rjupstate sends an article comparing how an IT infrastructure would be built today compared to one built a decade ago
"Easily the biggest (and most expensive) task was connecting all the facilities together. Most of the residential facilities had just a couple of PCs in the staff office and one PC for clients to use. Larger programs that shared office space also shared a network resources and server space. There was, however, no connectivity between each site -- something my team resolved with a mix of solutions including site-to-site VPN. This made centralizing all other resources possible and it was the foundation for every other project that we took on. While you could argue this is still a core need today, there's also a compelling argument that it isn't. The residential facilities had very modest computing needs -- entering case notes, maintaining log books, documenting medication adherence, and reviewing or updating treatment plans. It's easy to contemplate these tasks being accomplished completely from a smartphone or tablet rather than a desktop PC."
How has your approach (or your IT department's approach) changed in the past ten years?