This Thai word - pronounced Bahm-roong-RAHT - means "care for the people"

Abstract

The case describes the implementation of the Hospital 2000 information system by the Bumrungrad Hospital Public Company Limited (Bumrungrad), Asia's largest private hospital. It describes in length the need for implementing an advanced hospital information system by Bumrungrad, the system implementation process and the system & network architecture. It also discusses the challenges faced while implementing Hospital 2000 IS and elaborates the benefits reaped by Bumrungrad after the successful implementation of the system.

Issues

The case is structured in a way as to enable the students to:

Understand the need for a leading private hospital to adopt an information system.

Get an insight into the kind of challenges which a hospital could face while implementing the system.

Develop an in-depth understanding on the implementation process of a corporate information system including data conversion, training and hardware & software implementation.

Appreciate the benefits of implementing an organization-wide corporate information system in a large hospital.

Bumrungrad’s global healthcare services strategy. How should the company implement its global expansion strategy? Will the company be able to replicate the same customer experience in its global operations?

Which business segments must the company focus-upon to drive growth in future?

Keywords

Bumrungrad Hospital, Information System, IT Project Implementation, Electronic Medical Record, IT in Healthcare, Benefits of IT and Picture Archive Communication Systems.

INTRODUCTION

In early 2004, Bumrungrad Hospital Public Company Limited (Bumrungrad) in Bangkok (Thailand) was named the 'Best Small Cap Company,' by the Singapore-based magazine Asiamoney. The award was given on the basis of a 2003 poll conducted on more than 3000 fund managers, chief investment officers and heads of research at fund management firms, insurance companies and brokerage houses in the Southeast Asian region. Bumrungrad (market capitalization of under US$500 mn) was selected from over 180 companies considered for the award.

On Bumrungrad's remarkable achievements, Philip Owens, the Managing Director and Publisher of Asiamoney said, "This represents the first time that this award has been made to a hospital company in the twelve-year history of the poll. One glance at our best-managed companies on our 2003 poll reveals that they have one talent in common - the ability to recover fast. Bumrungrad Hospital in Thailand certainly fits this description with its remarkable success story."

On receiving this honor, Curtis Schroeder (Schroeder), CEO of Bumrungrad said, "We're very happy to be recognized in this year's poll. Bumrungrad has made a remarkable recovery from the dark days of the Asian economic crisis through an effective restructuring and has emerged as the dominant regional player in the Southeast Asian healthcare care market for cost-effective international medical care. This award is a wonderful capstone to the efforts of our management and employees.

INTRODUCTION contd...

Believed to be Southeast Asia's largest privately managed hospital, the 554-bed Bumrungrad Hospital treats both Thai nationals and foreign patients. The hospital is becoming increasingly popular with foreign patients. In 2002, out of the 850,000 patients treated in Bumrungrad, there were 250,000 foreign patients, coming from over 130 countries across the world.

Since the mid-1990s, Bumrungrad has come a long way to emerge as a leading healthcare brand in the world. In 1997, when Thailand was hit by the Southeast Asian currency crisis , Bumrungrad was among the several healthcare companies in Thailand that were severely affected.

A vast majority of Thai patients moved away from private hospitals to government-run ones. However, Bumrungrad perceived this adverse situation as an opportunity for growth and followed an aggressive marketing strategy that targeted foreign patients to the hospital.

Though Bumrungrad has been largely successful through its focus on foreign patients since mid-1997, the hospital faces a few important challenges in early 2004.

Bumrungrad faces fierce competition from leading hospitals in Thailand and other neighboring countries like Singapore and India, which are targeting the same clients by offering similar world-class healthcare facilities. Bumrungrad, therefore, has to discover new ways and means to differentiate its healthcare services from those of its competitors.

BACKGROUND NOTE

Established in September 1980, Bumrungrad was initially a 200-bed facility. The initial investment for setting up the hospital was Thai Baht 90 mn. The hospital was jointly owned by Bangkok Bank and the Sophonpanich family, one of Thailand's leading business families. In 1989, Bumrungrad went public and its shares were listed on the Thai Stock Exchange. Over the next decade, Bumrungrad adopted several innovative practices to emerge as the best privately managed hospital in Thailand. The significant increase in the number of domestic patients in its care over the years led to many fold increase in its revenues. ......

Challenge

Bumrungrad Hospital wanted an IT solution that would offer mission-critical availability, scalability and support for its operations and help it deliver enhanced levels of healthcare and customer service.

Solution

The hospital implemented a large-scale rollout of Microsoft Windows-based DellTM OptiPlexTM GX100 desktops, PowerEdgeTM 6300 servers and PowerVaultTM storage products running Hospital 2000, a unique integrated hospital information system from Global Care Solutions. The new enterprise solution also relies on Microsoft®  SQL ServerTM 2000 to support a database that grows by nearly 1GB a week.

Dedicated to using information technology (IT) to deliver enhanced levels of healthcare and customer service, Bumrungrad turned to Global Care Solutions (GCS), a worldwide provider of IT solutions developed exclusively for the healthcare industry.

GCS offers cost-effective enterprise solutions through Hospital 2000. This integrated solution combines both healthcare front office and back office operations in a single database, working in virtually all languages. With Hospital 2000, state-of-the-art functionality is provided in a manageable software package that operates on readily available platforms such as Intel®  architecture-based servers from Dell, and Microsoft Back Office products such as SQL Server 2000.

Hospital 2000 covers departments throughout a healthcare organization in addition to containing a fully integrated accounting system that collects financial and business information at the point of care. Hospital 2000's innovative design provides timely access to information to management and other users while reducing the complexity of operations in the data center.

Global Care Solutions selected Dell for its system features, reliability, support and service availability in Thailand. "The mission-critical nature of healthcare demands 100% availability of computer systems. Downtime in business costs money; downtime in healthcare costs lives! For the Bumrungrad Hospital system, we demanded the quality, reliability and support that Dell provided in Thailand," explained Patrick Downing, chief executive officer of Global Care Solutions.

The Hospital 2000 solution replaced several commercial healthcare applications based on more expensive Unix-based servers. "There has been virtually no downtime on the Dell servers since we switched platforms. And with our previous system, the annual maintenance cost alone could pay for all of the Dell systems we are using in our data center now. We found a truly

cost-effective and compelling solution in Dell." In fact, the Dell offering was so cost-effective that Bumrungrad added a back-up data center at GCS where data written to the production system is mirrored real-time.

The compact designs of Dell's systems are also a boon to the space-constrained hospital environment. A cluster of four Pentium®  III XeonTM -based Dell PowerEdge 6300 servers, a Dell PowerVault 650F Fibre Channel storage system and six Dell OptiPlex GX100 desktops effectively power the heart of the bustling Bumrungrad operations and complex Hospital 2000 solution.

To simplify support and maintenance, Bumrungrad standardized its systems, deploying 450 Dell OptiPlex GX100 Celeron-based desktops throughout the hospital to facilitate automation and full integration with Hospital 2000.

Results

Deploying the Hospital 2000 system in Bumrungrad was an enormous task, but the hospital and Global Care Solutions' teams completed it in just 45 days. Good planning and a close partnership ensured that data conversion, training of 1,200 staff and over 600 doctors, business process re-engineering and the massive hardware roll-out were achieved in record time. One of the most daunting tasks was rolling out 450 desktop PCs, 120 scanners and 100 network printers.

The Hospital 2000 solution really puts the Dell PowerEdge 6300 quad Xeon processor to work, with a single pair of clustered Dell PowerEdge 6300 servers and a PowerVault 650F servicing over 400 concurrent users. Clustering of the two Dell PowerEdge 6300 servers is achieved by using Microsoft Windows 2000 Clustering Service. At the height of daily out-patient visits - nearly 2000 visits in a four-hour time frame - server usage peaks at just below 50 percent, and the number of transactions processed approaches 170 SQL statements a second. All of this is done with 24x7x365 day reliability. Dickon Smart-Gill, Global Care Solution's network manager notes, "The Bumrungrad Hospital Microsoft SQL Server 2000 database grows by about 1GB a week, and with that type of growth, we really appreciate the speed and reliability of the PowerVault 650F Fibre Channel storage unit. With data that is this large and mission-critical, you cannot afford to be thinking about downtime or restoring data."

Performance aside, the Dell solution also helped improve system manageability by allowing for proactive maintenance through a central administrator. Dickon elaborates, "Through Dell's OpenManageTM standards-based systems management tool, I can monitor the status of systems, identify components that may need updating, receive system alerts, assess potential configuration problems and perform system maintenance, all from my desk!"

Dell OpenManage is designed to help Dell's enterprise customers manage server and client hardware from a single console, from anywhere and at anytime, helping administrators better sustain the health of their networks, increase system availability, and reduce the total cost of ownership.

The hospital's relentless efforts to enhance customer satisfaction through IT has certainly paid off, with waiting time reduced to levels never experienced before. Patients can also make appointments through the hospital Web site.

Providing excellent reliability and support, Dell's systems have proven to be a good choice for Bumrungrad, allowing the hospital's healthcare givers to focus on what they do best: delivering on their promise of world class medicine and world class service!

Challenge • Southeast Asia's largest private hospital had a long record ofusing IT to improve patient care. But with plans for rapid growth and anaggressive pursuit of Thailand's burgeoning international healthcaremarket, Bumrungrad International (BI) wanted to go further in enhancingthe patient experience and streamlining the delivery of healthcare

IT Investment Drives Healthcare Transformation:

Hospitals are information-driven institutions, but for many, that information is still paper based, orstored in a variety of incompatible information systems.Not at Bumrungrad International in Bangkok, Thailand. BI has modernized its IT infrastructure with an

integrated, Intel architecture-based information system that puts all information — patient records,appointment scheduling, diagnostic images, billing, pharmacy labels, you name it — online and in a singledatabase. The hospital has also led the way in implementing filmless radiology.The results have so transformed the institution that BI's CEO, Curt Schroeder, says many hospitaladministrators can't believe what his team has accomplished — and that the entire hospital runs on asingle rack of Intel Xeon processor MP based servers, with a second rack for redundancy. "People thinkit's science fiction," he says. "They wonder where I'm hiding the rest of the equipment. They can'tbelieve how powerful this system is and how much it is enabling us to do."

40% Growth, 33% Gross Margins

Since automating patient data and medical images,implementing filmless radiology, and using IT totransform its workflow, BI has eliminated its old medicalrecords unit, and converted its 10,000 square feet to akid-friendly, revenue-generating pediatric clinic. "Beforewe had electronic records, we had 30 people runningour medical records department,” Schroeder recalls.“We retrained those people, and now we’re gettingmuch more value from them, and they have a muchhigher rate of job satisfaction."The for-profit hospital has also been able to restrain oreven decrease the cost of healthcare — at a time whenglobal healthcare costs are soaring. "Our gross profitmargins this year are 33 percent, a significant increasefrom the low 20s in 1997," says COO Lee Chang Khor.She notes that despite a 40 percent growth in patientload since 2000, the hospital has not increased its ISor back-office staff. And in part because of its billingefficiency, the hospital collects about 93 percent of itscharges, a rate Schroeder characterizes as "incrediblyhigh by US standards."International Star

BI is a full-service hospital where you can get anythingfrom a tummy tuck to brain surgery. Thanks in largepart to its integrated information system, BI operateson a scale — and with a level of efficiency — that mosthospitals can only imagine. It has 2 million activepatients and handled more than 35,000 inpatients and850,000 outpatient visits last year. Its picture archivingand communications system (PACS) system holds 35million scanned images and is adding 5,000 to 15,000new images daily.

BI is also a formidable player in Thailand's burgeoningmedical tourism industry. BI treats 300,000international patients annually from 154 nations.That figure is almost seven times higher than it wasin 1997, and it accounted for 37 percent of BI's2002 revenues, up from single digits in 1997.BI's throughput statistics may make it sound like amedical factory, but its lobby looks like that of a five-star hotel, and the hospital is renowned for deliveringcare that's compassionate as well as efficient. Patientslove being able to walk in without an appointment, seea board-certified physician, get diagnostic tests and labwork, fill a prescription, and pay the bill — all in about45 minutes. And, according to Chief Operating OfficerLee Chang Khor, they've paid roughly one-tenth thecost of comparable care in the US.In April, 2002, BI became the first internationallyaccredited hospital in Asia and one of only 12hospitals worldwide to earn JCIA accreditation fromthe international arm of the US-based JointCommission for the Accreditation of HealthcareOrganizations (JCAHO). And it earned a specialcommendation for information management.Upgrading and modernizing their IT infrastructure isan essential step for today's hospitals, according toSchroeder. “You cannot run a modern hospital withouta sophisticated, integrated information system, and thedays of just adding on to your IT infrastructure, andspending $100,000 interfacing each new solution, are

coming to a close,” he says. “The industry has knownfor some time that the benefits of an integratedapproach are compelling, but the price tag has beena hurdle. Now, commodity technologies are makingintegrated solutions more affordable and openingnew opportunities. For hospital administrators, it's nota matter of if. It’s a matter of when. And the longeryou put it off, the longer you have to put up withyour inefficient operations."

Focusing IT on Patient CareEstablished in 1980 and traded on the Stock Exchangeof Thailand, Bumrungrad International made an earlycommitment to use IT to enhance patient care, not justrun its business operations. But in 1997, after openinga new, million-sq-ft hospital, the company's topexecutives wanted to accelerate growth and expandthe hospital's efforts to attract international patients.It quickly became clear that the hospital's complex,diverse IT infrastructure would be hard-pressed tosupport rapid expansion and internationalization. BI performed detailed workflow analysis focusedon enhancing the patient experience and makingBI a better place for doctors to practice medicine.The hospital then laid plans to eliminate legacyequipment and move wholesale to Global CareSolutions' integrated, single-databaseHospital2000 solution on Intel architecture. InDecember, 1999, after data conversion and training,BI pulled the plug on its data center full ofRISC/Unix servers — and never looked back.

Powering the TransformationPowering BI’s entire information system — andproviding the performance, scalability, and reliabilityto run the hospital — are GCS’s comprehensive

Hospital2000 information system and Inteltechnologies at both the server and PC.Hospital2000 combines clinical and administrativeapplications in a single Microsoft SQL 2000database. All aspects of the business use thatdatabase, including outpatient and inpatient care,registration/admission, billing/insurance, accounting,HR, purchasing, records and imaging, radiology,pharmacy, lab, and dietary management. Bumrungradalso deploys GCS's Amalga US FDA-approvedPACS system, which provides digital workstationand archive software for all radiology images.Hospital2000 uses industry standards to promoteinteroperability. It features a built-in, ANSI-standardHealth Level Seven (HL7) engine that makes it easierto share data with medical information systemsfrom other hospitals. The software is fully internationalized,a necessity given BI's internationalcommunity of physicians and patients. A fullMicrosoft Active Directory implementation is usedto pass hospital records among multiple facilities.

Return on Investment• The state-of-the-art solution has helped BItransform its workflow, creating efficienciesthat enabled it to accommodate a 40 percentrise in patient loads without increasing IThead count, achieve 33 percent gross profit,and handle 860,000 outpatient visits yearly,with the average visit – including registration,treatment, diagnostic procedures, pharmacyand bill-paying – taking just 45 minutes.• By going paperless and filmless, BI was ableto convert a former records storage room intoa profitable pediatric clinic and reduce bothmedical errors and infection rates.• BI became the first hospital in Asia to earnaccreditation from Joint Commission ofInternational Accreditation (JCIA), receiving

a special commendation for informationtechnology.

A hospital is an incredibly information intensive environment and information systems have become an invaluable asset, enabling doctors to make critical life and death decisions more accurately and faster and patient services to be improved. Highly consistent information is crucial to successfully providing the best healthcare.

Many hospital information systems today find their foundations in the accounting and billing functions and have had clinical systems bolted on over time, department by department. A typical scenario could include perhaps 20 or 30 different computers, data seldom adds up and doctors often have to walk to 5 or 6 PCs for specific patient information.

At Bumrungrad Hospital in Bangkok the scenario is certainly not typical. Formed in 1980, Bumrungrad is one of Asia's largest private hospitals providing care to nearly 800,000 patients a year. The hospital's founding members had a fairly unique view of hospital information systems and from day one wanted to use technology to help improve its quality of patient care and information delivery to its medical staff.

To take it to the next generation of information systems, the hospital's management team - in partnership with Global Care Solutions - switched overnight in December 1999 from its legacy Sun Microsystems solution using a mix of Oracle and Informix databases, to its fully integrated Hospital 2000 system based on Microsoft Windows 2000 and Microsoft SQL Server.

Bumrungrad Hospital prides itself on being a world-class service environment. To maintain this position it knew it had to take advantage of new technology to help define its business for the future. Curt Schroeder, CEO of Bumrungrad Hospital explains: "We needed to answer one fundamental question: How could we improve our already high level of service to our patients. To facilitate this we knew we had to improve information access and quality for all our staff."

The doctors are the primary 'product' at Bumrungrad, central to answering Schroeder's core business challenge - improving patient service. In addition, they are also one of the hospital's key customers. As they are not employees

of the hospital, they have the option to choose to practice in nearly 125 private hospitals in Bangkok alone. And as Schroeder advocates, people associate themselves with physicians, not with hospitals: "It is the hospital with the best physicians that will win."

He continues: "We need to create an environment that will allow our doctors to practice medicine in the best way and create the best relationships with their patients. At the core it comes down to good people as well as an exceptionally well-designed information system. We wanted clinical information at the fingertips of our doctors to enable them to make better decisions."

The needs of the medical and management staff, coupled with very high service expectations amongst the patient community, focused the Bumrungrad team on putting in place its new information system. "Patients assess their level of hospital care in different ways. How quickly they move through the system is a key measure. We'd reached a plateau on reducing patient time in the hospital and we knew that better information was the only way we could continue to provide excellent service and get patient days down."

Management information from the old system was fragmented. Schroeder explains: "I need to know what is happening in the hospital. Our old system could not deliver the kind of information to help us define the future direction of the business."

Schroeder also wanted a system that would allow Bumrungrad to roll out its technology solution to other sites around the world as well as seamlessly integrate with its online strategy. "We wanted to increase the interactivity of our web site so that patients and doctors could use it to carry out activities in the same way they can in the real world. For example, enabling patients to book appointments online. We also wanted a system that would enable us to electronically trade with our suppliers as well as the insurance companies we deal with everyday for billing."

Bumrungrad knew that by taking its core operational concept of service, rethinking its workflows and ensuring its information system matched its objectives then it could reach its ultimate goal of improved patient service.

Schroeder explains the key features of the system: "The solution is flexible enough for us to adapt, quickly and cost effectively. We are 100% sure that it is stable and trusted as probably nothing requires more security than health information. And finally, it is robust enough to deal with the huge variances in information, it works consistently online and offline and makes the most cost-effective use of the hardware."

Reliable and Scalable With over 2,000 patients entering the hospital every day, the hospital had to have a solution that was not only scalable but also highly reliable. Schroeder explains: "Reliability is key. Doctors are making life or death decisions based on the information the system generates. If it doesn't work, patients die - the system cannot go down."

Global Care Solutions' Hospital 2000, based on Windows 2000 and the SQL Server and NT platforms, has used the clustering technology available in Windows 2000 to enable the system to be more reliable.

Scalability was central to answering Bumrungrad's business needs. Pat Downing, CEO of Global Care Solutions explains: "At the hospital's peak time for patient admissions - 11am, 160-180 pieces of SQL are processed by the Hospital 2000 solution per second."

In addition, the system quickly and efficiently handles the 300,000 items that are charged to the patient's bill per day and the 10,000 paper documents that are scanned into the system every day. The system is very large and has 1,500 tables in the SQL Server 2000 database that grows by 1 gigabyte a week.

Downing continues: "We have ported our application to Microsoft SQL Server 2000 which will provide virtually unlimited scalability. We believe this will enable all healthcare operations using Hospital 2000 to meet the demands of the rapidly expanding Internet and e-commerce economy."

Faster Deployment & DevelopmentThe centralized management utilities of Windows 2000 have made it simple for the system administrators and users to deploy and adapt the system. In Schroeder's view "It's not difficult to come up with a technology solution to meet a particular need at a particular time, the skill is in designing a solution

to adapt to a constantly changing environment quickly and inexpensively." Global Care Solutions built the system using SQL Server 2000 as its common database and established standard protocols, tools and data in a systematic, predictable and well-organised fashion.

Desktop & Web ConsistencyBy utilising Windows 2000 and SQL Server 2000, GCS's Hospital 2000 solution has brought consistency to the organization's desktop and web systems. The hospital is now in Schroeder's words at a 'new plateau'. "We are looking at how the system can make us more competitive beyond the borders of the hospital." It is already doing this by directly linking Bumrungrad's interactive web site to its core business and clinical systems.

Schroeder continues: "When we initially designed the web site we wanted it to answer our customers' questions - What do your doctors specialise in? How can I make an appointment?"

By integrating Hospital 2000 with its web strategy, patients can make an appointment through the web site by directly linking into the appointments system. In addition, they can search for a doctor by language ability, specialty and even look at a doctor's resume.

Multilingual Information AccessBumrungrad supplies regional healthcare with its patients coming from 52 countries bringing the added challenge for its information systems of different languages. By using Windows 2000's multiple language ability, Global Care Solutions delivered Bumrungrad a system that is multi-lingual. "Our single largest non-Thai patient group is Japanese. We need to report, have pharmacy labels, brochures, our website and basic surgery information in Japanese. The system allows us to do this easily and seamlessly. We can answer our current customers' needs as well as readying us to enter new markets."

Improving the patient experienceIn addition to the Hospital 2000 system, Global Care Solutions utilised Windows 2000's networking features to provide Bumrungrad with more than 100 Internet PCs that are available at the patient's bedside. Patients can surf the web or communicate with friends and relatives during their stay at the hospital.

Picture Archiving and Communications SystemIn early 2002, Bumrungrad added another element to its solution - a Picture Archiving and Communications System (PACS) that allows the hospital to capture and store all Radiology images, digitally. The hospital now generates 4 gigabytes of images each day.

This new aspect of the hospital's solution was driven by a desire to improve the efficiency of its medical imaging facilities, for administrative and diagnostic purposes. The hospital now captures as many images as possible digitally, and also coverts others into digital formats. The PACS application then makes it possible to retrieve images quickly and easily, improving professional staff's ability to diagnose patients, or view changes in their conditions over time. The hospital has also implemented workflow systems as part of its PACS solution, to route images to appropriate staff.

All of these functions are supported by Hospital 2000 and SQL Server 2000 - another mission critical function allocated to the operating system, which now ensures that the investment in PACS is always available.

Reduced Management CostsBy basing the Hospital 2000 system on Windows 2000, Bumrungrad has reduced its costs through improved management and increased productivity. For example, its structured reporting tool has reduced report compiling from 20 minutes to 20 seconds dramatically improving the speed doctors and managers can make decisions.

Schroeder continues: "Our response rates and turnaround times had reached a level we just couldn't get below. Now that our staff are more comfortable with the system and suggesting ways of how we improve it, we have seen amazing improvements in patient turnaround time, waiting time and the accuracy of our bills."

In addition, it has reduced its technology total cost of ownership with a single manager now controlling its 600 PC LAN. Typically, for a network of this size, the manager to PC client ratio is closer to 1 to 50. Bumrungrad's mission critical systems no longer need to be hosted on expensive hardware.

Ready for the futureBumrungrad with Hospital 2000 has also readied itself to take advantage of

Microsoft's .Net strategy making the hospital's information available any time, any place and on any device. Schroeder plans to increase connectivity with its remote sites and clinics in Sri Lanka, Maldives, Cambodia, Bangladesh and Vietnam. Schroeder explains: "We want to give remote physician access so they can call in wherever they are in the world to get an update on their patients." In addition the hospital is looking into giving patients access to their records online.

Bumrungrad is also employing Internet technology to further streamline its business-to-business processes. "We deal with 60 different insurance companies, and have 1,000 corporate customers so being able to transact with them in an online environment will mean huge productivity savings," says Schroeder.

"We are already automating all our purchase orders and inventory. The next stage is to take advantage of the Internet to lower our costs by purchasing in bulk and reducing the number of stages in the paperwork cycle."

Schroeder concludes: "Our system has enabled us to achieve our objective of improved patient service already and we know it will continue to do so long into the future."

Bumrungrad Hospital, a 554-bed facility, ranks among the largest private hospitals in ASEAN and was the first hospitalin Thailand to be awarded both ISO 9002 and hospital accreditation. Dedicated to using information technology (IT)to deliver enhanced levels of healthcare and customer service, Bumrungrad turned to Global Care Solutions (GCS), aworldwide provider of IT solutions developed exclusively for the healthcare industry.GCS offers cost-effective enterprise solutions through Hospital 2000. This integrated solution combines both healthcarefront office and back office operations in a single database, working in virtually all languages. With Hospital 2000, stateof-the-art functionality is provided in a manageable software package that operates on readily available platforms suchas Intel® architecture-based servers from Dell, and Microsoft Back Office products such as SQL Server 2000.Hospital 2000 covers departments throughout a healthcare organization and contains a fully integrated accounting

system that collects financial and business information at the point of care. Hospital 2000’s innovative design providestimely access to information to management and other users while reducing the complexity of data center operations.