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.

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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

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© 2014 VMware Inc. All rights reserved.

Justin Beardsmore

IT Manager and End User Compute Lead

St. George’s Healthcare

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St George’s Healthcare NHS Trust

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• 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

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• 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)

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Success

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• 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

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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

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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

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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

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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.

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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!

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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

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What’s next?

• New VMware technologies:

– Workspace – enabler for BYOD

• RDSH Applications is the key here!

– CloudVolumes

– Project Fargo

– Hardware 3D capability for Radiologists

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© 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

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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

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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

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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

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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

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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

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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

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Agenda

• Healthcare Trends

• Opening Statement by Panelists

• Q&A with Audience

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Thank Youtmurdock@vmware.com