Walton centre HISS and LINUX case study.

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WALTON CENTRE HISS AND LINUX CASE STUDY

 

THE HISTORY

The Walton Centre INFOSTAT Hospital Information Support System (HISS) directly supports all the hospitals major functions including:

  • Medical Records;
  • In-Patients;
  • Out-patients;
  • Clinic scheduling;
  • Clinical Audit;
  • Pathology;
  • Contracting;
  • Clinical Coding;
  • Casemix & Koerner.

In addition it is directly linked to a number of other departmental systems, mainly PC LAN based, including Radiology, Nursing, Theatre, ITU and Finance.

The HISS INFOSTAT applications and associated hardware was purchased in 1992, after a competitive tender, from CHC(UK) Ltd, the UK division of an American company. The total project cost was £850,000.

The applications were installed on a HP9000/H30 mini running HP-UX (A.09.00) which had a purchase cost of £160,000, and a current costs of a similar spec machine of £80,000. Infostat has two underlying layers of technology:

Infostat is developed using CHC's proprietary dictionary based 4GL and database, 4th Write. The database uses a basic or simple relational model with some in-memory elements. The structure of the databases leads us to the, un-proven, theory that root of the database technology is fairly old and may pre-date disk file systems. The database engine is however, highly efficient, lean on disk space, very robust and fast.

The development tools are less good. These vary between true 4GL functionality and assembler like programming techniques. This has led to it being called a '3 and half GL'. Rudimentary SQL tools are provided but these are bugged.

4thWrite itself is developed in 'C'. Version 7 of 4th Write was shipped with the system.

As with any commercial product neither the 'C' code for 4thWrite, the 4thWrite code for INFOSTAT, nor the development tools are shipped with the system as standard. However, the Walton Centre was CHC's UK reference site and as such CHC personnel often developed the system on-site. As a result, the 4thWrite source code for Infostat and the development tools were installed on the Walton Centre's machines. The 'C' source code for 4thWrite was not installed.

Between 1992 and 1994 CHC(UK) Ltd. was the sole IT provider to the Walton Centre, there was no in-house IT expertise and CHC provided a non-contractual Facilities Management service. During this period the Walton Centre became concerned that it was not reaping the benefits from it's IT investment and that CHC (UK) Ltd. was not capable of delivering the range of services required. Therefore in 1994 the Walton Centre's first IT manager was appointed, who carried out a full review of IT services.

As a result of this review an action plan was implemented which saw the establishment of and in-house department and a phased withdrawal from CHC for IT support services.

In addition, as the INFOSTAT 4thWrite code was installed on the Walton Centre's systems, some in-house development of the INFOSTAT system was begun. This lead to a dispute with CHC who wanted œ60,000 for the right to use the development tools. However, other problems were looming. In December 1994 CHC (UK)'s American parent announced that they were in financial difficulties and could not support the UK subsidiary, which was placed in the hands of KPMG, who were appointed administrative receivers. A buyer for the UK operation was sought by KPMG and although some of the companies products were purchased the company was finally closed down in March 1995 and all support and development of INFOSTAT in the UK ceased.

From December 1994 the new IT staff at the Walton Centre had carried out all support of INFOSTAT in-house, and development was stepped up to replace CHC's efforts. There was no deterioration in service to end-users, in fact this improved. In addition a Novell LAN was introduced to support some new client server development. Over a period of time the two environments have become very closely integrated.

Several issues now faced the IT Management at the Walton Centre:

  1. They were using proprietary database technology for which there was no continuing support or development.
  2. The 4thWrite development language was limiting and would not cope with the type of developments required for the next millennium.
  3. The INFOSTAT application had become increasingly functionally rich and tailored so there was a desire to keep the application long term.
  4. The Walton Centre was due to re-locate to new premises in 97/98. The client server application now being used at the Centre could not be supported over short term WAN links, and the costs of obtaining the necessary HP9000 processors to facilitate 6 months dual running appeared prohibitive.
  5. Development was being carried out on the live system due to insufficient funds being available to purchase an additional HP9000 for development.
  6. The maintenance on the HP9000's was 10 times higher than the Novell servers.
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The view of the IT team was that if the source code to 4thWrite, the underlying database technology, could be obtained then these problems could be resolved. This would allow additional functionality to be added at the 'C' level so protecting the investment in INFOSTAT for a considerable time. In addition the database technology could be migrated to a lower cost platform. This would facilitate a development environment, lower costs, dual running and a lower cost maintenance. These requirements led to the start of the Walton Centre Linux project.

THE ESCROW AGREEMENT, SOURCE CODE AND LINUX

When the INFOSTAT HISS ...

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