Ken Abendshien is CIO of Midwest Health Systems Data Center, a tech support organization that provides outsourced data center services to 27 small county hospitals and long-term care facilities in Kansas, and two in Nebraska. Some of those sites are really tiny -- treating one or two patients a day. And with those hospitals having even tinier IT budgets, Abendshien needs to stretch his resources very carefully.Few of the hospitals that Abendshein's group supports have more than 25 beds -- the smallest hospital has 50 employees -- and while some of the sites take care of maybe 14 to 15 patients per day, it's not unusual for others to treat only one or two patients in a day, he says. Some of the counties that operate those hospitals have a total population of only 3,000 people, Abendshien says.

Resources for IT -- and just about everything else -- at those public hospitals are extremely limited, and most of them don't even have a resident IT person on board, he says.

"They are pressed for time, they are pressed for money," he says. "They can't afford elaborate IT budgets of $2 million to $3 million," Abendshien says.

So, for their tech operations, they turn to Abendshien's team of six people at the Hays, Kan.-based Midwest Health Systems Data Center, owned by the nonprofit Great Plains Health Alliance, which also provides an array of other administrative support services to Kansas and Nebraska community health care providers.

Among the duties of Abendshien's organization are running the member hospitals' Siemens MedSeries4, or MS4, financial applications, on IBM AS/400 and I Series servers, or what IBM now calls the "Power Server." But Abendshien's group often goes well beyond what a typical data center services provider does. For instance, when the payroll clerk at one of the hospitals recently -- and abruptly -- left the job, Abendshien's group scrambled to make sure everyone got their paychecks on time.

For the most part, the hospitals haven't digitized their clinical records yet -- that information is still largely kept in paper files, Abendshien says. But despite those small hospitals' very limited resources, they are slowly moving in the same direction that larger (and hopefully most) other U.S. hospitals are going -- transitioning to electronic heath record systems, which can help red-flag medical mistakes before they happen, improve process efficiencies, and reduce costs.

So, with e-health records starting to pop up on the to-do lists of those hospitals, Abenshien is pleased with news this week that IBM and Siemens are making available bundled configurations of Siemens' MedSeries 4 applications running on IBM's BladeCenter Servers.

That means that hospitals using the MS4 financial applications can also choose to adopt Siemen's MS4 clinical applications, which include e-health records and computerized physician order entry, and Abendshien's group won't be forced into having to support a new array of other systems platforms, he says.

The new bundle also would allow Abendshien's team to add server capacity for the hospitals' new clinical applications, without adding significant additional operating costs (including power consumption) or needing more physical space, he says.

The rack-mounted BladeCenter Servers allows servers, network infrastructure, and security applications to be "collapsed" into a single data center location, according to IBM. Initial cost analysis by IBM and Siemens indicates that initial hardware costs can be reduced by about 25% for community hospitals consolidating their operations onto the bundled offering.

Abendshien says he's not sure if the new configuration will lower costs in his data center, but he expects "it will give us increased capability, more [computing] power, access to the Web, for the same costs" the organization is spending now.

For Abendshien, that means his data center "will be able to physically contain our servers in racks, with one physical footprint, and keep support costs as low as possible to operate these new clinical applications," he says.

Midwest Health Systems Data Center is hoping to get initial project plans in place for the BladeCenter Servers by year's end. In the meantime, the hospitals, which aren't owned by Midwest Health Systems Data Center's parent, aren't being forced to choose Siemen's MS4 clinical applications, they're free to choose e-health record applications from any vendor they want, Abendshien says.

However, "if they don't want to go with Siemen's, they'll have to find a new way to run" their applications, he says. That's because Midwest Health Systems Data Center's own limited resources won't likely allow Abendshien's group to juggle multiple vendors' clinical software.

What's the biggest impact that space, time, and money limitations have on your organization's tech-related choices?