Hospitals

White Wizard

Has anyone here worked for large hospitals? If so, what are your opinions on specializing in this industry when it comes to IT?

How are the large hospitals when it comes to job advancement, day to day operations?

I am considering specializing in this field but have heard varying stories from others.

I would also like to know what kind of positions allow you to work with cisco gear exclusively? In other words, that's all you do, configure and maintain cisco equipment.

Phileeeeeeep651

I haven't worked for any hospitals but there are quite a few large ones in my area. I have been trying to get my foot in the door in that sector for a while with no avail. Competition seems to be pretty tough in my neck of the woods when it comes to hospital jobs.

As far as an only Cisco shop, I think you would be pretty hard pressed to find that outside of working for Cisco itself. My current employer uses mostly Cisco devices but there are still a bunch of Juniper, HP, and other devices used in our data center.

My question to you would be why do you want to limit yourself to only working with Cisco devices? The principles and concepts of networking will apply to all networking vendor devices, all it will be is different syntax as far as configuring. If you're worried that your CCNA certification only applies to networking jobs that use Cisco gear, I've seen jobs all over the country that while working with other vendor equipment, still require CCNA/CCNP type knowledge. Hell, I've even seen jobs working for Juniper that require Cisco certifications.

fuz1on

I worked at a very large hospital before and feel Healthcare IT specialization is becoming a really big deal with EMR migration/integration (EPIC/Cerner) as well as cloud/ubiquitous access and the HIPAA, HITECH and HITRUST governance that follows. Large hospitals are usually big bureaucracies that have to follow a specific protocol so the change process of day-to-day operations and advancement chances can be dictated by politics and/or a snails' crawl.

As for equipment, it's really a mix of what's economical at that time with their specific asset vendor and you probably have to be pretty versatile because there are so many different environments and regulations.

Nafe92014

I have worked at a large hospital as part of a regional health authority here in Manitoba. Day to day operations were pretty standard for our IT department, while maintaining confidentiality when testing clinical applications with EHR.
We use thin clients as terminal servers for other staff to connect to for their work, as well as an enhanced phone system on a separate network. Our servers were a mixture of vendors (IBM, HP, 3COM, SOPHOS, etc) set up in a SAN environment for data storage.
Regulations were strictly enforced on a day to day basis. I worked with a senior engineer a few times during my experience there and I was amazed of the things I learned in a hospital environment network. Surprisingly, a few of them graduated from the same program I'm taking now and one of my instructors was a former supervisor there. My last supervisor there gave me two pieces of advice that have been stuck in my head:

1. If you want to survive in this career field, you will learn Linux, even if you hate it.
2. It's not WHAT you know, it's WHO you know.

ImThe0ne

I work directly with what would technically be an MSP for a large number of hospital chains throughout the US. I say MSP however, I am in the office at the hospital and it's the only hospital chain that I work with, so it's pretty much I work for the hospital chain but somebody else pays me and provides my benefits.. Odd situation but would make more sense if I dove into it.

Medical facilities are definitely a different beast when compared to a typical Corporate IT job. Obviously every company's data is considered confidential, private, etc, but there is a much larger emphasis on it in the medical world due to the crap storm that ensues if someone's medical records are accessed by unauthorized personnel, stolen, etc.

As stated above, EVERYTHING is politics in a hospital system, it is annoying, it slows everything down, and you find yourself in 1 of two situations at all times. The first situation is boredom as everything is put on-hold due to fiscal year changes, etc, the second situation is 6345 things to do that all needed to be done "like, yesterday". You flip flop back and forth between those throughout the year.

If it is a larger health system, you typically have "Application Owners" or "App Managers" who handle application issues, and things of that nature. A large majority of these people are typically ex-nurses or clinical staff that "Knew the software pretty well". Anytime you are in meetings with these people you hear things like "Well, I am not very technical, but..." followed by some pretty hilarious suggestions, questions, etc. They have no desire to actually learn anything about IT, but they work in the department. 95% (or more) of them couldn't tell me the basics of DHCP, DNS, IP addressing, etc. or how their app actually works. Their job is typically to pick the phone up and call the vendor when they have issues.


Overall, it isn't terrible. I work on the windows server team and all I touch is Hyper-V, VMware, Windows Server, Citrix, and assist in keeping our datacenters up to snuff.

Wanting to work with specifically Cisco would really depend on a few things. One, while it would seem like everyone uses Cisco, that isn't always the case. We were a strictly Cisco organization for a long time until the aforementioned politics stepped in and decided that Avaya was cheaper (by 2%). The reality of this, is that someone higher up knows someone that is directly affiliated with Avaya and are both making money off of it.
With that being said, if you do find an "all Cisco org" then your best bet working with only Cisco stuff would be the network team, assuming they are segmented.

Nafe92014 wrote: »

My last supervisor there gave me two pieces of advice that have been stuck in my head:

1. If you want to survive in this career field, you will learn Linux, even if you hate it.
2. It's not WHAT you know, it's WHO you know.

I have to disagree with both of these, at least a little bit. The first one, maybe in some instances where you are "the everything guy" or the company isn't big enough to support separate groups, but every company I have worked for that used Unix based servers ALWAYS had their own Unix team. I am a Server Engineer now and if someone tries to drag me into a Unix convo I say "Not my team or job" and send them to the Unix team.

In most instances, the second thing only REALLY works if you DO know enough to be beneficial. Now notice I said most instances, because somebody somewhere is in a higher position than all of us making more than all of us and probably knows 100% less than we do. That is the nature of the beast. But for the general population, I would say WHO you know helps get you a job, WHAT you know helps you to keep that job.

gespenstern

I worked for a large healthcare network for almost two years. It can be argued that healthcare is behind many other industries in terms of IT, but other than that it's a very typical IT with some emphasis on PHI but I haven't dealt with it much. It can be clearly seen that healthcare has a history: almost all of them have IBM big iron with software running on it containing code back from 70's. Have a lot of Microsoft technology stack. As pretty much every other non-Internet related business they run their Windows/Linux on VMware. IBM, of course, has had its own virtualization tech for decades.

They certainly have a network team and it is pretty probable that they run Cisco equipment in average healthcare network because Cisco is more popular.

The pay is, I'd say, somewhat below the market average.

P.S. I double that disagreement with "have to learn Linux". Linux is the least represented OS in Healthcare compared with pretty much every other industry. They are, I'd say, 10-20% IBM big iron (z/OS, i OS, AIX) and 85-75% Windows with 5% being Linux, for the most part they are vendor provided and vendor serviced VMware appliances, VMware ESXi hosts themselves and some thinstations. They usually don't need much servicing, they are often just reimaged in case of any issues and are rarely troubleshot. That's my experience.

fuz1on

I triple the disagreement on the Linux statement as well. I was team lead of an Active Directory migration/integration team. 'Nuff said.

--chris--

@ImTheOne, I think we worked for the same place (Apex, PFI, Dell?). I worked for an MSP that sub'd us out to the hospital. We only worked on the hospitals tickets, but our paychecks came from someone else and we had different badges.

My experiences were from the Desktop support role. Pretty busy, lots of little tickets that are what I consider normal Tier 1 stuff.

ImThe0ne

--chris-- wrote: »

@ImTheOne, I think we worked for the same place (Apex, PFI, Dell?). I worked for an MSP that sub'd us out to the hospital. We only worked on the hospitals tickets, but our paychecks came from someone else and we had different badges.

My experiences were from the Desktop support role. Pretty busy, lots of little tickets that are what I consider normal Tier 1 stuff.

Sounds like it, they subcontract all of the Desktop work out. Server team, network, security, everything else was in house. I am directly employed by the MSP.

--chris--

ImThe0ne wrote: »

Sounds like it, they subcontract all of the Desktop work out. Server team, network, security, everything else was in house. I am directly employed by the MSP.

Yep! 97% utilization rate? I always chuckled about that...everyone fudged their numbers and no one cared.