Virtualization: Just What the Doctor Ordered

By Mel Duvall

When a doctor prescribes a new drug or remedy, it can often lead to complications. That, more-or-less, is the self-prescribed situation Huntsville Hospital found itself in two years ago.

The 900-bed not-for-profit hospital in Huntsville, Ala., made the decision in 2006 to deploy GE Centricity Enterprise, an integrated clinical and financial support system for hospitals. It's a powerful system that allows healthcare providers to capture patient information and automate workflow, essentially managing the entire patient encounter, from first visit to final discharge.

The problem is, it was also a little too powerful for the majority of desktops installed at the hospital. Administrators were looking at the cost of having to upgrade a large percentage of the close to 4,000 desktops that would need to access the system.

After looking at a variety of options, the hospital's IT department presented administrators with an intriguing alternative - virtual desktops. Rather than have applications installed on individual PCs around the hospital, thin client workstations or repurposed PCs could be used to access applications from servers. In so doing, the thin clients could be used to access the GE Centricity application, as well as all other applications needed by staff from a central datacenter.

The thin clients used to access the centralized applications were considerably less expensive—about $200 compared to $500 to $1,000 for desktops, and considerably cheaper to run, both in terms of management and power savings.

There was one other major bonus. By centralizing all patient information in the hospital's data warehouse, it didn't matter if a thin client was lost or stolen. Losing a desktop computer with patient information can be a nightmare scenario for any healthcare organization, says Tony Wilburn, network specialist at Huntsville Hospital. "Now, if someone walks away with a thin client, we don't really care—all we're out is 200 bucks," he says.

Testing the Remedy

While the prognosis for the technology looked promising, the hospital wanted to first run a few tests before proceeding with a full deployment. Beginning in November of 2006, it conducted a three-month pilot in a new tower at the hospital. The implementation used Hewlett-Packard Neoware thin clients operating on the VMware Virtual Desktop Infrastructure (VDI). The VDI infrastructure basically provides a management platform to connect thin clients to virtual desktops sessions running on servers in a company's data center. Applications are hosted and virtual sessions delivered by IBM Blade servers and supporting information is stored on an EMC storage area network (SAN).

"We knew the technology would work—we had seen it in action, but what we didn't know were things like, how many thin clients could be supported by a single blade server before we would see a degradation in service," says Wilburn. Through its tests, the team found that about 60 thin clients could comfortably be supported by a single blade server. More thin clients could be supported, but 60 left the blade servers at about a 70 to 75% utilization rate, which provided a safety net.

From a user standpoint, most doctors, nurses and other hospital workers said they found very little difference, both in terms of function and performance as the system was rolled out. "For some, all they knew was they went home one day with a little black PC on their desk, and they came in the next day to find a shiny silver box," says Wilburn.

The results of the pilot were strong enough to convince hospital administrators that virtualization technology could form a strong foundation in their efforts to create a hospital of the future. "We decided to pull the trigger and jump in completely," adds David Carlisle, manager of IT networks and systems.

Today, Huntsville Hospital has rolled out 900 virtual desktops on 28 blade servers. By June of 2008, the hospital plans to have 3,200 virtual desktops deployed. The use of blade servers has allowed the hospital to consolidate its servers into a single data center, from three prior to the project, and Wilburn says the power savings have been significant. Through a combination of energy sipping thin clients, fewer servers, and less cooling system requirements, the hospital estimates computer-related power consumption has been cut by 78%. The savings amount to close to $100 per year per desktop. And because the thin clients use less power, wireless thin clients which are wheeled around to hospital beds on carts can operate all day on a single charge.

Wilburn was not able to provide overall cost savings, but he says in addition to less expensive thin clients, the virtualized system is easier to manage. "One big benefit has been we're not getting nearly as many calls to our help desk, because the thin clients aren't breaking down or crashing," he says.

Meeting Compliance

Huntsville Hospital is not alone in finding virtualization technologies a good fit. In fact, analyst firm IDC of Framingham, Mass. predicts the market for virtual desktop products and services will exceed $1 billion by 2011.

Kindred Healthcare of Louisville, Ky., a post-acute healthcare provider with 35,000 licensed beds, is another healthcare organization that has deployed the VMWare virtual desktop technology on wireless thin clients, mounted on rolling carts. It allows caregivers to enter and access medical information at the patient's bedside. Similarly, Metro Health of Wyoming, Mich., is using the technology in its main hospital and more than a dozen affiliated area clinics. Doctors, nurses, and other medical staff can access X-rays, patient records, and more than 450 applications through the system.

VMware, of Palo Alto, Calif., says the technology is finding a ready home in the healthcare industry, in large part due to concerns over meeting security and privacy mandates instituted under the Health Insurance Portability and Accountability Act (HIPPA). "If a thin client is stolen in a hospital, there's nothing on it," says Jeff Jennings, vice president of desktop products for VMware. "All the patient information is secure back in the data center. That makes it a very valuable product for hospitals. It's been one of our areas of highest growth."

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