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Disclaimer
• This presentation may contain product features that are currently under development.
• This overview of new technology represents no commitment from VMware to deliver these features in any generally available product.
• Features are subject to change, and must not be included in contracts, purchase orders, or sales agreements of any kind.
• Technical feasibility and market demand will affect final delivery.
• Pricing and packaging for any new technologies or features discussed or presented have not been determined.
2
Agenda
• Healthcare Trends (5 min)
• Opening Statement by Panelists (40 min)
• Q&A with Audience (15 min)
3
We know you have a lot to do…
• Global move from paper to
electronic records
• The facebook generation
want a consumer experience
• New applications and
devices
• Ensures alignment in
treatment plan
• Hospitals incorporating tablet
devices into patient
experience
• IT has to secure and support
• Technology helps not impedes
• “The right access to the right
application and data at the right
time”
• Mobility, Security, Availability –
solution needs to solve for all
Powered by VMware Workspace Suite and
Imprivata
• 24/7 fast access with single sign on to clinical
desktops using VMware Horizon™ and Imprivata
OneSign – « Tap Turn Treat »
• Mobile device, application, and content management
using AirWatch® by VMware
• High performance 3D clinical images delivered to
virtual desktops using NVIDIA GRID or AMD
graphics cards in the datacenter
Agenda
• Healthcare Trends
• Meet our Panelists
• Q&A with Audience
9
© 2014 VMware Inc. All rights reserved.
Justin Beardsmore
IT Manager and End User Compute Lead
St. George’s Healthcare
10
St George’s Healthcare NHS Trust
11
• Largest healthcare provider in southwest London
• Acute Care
– St. George’s Tooting
– St. George’s, University of London
• Community care and Services
– Queen Mary Hospital
– 11 Centres and Clinics
• South West London Pathology Integrated Service
• Approx. 8,000 staff
• Serves a population of 1.3 million across SW London
Why we looked to VDI
12
• Approximately 5000 XP PCs (60% more than five years old)
• Failing desktop management. Benching exercise highlighted
- more desktop visits than our peers
- Supporting more sites than our peers
High Organisational change rate
- Hospital in constant motion (ward, clinic moves)
- Benchmarking highlighted we were deploying 30% more software than our peers
• Clinical lack of confidence in desktop infrastructure (inconsistent experience)
• Sharing of NHS cards, passwords and generic logons
• Aggressive Electronic Patient Record clinical implementation programme of work
The Medical Desktop
• VMware Horizon View 5.5
• ThinApp
• Imprivata OneSign
• Infrastructure – EMC XtremIO & Cisco UCS Blades
• McAfee Move AntiVirus
• Follow me printing
• NHS Smartcard, isosec identity agent for NHS spine connectivity
• Praim thin clients (wired, wireless)
13
The Medical Desktop Architecture
• Two clusters (Pods)
- Cluster One (Pool C), Cluster Two (Pool A, B) + testing pools
- One gold Images (two instances)
• Logons
- PIN and NHS smart Card, then Card only to reconnect for set period.
• Frontend Connectivity
-Hardware NLB (two View connection severs)
- Security server for N3 (other hospitals), Cisco VPN
-Distributed Directory Services (Imprivata Oneign, Microsoft AD)
14
Success
15
• Approx. 4000 registered users (50% active during a week), 250 VDI desktops
• Faster access to clinical data (21,000 SSO logons during one week = 60 hours saving)
• More Desktop consistency (Replaced 1100 XP PC’S with approx. 2000 thin clients)
• VDI Established and trusted platform for EPR rollout
-Order communication's, E-Prescribing and Clinical document Management system
-Consolidate on NHS smart card as the default access card
• Agile and mobile solution to various tactical problems – N3, GP surgeries, other hospitals, med school, remote access for all clinical users)
• Better Governance
Advice – Lessons Learnt
• Collaborate and Communicate (tell the story, sell the vision)
• Measure Success
• Clinical Change program of work not infrastructure (technology must be invisible)
• Think about printing at the beginning (we are not Paperless yet)
• Think about how VDI effects your existing team structure
• Reduce the complexity where possible
• Resource for deployment and training
16
What Next?
What We are Doing
• Mobility
– Airwatch (Photo App, Mobile reports)
• Testing Horizon View 6
• Cerner Instant Access
What we are reflecting Upon
• Wider deployment (Community Services, On premise vs hosted desktops)
• Application strategy
• More of the same, variation of the same, or more mobile (airwatch, work space, etc.)
17
© 2014 VMware Inc. All rights reserved.
Darren HendersonICT Services ManagerSouth Eastern HSC TrustNorthern Ireland
18
South Eastern HCT Trust
• South Eastern part of Northern Ireland, covering population of 440,000
• 12,000 staff, of which 8800 have regular access to ICT services today – forecast to grow with MyDesktop in Community project.
• Deliver acute and community services across 120 locations, including 3 Emergency Departments
• 120 Trust Facilities, but community services includes client homes! So much larger!
• Electronic Care Record (ECR) utilising Orion Portal
• Electronic Medical Record (EMR) utilising Evolve
19
Why we looked to VDI
• Follow me desktop has been an aspiration for literally decades, never quite achieved
• TYC – Transforming Your Care – pushing services further out to community and into Patient and client homes
• Windows…. Normal windows issues, slowing down, management etc..
• Laptops even harder to manage.
• Security
• Ease of use
• Single Sign On for Emergency Department needed VDI to provide the speed and convenience required
20
Our Solution• Software:
– Started with View 4.5 originally, now up to View 5.3 and looking forward to 6
– We currently use Application Virtualisation and are Investigating Thinapp, VERY interested in Cloudvolumes !
– Using persona management and normal folder redirection
– 100% non persistent desktops
• Hardware:
– HP Blades BL460c 256Gb Dual Proc (Circa 60-80 per host conservative)
– Storage – Tintri x 2 (Split Datacentre for resilience, HP POD containers) sized for 1200 concurrent users (currently achieving 1:5 ratio, so this would cover 5000-6000 users !)
– iPads, Zero Clients, Chromebooks and personal devices, so anything !
• Single Sign On:
– Imprivata Onesign… Secret sauce of the solution, ties everything together. Proximity passes for badge tap
• MDM:
– Airwatch managing all the iPads and iPhones as we migrated away from Blackberry this year.
21
What has the impact been
• Feedback has been overwhelmingly positive
• Follow me desktop vital in creating a much more efficient clinician experience and therefore better outcomes for the Patient
• Quick Anecote: Dr Harper – was at home, took a call about a patient from a family member, was able to access patient data, including NIPACS review, on the iPad WHILE talking to family member and provide direction immediately
– This was almost impossible before VDI
• IT savings
– IT savings were not an initial consideration or goal
– However, We fully expect to see savings from maintenance, service desk calls, power usage, BYOD enablement
– Zero client roll out trivial task now, hardware faults eradicated, devices are throw away effectively!
22
Success
• Buy in from influential clinicians, INCLUDING negative ones. (iPads helped!)
• Worked with great partners, BT and IT Alliance
• But important point, trust staff built the solution with partner help, this fostered ownership.
• Simplification – keep images as close to Physical setup as possible, so same desktop team looks after them
• Ultra notebook performance, as we selected the storage very carefully
• Re-connect times average 2.5 seconds, Initial login just over 20 seconds
• Tried to avoid bespoke solutions, playing to the keep it simple idea, however ED location based timings required a little bit of custom bespoke work with Imprivata.
• Ensured solution reached our performance goals, before rolling out wider
• If we were doing it again:
– Be more aggressive with rollout, maybe too cautious ?
– EVO-RAIL and hyper-converged solutions are interesting option now
23
What’s next?
• New VMware technologies:
– Workspace – enabler for BYOD
• RDSH Applications is the key here!
– CloudVolumes
– Project Fargo
– Hardware 3D capability for Radiologists
24
© 2014 VMware Inc. All rights reserved.
Martin PowisHead of Enterprise Architecture
NHS Yorkshire and the Humber
• We provide desktop and network services to GP Practices, Hospital Trusts, Community Health Services and other qualified Health Providers and charities
• 23 CCGs (Clinical Commissioning Groups)
• 800 GP Practices
• 33,000 users
• Covers an area of 15,000 square kilometres, population of five million
• Core clinical systems: SystmOne, Emis
26
Why VDI?
• Timing was right!
• 5000 desktops to replace (100% of desktop were at or way past EOL)
• Reduce complexity and drive for greater desktop consistency
• Expand on 15 year experience of roaming desktops across GP sites to give users a true 'always on' desktop
• 15 Years of experience of imaging technologies across a wide area made VDI a logical choice
• Centralise data for resilience and security
• Over 10 Years experience of virtualisation with 6 years of those being desktop
27
Challenges
• Server, Storage and Networking technologies were finding it hard to keep up with virtualisationwhich made making the right decision on the final solution difficult
• Many software vendors had not even grasped the concept of Desktop Virtualisation
• NHS Smartcards wouldn't work in VDI and struggled with SBC
• Convince the board of a new way of spending to save for desktop replacement programme
• User perception of losing control of data and hardware ownership
• IT Staff concerns that new technology will result in job losses or existing skills will no longer be required
28
Solution
• Wyse Terminals replaced all PCs (initially running Window embedded)
• Horizon View, ThinApp, Persona Management
• Roaming desktops for clinicians
– Kiosk – waiting room display screens, patient call, patient arrival
• RES VDX for supporting certain applications
– under building block design line
• Belt and Braces design
– Rackmount servers chosen for future expandability
– FusionIO chosen for risk free disk IO
• Built a dedicated team to manage rollout and then manage Virtual EUC
• Now been running 5000 desktops for 2 years
• Supporting other NHS organisations across the country via N3, Internet and 3G/4G
• Internally Developed Two Factor Authentication for Security Servers
• After a year switched on View security servers – enabled BYO and corporate Tablets / iPads
29
What has the impact been
• Great impact on Doctors ability to access patient information
– GP’s working from home.
– GP’s working in other care sectors – nursing home, able to access patients care record
– Given them their life back. • GP who would have done his work (surgery), would then have to carry out reports / admin tasks. Able to leave the
surgery at normal office hours, see the kids, then finish off at night
• Doctors using iPhones to access desktop – good feedback on iPhone 6
• Login time gone from worst case 20 minutes to < 1 minute (including terminal boot)
• Impact on support
– Support – ability to reset desktop with 1st line support. Standard Windows problems are a thing of the past.
– Windows / remote visits dropped by >75%
– Helpdesk calls didn’t reduce, but changed from break fix, to advice and support
– Improved perception of support – Our service quality has improved
30
Success
• We did it right – time and resources
– POC stages – 600 users, design, investment.
• Working with experts – VMware team
• Close partnership with software vendors – understanding software in virtual environment
• Work with the users - Ran roadshows to inform clinical staff, gave hands on –
– “It looks like a windows desktop” – “Yeah…”
• Launch event – invited key managers and clinicians
• What we’d do different: Did rollout of Windows 7 and VDI at the same time. Weren’t changing workflow, but introduced issues when certain software wasn’t ready for Windows 7
31
What’s next?
• Horizon Workspace and streamed Apps to compliment or replace desktops
• Multi datacentre resilience
• Near Zero Clients
• RDSH streamed apps
• In process of upgrading to View 6
• Converged technology roadmap following on from success for storage on the servers
32
Agenda
• Healthcare Trends
• Opening Statement by Panelists
• Q&A with Audience
33
Thank Youtmurdock@vmware.com
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