Microsoft Virtualization: Customer Solution Case Study

Healthcare Firm Speeds Application and Server Delivery, Cuts Costs with Virtualization

OverviewCountry or Region: United StatesIndustry: Healthcare

Customer ProfileSeattle, Washington–based Group Health Cooperative is a nonprofit healthcare system that provides medical coverage and care to residents of Washington and Idaho through 67 facilities.

Business SituationGroup Health needed a faster, more cost-effective, and reliable way to deploy and manage applications and updates, and make business-critical software available to users wherever they needed them.

SolutionGroup Health is using Windows Server 2008 R2 with Hyper-V and Microsoft Application Virtualization to streamline deployment and management of IT resources enterprisewide.

Benefits Accelerated server and application

provisioning Reduced physical servers by 40

percent, saving money Simplified IT management while

improving service

“Microsoft virtualization solutions help us operate more efficiently and cost-effectively and provide the resources that our clinicians and staff need in a fraction of the time previously required.”

John Sims, Supervisor of Desktop Engineering, Group Health Cooperative

More than 9,300 Group Health Cooperative employees provide healthcare services to residents in Washington and Idaho. With clinicians and administrators relying on multiple clinical applications at critical points of care, IT staff found it challenging to quickly and reliably deliver software. To address this issue, Group Health IT workers implemented Windows Server 2008 R2 Datacenter with Hyper-V technology and Microsoft Application Virtualization (App-V) in its terminal services environment, with the goal of expanding App-V to all users by the end of 2011. As a result, Group Health reduced the time to provision key servers from weeks to a few days and changed key software upgrades from an overnight process to a one-hour daytime task. It consolidated physical servers by 40 percent, saving about U.S.$100,000 , while vastly improving IT management and remote access to applications.

SituationGroup Health Cooperative was founded in 1947 as a community coalition dedicated to making quality healthcare available and affordable. The Seattle, Washington–based organization now serves more than 625,000 members through more than 65 facilities, including a hospital, primary care medical centers, specialty care units, behavioral health and eye care clinics, audiology centers, and speech and learning services clinics. In 2009, it realized revenues of approximately U.S.$2.9 billion.

Desktop Team Challenges “Updating our applications was a major pain point,” says John Sims, Supervisor of Desktop Engineering at Group Health Cooperative.

The company's primary clinical information system, Epic Hyperspace Spring 2007 medical records software suite from Epic Systems, is deployed to 1,800 computers in exam rooms and 6,000 desktop computers. Epic Systems issues updates roughly once a month and hotfixes more often. Since installing Epic Hyperspace Spring 2007, the Group Health IT team has deployed more than 1,300 hotfixes for it.

“Our clinicians rely on the information contained in Epic to provide care for their patients. So it’s critical that they have the most current versions available to them wherever they are examining patients, any time of the day or night,” Sims notes. Epic is a large, complex application suite. It is 1.2 gigabytes in size and has approximately 149,000 registry settings. Installing updates and hotfixes for this application on each computer in every exam room was time-consuming and introduced the risk that the

computers might not function properly when the physicians or nurses needed them.

The IT staff would package Epic updates by using HP OpenView Configuration Management (Radia) and then spend about two to three weeks conducting regression testing to ensure compatibility with applications that integrate with Epic, such as Adobe Acrobat. The Group Health team spent time monitoring patches overnight. For major upgrades, it would be a 12-hour process of managing the installation of Epic on all the computers.

Group Health made some of its applications available remotely to clinicians and administrative staff through Citrix XenApp 4.5 on about 50 servers, but it could not make as many applications accessible as users would have liked. “Many applications required dedicated servers so that we could run them without conflicts, so we had to evaluate whether enough people needed remote access to warrant additional computers,” says Mandy Sheets, Desktop Engineer at Group Health Cooperative. If the application was not made available remotely, users would have to drive into the office to use the application on their desktop computer.

In addition, deploying new applications and upgrades to the Citrix terminal services environment in the Group Health data center was a cumbersome process. “We had to make sure that all users were logged off the servers, run the update, and then bring the servers back online. And, like the Epic upgrades, we did these at night, when fewer people were likely to be accessing applications,” says Sims.

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“Our clinicians rely on the information contained in Epic to provide care for their patients. So it’s critical that they have the most current versions available to them wherever they are examining patients, any time of the day or night.”

John Sims, Supervisor of Desktop Engineering, Group Health Cooperative

Group Health needed a faster, more cost-effective, and reliable way to deploy and manage applications and updates on desktop computers and on its Citrix-based terminal services environment, and make them available to users wherever they needed them.Server Team ChallengesOne of the biggest challenges facing the Microsoft Server and System group, part of the Group Health Server team, was keeping up with the organization’s appetite for servers. This was evident in the Desktop Engineering team’s implementation of Citrix and the proliferation of applications requiring Microsoft SQL Server data management software. Traditional standalone servers could take up to six weeks to procure and provision, potentially causing delays to major organizational initiatives.

The second largest challenge was related to rising costs and fast rates of change. For example, using VMware products for certain architectures was cost prohibitive and did not leverage the existing in-house Microsoft skill set. SolutionThe Group Health Cooperative Desktop and Server teams envisioned a new virtualization architecture to enhance efficiencies. The company worked with its Microsoft account team and Microsoft Premier Services to create a desktop-to-data center virtualization solution.

Implementing Server Virtualization Group Health began in May 2008 by evaluating the Windows Server 2008 operating system with Hyper-V

virtualization technology for use with its SQL Server deployments. At the time, the organization had been deploying SQL Server to large clusters.

In the first quarter of 2009, Group Health built its first Hyper-V–based server back-end farm. As new requests for SQL Server 2005 and SQL Server 2008 builds came in, the IT team deployed them all on Hyper-V virtual machines. “Now, we can deploy SQL Server instances without the complications of SQL Server clustering but still provide redundancy through Hyper-V,” says Troy Holmes, Systems Engineer at Group Health Cooperative. “This infrastructure allows us to mix SQL Server versions on the same server farm, reducing the need to build SQL Server clusters for every version and operating system change.”

The Group Health Infrastructure Server and Desktop teams extended their use of Hyper-V in July 2009 when they decided to provision Citrix XenApp 4.5 with Microsoft Application Virtualization (App-V) on the Hyper-V platform. This allowed Group Health to retire older desktop hardware, implement thin-client technology, and consolidate older server hardware. Group Health worked with Right! Systems, a Microsoft Gold Certified Partner, to deploy XenApp and Epic software on Windows Server 2008 R2 Datacenter with Hyper-V. This clinical “Point of Care system,” as Group Health now refers to it, runs on HP 5730 thin-client computers. “We knew that the Microsoft solution would enable Group Health to achieve much more flexibility with its deployments,” says Terry Aoki, Executive Vice President of Corporate Development for Right! Systems.

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“We knew that the Microsoft solution would enable Group Health to achieve much more flexibility with its deployments.”

Terry Aoki, Executive Vice President of Corporate Development, Right! Systems

By incorporating Hyper-V into its daily operations, the Group Health Server team was able to rapidly deploy and provision servers in a timelier manner. As evidence, Group Health is now more than 50 percent virtualized with more than 150 virtual machines running on more than 30 physical servers. It uses Microsoft System Center Virtual Machine Manager 2008 R2 to manage Hyper-V virtual machines and convert physical servers to virtual machines.

Extending Deployment with Application VirtualizationIn October 2009, to ease provisioning and management of applications in its Citrix environment, Group Health began rolling out App-V for Terminal Services on Dell PowerEdge R710 computers running XenApp and Windows Server 2008 R2. As of April 2010, the IT team had virtualized about 80 applications, including the Epic medical records software that clinicians access in exam rooms, Adobe Acrobat 9 Pro, Philips iSite Radiology 3.5, Picis Preop Manager 8, Picis Anesthesia Manager 8, and Microsoft Office Communicator 2005. Group Health plans to migrate its entire App-V and XenApp infrastructure to the Hyper-V platform.

Group Health will be extending the efficiencies gained by using App-V to package applications for the XenApp environment to its general desktop environment when the company retires its current application deployment software. 

Group Health expects that about 95 percent of its applications will be virtualized and deployed using App-V by December 2011. The company rolled out Microsoft System Center Configuration Manager 2007 R2 in July 2010, and will use it to

deploy the remaining 5 percent of applications that are not candidates for virtualization.

The company is also working with Right! Systems to evaluate Virtual Desktop Infrastructure (VDI) technology with App-V and Citrix XenDesktop. Group Health is considering using VDI with a radiology application to allow users to view graphic-intensive images via the company’s Philips iSite picture archiving and communication system (PACS) without having to travel to the hospital.

BenefitsBy using Microsoft App-V and Hyper-V virtualization technologies, Group Health Cooperative was able to speed both server and application provisioning, consolidate physical computers—saving considerable money—and simplify IT management tasks, while improving the services that it provides to clinical and administrative employees.

“Microsoft virtualization solutions help us operate more efficiently and cost-effectively and provide the resources that our clinicians and staff need in a fraction of the time previously required,” Sims says.

Accelerated Server and Application ProvisioningGroup Health now provides the instances of SQL Server that its development team requires much more quickly. “In the development world, time-to-availability is everything. Instead of waiting up to six weeks for a physical server to be ready, or tearing down and rebuilding an environment if we didn’t have budget for a new server, our developers can be up and

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“Instead of waiting up to six weeks for a physical server to be ready, or tearing down and rebuilding an environment if we didn’t have budget for a new server, our developers can be up and running with a new Hyper-V virtual machine in just a few days.”

Troy Holmes, Systems Engineer, Group Health Cooperative

running with a new Hyper-V virtual machine in just a few days,” Holmes says.

Updating applications is also much faster. “Using App-V to deploy upgrades to our Citrix environment makes the process so much faster. For instance, instead of taking all night to update Epic on all of the server computers, now it takes only one hour, and we can do it during the day without interrupting users by requiring them to log off,” Sims notes. “As you can imagine, this is great for our IT staff members, because they don’t have to stay awake all night managing the upgrades.”

Once Group Health deploys App-V on its desktop computers, the update process will be accelerated enterprisewide. According to Sims, “We’re constantly churning out application updates, and each one goes through two to three weeks of regression testing. By using App-V on the desktop and eliminating the need for extensive testing, we expect to reduce that timeframe considerably.”

Reduced Physical Servers by 40 Percent, Saved Money Group Health no longer has to purchase new server computers every time the IT team needs to build out a SQL Server environment, which saves up to $250,000 every year. “We can provision new SQL Server instances much more cost-effectively with Hyper-V,” says Holmes.

Furthermore, because virtualized applications can run side-by-side on the same computer without conflict, Group Health can now run 129 applications on each server computer. “By using App-V, we were able to reduce the number of server

computers in our remote access farm from 50 to 30, saving about $100,000,” Holmes says. Maintaining fewer physical servers also means that Group Health saves money previously spent on powering and cooling the environment.

The company also realizes savings from converting the rich desktop computers that ran Epic software in exam rooms to thin-client computers that access virtualized applications from its Citrix infrastructure. Group Health estimates that this has resulted in about $65,000 in direct energy savings annually. “We’re also hoping to move from the four-year replacement cycle that we had with these desktop computers to a six-year cycle with the thin-client computers, which will save us even more money,” says Sims.

Simplified IT Management, Improved ServiceUsing App-V in both terminal services and desktop computer environments will simplify IT management. “We’ll be able to use one system to manage and deploy applications to both desktop and server computer environments and ensure that the applications will follow users wherever they need them,” says Sims.

Group Health can also ensure reliability of its applications. “With application virtualization, we’re able to remove complexity from our computers. Now we can update applications that run on all computers quickly and guarantee their state,” Sims notes. “We’ve taken the risk out of updating Epic in our exam rooms by ensuring that it runs reliably 24 hours a day and that users are always accessing the most current version of the software. And

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“By using App-V, we were able to reduce the number of server computers in our remote access farm from 50 to 30, saving about $100,000.”

Troy Holmes, Systems Engineer, Group Health Cooperative

that is essential to helping our doctors and nurses at critical points of care.”

Because more applications can run on shared servers instead of requiring costly dedicated computers, the IT team does not have to turn down requests for remote access. “Since we began using App-V, we’ve become much more flexible in what applications we can provide remotely to users and much more responsive to their needs. Now, clinicians and administrators can access all the applications they need, even when they’re not in the office,” says Sheets.

Sims concludes, “Microsoft virtualization solutions have helped us resolve key challenges in our server environment. By extending our implementation from the data center to the desktop and remote access, we’ll be able to create a standardized, efficient infrastructure that is much easier to manage and maintain.”Microsoft VirtualizationMicrosoft virtualization is an end-to-end strategy that can profoundly affect nearly every aspect of the IT infrastructure management lifecycle. It can drive greater efficiencies, flexibility, and cost effectiveness throughout your organization.

From accelerating application deployments; to ensuring systems, applications, and data are always available; to taking the hassle out of rebuilding and shutting down servers and desktops for testing and development; to reducing risk, slashing costs, and improving the agility of your entire environment—virtualization has the power to transform your infrastructure, from the data center to the desktop.

For more information about Microsoft virtualization solutions, go to: www.microsoft.com/virtualization

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For More InformationFor more information about Microsoft products and services, call the Microsoft Sales Information Center at (800) 426-9400. In Canada, call the Microsoft Canada Information Centre at (877) 568-2495. Customers in the United States and Canada who are deaf or hard-of-hearing can reach Microsoft text telephone (TTY/TDD) services at (800) 892-5234. Outside the 50 United States and Canada, please contact your local Microsoft subsidiary. To access information using the World Wide Web, go to: www.microsoft.com

For more information about Right! Systems products and services, call (360) 956-0414 or visit the website at:www.rightsys.com

For more information about Group Health Cooperative products and services, call (888) 901-4636 or visit the website at:www.ghc.org

This case study is for informational purposes only. MICROSOFT MAKES NO WARRANTIES, EXPRESS OR IMPLIED, IN THIS SUMMARY.

Document published May 2011

Software and Services Microsoft Server Product Portfolio− Windows Server 2008 R2 Datacenter− Microsoft System Center

Configuration Manager 2007 R2− Microsoft System Center Virtual

Machine Manager 2008 R2 Microsoft Desktop Optimization Pack− Microsoft Application Virtualization− Microsoft Application Virtualization

for Terminal Services Technologies− Hyper-V

Hardware Dell PowerEdge R710 computers HP 5730 computers

Partners Right! Systems