Founded in California in 1963, Beverly Enterprises has grown to become a leading U.S. provider of healthcare services to the elderly. The company operates more than 400 nursing homes, assisted living facilities and hospice centers nationwide, staffed by 34,000 employees. Beverly is publicly traded on the New York Stock Exchange and is headquartered in Fort Smith, Arkansas.

The Challenge: Revitalizing Information Access into a Platform for Growth

With a decentralized organization whose facilities each ran its own elderly minicomputer and networked PCs or laptops, Beverly Enterprises faced impediments to its corporate goals of quality care, compliance with HIPAA and Sarbanes-Oxley regulations, and cost savings to fuel future growth. Specifically, the company had a pressing need to overhaul its IT infrastructure, because the existing system could no longer deliver adequate application performance. Slow performance was causing a host of problems, including distracting nurses from clinical care duties and leading to expensive overtime and extra staff to do charting and reports. In addition, the high cost of administering this decentralized IT model was a drain on corporate capital.

Beverly initially allocated $3 million for replacement of local server and desktop hardware to support faster access to applications such as its patient record system, care documentation, financials and billing. However, in view of the high initial expense and ongoing administrative costs, the organization sought a better solution than simply upgrading its existing client/server architecture.

Implementing a Citrix Solution for Remote Office Connectivity

Beverly Enterprises selected the Citrix Access Suite™ to centralize its IT infrastructure and deploy a standard desktop — consisting of its business productivity tools — over the WAN to approximately 7,000 desktops across its healthcare facilities. With assistance from Citrix® Consulting, the company’s IT staff implemented Citrix Presentation Server™ with Microsoft® Windows Server™ 2003 on central servers in a data center at corporate headquarters. Conferencing Manager for Citrix® Presentation Server is used to remotely train users and prepare them for the new solution. The Secure Gateway for Citrix® Presentation Server enables Beverly to deliver what they term “Office Anywhere” — secure access to applications over the Internet for mobile users and employees who are not located in a Beverly facility. Users include nurses, business office employees, and billing and maintenance staff.

“We chose to publish a standard desktop of applications because it makes training easier — plus, it’s seamless for our users to move to the new technology,” explained David Valcik, Vice President of Infrastructure Services. “Thanks to Citrix, we can deploy a mix of applications in the same desktop, including Microsoft Office, Web applications, and emulation software for our mainframe and AS/400, which run PeopleSoft as well as business solutions.”

Subsequently, Beverly implemented Citrix Password Manager™. Combined with Citrix Presentation Server, the solution strengthens compliance with government regulations, including Sarbanes-Oxley and HIPAA. Password Manager helps to enforce strong password usage and reduces the large number of password-related help desk calls. Currently, 25,000 employees across the organization use Password Manager to connect to their standard desktop; 8,000 licenses were purchased to support this user population.

“Password Manager was very easy to implement and requires minimal maintenance,” said Valcik. “For example, it only took us 30 minutes total to single-sign-on-enable our six Web applications. For training, we sent out a quick reference card to the nursing homes that explained how to use the new system. In our initial rollout to 7,000 employees, which only took one week, we only received about 35 help desk calls out of a total of 70 facilities.”

Rapid Application Access Allows Caregivers to Focus on Patients

Beverly Enterprises has built a reputation for continuous improvement in healthcare, and the Citrix access platform supports this goal by enabling clinical staff to devote more time to direct patient care. Valcik noted, “Prior to Citrix, our employees were very frustrated by having to wait minutes for screen refreshes, or a half a day to run a report. Citrix has changed this workflow pattern by making it very fast and easy to document care electronically throughout the workday. In fact, a patient entry that previously took 30 to 60 minutes now takes only five.”

He continued, “Citrix provided a secure roaming solution that allows a nurse to finish at one workstation, lock it, go to another floor and log back in on another machine. The previous session instantly disconnects and moves to the current workstation. Now instead of tying up the computers at the end of the day, nurses and certified nursing assistants can conveniently document in real time, right after seeing the patient. The results are greater efficiency and accuracy, as well as more time spent on caregiving.”

Citrix Password Manager supports this SmoothRoaming™ capability by reducing login times from one machine to another to less than five seconds. “With Citrix, our nurses don’t have to remember any passwords except their Windows NT logon password,” explained Valcik. “This speeds up and simplifies the roaming process, and supports compliance by eliminating generic logons.”

In addition to enabling caregivers to spend more time with patients, the new system has saved Beverly money. Because the previous system was so slow, some nurses were spending two or three hours of overtime at the end of the shift to document patient care. Overtime costs have now been reduced — in one location by $156,000 annually — and the company no longer needs to have staff dedicated to taking handwritten notes that would be entered later by the midnight shift.

“Secure by Design” Solution Promotes Compliance and Security

As a healthcare company, Beverly must comply with a variety of government regulations regarding confidentiality and privacy of patient information, as well as corporate data. The Citrix access platform, which is “secure by design,” allows Beverly to protect data across the organization through a range of security features. First, application data is kept in the data center instead of on local PCs or servers, providing greater IT control and oversight. Second, the screen images and keystrokes that are sent over the WAN are encrypted by Presentation Server to prevent theft or hacking. For secure connectivity via the Internet, the Secure Gateway feature encrypts this data traffic.

“When we launched PeopleSoft HR and Benefits, one goal was to give associates the option of self-service enrollment for our benefits plan,” said Valcik. “Secure access at work is easy, but we wanted them to have the flexibility of talking with their spouse and going online from home to sign up for benefits. To ensure a high level of protection for confidential information over the Internet, we use Secure Gateway.”

Security at Beverly has been further enhanced with Password Manager, which enables enforcement of uniform password policies and the use of strong passwords across the organization. “We were an early adopter of Password Manager,” said Valcik. “Our main goals for this solution were to spare users from dealing with 10 to 15 passwords with different rules for different application types, and to cut down on password-related help desk calls, which amounted to about 30 percent of total volume. With Password Manager, users only need to remember one password. Once they have logged into the Citrix desktop, the system automatically logs them into all their applications. Employees don’t know and don’t need to know the individual application passwords, which are transparently changed on a regular basis by Password Manager.”

According to Valcik, employees love the simplicity of Password Manager. “We received one comment that this is the second-best thing that IT has done — the first being implementing Citrix.”

Savings of $3 Million Helps Fuel Growth

One of the primary objectives of Beverly’s IT system upgrade was to reduce the high cost of administering a client/server architecture with hundreds of local servers and thousands of “fat” desktops. With the choice of the Citrix Access Suite, Beverly has not only reduced ongoing administrative costs, but also saved millions in new hardware purchases and installation expenses. These major savings can be channeled into new acquisitions or facilities improvements, giving Beverly a competitive advantage.

“We had a budget of $2 million for installation that we didn’t touch, because the Citrix rollout was done in-house, remotely, instead of visiting every location and desktop,” recalled Valcik. “We also saved a million dollars on new hardware because Citrix enables high-performance access over our existing PCs and workstations. In addition, the solution’s support for secure Internet access via any Web browser will allow us to reduce the number of laptops supplied to mobile users, saving even more.”

From a TCO perspective, Beverly has been able to turn the tables on its previous routine of regular upgrades to operating systems and desktop hardware to keep performance in line with business needs. The company is now leveraging its Citrix solution to extend the lifespan of hardware, while realizing significant savings from centralized administration, training and support.

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