More than 500 Columbia facilities nationwide use the application to inventory assets, record communications with vendors, and track Y2K activities for each asset. Columbia is tracking more than 2 million pieces of equipment and software.

"We're checking every piece of medical equipment, every elevator, everything that might have a chip to ensure they're either Y2K compliant or that we have a strategy to replace them or have decided not to use them any longer," says Barbara Fotopoulos, VP of strategy and planning.

The system uses Microsoft SQL Server 6.5 for its OLTP database and a replicated SQL Server 7.0 database for reporting. Microsoft Transaction Server, Active Server Pages, Visual Basic, and Internet Explorer 4.01 are supporting the application interface. Microsoft Windows Load Balancing System is used to let multiple Web servers access a single data store. Columbia developed the system with Microsoft.

Keeping Costs Down
Washington's demands for a higher quality of care have also increased the pressure to cut costs elsewhere. "On one hand, you've got these big health organizations trying to maintain and promote quality, which is rather difficult to measure," says Thomas Lawry, president of Verus LLC in Bellevue, Wash., which helps hospitals implement Web systems. "On the other hand, the federal government, which typically accounts for half the revenue of an average hospital, says it can't afford cost increases in Medicare, so hospitals have to change the way they operate."

One way to do this involves standardizing equipment and processes to reduce training costs. At Universal Health Services Inc. in King of Prussia, Pa., standardization means having the same user desktop features and look and feel companywide. Universal Health Services is the nation's third-largest hospital-management company with 72 entities, including medical and surgical facilities, behavioral-health facilities, and radiation-oncology centers in 25 states.

CIO and assistant VP of IS Linda Reino says Universal Health accomplished the standardization by instituting a centralized IS department and got user buy-in by putting user groups in charge of all applications. "When I first implemented our patient order-entry tracking system, I had a team from four hospitals help design the way they wanted it to look," Reino says.

After implementing the system at the four hospitals, Reino got the hospital staff to help with implementation at other institutions. "It's become part of the modus operandi now, and as we move forward, I continue to adopt multifacility, multidisciplinary user teams to help design, implement, and install systems," she says. Back-end servers run either Windows NT or Unix. Universal Health Services also has AS/400 servers. On the front end, it runs Windows 95 with Lotus Notes as its E-mail standard.

Getting a buy-in from users was also crucial at Columbia Information Systems, says CIO Noel Williams. "Health care is not like turning out cars; every product is individual, based on the physician, the patient, and the clinical, so we have to look at the process around those things."

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