A hospital's one-man network band, 11/12/01

"Bleeding edge" assumes an unconventional meaning when applied to Don Woeltje and his role as a largely one-man network shop for St. Elizabeth's Hospital.

That's because constant triage - as opposed to technological daring-do - has driven St. Elizabeth's IT agenda since Woeltje came on board at the Belleville, Ill., institution two-and-a-half years ago. What innovation has occurred has been born of the type of necessity that should be familiar to any network professional who toils for a nonprofit with limited budget resources.

However, the sheer breadth of what Woeltje and St. Elizabeth's have accomplished in such a short period of time - often against corporate resistance and mounting pressure from federal privacy regulations - warrants recognition for the hospital as a runner-up in this year's Network World User Excellence contest.

Accomplished almost single-handedly

St. Elizabeth's is part of the 13-member Hospital Sisters Health System run by The Order of Franciscan Nuns. Among the IT projects finished or launched there during Woeltje's limited tenure:

A passel of security initiatives - "There was no security," Woeltje says - including the establishment of a formal security policy, deployment of four firewalls, intrusion-detection, authentication and authorization systems, as well as desktop virus protection.
The replacement of Novell's GroupWise e-mail package with Microsoft� Exchange 5.5 and Outlook, a move initially opposed by St. Elizabeth's corporate IT overseers then emulated throughout the hospital chain.
A pair of homegrown wireless mobile patient admissions carts for the emergency room that cost less than half of what a vendor was asking for an off-the-shelf version.
Initiation of 10M bit/sec wireless service - with an upgrade path to 100M bit/sec - at a pair of remote clinics, a project that included gaining permission from municipal authorities;
An overhaul of the hospital's network infrastructure that included swapping out antiquated Chipcom hubs in favor of 20 Cisco switches: Cisco 5509s in the core and 2948Gs at the edge.
An ongoing three-phase deployment of network management software from Tivoli Systems.
A network fax rollout that one department head says has "improved efficiency immensely."

Woeltje's immediate supervisor is quick to credit him.

"Don has accomplished most of this single-handedly," says Ruth Joachimstaler, IT director at the hospital. The institution employs four or five "rounds technicians," who relieve Woeltje to handle support calls on top of a mountain of network management duties.

A lack of staff is by no means the department's only challenge.

"It can be difficult getting funding, but little by little we get the money, and as I get the money, I get things done," Woeltje says.

All that piecework has been noticed where it matters most: on the hospital floors and in administrative offices.

"From a user perspective, the network is just so much better," says John Ancy, director of the respiratory and sleep disorders department. "There's virtually no volatility that I see as a user. I used to dread having to do anything on the network, and now it's just there, it works; it's like the light switch you turn on."

St. Elizabeth's is spread across a dozen on-campus buildings and a pair of satellite healthcare facilities. The network serves 1,700 end users and features 17 Windows NT servers and 600 workstations, some of which are shared by up to 20 employees.

Change posed problems

As with all healthcare providers, St. Elizabeth's is gearing up to implement the federal government's evolving Health Insurance Portability and Accountability Act regulations. Therefore, Woeltje counts getting the hospital's network security house in order as foremost among his accomplishments.

How much security work had to be done? Well, before Woeltje's arrival, only 10% of desktops had virus protection and the network had no firewalls.

"When I got here we had no need for them because the policy was that there would be no access to the Internet," Woeltje says. "That policy by necessity had to change shortly after I got here to solve an e-mail problem. We needed some way to connect our internal network to the Internet, and that's when our first firewall went into place, which was a Gauntlet for NT from Network Associates."

Getting that e-mail project accomplished required running a different type of gauntlet.

Although the 13-hospital system to which St. Elizabeth's belongs had standardized on GroupWise, Woeltje was loath to maintain a NetWare server simply to run the corporate e-mail choice. The switch to Exchange and Outlook seemed natural because St. Elizabeth's was already paying for that software through its Back Office licensing. Convincing corporate of that wisdom was another matter.

"When we moved to switch from GroupWise to Exchange, you-know-what hit the fan," Woeltje says. "But it made no sense to keep running a NetWare server, support two network environments and continue supporting GroupWise. And now we also have the ability to communicate with people across the Internet. That move solved a whole host of problems for us."

Before switching e-mail platforms, some employees had been communicating through e-mail with another healthcare institution in St. Louis. They were dialing into that organization's network to use its Microsoft Mail Servers, Woeltje says. When that organization discontinued its mail server, St. Elizabeth employees had to find another way to send those e-mails. The new Exchange server was the answer.

As for that corporate opposition?

"The interesting thing is that our corporate office has just made the decision that Exchange is going to be the corporate standard for e-mail," says Joachimstaler, Woeltje's boss. "We were the groundbreakers here."

Strengthening the network's shaky user name/password system was another priority for Woeltje. Beginning with key employees, the hospital has been rolling out a token-based authentication system called SafeWord Plus from Secure Computing.

"Even if passwords are not secure, they will still be backed up by the token-based authentication," he says.

Overall, the security initiatives are "only about half way" to where he'd like them to be, Woeltje adds.

ER carts half the cost

One project that paid immediate dividends was Woeltje's solution for letting emergency room personnel admit patients at bedside. The admitting department manager had been pitched by a vendor whose product could be wheeled from room to room by emergency room personnel. However, the vendor's product was pricey enough to convince Woeltje to attempt a do-it-yourself alternative.

"We purchased a couple of upright computer carts, got Toshiba laptops with docking stations, external keyboards, external wireless mice, a [uninterruptible power supply] and a wireless badging system," he says. "We had a vendor come in and install the wireless networking component, then we put the carts together."

The two carts cost about $3,000 apiece to outfit, or less than half of what the vendor was asking, Woeltje says, with the full project price tag landing at $6,000, excluding the wireless networking. St. Elizabeth's has two satellite clinics located seven and 12 miles from its campus that are connected to its network via T-1 lines. Replacing those T-1s with 10M bit/sec wireless Ethernet "will save $24,000 a year," Woeltje says, enough to pay back costs within three years.

As a bonus, the wireless project also lets the hospital service two additional facilities located across the street from its main campus that had previously not been part of the network.

"We get four facilities hooked up, and it's all paid for by getting rid of those two T-1s," Woeltje says.

Woeltje is a man who clearly loves his job and takes an intense personal pride in the success of his network. He didn't want his salary published, but let's just say it's modest and in line with what might be expected at a nonprofit. Of course, Woeltje's supervisor worries about the possibility of her one-man network operation leaving for greener pastures.

"That's a vulnerability, not having a backup for Don," Joachimstaler says. "When he interviewed here, he told me that he stayed at a job as long as he could make a difference. And at this rate, he'll be here until the day he dies."

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