A

re you finding it harder and harder to maintain your information technology (IT) department? Do you have an IT department, or is a single person just doing a great job keeping the systems going? Do you have a backup plan? Have you ever performed a backup of your IT systems? These are just a few of the questions you need to ask before you begin to consider an application service provider, also known as an ASP.
       Healthcare IT systems are more than the software running your care plans and processing the Minimum Data Set (MDS). They can handle your dietary needs, human resources, billing, and much more. Individually, these processes are not that complex, but getting the best use out of all your systems can save you time and extend your dollars to provide better, safer, and more uniform care. If these systems are not in balance, chaos can—and will—pursue.
       In some cases, lengthy rituals may begin to develop. You may find yourself doing what’s “normal,” and you might not think twice about it…but now you should.
       Can you explain the elaborate “work arounds” that have been developed to compensate for the “exceptions” to your system? Or do you find your system is not there when you are? If the answer to either of these questions is yes, start thinking about an overhaul.
       If the thought of an ASP causes you to drool because of the “ease of maintenance and effort” on your part, you have some homework to do. Before you build a home, you must first lay the foundation. This is true with implementing an IT system as well, especially when your company’s future is at stake.
       What is the shape of your LAN? For those unfamiliar with acronyms, that’s the short way to refer to your local area network. If you link up more than one network over long distances, that’s referred to as a WAN or wide area network. Regardless, if you are going to host (run your own servers) or work with an ASP, you will still need to print on your LAN. Examine your printing setup. Do all your users have their own printers? Do they need access to a copier? Are you current on the Health Information Portability and Accountability Act (HIPAA) guidelines for computer security? These issues do not resolve themselves and can become more bothersome with a connection to an ASP. It is sometimes better to look at the entire scope of your workflow before you start changing applications. Maybe now is the time to consolidate printing to network printers/fax machines and copiers in order to lower your technical support and break-fix time.
       What is old is new again. Before low-cost networks, there was only one way to have multiple entry and access into applications. That was to use “dumb” terminals hooked directly to a server. I use the term server lightly here; today’s PCs have so much more computational power than the earlier systems that it’s hard to imagine the speed at which we were happy just years ago. Today’s operating systems, such as Windows NTXP/200X and Linux, allow for these multisession capabilities over networks, thus allowing one to utilize standard PCs or dumb terminals now commonly referred to as “clients” to access shared applications over a network resource. So, even though you have plenty of computational power at your desktop, the work is really being done on a “shared” server. The trend to move to distributed computing with powerful desktop PCs is shifting back to the server and terminal days of the bigger mainframe systems for easier management and control.
       How do you connect to your ASP? This seems to give more problems than it should. The connection to your ASP usually will occur over the Internet. This internet connection can come in a wide variety of ways, such as ISDN/DSL or dedicated line, such as a T-1 or even wireless or cable, but no matter which connection you use, they all are going to interface into your LAN the same way.
       The cost of these lines can vary depending on many factors from location to concentration of competitors in a market. This gives you a tremendous opportunity to save money and extend new technology to the rest of your organization. Internet access gives you many advantages today, and with dedicated access, your facility can start utilizing services, such as VOIP (voice over Internet protocol) no long distance and inexpensive but robust telephone solutions, that can integrate into your applications. Imagine being able to pick up your telephone and instantly have a message giving you up-to-date conditions in your facility.
       Don’t believe all the hype you hear. The real world is much different than a development lab. Successful implementations take time, education, and planning. Not all of your technology choices have to be costly and hard to implement.