Columbia is standardizing on Windows NT with Microsoft SQL throughout the enterprise. It has also deployed a common patient-accounting system, a common clinical-information system, and a common set of general-accounting sys- tems companywide.

"We spent a year and a half making sure the systems are standardized," says Fotopoulos. All the systems are integrated, and that means Columbia is "a big leap ahead of most of our competitors at every single one of our hospitals," Fotopoulos adds. Columbia is also looking at shared services for revenue cycle and the general financial side and is considering ways to capture best practices and use common practices where possible.

Meanwhile, Vencor has implemented standard accounting processes companywide, replacing Lotus 1-2-3 and spreadsheet packages from other vendors with a system using SAP 4.0 and the Microsoft SQL 7.0 version of SAP's Business Warehouse. It also has Meditech's new Long-Term Care Client-Server Solution, which is housed on Microsoft NT running on Data General servers.

Front ends are Windows 98 PCs, which are being rolled out throughout the company in advance of the SAP system. The SAP system was piloted in October and November 1998, and full rollout began in January to 50 hospitals and nursing centers a month. It is "one of only five companies worldwide deploying this combination of leading-edge products," Markham says. The new financial system will let Vencor close the books on time each month-instead of at the end of the following month, as happened under the old system.

Another plus is that the company can take advantage of bulk purchasing since it has a companywide view of suppliers, Markham says. Vencor is also standardizing on NT servers throughout the company. "Common systems across facilities, with common processes, let you drive down the cost of systems and training," she says.

As the managed-care approach gains ground, providers are seeing revenue fall, so getting the edge on the competition is a must. Each company has its own approach. For example, Columbia Information Systems is implementing a Physician Services data warehouse that consolidates all decision-support information used by its physicians.

The data warehouse will be supported by regional service centers in the Dallas-Fort Worth area; Louisville, Ky.; Nashville, Tenn.; Orlando, Fla.; and San Antonio. Built to be scaled enterprisewide, Physician Services uses NCR's Teradata hardware and software for the data warehouse; Informatica to extract, transform, and load data; and Cognos for OLAP and analysis.

Information in the data warehouse will be used to look at accounts receivable, profitability, and other business drivers, Fotopoulos says. Columbia has also implemented a managed-care data mart with 15 Gbytes of patient accounting information pulled from its mainframe systems into a SQL/Windows NT environment to automate reporting processes. This gives executives timely and market-specific information to manage payer contracts and reimbursement and support contract negotiations.

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