When patients think about their health care, it’s doctors, nurses, tests and prescriptions that come to mind—not to mention the occasional hospital visit. But at Southern New Hampshire Health Systems (SNHHS), we know there’s more to providing quality health care than what patients see on the surface.
Quality care revolves around the individual and the expertise of practitioners, of course. But in the digital age, it also revolves around technology and the data that powers it. From the examination room to the emergency room, from the ICU to the surgical ward, reliability, quality and speed of access to patient data is critical. It’s not only for the health-care facility’s operational efficiency, but also for the lives of the patients it serves. Inflexible, unresponsive or unreliable IT infrastructure does more than hurt a hospital’s bottom line. It can lower the quality of patient care and even endanger lives.
Picture ER doctors having to wait two to three minutes for a desktop to boot up, then even longer to launch and log into several separate applications before recording their notes and other encounter data. They even have to wait to log out afterwards—critical minutes lost that could have been devoted to the next patient in need of critical care.
Such is the situation in which our SNHHS medical center found itself, when our IT team tackled these challenges with virtual-desktop infrastructure (VDI).
Obstacles to Providing Excellent Patient Care in the Digital Age
For 125 years, SNHHS has provided innovative health care to residents of southern New Hampshire. Today, with over 20 campuses and more than 500 primary and specialty health-care providers in our network, we serve an estimated 100,000 patients a year. In addition, the SNHHS Medical Center is a 300-bed acute-care facility that offers the comfortable feeling of a local community hospital while providing its patients the full resources of a major regional medical center.
Providing efficient, reliable access to patient data and charts across so many facilities is a challenge. Having nearly 3,000 physical desktops in doctor offices and exam rooms across the state, speed and responsiveness of these devices is important. But in a hospital and ER setting, the demands are far greater.
Our SNHHS IT team is charged with managing the systems and data our doctors use to make critical health-care decisions—decisions that can mean the difference between life and death. Hospital personnel are constantly moving between the ER, ICU wards and patient rooms, which span multiple floors. They don’t have time to wait for multiple applications to start up each time they treat a patient—applications that access everything from medical records (EMRs) to high-resolution imaging, notepads, browsers, Microsoft Office and more. They need immediate and reliable access to these data and applications from multiple devices and from multiple locations.
Identifying the Requirements for a Virtual-Desktop Solution
SNHHS has always been an innovator when it comes to incorporating technology into its health-care approach. To address the needs of our medical staff and our patients, we decided to implement a virtual-desktop infrastructure (VDI) for our medical center.
VDI is a virtualization technology that hosts our desktop operating systems on a central server in a data center. It then makes images of those environments available to our users across an array of client devices while keeping each user’s login sessions, application state and data separate.
In selecting a VDI solution, it was important to consider the underlying infrastructure. SNHHS needed a solution that was the following:
- Scalable to support hundreds of desktops across multiple data centers
- High density, allowing us to run more virtual machines with less hardware and thereby less expense
- High performance, highly available and fault tolerant
- Redundant, resilient and always on
- Simple to manage and administer, with rapid deployment and migrations
Perhaps most importantly, we needed a health-care-validated solution, purpose built for VDI, one that would let us focus on supporting our health-care professionals rather than the complexity of building out and integrating infrastructure.
To address these requirements, we partnered with Pivot3, whose hyperconverged infrastructure (HCI) combines the core elements of the data center into a single appliance controlled by a single software interface. This approach provided the ideal backbone to seamlessly and efficiently operate our VDI solution.
Boosting Productivity, Efficiency and Overall Quality of Care With VDI
With Pivot3’s help, we built out a highly available, resilient environment by implementing two identical data centers.
Each data center has three HCI nodes and one 12TB data node in a cluster. All nodes run VMware vSphere 6.0. On this infrastructure, we deployed VMware Horizon View 7 to deliver desktop-virtualization capabilities to roughly 200 desktops—many of them on wireless mobile carts that can be moved from room to room and floor to floor. These “workstations on wheels”—which we call WOWs—support the clinical apps our doctors and nurses need all over the hospital. For some workstations, we’re also using VMware’s Blast protocol. Blast provides high performance for both traditional VDI desktops and mobile environments like our WOWs.
Two F5 load balancers in each data center route incoming requests to the data center with the most available bandwidth, processing capacity and storage-I/O resources. That means even at peak usage, virtual-desktop access and response remain optimal. And because of the redundancy of the two data centers, we automatically ensure continuous operation in the event of an outage or planned maintenance.
Perhaps one of the greatest productivity boosts our VDI implementation enables is a rapid single sign-on (SSO) procedure using digital card readers on our WOWs. Doctors simply swipe their badge on any WOW desktops to log into their virtual desktop. Coupled with sophisticated session management from HealthCast Solutions, this setup lets our doctors access their active sessions without having to start a dozen clinical apps each time they login. They simply pick up where they left off as they move from location to location. If they have to leave the room, a quick swipe locks their session, ensuring the privacy of any patient data from prying eyes.
At any given time, we have between 100 and 120 active virtual-desktop logins. The time required to access all the applications a practitioner needs has dropped to mere seconds, saving precious time in critical-care situations. Even so, we plan to add more Pivot3 HCI nodes with all-flash storage to each data center this year, and we expect they will boost access speed by 400 percent.
What Has HCI Done for SNHHS Medical Center’s Virtual Desktop Environment?
SNHHS’s VDI implementation using an innovative HCI architecture has transformed our IT systems into a strategic asset for both our business and our IT department. VDI delivers many important benefits that allow our medical center to provide more-efficient, higher-quality patient care, without ballooning either capital IT costs or staffing. From an infrastructure perspective, Pivot3 HCI allows us to deliver a virtual environment that provides the following:
- Reduction in the complexity of managing the virtual-desktop environment
- Reduced maintenance and deployment time for security, OS and application updates—now hours instead of months—with central management for all end points
- High availability and redundancy for universal, 24/7/365 access to virtual desktops and IT resources for all end users in our medical center
- Mobility and rapid access to critical data and clinical applications from any device or virtual desktop in any room—especially via our WOWs
- Major improvements in speed to access EMR data from anywhere in the medical center
- High-performance delivery of clinical and administrative apps, as well as securing and delivering critical patient data doctors need to make real-time, life-and-death decisions
- Compliance with stringent health-care requirements, including HIPAA and PHI, thereby reducing compliance penalties, unnecessary lawsuits and reputation damage
- Excellent advice and support from a leading vendor in HCI and VDI
HCI allows our IT team to deliver a more dynamic and efficient VDI solution. It’s now much easier to deploy a security or other upgrade to a single image and have that upgrade automatically propagate to all VDI user sessions and desktops, as opposed to updating 3,000 physical desktops manually.
HCI and VDI: An ideal Fit for Health Care
By deploying VDI using the Pivot3 HCI solution and VMware Horizon 7, we’ve met the challenges of providing quality health care in today’s digital age. We’ve increased availability of critical patient data and resources for our staff and practically eliminated downtime, which can result in poor patient care and lost revenue. At the same time, VDI has simplified the complexity of maintaining traditional desktop infrastructure and reduced our total cost of ownership.
But the benefits to our practitioners and their patients are even greater. Implementing VDI on our wireless COS desktops provides seamless mobility to SNHHS’s practitioners. Doctors’ roaming access to active sessions becomes even more efficient by coupling it with our badge-activated SSO. This integration also reduces paperwork and simplifies clinical-information workflows.
All this leads to faster access to the information medical professionals need to do their primary job: treat patients. By reducing the amount of time doctors, nurses and clinicians spend with technology, VDI enables our health-care professionals to spend more time with their patients. The benefit to this extra time is twofold. With more time, we can see more patients, which increases revenue. But more time spent with patients also means better patient outcomes.
In short, HCI and VDI is an ideal combination for modern health care.
About the Author
Scot Tymowicz is a desktop-configuration engineer at the Southern New Hampshire Health Systems medical center. He helps maintain the desktop environment for the SNHHS network of facilities across southern New Hampshire, including the virtual-desktop infrastructure (VDI) powering the COS desktops used to treat medical-center patients.