Customer Solution Case Study
/ / Healthcare Provider Saves Millions of Dollars by Centralizing IT Operations
Overview
Country or Region: United States
Industry: Healthcare Providers
Customer Profile
Founded in 1963, Beverly Enterprises offers complete healthcare services to the elderly. Headquartered in Arkansas, the company has facilities in 23 states and employs 34,000 people.
Business Situation
Beverly Enterprises wanted a centralized IT solution that would speed application deployment, improve performance, and enhance data security while cutting costs.
Solution
Beverly Enterprises implemented Citrix Presentation Server™ and Microsoft® Windows Server™ 2003.
Benefits
n Cut IT operating expenses by U.S.$10 million
n Improved operational performance
n Reduced help desk calls and improved security
n Decreased overtime and payroll expenses
n Strengthened support service and increased morale / “Citrix has changed our support world, providing us with the technology to always 'be there' for our customer even when we can't physically be on site.”
Debbie Goux, Director, Field Services and Operations, Beverly Enterprises
Beverly Enterprises, a provider of healthcare services with more than 400 locations in the United States, wanted to centralize its IT functions. Each location maintained its own network, data-storage system, servers, and personal computers. The decentralized systems were difficult and costly to maintain, and presented a potential risk to data security. Beverly turned to Citrix® Systems for help building a centralized solution based on Citrix Presentation Server™ and Microsoft® Windows Server™ 2003. Now the company administers both data and software from one location, reducing costs and improving application speed and data security. With applications accessed through a Web browser, Beverly also saves by using existing hardware. As a result of fast, centralized application deployment, the IT department has cut its operating budget from U.S.$28 million to $18 million in four years.
Situation
Beverly Enterprises is a leading provider of healthcare services to the elderly in the United States. Its services include nursing homes, assisted-living facilities, rehabilitation therapy, and hospice and home healthcare. With more than 400 locations nationwide and a staff of 34,000, the company generates revenue in excess of U.S.$2 billion. Beverly Enterprises is headquartered in Fort Smith, Arkansas, and publicly traded on the New York Stock Exchange.
Until 2003, Beverly operated a decentralized IT environment. “We had 400 locations at that time running their own local area networks, Novell environments, servers, and personal computers. They had to support their own security, disaster coverage, back-up procedures, and installations. Each facility had a very self-contained environment,” says David Valcik, Vice President of Technology Services at Beverly Enterprises.
Healthcare and business workers often performed their own IT maintenance because the facilities didn’t employ IT staff on site. IT staff would travel to each location annually to refresh software, but updating more than 400 facilities could take half a year. Every three years, Beverly would perform a costly major software update throughout the organization, simultaneously upgrading hardware, operating systems, and security updates.
Even with the upgrades, the facilities were using outdated hardware running on a slow network. “We used to be on a satellite-based network, very good for credit-card transactions but not good for real-time Web browsing or e-mail traffic,” says Don Griffin, Director of Infrastructure/Research & Development at Beverly Enterprises.
Slow application performance had driven up overtime costs. Nurses regularly stayed two to three hours after each shift logging patient information, and some facilities hired extra staff simply to record it.
Data security challenges and tightening regulatory requirements from the Health Insurance Portability and Accountability Act (HIPAA) and the Sarbanes-Oxley Act stressed the organization’s resources further. Beverly had to demonstrate that data was adequately safeguarded, and that access was controlled through secure passwords. With data spread out across the organization, centralized oversight was virtually impossible. Password control was also a challenge, because employees needed between 10 and 15 passwords to access the necessary applications. As a result, password sharing and generic logons had proliferated, and password-related problems accounted for 30 percent of help desk calls.
By 2002, Beverly Enterprises was ready for a change. The company wanted a more affordable, centralized, scalable solution that would boost application speed, improve security, and allow more effective management overall.
Solution
Having decided that a more centralized IT model was necessary, Beverly considered several options. The company had initially put aside a budget of $3 million to upgrade server and client computers, but realized another PC-dependent solution would lock Beverly into the familiar cycle of costly upgrades and diminishing application performance.
The company instead chose to use existing client hardware as thin clients, delivering applications to them remotely from a central data center. It decided to use Terminal Services in the Microsoft® Windows Server™ 2003 operating system, the foundation of Microsoft Windows Server System™ integrated server software. For additional management features, Beverly selected the Citrix Access Suite™ from Microsoft Gold Certified Partner Citrix® Systems. The suite includes Citrix Presentation Server, Citrix Access Gateway™, and Citrix Password Manager™.
Centralized Servers
Beverly implemented a solution with help from Citrix Consulting, a support service specializing in the development and implementation of Citrix technologies. Citrix Presentation Server and Windows Server 2003 on 200 HP blade servers were installed in a data center at corporate headquarters. The technology offers complete remote management, including software deployment and remote-user access. Applications can be deployed to any device, not just devices that use Windows®, and remote users have access to the same desktop as they do locally. Because only keystrokes and images are transmitted over the wide-area network (WAN), administrators have secure management of applications and data.
Beverly deployed a mix of business, healthcare, and Web applications on a standard desktop deployed over the WAN. Users are virtually everyone in the organization, including healthcare professionals, business staff, human resources, billing, and maintenance personnel. Beverly even extended a similar standardized desktop to its offshore help desk, deployed through a secure tunnel using a single-frame relay.
Employees working outside the WAN access their desktops using Citrix Access Gateway. Part of the “Office Anywhere” concept at Beverly, Citrix Access Gateway allows traveling or home-based clients access to their work applications over the Internet. The centralized solution also includes the Universal Print Driver, which Beverly depends on for printing to computers outside the network—in home-office devices, for example.
Implementation Through WAN
Beverly began the first pilot tests of the solution in late 2002. After concluding successful pilots, the company proceeded to upgrade its network and field infrastructure, implementing the frame relay system and upgrading server computers. Beverly decided not to immediately replace personal computers, because application performance would no longer depend on them. In June 2003, the company began beta tests and preparation for deployment. By August 2003, Beverly had begun installing servers and deploying desktops to the facilities through the newly rebuilt WAN.
Determined not to impact business operations during the deployment, IT staff engineered a remote conversion using automated processes to pull in local files, rebuild workstations, and deploy the new desktops. The company also trained users remotely, using Conferencing Manager for Citrix Presentation Server.
Secure by Design
Beverly implemented Citrix Password Manager, a product instrumental in helping it strengthen regulatory compliance. The company first piloted a shared directory, implementing the full rollout with the Active Directory® service in Windows Server 2003. Deployment was entirely remote, giving all employees single sign-on access to e-mail, third-party applications, Web applications, and terminal emulation. The security features Citrix provides has helped Beverly “establish a corporate culture where people keep their credentials, like their house keys, safe and secure,” says Griffin. Centralized data collection and storage also provide enhanced security, as does data encryption. Presentation Server is used to encrypt data sent over the WAN, and Access Gateway encrypts data sent over the Internet.
Active Directory is used to set single-password logons and for network management. Beverly has used Active Directory for more than five years and now uses the enhanced version available in Windows Server 2003. “We were actually an early adopter of Active Directory, and we have been an Active Directory shop since October of 2000,” says Griffin. “It is our directory service; it is the foundation of all of the authentications, rights management, and end-user solutions in the enterprise.”
Rollout was complete in November 2003. Within 11 months, from late 2002 to autumn of 2003, the company had implemented the Citrix solution at approximately 385 facilities. The solution was deployed to 25,000 employees accessing deployed desktops through approximately 9,000 personal computers.
Benefits
By implementing the Citrix, Windows Server 2003, and HP solution, Beverly Enterprises has cut costs and improved performance. Instead of spending its entire budget for the project, the company actually saved $1 million by using existing hardware, and a further $2 million through remote training and deployment. Moreover, the five-year return on investment (ROI) projected for 2007 has been expanded from $5 million to $8 million above the initial hardware investment. In addition, the company has significantly reduced help desk calls, labor hours, and transcription errors, while improving IT responsiveness and boosting staff morale.
Reduced IT Budget by $10 Million
Beverly was able to significantly reduce the IT operational Parts and Labor budget through staff reductions and hardware savings. Five years ago, Beverly had an IT staff of more than 300 associates and an operational budget of $28 million. Currently, the company employs 125 IT personnel, and the budget has shrunk to $18 million.
With remote administration and deployment, the company can minimize travel costs and labor expenses. In addition, by using Presentation Server and Windows Server 2003 to deploy and execute software from a central location, Beverly can take advantage of older PCs by running them as thin-client devices. The company continues to run six-year-old, 800Mhz desktops and, according to Valcik, is just now beginning a deployment of the new HP thin-client device and flat-screen monitors. Beverly has also reduced portable computer usage, adding 500 new remote users while reducing approximately 30 percent of current portable computer deployment.
The solution allows Beverly to shift IT resources to support of training activities. Deploying software and managing systems remotely has helped Beverly reduce field staff by 70 percent and core engineering staff by as much as 50 percent. Valcik says that because everything is handled remotely, one field staff support person can support facilities across several states. “So our skill set has changed, but what it’s allowed us to do is focus more on training staff. Now we’re offering more real-time training to new hires instead of making them wait weeks and months. And we couldn’t do that without the technology we now have in place.”
Easier System Administration
Windows Server 2003 and the Citrix Access Suite have provided the end-to-end management Beverly wanted. Griffin says, “We have the ability to manage many more clients and to make the client experience much more palatable. We have a number of ways to deploy applications for desktops, via either a classic applet, by Web browser, or by agents. We can totally monitor our entire Citrix farm and take actions and have automatic things occur based on CPU overhead, amount of disk use, memory use, all of those idiosyncrasies inside of the technical environment.” In other words, says Griffin, Beverly can now “look from the top down at the entire infrastructure that we deployed and that is servicing our end users.”
Improved Operational Performance
Terminal Services technology combined with Citrix and the new, faster network allows software to run like local applications. The results are greater speed and responsiveness, optimizing the performance of critical healthcare operations. Screen refreshes take seconds rather than minutes, and reports that took hours to run now execute in under an hour.
Healthcare providers immediately noticed improved application performance, which in turn benefited workflow. They observed that Citrix SmoothRoaming™ allowed their desktops and work sessions to follow them from one PC to another. For example, a nurse could enter patient data into a computer, lock her session, quickly log onto a PC on a different floor, and pick up her session exactly where she left off. Improved application performance was evident; less obviously, both data and applications resided securely at corporate headquarters.
Application deployment speed has also improved tremendously. “Applications can be quickly deployed with minimal impact to the users,” says Valcik. In one example, regulatory requirements for an important clinical application that used to take months to install organizationwide now can be upgraded in three days. In another scenario, Beverly recently acquired a physical-therapy division. Using the same remote capabilities, Beverly deployed its standard desktop to the new organization, providing immediate, secure access to corporate resources. As Valcik describes it, “Technology these days is not an inhibitor, it’s an enabler.”
Reduced Help Desk Calls
Password Manager has improved security by safeguarding access, and it also has improved performance by shortening logon time and reducing help desk calls. The month after Password Manager was implemented, call volume had been reduced by 50 percent, continuing at a 20 percent downtrend over a 90-day implementation, says Valcik. “Over that period of time it has made a huge difference in lessening the number of help desk calls on incoming security and password resets.”
Decreased Labor Hours and Transcription Errors
With enhanced application performance and SmoothRoaming functionality, Beverly has successfully reduced annual overtime costs in one facility alone by U.S. $140,000. Staff hired to transcribe handwritten notes were reallocated, and the company noticed a reduction in application-related transcription errors. Michael J. Marchant, Senior Executive Director of Ridge Health Care Center, a former subsidiary of Beverly, says, “This system solved all of our problems. Response time was immediate after Citrix. The number of errors decreased and so did the number of med/transcription errors. We were able to improve morale and thus keep our staff. We have successfully decreased hours of labor by about 90 per pay period.”