Now three delivery systems and a hospital are implementing new e-mail server applications built on Linux as a cost-cutting move.
The organizations—Moses Taylor Healthcare System, Scranton, Pa.; Applachian Regional Healthcare System, Boone, N.C.; and Southeast Alabama Medical Center, Dothan, Ala. — are rolling out applications from PostPath Inc., a new company based in Mountainview, Calif.
Users at each organization still access their e-mail primarily via Microsoft Outlook. But they are either phasing out Microsoft Exchange Server messaging and collaborative software on the back-end or they are no longer buying additional licenses.
Growing Interest
More hospitals are likely to consider alternatives to Exchange, including Linux-based groupware that emulates Exchange’s features, says Ken Walling, senior consultant with ACS Healthcare Solutions, a Dallas-based consulting firm. “The CIOs I’ve worked with have always been happy to have alternatives,” he says. “For many years now, Microsoft Exchange has often been the only viable option.”
Walling also expects more hospitals to test the Linux waters with other niche applications, such as for network monitoring and security testing, because of the potential to cut costs by using the open-source operating system.
Faced with an inadequate 16-gigabyte storage limit on e-mails for its older version of Microsoft Exchange, executives at Moses Taylor carefully considered whether to upgrade to the latest enterprise version with much more storage capability or shift to one of several alternatives, including PostPath, says Frank Fallo, manager of network systems workflow development.
Filled to the Limit
E-mail storage capacity using the older Exchange system was so tight that each Friday, I.T. staff would check capacity levels and then, if necessary, request that users delete stored e-mails to avoid the system shutting down because of lack of capacity, says Patricia Bracey, director of I.T. at the two-hospital system.
Upgrading Exchange would have required a move to a server with a 64-bit processor, rather than a lower-cost 32-bit processor, Fallo explains. Open-source Linux-based applications require less processing power and storage capacity than software based on Microsoft Windows, he adds.
Executives at Moses Taylor decided to take a leap of faith and try the Linux-based PostPath system, Bracey says. “We were willing to take the risks associated with being an earlier adopter in health care to obtain the benefits,” she says.
The organization’s costs for implementing the PostPath technology were about 45% less than they would have been for upgrading to the latest version of Exchange, including $7,000 less for hardware, she says.
Software licensing costs were lower, she says, because while Exchange requires licenses for users, servers and the operating system, PostPath only requires licenses for users.
So far, 700 of 1,300 staff members are using e-mail supported by PostPath. While most continue to access their e-mail via Outlook, some are using PostPath’s Web Mail application to access their e-mail via a variety of smart phones and PDAs.
One reason the organization selected PostPath rather than other alternatives to Exchange was that it integrates well with Microsoft Windows Server Active Directory, which manages the identities and relationships that make up the network environment, Fallo says. This was important, he stresses, because the organization uses so many Microsoft applications.
“Active Directory thinks that the PostPath server is just another Exchange machine in the network; it’s unaware it’s a third-party machine,” he explains. “The benefit of that is when I create a new user in Active Directory, that e-mail account is created just as though it was running on Exchange.”
In moving to the new e-mail platform, Moses Taylor Healthcare System concluded that it had stayed too long with an older version of Exchange Server, as well as older versions of other Microsoft applications on some desktops, Fallo says. “We need to keep things more up-to-date,” he says.
Growing Pains
Keeping things up-to-date and consistent can be particularly challenging when an integrated delivery system grows through acquisitions.
Appalachian Regional Healthcare System, for example, recently grew to include three hospitals. Each had different e-mail server applications, says Wade Grimes, director of information technology. But only about 20% of its approximately 2,000 total staff members had e-mail access.
So Grimes investigated whether to standardize all the sites on an upgraded version of Microsoft Exchange Server or choose another system.
Because several members of his staff had Linux experience, the I.T. director was particularly intrigued by the possibility of implementing a Linux-based alternative to cut costs.
By shifting to PostPath as its standard, Appalachian Regional is cutting its hardware and software costs by 75% compared with installing the latest version of Exchange, Grimes says. So far, 550 employees are using the new e-mail platform.
The organization is experimenting with Linux in other arenas as well, including for server and network monitoring, he adds. “I like the open source concept,” he says. “Linux is a stable application that’s well-integrated to the Web. And it’s easy to do upgrades.”
Appalachian Regional expects to make PostPath e-mail available to all its employees within about eight months as part of an “e-mail for everyone” project to improve communication, Grimes says.
Likewise, Southeast Alabama Medical Center is implementing PostPath as it expands e-mail access. The project is in conjunction with a shift to single-sign-on technology.
The 370-bed hospital, which also runs other care delivery sites, is using a single-sign-on application from Sentillion Inc., Andover, Mass., to give caregivers easier access to multiple applications while improving security, says Clyde Williams, infrastructure systems manager. It was gradually adding more licenses for Microsoft Exchange to make e-mail more pervasive when it stumbled across PostPath, he adds.
The hospital will retain Exchange for 1,000 existing users but use PostPath as a lower-cost way to provide e-mail to 1,400 other staff.
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