ETZ strengthens load balancing for critical healthcare apps

Citrix ADC underpins consistent user experience as Dutch hospital accelerates digital transformation

Elisabeth-TweeSteden Ziekenhuis (ETZ) is a top clinical hospital and healthcare provider in the south of the Netherlands, split across three locations. It was formed in 2016 by merging existing hospitals in the towns of Tilburg and Waalwijk.

The merger presented a host of consolidation opportunities. For example, incorporating IT infrastructure – from networking to storage to load balancing – would deliver cost savings and establish a platform for future growth.

Like other organizations in the healthcare sector, ETZ is in the process of long-term digital transformation. Staff are working remotely, and there is a greater use of mobility features and a focus on the secure sharing of data to enable collaborative workflows. To support this new digital workstyle, ETZ must ensure reliable, secure access to critical workplace applications.

“This was a perfect opportunity to rethink how we handled load balancing,” says Ludo Verhamme, ETZ’s Head of ICT Infrastructure Services. “Our existing load balancing solutions were coming to end of support, and the merger forced us to take action.”

Much of ETZ’s application estate is on-premises, but ETZ Project Manager Dennis Groen says that a hybrid future, with new cloud-based applications, had to be factored in: “We wanted to give ourselves flexibility – flexibility in the number of applications, and flexibility in how we manage them.”

Choosing operational consistency with flexibility built in

ETZ chose Citrix ADCto meet its immediate need to support on-premises application delivery for its remote workforce and to provide future flexibility to deliver cloud-based applications. The solution was deployed and configured by PQR, a Netherlands’ IT service provider and the first Citrix Platinum Plus Partner in Benelux.

The Citrix ADC portfolio uses a single code base, which provides operational consistency across both on-premises and public cloud environments. With ETZ’s exploring cloud options for application deployment and delivery, ensuring holistic visibility across hybrid cloud deployments becomes key. Citrix Application Delivery Management works in tandem with ETZ’s fleet of ADCs as a single pane of glass to provide holistic visibility, one-click provisioning, and actionable insights across multi-cloud environments.

Choosing Citrix ADC to provide an optimal application experience for its workforce is the latest evolution in ETZ’s long-term engagement with Citrix. “We used Citrix in both the Tilburg and Waalwijk hospitals,” says Verhamme. “Here, the priority was consolidation, but with the multi-factor authentication within Citrix ADC, we could see the scope for a future cloud strategy.”

ETZ favors long-term relationships with vendors, Groen adds, but insists on competitive tenders: “No vendor is guaranteed. We’ll always check the market for the latest technology, but we do value consistency and continuity. We have an excellent working relationship with Citrix, and Citrix ADC clearly impressed – certainly in terms of the number of virtual instances we could run. Also, our admin teams needed very little training to understand the new features. In terms of time saved, virtualization, and license costs, Citrix ADC made a compelling commercial case.”

Supporting application delivery during a period of unprecedented strain

The deployment of Citrix ADC was completed in late 2019. By March 2020, the hospital network came under unprecedented strain as the COVID-19 pandemic swept the Netherlands. ETZ had to move some support staff offsite, quarantine parts of the hospitals, and digitally manage many clinical workflows.

“COVID-19 accelerated our adoption of many new applications,” says Verhamme. “We very quickly rolled out Microsoft Teams to support new styles of collaborative working. Citrix ADC meant we were able to do so with no impact on the user experience. At a time when things were changing quickly, when staff were stressed, the fact that our key applications were working smoothly was very reassuring.”

Responding to the challenge of COVID-19 required new approaches. “We’ve seen a lot more video consultations,” Groen explains. “We quickly deployed new applications within the organisation. These projects wouldn’t be possible without excellent load balancing.”

Developing a strategy to support digital innovation

The number of users on the ETZ network changes continuously, and use cases continue to expand: Patients use their own devices onsite, staff working remotely is commonplace, and there are a host of new sensors and smart devices in place across hospital buildings.

Despite the growing number of applications and the increase in user traffic, load balancing is smoothly managed by just two full-time administrators. Groen says the ease of implementation that enabled a hitch-free consolidation of application delivery across two busy hospitals cannot be understated: “Not every project goes so well. There are many other projects to focus on, and time saved on this project is time we can spend ‘fighting fires’ elsewhere.”

ETZ is planning to expand the Tilburg site, with work starting in 2022. There are a raft of new health-tech applications to be evaluated, and COVID-19 has encouraged the hospitals to try new ideas. ETZ is developing an innovation strategy that will guide future partnerships with health tech start-ups and will coordinate healthcare initiatives across the country.

“Our project management teams are backed up with suggestions,” says Groen. “It’s important we put an infrastructure in place that allows the business to explore new technologies quickly and simply. With Citrix ADC, we have our load balancing infrastructure in place for years to come.”

It’s important we put an infrastructure in place that allows the business to explore new technologies quickly and simply. With Citrix ADC we have our load balancing infrastructure in place for years to come.
Dennis Groen
Project Manager
Elisabeth-TweeSteden Ziekenhuis (ETZ)

Citrix solutions

Citrix ADC is a comprehensive application delivery solution, including advanced load balancing capabilities to ensure that a remote workforce has reliable and secure access to critical applications.