“OpenVMS is the dominant operating
system in healthcare because it combines
all the capabilities that are critical for a
life-or-death organization — 24 x 7 uptime,
instantaneous response time, security, and
the ability to support complex organizations
that are trying to integrate diverse
application sets.” – Peter Johnson,
Senior VP and Chief Information Officer,
Dartmouth-Hitchcock Medical Center Success story: HP technology helps Dartmouth-Hitchcock
Medical Center integrate diverse applications Dartmouth-Hitchcock Medical Center

Dartmouth-Hitchcock Medical Center delivers leading-edge
healthcare with HP technology and IDX solutions. And
today, the computer system has become as important as the
stethoscope for providing quality healthcare. Joshua Lee, M.D., Assistant Professor of Medicine and Staff,
Dartmouth-Hitchcock Medical Center, explains: “If I didn’t
have access to longitudinal and real-time knowledge —
including instant access to the patient’s history, lab results,
or how other providers are treating my patient — I couldn’t
provide competent care today. It would be like trying to take
care of patients without a stethoscope. It’s equivalent in
my mind.” An early adopter of information technology, DHMC relies on
comprehensive, integrated solutions from HP and IDX Systems
Corporation, including HP OpenVMS AlphaServer systems
and IDX software applications, to provide state-of-the-art
patient care. Advanced care in a rural setting
Serving more than 1.5 million people each year, DHMC
is an integrated academic medical center located on 225
acres of the upper Connecticut River Valley in Lebanon,
New Hampshire. Recognized nationally for the quality and depth of its services,
DHMC is home to leading specialists and researchers who
provide care in almost every area of medicine. In 2001, U.S.
News and World Report  rated DHMC as one of the top 50
providers in the country for cardiovascular, gastroenterologic,
gynecologic and orthopedic cares. It’s no coincidence that DHMC is also a leader in the use of
information technology. Peter Johnson, Senior VP and Chief Information Officer at
DHMC, explains the increasing importance of IT. “Fifteen
years ago, we used computers principally for our business
operations. Now, IT is critical to our overall operations
because all of our medical equipment is computerized as
well. As healthcare changes and we are under increasing pressure to be more efficient, technology helps us come to
grips with such factors as nursing shortages, lower payments
and reimbursements, improved quality of care, and safety for
our patients.” Complete encirclement of care
At the core of the Medical Center’s applications is the
Clinical Information System (CIS), which runs on HP
OpenVMS AlphaServer systems. CIS gives caregivers quick
access to all information about a patient at any point of care
— emergency room, critical care unit, inpatient ward, or the
outpatient setting. It provides a single, comprehensive view
of a patient’s lab values, medication allergy history, prior
diagnoses and therapeutics, and provides instantaneous
reports of operative procedures. Any authorized person along
the entire chain of care at DHMC can access and update
information or transmit information to referring physicians. According to Lee, this access to information improves patient
care. “We clearly know that when patients’ medication and
lab information is available to the clinician, the number of
overall medical errors is reduced.”   It takes significant expertise to create an IT system that
achieves the high standards set by DHMC. “The challenge
we face is making sure that information technology supports
our overall clinical, operational, business, educational and
research agendas — now and in the future,” says Johnson. From Lee’s perspective, the challenge is to make the system
comprehensive, yet usable. “HP and IDX are powerful
partners because they accomplish both missions. They put
the information in front of the provider in a timely and
understandable way — no matter where they are. For
example, with IDX RAD, our radiology solution, we have a
direct link online to radiology images, so it’s a complete
encirclement of care.”   The DHMC system brings computers into the operating
rooms, where they help surgeons know where, when, and
how deep to cut. In outpatient areas, the IDX system helps
DHMC with scheduling, patient reminders and operational “We would not be able to do what we’re
doing today without the level of automation
and integration that we have.”
– Mary Kay Boudewyns, Vice President for
Revenue Management at DHMC

efficiency. At the medical school, interactive databases
facilitate learning and research. Over the past year, DHMC extended CIS to its inpatient
nurses by rolling out a completely online discharge
documentation form. The results are impressive. “We’ve
increased the capture of proper medication lists at the time
of discharge from a baseline of 20 percent up to greater
than 90 percent,” says Lee. DHMC has also brought CIS to the Internet. “If I’m in a
conference in San Antonio, I can log onto CIS and answer
patient questions, update medication histories, or review
results,” says Lee. “So we’ve really taken medical care into
the 21st century.” Good technology yields good medicine
In addition to CIS, DHMC uses OpenVMS in a number of
critical applications, including its business and operating
systems. “We find that OpenVMS is a very rich operating
system,” says Johnson. “We have used it for 20 years and it
has done the work flawlessly for us during that period of
time. We look forward to continuing with OpenVMS and
our strong relationship with HP.” OpenVMS clustering allows DHMC to have disaster tolerant
systems, so that if one computer goes down for whatever
reason, the application is still available. Mary Kay Boudewyns, Vice President for Revenue
Management at DHMC, agrees with the importance of
information technology. “We would not be able to do
what we’re doing today without the level of automation
and integration that we have.” One of the key advantages of the system — from both a
clinical and business viewpoint — is flexibility.  Boudewyns
explains, “We need a system that enables our staff to
interact with patients in an efficient way: get the information
once, make certain that it’s accurate, and carry it through to
the billing process. We need a system that can adapt to all
the rules and regulations that are continually coming at us.
And with the volume of bills that we put out on an annual
basis — approximately 3 million claims — we need to be
able to edit, refine and stop the ones that don’t meet the
requirements. That requires a lot of system flexibility,
and that’s what we have in our system from HP and IDX.” Partnering for big city support
You can bring technology to the country, but what
about support? A unique aspect about DHMC is that it’s in a rural area, far
away from any large metropolitan center. Despite its
location, DHMC receives big city service. “Service and
support have been great over the years for us, from both HP
and previously from Compaq,” says Johnson. “They’ve gone
the extra mile to make sure that we have the local support
that we need. HP has created a local warehouse, so the folks
that support us live in the community. They get out of bed in
the middle of the night when we have a problem, and
they’re here until it’s fixed.” DHMC attributes much of its success to partnerships with its
IT vendors. “Our success is built on the partnerships with
both HP and IDX and we will only get where we want to be
with their assistance. Both HP and IDX are trusted partners
because when we have a problem, we all pull together to
make it work, no matter where the problem originated,”
says Johnson. “Oftentimes when we acquire new applications, we need
to integrate the software into our existing applications —
which really is an art form and requires the assistance of
our hardware and application software vendors,” Johnson
continues. “HP and IDX have done a wonderful job in
providing the kind of coordination and support that we
need to provide overall integration across the board.”   Continuing the advancement
Never content to rest on its well-deserved laurels, DHMC
is working with HP to explore ways to continue the
advancement of quality healthcare. DHMC will soon be
deploying IDXtend v9.0, the latest version of IDX’s business
performance solution, on HP OpenVMS AlphaServer
systems. “For the first time we will be able to capture certain
parts of people’s pharmacy benefit information, which
will be a huge convenience for both patients and
physicians,” says Johnson. DHMC has also signed an agreement with IDX to provide
vnetix imaging software, which will allow HP technology to
deliver on-demand access to full-fidelity images and related
patient information — anytime, anyplace. The strengths of OpenVMS are timeless. Johnson explains,
“OpenVMS is the dominant operating system in healthcare
because it combines all the capabilities that are critical for a
life-or-death organization — 24 x 7 uptime, instantaneous
response time, security, and the ability to support complex
organizations that are trying to integrate diverse
application sets.” What about the future? “It’s an exciting time for us. The world
is changing and those changes are being brought about by
technology,” says Johnson. “We look forward to IDX and
OpenVMS playing as significant a role in our future as they
have played in our past.”

Adaptive enterprise solution overview:
Increase performance to satisfy capacity demands Challenge •  Create a patient information management system that integrates all medical
information, and make it available to
everyone along the entire chain of care •  Provide continuous access to critical information — anytime, anywhere •  HP enterprise knowledge to help clarify good architectural choices •  HP OpenVMS clustering to provide disaster tolerant systems and reduce risk
of downtime AlphaServer systems for high
availability, reliability and performance •  Flexibility — enables DHMC to maximize business performance and keep pace
with ever-changing healthcare rules and
regulations •  Improved care — increased capture of proper medication lists at time of
discharge from 20 to 90+ percent Solution Results At a glance • Name: Dartmouth-Hitchcock Medical Center • Headquarters: Lebanon, New Hampshire • Founded: 1797 (Dartmouth Medical School), 1893 (Mary Hitchcock Memorial Hospital), 1927
(Dartmouth-Hitchcock Clinic), 1938 (The Veterans
Affairs Medical Center) • URL: www.hitchcock.org • Products/services: an integrated academic medical center that includes the Mary Hitchcock Memorial
Hospital (a 396-bed hospital), the Dartmouth-Hitchcock
Clinic (a network of more than 900 physicians located
in New Hampshire and Vermont), the Dartmouth
Medical School, and the Veteran’s Affairs Memorial
Hospital in White River Junction, Vermont. DHMC is
also home to the Children’s Hospital at Dartmouth and
the Norris Cotton Cancer Center. Technology highlights • Hardware: HP AlphaServer systems   • Operating system: OpenVMS • Storage: HP Storage Works • Services: IDX suite of products, including clinical, financial and administrative management systems For more information on how working with HP can benefit you, contact your
local HP service representative or visit us at www.hp.com © 2003 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change
without notice. The only warranties for HP products and services are set forth in the express warranty statements
accompanying such products and services. Nothing herein should be construed as constituting an additional
warranty. HP shall not be liable for technical or editorial errors or omissions contained herein. 5982-3819EN