At the AMC, 6600 hospital workers have approximately 4500 PCs and 1200 non-intelligent terminals at their disposal. For each Windows-PC Mr. Van der Kolk estimates that an annual amount of 100 hours is spent on implementation, re-installation, software replacement, feature adjustments, and restarts of jammed systems. These are partly carried out by the clinical users themselves, and partly by the more than eighty collaborators of the ICT Services Hospital Department. Fast calculation leads to a total management of 450.000 hours a year. Although a part of the software is centrally being distributed via the Novell Application Launcher, the AMC does not want to drag this management's burden anymore. In addition, hospital workers have to be prevented from deregulating systems via independent feature changes.
Critical software in particular has to be managed and distributed centrally, according to Mr. Van der Kolk. In this regard, he regrets that both Sun and Oracle have not made any more progress in delivering applications, such as Java, thin clients, and network computers without hard disks for the health care sector. The hospitals still struggle with the unstable Microsoft products which in fact are made for the consumer and not for the professional market. For the next years, AMC therefore plans to implement software that can only minimally be influenced by the end user. Even text processing with Microsoft products forms technically no problem via thin clients, according to Mr. Van der Kolk.
In the past, AMC exclusively relied on a Hiscom hospital information system, running on non-intelligent terminals from a mainframe system. Mr. Van der Kolk admits this is the other extreme but stresses the fact that the Hiscom system was up for 99,9% during 365 days a year. Some 45 medical experts within AMC are currently working with Zouga, an electronic patient record based on Java/Corba. "Zouga" stands for Very Open Universal Medical Application and enables physicians and nurses to request data from various Hiscom modules as well as other systems. Plans are being made to bring Zouga to the commercial market, in collaboration with the industry.
The continuous spread of PCs within AMC has become uncontrollable during the past years. Internal divisions were allowed to decide independently which hardware and software was to be implemented. Single PCs were clustered in networks of PCs, which later on offered access to the Hiscom system through terminal-emulation. In no time, 5000 PCs were linked to a network, coupled in turn to the hospital information system. Mr. Van der Kolk now pleads for ICT-governance, more regulation and central control. In the next few years, AMC wants to obtain more grip on the total ICT-architecture. Recently, Mr. Van der Kolk has been appointed to general manager of ICT-strategy, a whole new function within the hospital structure.
AMC spends about 2% of its budget to ICT, apart from the expenditures from separate divisions. In the future, the hospital's ICT-policy will become more centralised. Clinical users will no longer be granted the freedom to bring in their own solutions. For this article, the Automatisering Gids has served as a news source.