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Stratus^® ftServer^® system keeps hospital information system in continuous operation

The 267-bed Yuai Commemorative Hospital is the local center for health services, providing medical exams, 20 kinds of specialty care, and secondary emergency care. Located in the Ibaraki Prefecture, which lies north of Tokyo, the institution also specializes in surgical treatment of gastrointestinal conditions and cancer. The average hospital stay compares favorably with the nation's other acute care facilities, making Yuai Commemorative an efficient health care provider.

Yet like its counterparts, Yuai Hospital is dealing with the reform of Japan's health care system and treats a rapidly aging population. Hospitals are looking to information technology for much-needed relief, so they can achieve greater efficiency while delivering top-quality care.

Timely access to medical information has become more crucial than ever. With traditional paper-based medical records, it is difficult to smoothly coordinate patient care among different medical specialists. A related concern for busy clinicians is the time consumed by record keeping, which can interfere with the time available for patients. At Yuai Hospital, an electronic medical record system enables each specialist to readily share information about each patient.

Naturally, patient safety is of the essence. One way that the information system helps the hospital avoid mistakes is by automatically checking patients' prescription histories for interactions between drugs prescribed.

An efficient "reservation system" is a priority in terms of customer service. Executives at Yuai Hospital did not want to keep outpatients or inpatients waiting to receive treatment, so their system plays an important role in scheduling appointments and procedures.

According to Dr. Shoichi Kato, hospital director, the information system involves far more than simply replacing existing processes with computers: "It means transforming how the hospital functions. We are continuously going to provide the best medical services as the core hospital in this area."

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Diagnosis: platform problem

The comprehensive medical information system behind all these functions at Yuai Hospital is known as MEII: MEdical Information Interface. The hospital chose to develop this system in-house to achieve the functionality and user-friendliness desired.

"Of course, in-house development involves such risks as excess cost and time. However, building the system step by step decreases such risk," says Mr. Naoki Takada, chief of the Information Planning Section, who was instrumental in the effective application of IT throughout the entire hospital. "Mois (Management of Information Systems Institute Co., Ltd.) joined us as a joint-development partner."

After MEII was implemented, physicians who at first did not welcome the system began to appreciate the merits of better information access and increased efficiency.

According to Mr. Takada, "There was no going back. Then a server crash occurred." It became impossible to request an examination, read patient records, or issue prescriptions. The chaos continued for an entire day.

The time needed to resolve such issues posed another difficulty. At that point, the server cluster consisted of six units: three servers and their respective backups. Switchover in case of trouble and ensuring the integrity of data after recovery were manual. All this took a tremendous amount of time.

A second, similar server breakdown prompted Yuai Hospital to examine the alternatives. "First of all, we reviewed the cluster system. However, there were too many problems," states Mr. Takada.

System administration was too complicated for the hospital staff member in charge of the cluster, who did not have the special training required for the task. Software applications also had to be modified to take advantage of the cluster's reliability aspects, requiring extra cost and time.

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Stratus remedy brings reliability

When the hospital first introduced MEII in 1999, Stratus Technologies had not yet released its ftServer systems to the market. Fortunately that had changed, giving the hospital a fresh option when it sought a new hardware platform in 2002. The ftServer line is a fault-tolerant family of Intel^® processor-based servers for Microsoft^® Windows^® server environments.

What specific considerations led Yuai Hospital to choose the ftServer system? "One of the reasons is that this reliable server is simple and easy to understand. Therefore, non-experts can comfortably use it," explains Mr. Takada.

The design of the Stratus ftServer system features replicated components that operate in lockstep. When this self-monitoring server identifies a problem, the affected components are automatically removed from service while the rest of the server continues to operate normally. Problem isolation occurs without any need for action by a hospital staff member. There is none of the downtime that occurs while a cluster switches processing from a malfunctioning server onto a working server. Furthermore, the server's built-in diagnostics, automatic problem notification, and remote support capabilities enable issues to be resolved quickly.

Another significant plus is that ongoing operation of the ftServer system does not call for the special skills required by the cluster system. Adds Mr. Takada, "And having high reliability does not impose an additional system management load on our staff."

"Application development is easy," he continues. "It is the same as developing for a single server." Standard Windows server-based applications run without a problem, operating transparently on the fault-tolerant platform.

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Supporting the future of health care

The ftServer system has been running smoothly since its implementation. Yuai Hospital regards the Stratus server's outstanding reliability and operational simplicity as great advantages that will shorten development time and reduce the cost of expanding its information system in the future.

And Mois, the hospital's system development partner, has developed the HOSLINK hospital information support system based on its work with Yuai Commemorative.

Comments Mr. Takada, "It seems many hospitals will aggressively adopt electronic medical records and related systems. Naturally, non-stop operation is a must. If the choice of hardware is the question, the key point is system operation. If a hospital has a tight budget for system staff or is looking to reduce high support fees, our experience recommends the ftServer system."

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