Putting the servers in client-server

Health Management Technology, Jan, 1997 by Lindsay Smith

Publicly held Mariner Health has approximately 80 facilities in combinations of subacute and long-term care facilities. They operate in more than 413 markets in 29 states.

While few healthcare information professionals can equate their operations with the scope of Mariner's operation, O'Brien's comments apply to scaled-down systems as well.

"What servers allow you to do," O'Brien says, "is decentralize major processing capabilities and get high-volume processing transactions to a smaller segment of the business in a cost-effective manner. Although you may be spending the same amount of money that you would be for a mainframe, now you're spending it for a more packaged solution, so you're buying smaller packages. What it has allowed us to do, as with all organizations using client-server technologies, is create very specialized, focused systems and put them in place managing specific business lines."

Within the last six months Mariner Health has put in a totally new data center which, basically, processes all its core business applications. Mariner Health has a centralized information systems department in Connecticut which is the central office for their servers, the hub for all its LAN and WAN connectivity.

O'Brien says Mariner uses IBM's RS/6000 SP [Scalable Powerparallel] architecture. All of their facilities are connected via a frame relay wide area network. Each of their five regional offices also is connected to a T1 high-speed data line, connecting both voice and data.

O'Brien explains how Mariner is using servers. "Basically we are decentralizing the patient care model. We're putting technology in the hands of our caregivers in order to make them more effective in the treatment of our patients.

"In rehab, for example, we have approximately 1,500 therapists who are professional rehab providers. We're taking a pencil out of their hands and putting a PC in front of them. From the time a patient walks into one of our facilities in rehab, they are taking patient demographics, creating the care path by which they're going to provide care, measuring and monitoring the outcomes associated with their care path, and it's all happening on a decentralized basis.

"What we're using the server for back here in Connecticut is to gather on a centralized basis all the patient care demographics, the billing information and the outcomes. We're gathering all that centrally which allows us to build our enterprise-wide data model around that patient care information which helps us determine things like length of stay, how effective our facilities are at putting total quality management practices into place, so that we know if facility A is being a little bit more effective in treating a broken hip, for example. Based on that information we can figure out why that facility is more effective and be able to alert other facilities to improve their effectiveness.

"Art Stratton [Arthur Stratton, Jr., MD.., chairman and chief executive officer of Mariner Health] has made a strategic decision that information systems is going to be the enabler of this company to take Mariner to the next level.