, EMR, diagnostic tests)
- Low virus/worm susceptibility
- Ability to restrict or eliminate user options and preferences to increase employee productivity
- h) Long term control and predictability of costs
Based on previous experiences with Windows 95/98 desktops, user abuse of non-business functions (e.g. solitaire, music files, Internet, etc.) constituted a significant loss of employee productivity. Estimating that if the average employee spends 15 minutes per day “playing with the computer” he/she would waste greater than 50 hours per year. At $15.00 per hour that translates into $750.00 per employee each year. For 200 employees the productivity loss could amount to $150,000.00 per year. Thus, we considered the ability to prevent those abuses an important network function. We believe that the structure of the standard Windows desktop actually entices employees to use and abuse non-business applications. Linux would much better control this cost.
What applications do employees really need?
Most employees (patient check-in, patient check-out, billing, nursing and tech support) need only a very few core functions:- MIS appointment and charge/payment posting
- Email
- Internet access (including our EMR)
- Basic word processing and spreadsheet functions
More complex business applications are used only by relatively few employees (accounting, payroll, analytical software).
The use of specialty diagnostic software (pacemaker checks etc.) is limited to a few technical employees.
We compared a Linux thick and thin client conversion to a Windows upgrade, analysis how each option would affect our core IT network features.
Microsoft's main strengths are the abundant availability of qualified vendor and technical support. Its main weaknesses include frequent crashes, high service costs due to frequent desktop problems, high virus/worm susceptibility and software costs.
Linux thick client main strength is the stability of the Linux operating system and its low susceptibility towards virus damage. In addition, licensing costs are low to absent. The presence of a thick client desktop however still demands onsite desktop IT support as application software & programs still reside on the local hard drive.
Linux thin client features all the advantages of the Linux thick client plus the virtual absence of onsite desktop IT support. The thin client consists of a diskless (“dumb”) computer that boots directly from a central server. All file and program access is off of central servers. The only remaining desktop hardware option is the power switch. Thus, there is virtually no desktop breakdown potential and on site desktop IT service needs are minimal. There is no end user abuse potential.
A cost comparison of the Linux desktop - thick vs. thin
- Costs per added workstation (hardware, licenses, installation support)
Thin client reduces costs: cheaper hardware and labor costs, no software costs
- Remote locations
Thin client greatly reduces remote onsite labor costs
- Coordination of service and installations
Thin client reduces installation costs. Desktops are configured centrally and simply plugged into the remote network. No significant onsite labor costs.
- User abuses
Thin client reduces “user powers” thus increasing employee productivity.
-- More --
(Click here for further information)
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