EMC SOLUTIONS FOR A VIRTUALIZED CERNER MILLENNIUM ENVIRONMENT

MOVING TO THE 3RD PLATFORM OF HEALTH IT TECHNOLOGY Organizations across the healthcare spectrum are looking for ways to take advantage

of existing storage investments while gaining the benefits of the Third Platform of IT

technology. These are web-scale capabilities and efficiencies that provide a path to the cloud leveraging your existing storage investments.

This journey begins with cloud computing, a dynamic, secure and compliant solution

that dramatically reduces IT services-delivery time in order to increase business agility, to break this cycle and unlock resources to fuel more innovations.

Healthcare organizations are no longer asking whether they should deploy and

leverage virtualization and cloud computing models, but how and how fast can they deliver Cerner via flexible cloud-based services throughout their organization.

This transformation would extend from the datacenter to the desktop, but also

reaches beyond the four walls of a single hospital to manage collaboration and

consolidation from hospital mergers and health network acquisitions. It could include

alliances with specialty clinics and labs, even managing software upgrades and data

migrations across multiple sites. The end result of this transformation yields not only

the high performance and availability demanded by your Cerner application and your

caregivers, but could also result in an overall reduction in your IT complexity and risk, and an increase in your IT efficiencies.

EMC PERSPECTIVE

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This EMC Perspective describes how EMC, the global leader global leader in IT and business transformation, VMware, the global leader virtualization software, and Cerner, a world leader in virtualization software for healthcare organizations of all sizes, are working together to provide solutions for healthcare IT. These solutions provide the foundation to meet current service requirements, and accelerate your journey to cloud computing and deliver Cerner-as-a-Service throughout your healthcare enterprise. They also enable Health IT to play a major role in creating an agile healthcare organization, ready to face new challenges as they arise.

EMC, VMware, and Cerner work together to test and deliver innovative and integrated solutions that help make Cerner Millennium environments more agile, efficient, and secure, and to deliver higher availability and performance. EMC has tested advanced backup and recovery solutions with Cerner and EMC storage platforms and Vblock systems are used in Cerner’s Kansas City data centers. No one else has developed and tested more point of integration with VMware than EMC.

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TABLE OF CONTENTS

MOVING TO THE 3RD PLATOFRM OF HEALTH IT TECHNOLOGY 1  

REDEFINE YOUR STORAGE AS CLOUD READY 4  

EMC SOLUTIONS FOR CERNER EHR 5  Advanced Backup and Recovery in Virtualized Cerner Environments 5  EMC Data Protection Software 6  EMC Data Domain Backup Storage 6  

CONTINUOUS OPERATIONS AND AVAILABILITY 7  

Integrated, Virtualized Data Protection 8  Managing Your Virtualized Backup Environment 9  

DESKTOP ENVIRONMENTS 9  Integrated and Virtualized 9  

REDEFINING TRUSTED HEALTH IT 11  

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REDEFINE YOUR STORAGE AS CLOUD READY EMC VMAX Cloud Edition is the first self-service, enterprise class-storage delivery platform that accelerates time-to-value for Cerner users’ private, hybrid, and public clouds. VMAX combines the foundation for six-9s of high availability and resiliency that Cerner EHR environments demand with the immediate access and flexibility of self-service VMAX Cloud Edition also delivers automatic provisioning, trusted multi-tenancy, built-in metering and chargeback reporting.

VMAX comes with built-in support for external servers using RSA® Data Protection Manager for data-at-rest encryption (D@RE). This includes key management for maximum flexibility in securing data at the drive-level, both capabilities helpful in addressing HIPAA and HITECH regulations

VMAX also enables the consolidation of front-end global memory and back-end functions, enabling direct memory access to data for optimized I/O operations. This is an ideal design for the demands of your Cerner production environment, and along with dynamic cache partitioning for VMAX, allows Cerner users to prioritize I/O’s so the production database delivers a consistent and high level of performance.

EMC VNX Unified Storage provides Cerner environments with, five-9s availability, management tools and built-in protection software. VNX advanced efficiency services may reduce your capacity requirements up to 50 percent.

VNX also enables healthcare organizations running Millennium to cost-effectively manage multi-protocol file systems and multi-protocol block storage on a single, unified platform. With fast-growing Cerner environments, centralized management and visibility across diverse storage assets enables healthcare providers to scale more efficiently and smoothly while reducing the level of complexity.

Vblock™ Systems from VCE represent the next evolution of IT—one that unleashes simplicity by delivering to Cerner users the extraordinary efficiency and business agility of virtualization and cloud computing. Seamlessly integrating best-in-class compute, network, and storage technologies from industry leaders Cisco, EMC, and VMware, Vblock Systems provide dynamic pools of resources that can be intelligently provisioned and managed to address changing demands of your Millennium environment.

Pre-integrated, tested, and validated with Cerner Millennium, the systems can be quickly deployed, easily distributed, and counted on to increase the predictability and timeliness of your Millennium rollout and operations. Cerner has deployed Vblock systems to help them run a new Population Health Management software offering.

Many healthcare organizations have already taken an important first step toward cloud computing by virtualizing and standardizing their IT infrastructure. With the help of Healthcare ISVs like Cerner along with medical imaging vendors, healthcare IT Managers and CIOs are accelerating their adoption of virtualization and cloud computing to help power their most critical patient-care systems. EMC can help.

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EMC SOLUTIONS FOR CERNER EHR ADVANCED BACKUP AND RECOVERY IN VIRTUALIZED CERNER ENVIRONMENTS Fast, reliable backup and recovery of virtualized Cerner applications and data is essential to complying with strict HIPAA and HITECH regulations and achieving meaningful use. Given the typically large size of Cerner databases, establishing acceptable backup and recovery service levels is challenging for many users. The complexity and poor reliability of many existing solutions also make it difficult to frequently test backup and recovery plans as required by HIPAA.

To address these needs, EMC offers an integrated suite of data protection software and backup hardware solutions that deliver high performance, extensive scalability, and rock-solid reliability for virtualized Cerner environments (Figure 1).

Figure 1. EMC Reference Architecture for Backup and Recovery of Virtualized Cerner Environments

Simplify your Oracle backup and recovery for Cerner with EMC Data Domain deduplication storage systems. These systems are optimized for backup and archive data, making them a cost-effective alternative to tape. Because they store data on disk, recovery from backup becomes fast and reliable while their deduplication technology enables you to keep more copies of data for longer periods. In addition, Data Domain integrates with Oracle Recovery Manager (RMAN), which lets you back up your Cerner Oracle environment directly to disk using RMAN and a network-attached storage Data Domain as a target. Data Domain systems can reduce the amount of storage required by as much as 30 times through inline deduplication, which lets you store weeks or months of full backups

You can further enhance Cerner backup efficiency with the Data Domain Boost plug-in for RMAN, which improves backup performance by distributing parts of the deduplication processing from the Data Domain system to the Oracle server. This integration can decrease CPU utilization on the Oracle server and reduce LAN bandwidth required by 80 to 99 percent because only unique data is sent to the Data

ORACLE CUSTOMER BACKUP EXAMPLE • Up to 99% less bandwidth

consumption for your backups and replication

• Simplify Oracle protection and reduce disk storage footprint by up to 30X with backup and recovery solutions integrated with Oracle Recovery Manager (RMAN)

• Avoid disasters – rather than recover from them – with active-active data centers (zero RTO and RPO)

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Domain system. Integration of Oracle RMAN and Data Domain Boost gives DBAs needed visibility into and control over backup and disaster recovery processes without involving the backup administrator. EMC Data Domain deduplication storage systems can simplify complex Oracle backup processes while also controlling costs and meeting retention requirements.

EMC DATA PROTECTION SOFTWARE EMC's data protection software is tightly integrated with VMware to streamline backup and recovery operations in highly virtualized environments. The software centralizes, automates, and accelerates data backup and recovery across your Cerner environment. It also includes client-side deduplication, which can reduce the amount of data being backed up by as much as 99 percent, dramatically improving backup performance. Recovery is fast and easy, invoked in a single step.

For protecting Cerner services running on VMware virtual machines (VMs), EMC embeds Avamar deduplication software in the VMware ESX Server, as well as the VMware vStorage API for Data Protection (VADP) toolset. This enables you to easily perform guest- or image-level backups from your VMware virtualized Cerner environment.

EMC DATA DOMAIN BACKUP STORAGE The hardware foundation for protecting virtualized Cerner environments is EMC Data Domain® deduplication storage systems. Data Domain provides a single backup storage system for the full range of Cerner data streams, delivering the speed, capacity, and resilience to fully protect clinical, financial, and administrative information.

The Data Domain data invulnerability architecture (DIA) enables the system to protect billions of blocks of data without loss or corruption while maintaining high performance to meet service-level agreements (SLAs). Data Domain will also deduplicate data in-memory before writing to disk, optimizing system utilization without impacting backup performance.

With stringent HIPAA security rules, data encryption has become especially important in virtualized Cerner environments. Data Domain encryption software seamlessly integrates with the deduplication process to encrypt data "in flight" before it is written to disk, maximizing efficiency and security. Once written to the Data Domain system, data remains encrypted at rest, preventing it from being accessed without proper authentication. Plus, if the Data Domain system is replicated to a remote site for disaster protection, the data remains encrypted and secure.

“Running applications on vSphere ensures their reliability, which is the number-one reason we began adopting it across the board in our datacenter. So many of our applications and systems are absolutely vital to staff and patients. So making sure they’re available whenever they’re needed is our paramount concern.” — Tim Harper, Senior Systems Analyst Kadlec Medical Center

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CONTINUOUS OPERATIONS AND AVAILABILITY The life and death realities of health delivery organizations demand always-on application and information availability, particularly from EHR applications. You must have aggressive RTOs and RPOs for Cerner Millennium, and to meet these objectives, and you must eliminate single points of failure and maximize the number of available points-in-time for disaster recovery—all while reducing infrastructure costs and increasing resource utilization.

One way that healthcare organizations manage these challenges is with Oracle RAC, which enables a single database to run across a cluster of servers with access to shared storage, providing fault tolerance and 24/7 availability, combined with active-active datacenter innovation. RAC can span between data centers, but geographic distance is limited. EMC VPLEX helps you overcome the distance limitation by delivering availability and mobility between arrays in a single datacenter and in arrays separated by distance. VPLEX is a continuous availability and data mobility platform that allows mission critical applications like Millennium to remain up and running during a variety of planned and unplanned downtime scenarios.

VPLEX also lets you extend Oracle RAC across remote sites for a true active-active solution that helps you avoid disasters—not merely recover from them. EMC VPLEX resides between your Cerner application servers and heterogeneous storage assets, making your IT infrastructure more resilient, while complimenting Cerner best practices for disaster recovery. One way that healthcare organizations manage these challenges is with Oracle RAC, which enables a single database to run across a cluster of servers with access to infrastructure more resilient, while complimenting Cerner best practices for disaster recovery.

By using VMware SRM with VPLEX, you can create a coordinated plan to prioritize the VMs that fail over operations to the secondary site and those operations that are suspended during an outage. SRM also automates the entire VM failover process, eliminating the need for manual intervention.

You can also deploy VMotion with VPLEX to move live VMs from one physical host to another at the remote site. This provides added flexibility to avoid downtime during planned maintenance or upgrades at the primary site. Since VPLEX maintains a virtual copy of data at both sites, there is no need to fail over storage when moving VMs with VMotion.

Adding EMC RecoverPoint® to the VPLEX environment ensures continuous data protection for Cerner service servers by providing digital video recorder (DVR) capabilities that capture and play back data to a specific point in time. With this integrated, virtualized, and geographically separated environment, you can achieve a recovery time objective (RTO) of zero while approaching a recovery point objective (RPO) of zero for assured business continuity of Cerner service servers.

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“With VMware View, our physicians don’t just have access to lab reports. They can see actual X-ray images, access emergency department records, and even monitor biofeedback if a patient’s in a critical care situation. All the applications they need are right there at their fingertips, giving them a more global picture of their patients than ever before.” — Michael LaForge, Network Administrator, Columbia Memorial Hospital

Figure 2. EMC Reference Architecture for Active-Active Virtualized Cerner Environments

INTEGRATED, VIRTUALIZED DATA PROTECTION EMC's data protection software is tightly integrated with VMware to streamline backup and recovery operations in highly virtualized environments. The software centralizes, automates, and accelerates data backup and recovery across your Cerner environment. It also includes client-side deduplication, which can reduce the amount of data being backed up by as much as 99 percent, dramatically improving backup performance. Recovery is fast and easy, invoked in a single step. EMC stands out in the industry for the deep integration between EMC and VMware technologies. By embedding EMC’s data protection software with VADP and employing Changed Block Tracking, EMC accelerates backups of all VMware VMs in the Cerner environment.

Thanks to this integration, EMC data protection software also is aware of the current state of the VM and can determine which blocks from the last backup are needed in a restore scenario. This reduces the time to restore full VMs or individual files from hours to minutes keeping patient data highly available to your caregivers.

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In addition, EMC data protection software offers VM Instant Access, which allows a VM backed up on Data Domain to run directly from the backup within seconds. While the VM is running from backup, the data protection software does not overwrite the original backup image. Any new data is backed up to a separate file. When the production environment is stabilized, the live VM can then be moved from backup to production using VMware vMotion, eliminating disruption to Cerner users.

For protecting Cerner services running on VMware virtual machines (VMs), EMC embeds Avamar deduplication software in the VMware ESX Server, as well as the VMware vStorage API for Data Protection (VADP) toolset. This enables you to easily perform guest- or image-level backups from your VMware virtualized Cerner environment.

MANAGING YOUR VIRTUALIZED BACKUP ENVIRONMENT EMC also simplifies administration of backup and recovery for virtualized Cerner environments. By integrating EMC’s data protection software with VMware vCenter Operations Manager (vCOPs), administrators have a single pane of glass through vCenter to initialize and monitor backups, as well as invoke recoveries as needed.

By taking a holistic approach to backup and recovery for virtualized Cerner environments, EMC enables you to streamline the entire process, reducing time and cost while maximizing protection of critical Cerner data. In addition, an integrated EMC solution simplifies backup and recovery testing to meet HIPAA and meaningful use requirements without disrupting production operation.

DESKTOP ENVIRONMENTS The benefits of virtualization are being extended to the point of care in hospitals everywhere. Virtual Desktop Infrastructure (VDI) solutions provide secure and mobile access to patient-care systems, enabling clinicians and caregivers to securely access patient data from a variety of devices either within the hospital setting or remotely, if need be.

The EMC solutions for Cerner virtual desktop environments integrate EMC technologies with those from VMware, VCE, and other partners to deliver an end-to-end “always on” and secure desktop environment for Cerner users. VMware vSphere Desktop suite of software is a highly scalable, reliable and robust platform for running virtual desktops and applications. This suite includes built-in business-continuity and disaster-recovery capabilities to protect desktop data and availability.

vSphere Desktop also includes software that offloads and centralizes antivirus and antimalware (AV) solutions, eliminating “agent sprawl” and “AV storm” issues while minimizing risk of malware infection. Finally, vSphere Desktop software acts as a central management hub for vSphere—giving you complete control over and visibility into clusters, hosts, virtual machines, storage, networking and other critical elements of your virtual Cerner infrastructure.

VMware Horizon View is a tightly integrated with on VMware vSphere, and extends business continuity and disaster recovery features to their desktops, standardizing on a common platform, from the desktop through the datacenter—to the cloud.

INTEGRATED AND VIRTUALIZED A large number of healthcare organizations have taken steps to implement Cerner but are struggling to manage distributed endpoints such as desktops, laptops, tablets and smartphones used by caregivers and administrative staff. VMware Horizon View allows unified access to virtual desktops for both clinical and business applications to run in a secure, centralized datacenter accessible from a wide variety of devices, such as PCs, thin clients, zero clients, iPads, and other tablets.

Horizon View moves desktops and applications into the cloud and delivers them as a highly available managed service, allowing IT to manage desktops, Cerner applications, and patient data centrally while increasing flexibility and customization for the end-user.

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The architecture for this solution, depicted in Figure 3 below, is delivered on a Vblock Specialized System for Extreme Applications and specifically designed for solutions like VDI. Vblock Systems seamlessly integrate leading compute, network, and storage technologies, providing at-scale virtualization and application performance. XtremIO, the highly scalable, all-flash storage array in this Vblock System, combines multi-level cell (MLC) flash with sophisticated wear leveling, data reduction, and write abatement technology. This delivers extended flash endurance that makes the system both enterprise-reliable for Cerner environments and also cost effective. XtremIO delivers six-9’s of field-proven availability.

Figure 3. EMC Reference Architecture for Active-Active Virtualized Cerner Environments

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In this Cerner desktop solution, user data and Horizon View personal data are directed to an EMC storage platform. Sending user data to an EMC storage platform and the data from virtual desktops to XtremIO SAN increases desktop footprint capacity and value per desktop. It also improves Cerner users’ experience by separating storage I/O workloads by directing them to different storage platforms.

This solution also provides single-sign-on (SSO), strong authentication, and utilizes a less invasive and lighter weight provisioning approach that enables rapid application on-boarding, permitting users to access quickly all workstations and application they are authorized to use.

REDEFINING TRUSTED HEALTH IT Health IT is what EMC does. As a result we have been extremely successful in delivering Cerner IT infrastructure that satisfies both the demands of the Cerner application and the demands of Cerner users for instant and continuous access to patient data by authorized users. We are redefining trusted health IT with our Cerner customers.

You can trust EMC, working with VMware, and our partners to deliver continuous innovation for your Cerner EHR, your other clinical applications, and all of your enterprise IT infrastructure.

All EMC and VCE storage platforms and Vblock Systems noted above leverage innovative Flash drives to deliver sub-millisecond reads of your Cerner data.

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CONTACT US To learn more about how EMC products, services, and solutions can help solve your business and IT challenges, contact your local representative or authorized reseller—or visit us at www.emc.com.

EMC2, EMC, the EMC logo, DataDomain, Isilon, RecoverPoint, XtremIO, VPLEX are registered trademarks or trademarks of EMC Corporation in the United States and other countries. VMware vCenter, vMotion, vSphere, and vCloud are registered trademarks of VMware, Inc., in the United States and other jurisdictions. Vblock is a registered trademark of VCE. Cerner, Cerner Millennium and CernerWorks are trademarks of Cerner Corporation. General Electric is a registered trademark of the General Electric Company. All other trademarks used herein are the property of their respective owners © Copyright 2014 EMC Corporation. All rights reserved. Published in the USA. 05/14 EMC Perspective H13016 EMC believes the information in this document is accurate as of its publication date. The information is subject to change without notice.

CONTACT US To learn more about how EMC products, services, and solutions can help solve your business and IT challenges, contact your local representative or authorized reseller—or visit us at www.emc.com.