Domestic IT consumption has healthy tailwinds despite the prevalent nervousness of how macroeconomics are playing out globally, said Manish Gupta, vice president and general manager of infrastructure solutions group, Dell Technologies India.
"We see robust demand, and adoption of new workloads by customers in India," Gupta told EnterpriseStory. Enterprises are having the intent to secure themselves from cyberattacks, and boards are supporting investments towards modernising the technology infrastructure, he added.
Dell Technologies counts IT and IT-enabled services as a bulk of its domestic business in infrastructure solutions. This segment includes system integrators like TCS and Wipro, startups, as well as global development centres of Fortune 500 enterprises in India.
In the past couple of years, the telecom industry has also been a large customer, as data workloads grew exponentially during the nationwide lockdowns because of the COVID-19 pandemic, Gupta explained. The 5G network rollouts will be another tailwind for the telecom sector in coming years, he added.
The pandemic also ushered in a wave of enterprises with less than 1,000 employees that want to digitise. Dell Technologies India classifies these as 'Medium Businesses' (MB), which has been its fastest-growing segment.
Towards this end, Dell Technologies carved out a separate sales organisation, to manage partner engagement and build awareness of its products and services.
"We started investing in the mid market, and the charter is to spread wide, Strengthen the coverage, add more customers into the fold more in terms of acquiring customers and spreading to the tier-2 cities," said Sandeep Dutta, Director - Storage, Platform and Solutions, Dell Technologies India.
The distribution partners who are the link between Dell Technologies and MBs play a crucial role in terms of implementation and system integration, Gupta noted. Services and manufacturing businesses form a large chunk of the MB business. It is a fallacy that MBs are at the lower end of technology adoption, he added.
Dell Technologies hosted a customer event in Bengaluru on July 13 to launch its array of software-driven storage solutions to drive intelligence, automation, cyber-resiliency and multi-cloud flexibility.
Businesses must focus on upgrading mission-critical infrastructure, Gupta said, attributing the need to changes like remote working, higher volume of data transactions, use of newer applications, and increased IT workloads across industries.
The Dell PowerStore, for instance, enables businesses to get insights from data residing at any cloud environment, the company said. Similarly, the upgrades in its PowerMax architecture have cyber-resiliency advancements, including cyber vaults for traditional and mainframe deployments.
From planning infrastructure on-premise a decade ago, customers moved to the public cloud. As the industry matured, customers realised that it is going to be hybrid cloud, Gupta said.
"Customers will continue to live in a multi-cloud world. Our innovations are focused on how to supply customers the best experience on multi cloud, and how they can get the best enterprise-grade software on premise as well as with a hyperscaler. It is about collaborating, and keeping the customer at the centre," Gupta explained.
Dell Technologies (NYSE: DELL) launches software-driven modern storage solutions across its industry-leading storage portfolio to drive increased intelligence, automation, cyber resiliency and multi-cloud flexibility. These advancements will supply businesses a secure and flexible environment to derive critical insights to grow in the digital era.
"With dynamic changes like remote working, higher volume of data transactions, use of newer applications and increased IT workloads across industries, businesses in India must heed to the urgent need of upgrading their mission-critical infrastructure to succeed in the competitive landscape.
Our storage advancements are aimed at helping businesses prepare for today and tomorrow's business challenges", said Manish Gupta, Vice President& General Manager, Infrastructure Solutions Group, Dell Technologies India. "Businesses with a future-driven outlook in the age of digital progress have the unique opportunity to avail our industry-leading offerings such as Dell PowerMax, Dell PowerStore and Dell PowerFlex which supply them better cyber-resiliency and optimize their processes across environments,” he added.
. We are committed in supporting our customers realize real-time growth in their digital transformation journey and our newly launched storage innovations are designed to help businesses achieve this goal", he added.
The introduction of these new storage innovations comes at a time when Dell continues to lead the storage market. According to IDC Worldwide Quarterly Enterprise Storage Systems Tracker Q1 2022, Dell Technologies is the No.1 external storage solutions provider for enterprises in the country with 26.2% market share(in terms of vendor revenue).
Since an outcome-based approach requires innovation, enterprises are adopting this strategy for enhanced performance.
With a team of more than 60,000 employees spread across 170 countries, Dell Technologies Inc. is committed to delivering outcomes for enterprises by leveraging the power of technology, according to Doug Schmitt (pictured, right), president of Dell Technologies Services.
“When I talk about outcome-based services, it’s not managing just the IT infrastructure; you have to modernize and transform,” Schmitt said. “So we have a great suite of services, and it’s bringing all that together for the customer — everything from consulting to deployment, support, managed services, security, education services, residency services, and asset sustainability and recovery.”
Schmitt and Alex Barretto (pictured, left), senior vice president of emerging services and technology at Dell, spoke with industry analysts Lisa Martin and Dave Vellante at the Dell Technologies World event, during an exclusive broadcast on theCUBE, SiliconANGLE Media’s livestreaming studio. They discussed how Dell delivers outcomes, flexible consumption, and life cycle services to enterprises for optimal returns. (* Disclosure below.)
Having recently created an emerging services group, Dell is committed to addressing customer needs and preferences under one roof, according to Barretto.
“So APEX, telco, edge, data management, and all the things our customers are asking for, and we are convening new solutions and services to meet their needs — all that is housed in one unit,” he stated.
Since enterprises are looking for life cycle services, flexible consumption and a trusted adviser, Dell has stepped in to fill the void, Schmitt added.
“Determining what they need to deliver their outcomes, Dell can bring that trusted adviser status to them … they can choose the way they want to consume the technology. You consume it by usage. We allow our customers clearly the choice to say what pieces of the services they need,” he said.
Emerging services enable organizations to radically transform so they remain competitive and thrive in the new economy, according to Barretto.
“If you look at Dish, they’re actually launching one of the first Open RAN networks, leveraging the power of 5G. We’re working very closely with them on the services and solutions to enable them to deliver that service to their customers,” he said.
With the primary objective of Dell’s partner ecosystem being co-delivering, meeting customer needs is a top priority, according to Schmitt.
“We’re very open with our partners about if they want to be prime and then leverage those same life cycle services we have. This is about getting this transformation and technology into the hands of the customers in the best way possible,” he stated.
When it comes to assisting enterprises in their modernization journey, Dell helps by addressing professional services, security and sustainability, according to Barretto.
“We have a whole slew of roadmap with high-performance computing to be announced soon. And machine learning operations — all that is to meet the customer needs. Whether you want to go cloud-based, on-prem, or hybrid, we’re there to solve your needs,” he said.
As managed services continue to grow, improving operational performance is becoming vital, because it enables enterprises to spend more time on their business outcomes, according to Schmitt.
“One of the things that they like the best about doing that management is bringing kind of the AI and the BI to it … we’re actually able to help manage those environments much better,” he said.
Here’s the complete video interview, part of SiliconANGLE’s and theCUBE’s coverage of the Dell Technologies World event:
(* Disclosure: TheCUBE is a paid media partner for Dell Technologies World. Neither Dell Technologies Inc., the sponsor for theCUBE’s event coverage, nor other sponsors have editorial control over content on theCUBE or SiliconANGLE.)
Dell Technologies has announced the introduction of software-driven modern storage solutions across its storage portfolio to drive increased intelligence, automation, cyber resiliency and multi-cloud flexibility, the company said.
These advancements will supply businesses a secure and flexible environment to derive critical insights to grow in the digital era, it added.
“With dynamic changes like remote working, higher volume of data transactions, use of newer applications and increased IT workloads across industries, businesses in India must heed to the urgent need of upgrading their mission-critical infrastructure to succeed in the competitive landscape,” said Manish Gupta, vice president & general manager, Infrastructure Solutions Group, Dell Technologies India.
“Our storage advancements are aimed at helping businesses prepare for today and tomorrow’s business challenges,” he said.
“Businesses with a future-driven outlook in the age of digital progress have the unique opportunity to avail our industry-leading offerings such as Dell PowerMax, Dell PowerStore and Dell PowerFlex which supply them better cyber-resiliency and optimise their processes across environments,” he added.
The company said the introduction of these new storage innovations comes at a time when it continues to lead the storage market.
Dell Technologies on Friday launched software-driven modern storage solutions across its industry-leading storage portfolio to drive increased intelligence, automation, cyber resiliency and multi-cloud flexibility.
The company said that these advancements -- PowerStore, PowerMax, and Dell PowerFlex -- will supply businesses a secure and flexible environment to derive critical insights to grow in the digital era.
"Our storage advancements are aimed at helping businesses prepare for today and tomorrow's business challenges," Manish Gupta, Vice President & General Manager, Infrastructure Solutions Group, Dell Technologies India, said in a statement.
"Businesses with a future-driven outlook in the age of digital progress have the unique opportunity to avail our industry-leading offerings such as PowerMax, PowerStore and PowerFlex, which supply them better cyber-resiliency and optimise their processes across environments," he added.
Dell PowerStore is aimed at keeping businesses future-ready at all times. The upgrade will allow low-latency end-to-end NVMe connectivity using existing infrastructure.
Dell PowerMax continues to be the world's most secure mission-critical storage solution for businesses in a Zero-Trust environment. The new upgrades will introduce cyber resiliency advancements, including cyber vaults for traditional and mainframe deployments.
Dell PowerFlex software-defined infrastructure consolidates traditional and modern workloads with new file services that allow for unified block and file capabilities on a single platform. It simplifies multi-cloud and DevOps with the broadest file and block support for all major Kubernetes and container orchestration platforms from Amazon, Google, Microsoft, Red Hat, SUSE and VMware.
The company mentioned that PowerStore and PowerMax are available for customers. PowerFlex advancements will be available in the third quarter of 2022.
Let’s talk about Oracle’s successful and expanding investment in cloud infrastructure. The company just celebrated its 45th anniversary, beat Wall Street’s estimated revenue in its fiscal fourth quarter, and showed its highest organic revenue growth rate in over a decade. The company is clearly doing a lot of things its customers like.
Front-and-center to Oracle’s success is Oracle Cloud Infrastructure (OCI) growth. Over the past year there has been a steady stream of OCI-related announcements. These have included plans to grow from 30 to 44 public cloud regions by the end of 2022 (39 are already in place), smaller Dedicated Region configurations, plans for Sovereign Clouds, new Cloud@Customer offerings, and expansions of OCI’s already impressive portfolio of services. This is perhaps the fastest expansion of cloud services by any service provider, and it helped drive Oracle’s 49% year-over-year IaaS growth and 108% growth in Exadata Cloud@Customer (Q4 FY22 earnings report).
And, if those aren't enough to make you consider OCI for your public cloud, what about the new Oracle Database Service for Microsoft Azure that Larry Ellison and Satya Nadella announced at Microsoft Inspire on July 20th? This new service allows Azure customers to choose where to run Oracle Database for their Azure applications. Azure users can easily set up and use Oracle databases running on optimized OCI infrastructure directly from Azure, without logging into OCI.
The Oracle Database Service for Microsoft Azure is an Oracle-managed service currently available in 11 pairs of OCI and Azure regions worldwide. It uses the existing OCI-Azure Interconnect to offer latency between the two clouds of less than 2 milliseconds over secure, private, high-speed networks. This means that developers and mission-critical applications running on Azure can directly access the performance, availability, and automation advantages of Oracle Autonomous Database Service, Exadata Database Service, and Base Database Service running on OCI.
Oracle’s growth numbers represent a great metric to measure its overall success. However, most IT architects and developers want to understand why Oracle's cloud offerings are better than the likes of Amazon Web Services (AWS) for their Oracle Database workloads.
The answer is simple. While Oracle is undoubtedly a strong competitor when matched head-to-head against nearly every public cloud offering, it offers clear advantages for Oracle Database applications. For example, organizations that use Oracle Database in their on-premises data center can more easily move workloads to OCI because it provides extreme levels of compatibility with on-premises installations and offers organizations the same or greater performance, scale, and availability. You won't find a better example of this than Oracle’s cloud-enabled Exadata X9M platform that’s available natively in OCI or for Azure users through Oracle Database Service for Microsoft Azure.
Last year, Oracle delivered what may be the fastest OLTP database machine with the Exadata X9M. This machine is engineered to do only one thing: run Autonomous Database Service and Exadata Database Service faster and more efficiently than anything else on the market, delivering up to 87% more performance than the previous generation platform.
Wringing every ounce of performance and reliability from a database machine such as Oracle Exadata requires thinking about system architecture from the ground up. It requires a deep knowledge of Oracle Database and the ability to optimize the entire hardware and software stack. This is a job that only Oracle can realistically take on.
Exadata X9M’s employs a flexible blend of scale-up and scale-out capabilities that support virtually any workload by separately scaling database compute and storage capabilities. Of particular note is how the Exadata X9M provides high performance for both transactional and analytics workloads and efficient database consolidation.
Let’s start with analytics. At the highest level, Exadata X9M enables fast analytics through parallelism and smart storage. Complex queries are automatically broken down into components that are distributed across smart Exadata storage servers. The storage servers then run low-level SQL and machine learning operations against their local data, returning only results to the database servers. This allows applications to use 100s of gigabytes to terabytes per second of throughput—something you won’t find on your typical cloud database.
For OLTP, Exadata X9M breaks out some additional secret sauce in the form of scalable database server clusters, persistent memory (PMem) in the smart storage servers, and remote direct memory access over converged Ethernet (RoCE) that links them together. Databases run across hundreds of vCPUs to provide high performance and availability and read data directly from shared PMEM on the storage servers. The end result is that Oracle Database achieves SQL read latencies from shared storage of under 19 microseconds, which is more than ten times faster than traditional flash storage.
However, Exadata X9M in OCI doesn’t forego the use of flash memory, it embraces it. Without applications having to do anything, Exadata storage servers automatically move data between terabytes of PMem, tens or hundreds of terabytes of NVMe 4.0 flash, and terabytes to petabytes of disk storage to provide the best performance for different types of workloads. This results in a level of performance that isn’t possible with a traditional on-premises or cloud architecture built using generic servers and storage.
Bringing X9M to the Cloud
There's no question that cloud resources are integral to nearly every enterprise's IT infrastructure. The cloud offers a flexible and scalable consumption model with economics that can be superior to traditional on-premises deployments. While cloud infrastructure can be easily scaled to meet many growing application needs, this is not necessarily true for databases that support mission-critical applications. It's common for organizations to have to refactor applications and redesign databases when they move to the cloud to provide the same levels of performance and availability they had premises, such as when moving Oracle Database to AWS. However, by deploying Exadata X9M in OCI, Oracle eliminates the expensive and time-consuming need to refactor applications for the cloud.
Oracle Exadata X9M in OCI shines for enterprise applications by delivering an elastic cloud database experience. For example, when running Autonomous Database Service or Exadata Database Service on dedicated X9M infrastructure in OCI, you can use 2 to 32 database servers and 3 to 64 smart storage servers in any combination. This means you can deploy platforms with more database servers for heavy OLTP workloads, more storage servers for data warehouses, or an even mixture of each when consolidating both types of workloads.
You can get the raw numbers for CPUs, storage, and memory for Exadata X9M in OCI from the Oracle website. Still, the critical thing to know is that all configurations deliver the database capabilities that enterprises require. For instance, the “entry” Exadata X9M configuration in OCI supports 19 microsecond SQL Read IO latency, 5.6 M SQL Read IOPS, and 135 GB/second of analytics throughput. Furthermore, with the ability to scale database servers by 16x and storage servers by 21x, we expect that no organizations will run into performance limitations.
Oracle tells us that by putting Exadata X9M into OCI, it now delivers the world's fastest OLTP cloud database performance, and they have the data to back it up. Latency is critical for OLTP workloads, an area where the X9M has no equal. Exadata X9M’s 19 microsecond SQL IO latency is 25x better than when running Oracle Database on AWS Relational Database Service (RDS). The analytics throughput numbers from shared storage are even more impressive, with Oracle claiming that Exadata X9M in OCI delivers up to 384x the analytics throughput of Oracle Database running on AWS RDS.
Oracle has conquered the performance challenges for OLTP and analytics in the cloud and delivers this level of performance with attractive economics. Oracle makes the Exadata X9M for OCI available with a true consumption-based model where you only pay for the size of platform you need and the consumption you use. One key feature of Oracle Autonomous Database running on Exadata X9M is that it can auto-scale consumption by 3x based on the demands of the queries executing at every point in time. This helps you meet peak requirements by scaling up database consumption when needs grow and minimizes costs by scaling it back down later. Oracle cites global customers using these scaling capabilities to economically meet seasonal demands for retail companies and end-of-quarter financial closes for any business.
Running business workloads in the cloud is popular and continues growing at impressive rates because it solves practical problems for IT practitioners and business users. However, generic cloud infrastructure hasn’t delivered the same level of performance and availability for mission-critical OLTP and analytics workloads that many customers achieved with on-premises platforms.
If your enterprise depends on Oracle Database technology—and 97% of the Global Fortune 100 companies use Oracle Database, with 88% relying on Oracle Exadata for business-critical workloads—you need to seriously consider running your cloud database workloads on Exadata X9M in OCI. Oracle's expanding portfolio of OCI services and delivery platforms, coupled with its unique ability to integrate optimized database platforms like Exadata X9M into OCI redefines what it means to run mission-critical databases in the cloud.
The Exadata X9M is built by the same people who build the Oracle Database, best positioning Oracle to optimize the performance, reliability, and automation required to get the most out of Oracle Database in the cloud. Oracle Exadata X9M is a stellar piece of engineering, bringing together compute and storage in an optimized architecture that delivers levels of throughput and reliability that deserve the superlatives I'm throwing around. And, it's not just me saying it; Oracle's momentum in the cloud bears this out as customers continue to make Exadata their preferred option to run Oracle Database.
When combined with the new Oracle Database Service for Microsoft Azure, Exadata X9M in OCI should cause organizations to rethink strategies focused on using generic cloud infrastructure for critical database applications.
Note: Moor Insights & Strategy writers and editors may have contributed to this article.
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Dublin, Aug. 08, 2022 (GLOBE NEWSWIRE) -- The "United States Data Center Market, By Solution, By Type, By End User Industry, By Region, Competition Forecast & Opportunities, 2027" report has been added to ResearchAndMarkets.com's offering.
The United States data center market is projected to register growth at a significant CAGR during the forecast period, 2023-2027. The market growth can be attributed to the rise in investments made by companies to adopt advanced technologies and the growing need to process, analyze, and store large volumes of data.
A data center is a physical location that houses critical data and applications. It comprises a large group of networked computer servers used for remote data storage, processing, and distribution. Customers can obtain services from data centers at a low cost, eliminating the need to invest in physical infrastructure.
To Strengthen scalability and reduce data center complexity, hyper-convergence combines networking, computing, and storage capabilities into a single system. The software and hardware systems are integrated into a single data center to streamline management and processing and Strengthen application performance.
The benefits of using hyper-converged infrastructure include lower operational and capital costs and disaster recovery capability. When used in the data center, the hyper-convergence infrastructure provides appealing features such as data de-duplication and compression. In the data center, hyper-converged infrastructure reduces the need for separate backup software, Solid-State Drive (SSD) arrays, and deduplication appliances. Moreover, growing awareness of the benefits of using hyper-converged data centers and an increase in the number of market players are expected to drive data center market growth in the United States over the next five years.
Hyperscale data centers are mission-critical facilities used to support scalable applications efficiently. They are frequently associated with companies that generate large amounts of data, such as Google, Amazon, Facebook, Microsoft, and IBM. Hyperscale data centers provide IT technology behemoths with massive amounts of data storage and cloud space. They have approximately 500 storage cabinets with ample space and a connection of 5,000 servers to end-users via an ultra-high-speed fiber network. The United States government has launched a Data Center Optimization initiative to Strengthen public services while also maximizing return on investment by consolidating a large number of data centers across the country.
In this report, United States data center market has been segmented into following categories, in addition to the industry trends which have also been detailed below:
United States Data Center Market, By Solution:
United States Data Center Market, By Type:
United States Data Center Market, By End User Industry:
IT & Telecom
United States Data Center Market, By Region:
Key Topics Covered:
1. Product Overview
2. Research Methodology
3. Impact of COVID-19 on United States Data Center Market
4. Executive Summary
5. United States Data Center Market Outlook
6. United States IT Infrastructure Market Outlook
7. United States General Infrastructure Market Outlook
8. United States Electrical Infrastructure Market Outlook
9. United States Mechanical Infrastructure Market Outlook
10. Market Dynamics
11. Market Trends & Developments
12. Policy & Regulatory Landscape
13. United States Economic Profile
14. Competitive Landscape
15. Strategic Recommendations
Cisco Systems, Inc.
Dell Technologies Inc.
Hewlett Packard Enterprise
Lenovo Group Limited
Verizon Communications, Inc.
For more information about this report visit https://www.researchandmarkets.com/r/vwixpb
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Taking place on Tuesday, September 27 in The Convention Centre, it promises to help businesses discover technology solutions for a rapidly changing world.
ndividuals, companies and organisations are looking to upskill their staff and reinvent their digital infrastructure, to better keep up with the changing demands of our modern world. Businesses have come to rely more heavily on technology, which is a trend that has given rise to a greater need for technical expertise, enhanced digital storage solutions and the adoption of stronger cyber security measures.
In this context, an event that brings together some of the most renowned voices in the tech and business worlds is to be welcomed. The Dell Technologies Forum, set to take place in the Dublin Convention Centre on September 27, will focus on helping businesses to explore how emerging technologies can unlock new possibilities for growth. This event will be held in partnership with Intel and Microsoft.
Dell Technologies is committed to helping individuals and organisations to build their digital future and transform how they work, live and play. The company provides customers with the industry’s broadest and most innovative technology and services portfolio for the data era. The Dell Technologies Forum is a natural extension of this overall mission, as explained by Jason Ward, Vice-President and Managing Director of Dell Technologies Ireland.
“Over the past two years, we have witnessed first-hand the impact that technology has had in empowering businesses to achieve continued growth at a level we hadn't imagined before,” he said. “But for organisations of any size to succeed into the future, they’ll need to unlock the value of data at the edge and invest in new and emerging technologies.”
The Dell Technologies Forum, an annual conference which has been held virtually for the past two years, is returning to an in-person experience at the Convention Centre this year. Over the course of the conference, a series of keynote speakers will discuss some of the most exciting trends in the world of technology today.
The event will guide organisations on enhancing cyber resilience, continuing to innovate while mitigating costs, and embracing new technologies to transform and grow. By engaging in breakout sessions and interactive experiences, while connecting with renowned technologists and industry experts, attendants will gain valuable insights on everything from multi-cloud strategy delivered as-a-service to modernised and secure technologies and enabling AI decision making.
Mr Ward explained: “The Dell Technologies Forum provides the opportunity to discuss how businesses can gain valuable insights into managing and analysing data.
“We will also discuss how Dell Technologies is investing in different solutions, including APEX, multi-cloud environments and cybersecurity, to help ensure that companies can secure their data while gaining a competitive edge.”
The Dell Technologies Forum will supply participants the confidence, control and scale they need to address security challenges with modern, end-to-end solutions.
Speakers will address this issue with the full understanding that data is key to individual business success and discuss how it can also be used to work towards positive change and development in a wide array of social, economic and environmental areas.
Dell will also be showcasing the innovations afforded by APEX – the company’s breakthrough portfolio of as-a-service offerings that promises to simplify digital transformation for businesses across Ireland and reduce costs by increasing IT agility and control.
Following the launch of Apex Data Storage Services into the Irish market earlier this year, the Forum will be the ideal opportunity to help Irish business leaders to learn more about how they can harness the value of this as-a-service solution for their business.
Commenting on the demonstrations and technological insights that will be available to Irish business leaders at the event, Mr Ward said, “By accessing the insights and solutions from the team of experts at this year’s Dell Technologies Forum, leaders across Ireland can harness new growth opportunities, unlock the true value of data and accelerate the pace of digital transformation in 2022 and beyond.”
The Dell Technologies Forum will take place from 10AM on Tuesday, September 27, at The Convention Centre Dublin.
The Dell Technologies Forum is run in partnership with Intel and Microsoft. Click here for more information and to register for this event.
The Travis County Commissioners Court voted unanimously July 26th to require that Central Health undergo an unprecedented independent performance audit. Commissioners voted again August 2nd to go with the tougher of two proposals for the scope of that audit.
A key goal of the audit is to obtain nitty-gritty details about what medical services Dell Medical School has provided to low-income Travis County residents in return for the $35 million annual payments from Central Health—$280 million so far. Over the initial 25-year term, payments will add up to $875 million and every penny of it comes out of the pockets of Travis County property taxpayers.
By law, Central Health may only use its resources to provide healthcare services for Travis County residents earning no more than 200 percent of the Federal Poverty Level. For a single person that’s $27,180. For a family of four it’s $55,500. If Dell Medical School is using Central Health’s funding for other purposes then it may constitute an unlawful gift of public funds. Which is what The Austin Bulldog’s investigative report documented.
On July 27th the Central Health Board of Managers confronted Dell Medical School’s top managers with exactly the kinds of questions the performance audit should answer: What healthcare services do low-income patients get from Dell Medical School for that torrent of property tax money?
The Board of Managers’ fired off their questions after Dell Medical School’s top executives delivered a 55-minute briefing. Their presentation was carefully scripted to include a 67-page PowerPoint show featuring a long list of medical school accomplishments.
The presentation was delivered by Dell Medical School’s Interim Dean George Macones, MD, who in January was elected president of the American Board of Obstetrics and Gynecology. Also briefing the Board of Managers was Amy Young, MD, vice dean of professional practice for Dell Medical School and chief clinical officer of UT Health Austin, the medical school’s clinical practice.
They no sooner finished than board members started peppering them with questions they were not prepared to answer. If they had read the meeting agenda, they would have seen a “key takeaway” the managers were looking for: “How do UT/DMS expenditures of the $35 million Central Health contribution align with the Central Health mission, and what healthcare benefits/services are provided to the population that we serve pursuant to this spending?”
While Macones and Young could not answer the managers’ questions, they said they would try to do so later—but might not be able to.
In closing the presentation and before taking questions, Macones said, “Thanks for having us today. We do know there will be an audit. We will be willing partners in that. We’re absolutely willing partners.”
The board’s questions were pointed but they were not new—not at all. They were questions the managers have been putting to medical school officials for many years.
What seems never to be discussed in Central Heath Board of Managers public meetings is why Dell Medical School officials never answer questions.
The explanation is simple: They don’t have to.
Central Health forfeited all rights to accountability when it entered into the Affiliation Agreement July 10, 2014. The agreement involves Central Health, its nonprofit subsidiary Community Care Collaborative, and the University. The agreement clearly requires Central Health to make those $35 million annual payments. It requires nothing from the University in return.
The University is quite clear about having no obligations. In its annual operating budgets, the University classifies this money as “nonoperating” revenue, or funding “from state or local governments for which no exchange of goods or services is perceived to have occurred (including) funding for the U.T. Austin Medical School provided by the local healthcare district.” (Emphasis added.)
Outside lawyers drafted the Affiliation Agreement. Lawyers from the Travis County Attorney’s Office, who act as Central Health’s general counsel, presumably reviewed the agreement. The Board of Managers approved the Affiliation Agreement. The senior Central Health official at the time, Executive Vice President Larry Wallace, signed the agreement. All either knew or should have known they were funding startup costs for a new medical school—not funding healthcare services for the poor. The Board of Managers voted to approve the agreement July 2, 2014, according to a statement on Central Health’s website.
Guadalupe Zamora, MD, the only current manager who was on the board when the Affiliation Agreement was approved, told the Bulldog in a telephone interview today, “We told Dell Medical School this money is supposed to go for services. We need services for that money. We need transparency.
“It’s about the patients. We need to get what the patients need. It’s not about what the medical school needs,”’ Zamora said.
Do the Board of Managers understand that under the Affiliation Agreement of July 10, 2014, they have no legal right to get accountability from Dell Medical School? That’s the question the Bulldog asked Central Health.
Ted Burton, the agency’s vice president of communications, responded via email August 5th, as follows:
“As you know Central Health is the defendant in a lawsuit regarding funding of the Dell Medical School, which prevents us from commenting on that case.
“However, Central Health has broad discretion to determine whether funds are being spent in a way that is consistent with its mission of coordinating and delivering medical and hospital care for Travis County residents with low income.
“That is why Central Health board members, at the July 27 public meeting, asked Dell Med leaders for additional detailed data with regards to the specific ways funding is being used.”
That statement appears to fly in the face of information presented to the Board of Managers at that meeting. One of their slides stated the Affiliation Agreement (see screenshot) provides for “Permitted Investments” that will be “used by UT in its discretion (emphasis added) to facilitate and enhance development, accreditation and ongoing operation of UT Austin Dell Medical School and its administrative infrastructure….”
That wording was taken directly from the 49-page Affiliation Agreement. It clearly explains why Dell Medical School is not obligated to do anything for Central Health or its needy healthcare patients.
The Travis County Commissioners Court is working to initiate a third-party independent performance audit, but that effort will take considerable time. They have to finalize the scope of work, issue a request for proposals to find qualified consultants who have no conflict of interest, and select and hire them.
If the originally drafted scope of work is specified in the performance audit contract, then the auditor’s would have 90 days to provide a thorough review of “The number and scope, by aggregate patient encounters, by universal diagnostic codes, universal treatment codes, and other pertinent utilization or other data, in the audit firm(s) discretion, by year of any and all healthcare services as defined in Texas Health and Safety Code, Section 281.028 and .029, provided by DMS (Dell Medical School) to Central Health MAP (Medical Assistance Program) and eligible patients from the $280 million in CH/CCC annual $35 million payments.”
The auditors would have an additional 90 days to complete a long list of additional findings.
All of which is to say that the performance audit will take considerable time to complete—and that’s if Central Health and its affiliated partners—including Dell Medical School, the University of Texas, Ascension Seton, Community Care Collaborative, and CommUnityCare—all decide to cooperate and provide full access to the records the auditors will need. It is entirely possible that one or more of these entities may either refuse to provide access to the necessary records or initiate litigation to prevent it.
Ten lawyers signed a position paper stating the Commissioners Court has the statutory authority to order and oversee an independent third-party performance audit of Central Health. But that advice may not be binding on all parties involved.
For what it’s worth, Interim Dean Macones told the Board of Managers Dell Medical School would be “willing partners” in the audit. But what of the other agencies?
Setting aside the many factors involved in a completing a successful performance audit, the University’s easy access to cash from Central Health’s ATM faces a much more immediate threat from a 2017 lawsuit challenging Central Health’s spending. That lawsuit will likely go to trial this fall. (Birch et al v. Travis County Healthcare District dba Central Health, et al, Cause No. D-1-GN-17-005824.)
Plaintiffs in that litigation argue it is not legal to supply $35 million a year to the medical school. A court verdict will likely be delivered long before the performance audit is completed.
The documents published with our investigation showed that the University’s budget for Fiscal Year 2022 for Dell Medical School included $35 million in income from Central Health. The budget displays 12 line items for medical school expenses totaling $11.5 million. None of those have anything to do with providing healthcare services for indigent patients. Further, there is no indication of what the University intends to do with the other $23.5 million received from Central Health for that budget cycle. The University confirmed that in its response to our public information request.
But wait—details missing in the University’s budget documents were supplied in Dell Medical School’s presentation to the Board of Managers. The Budget Overview slide (see screenshot) shows FY 22 allocations of $38,240,000. Of that amount, $13,490,000—more than 35 percent—is for “overhead allocation” to support “salaries and operating costs of departments such as IT, business support, communications, utilities, etc.”
Of the $19,470,000 allocated for genuine healthcare services (women’s health, surgery, internal medicine, pediatrics, and clinical practice operations) there is no indication these healthcare services would be delivered to Travis County’s low-income patients
Central Health’s Board Vice Chair, Cynthia Brinson, MD, told the Dell Medical School executives, “We need to account for the $35 million as it pertains to the population we serve. Could you summarize how this furthers the mission of Central Health to provide services for the low-income residents of Travis County?”
Interim Dean Macones replied that most of what was included in the briefing “was to optimize care for the poor. Almost all the clinical care has a significant focus in that area. We are really engaged in care for the poor.”
Brinson said more detail is needed. “How many hours were spent in clinics, in hospitals, so we can get a better idea of where our $35 million is going? You supply us large swatches of information but we really need a lot more detail.”
Macones responded, “We may be able to do some of that, but maybe not as granular as you asked.”
Manager Cynthia Valadez said, “I want the numbers for our population of uninsured patients of Travis County.”
Young asked Valadez if she meant the percentage of patients enrolled in the Medical Assistance Program, and Valadez replied, “Not the percentage— numbers—and care provided by Dell Medical faculty…Exactly how much of the $35 million is spent on that population, how many are served, and where can we see the records? We provide money for services that are supposed to be provided to our patient population. We need this information so we have transparency.”
Macones replied, “I imagine some of this will come out in the audit.”
To which Valadez responded, “We’re going to have an audit. I don’t know if that includes UT. I hope that’s the case. In attempting to reset our relationship, I hope y’all would be willing to provide regular reports, and we don’t have to keep begging for that information.”
Manager Sherri Greenberg complimented Macones and Young for their presentation, saying, “This is more comprehensive than we’ve seen in the past.” But she repeatedly stressed the importance of getting detailed data. Referring to the Budget Overview slide, she said, “Which line items or portions of those line items are specifically directed at Travis County residents under 200 percent of Federal Poverty Level?”
Later, Greenberg said, “Some of these questions about granular information and line item budgets we’ve asked for, for years. I’d like to see you go back at least three years in providing that information.”
To which Macones replied, “We can try.”
Board member Shannon Jones said, “Can we get a matrix on the number of clients seen so we can go back to our commissioners and tell them what we’re getting for the money, who’s getting care and how much?” (Because he posed another question at the same time, this part of his question was not addressed.)
Manager Valadez concluded the board members’ statements. “Sherri (Greenberg) and I asked these questions of your predecessor (Medical School Dean) Clay Johnston. We are a legislative creation and we go by the law,” Valadez said. “We’re here to represent the working poor, under 200 percent of the Federal Poverty Level. I hope our efforts to support Dell Medical School is well founded. Thanks for your courage in being here. I’m confident we can work this out and forge a much better relationship.”
Trust indicators: Ken Martin has been doing investigative reporting in the three-county Austin metro area since 1981. His aggressive reporting twice garnered first-place national awards for investigative reporting. Both of those projects resulted in successful criminal prosecutions. His 2011 investigation of the Austin City Council’s open meetings violations triggered a 20-month investigation by the Travis County attorney that resulted in the mayor and council members signing deferred prosecution agreements to avoid being charged, tried, and if convicted serving one to six months in jail and forfeiting their elective offices. He’s been investigating and reporting on Central Health since 2018. See more on Ken on the About page. Email [email protected].
Affiliation Agreement, The University of Texas at Austin, Central Health, and Community Care Collaborative, July 10, 2014 (49 pages)
Dell Medical School presentation to Central Health Board of Managers, “Progress and Impact: Aligned with the UT Austin/Central Health Affiliation Agreement,” July 2022 (70 pages)
Draft order of Travis County Commissioners Court requiring an independent, third-party performance audit of the Travis County Healthcare District (4 pages)
Legal position paper stating the Commissioners Court has the statutory authority to order and oversee an independent third-party performance audit of Central Health, July 7, 2022 (12 pages)
Plaintiffs’ Original Petition, Birch et al v Travis County Healthcare District, October 18, 2017 (7 pages)
Plaintiffs’ First Amended Original Petition, Birch et al v Travis County Healthcare District, March 21, 2022 (10 pages)
Video of Central Health Board of Managers Meeting, July 27, 2022 (Starts at 1:29:00 on the recording)
Related Bulldog coverage:
Commissioners order Central Health performance audit, July 27, 2022
Central Health critics ramp up pressure ahead of vote on audit, July 25, 2022
Central Health’s $35 million payments to Dell Medical School an unlawful ‘gift of public funds’ that exceed statutory authority, June 30, 2022
New documentary takes aim at diversion of indigent healthcare funds, November 15, 2021
Lawsuit challenges Central Health spending, October 18, 2017