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Hardware: When to Hold 'Em, When to Fold 'Em


By Bill Briggs, Senior Editor December 2006
Faster! Smarter! Cheaper! These terms all are used today to describe computer hardware, from handhelds to servers. Dizzying processor speeds, oceans of memory and falling per-unit costs mean today's new PC likely can outperform the computers bought last summer, never mind those bought last year.

That's good for health care executives trying to meet the rapidly changing needs of more sophisticated applications and operating systems. The tricky bit for these executives is keeping up with an increasing number of new or improved clinical applications-that command the highest computer performance levels-while meeting the growing I.T. needs of the rest of their organization.

The advent of more clinical applications is revving up demand for new computer hardware. And although providers are rolling older computer hardware into back-office and support areas, they still face a significant challenge in meeting system and user demand.

The reasons? Even as per-unit prices are declining, the replenishment cycle for desktops, workstations and mobile computers is shortening and the clinician user base is growing. The combined effect of these conditions is pushing many provider organization executives into rethinking their computer purchasing patterns.

The rate and scope of refreshing computers varies by organization, but for delivery systems like Advocate HealthCare in Oak Brook, Ill., replenishing computer hardware is part spending and part mending. The eight-hospital delivery system addresses computer upgrades as needed, evaluating each hospital's needs annually.

"Across Advocate we have 12,000 computers and workstations," says Dan Lutter, corporate director of field technology services for information systems.

"Even at 2,500 per year it would take five years to get through an upgrade. We look at operating systems needs and look at what we can patch and secure, then make sure the computer meets the business needs of the user. Next year we will replace about 1,200."

Hand-me-downs

The greater the need for computing power at the clinical level, the higher replenishment moves up the budgetary food chain, Lutter says. Departments that don't need as much computing power get the best hand-me-downs.

"We're all competing for the same dollars," he says. "Our business is health care and we have to maintain clinical excellence, so business functions that don't need high processing power don't need to be refreshed as often."

Not long ago, many providers' replacement cycle for PCs was five years. Now it's often two or three, although some computers operate well beyond that range depending on where they are used.

The server replacement cycle is around five years for many providers, but also is contingent on application and operating system upgrades, observers say.

The list of reasons for refreshing computer hardware is led by application upgrades, which can tax processors and memory. Another trigger is hardware maintenance costs, which can be driven by warranty expiration.

"Aging hardware is still an issue," says Tim Webb, a consultant in the health care division at Kurt Salmon Associates, Atlanta. "New applications come out and demand more from existing hardware, whether it's servers or desktops."

The new Vista operating system from Microsoft Corp., Redmond, Wash., is expected to compel an industrywide computer hardware review. "I have not seen benchmark data on Vista, but the impact on desktops will be interesting," Webb says.

There's a pattern for Microsoft's Windows operating system upgrades and Webb expects it to continue. "Every time Windows comes out with a major desktop upgrade, providers put it off, then realize their desktops won't cut it. That forces a major upgrade."

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