“Consolidation will make things more efficient,” the University of Vermont Medical Center (UVMMC) team decided. It sounds like a simple mandate, but such a project represents years of work. It isn’t only about what previously was two technology siloes – one a VMware stack and the other based on Citrix. It’s also about financial matters, physical resources such as software, hardware and storage, and knowledge workers and the skills they must have in order to manage a newly consolidated environment. To UVMMC IT leaders, consolidation ultimately will mean having a well-orchestrated strategy based on Citrix technology and a plan that will reach well beyond 2020.
One easy-to-manage IT environment
The University of Vermont Health Network (UVMHN) IT organization had one simple goal in mind, standardize. First comes standardizing the electronic health record platform. Next is deploying one digital workspace infrastructure across the entire seven-member healthcare network. Citrix Workspace will be the foundation for the health system’s infrastructure.
The team made a fact-based decision in choosing the technology platform onto which it would consolidate its operations. “Based on our experience with the two platforms, it was easy for us to say that Citrix offered a virtual desktop solution that could replace what we were doing with VMware Horizon View,” says Lisa Pratt of UVMMC. “On the other hand, we could not say that VMware offered a virtual apps solution that could replace what we were doing with Citrix Apps.”
She adds, “VMware technology could not deliver what we needed when it comes to Epic electronic health records and the many other apps that are integrated into Epic.” At the time when the team started the project, VMware did not provide app virtualization support for the version of Epic that was in use at UVMMC.
One technology platform for users
The team chose to deploy one Citrix Farm to meet its needs. The environment is managed from one interface at UVMMC. Today, the UVMMC IT leaders have completed the consolidation onto Citrix Apps and Desktops Service.
This replaces the old environment in which the team used Citrix Apps to deliver Epic to physical PCs as a virtual application. Inpatient floors in the hospital had a different technology infrastructure: there, thin clients were connected to a VMware Horizon View virtual desktop environment. As part of this initiative, the team recently migrated that technology infrastructure from View to Citrix Virtual Desktops. Today, all of the inpatient floors are up and running on Citrix.
One interesting offshoot of the team’s Citrix deployment is the availability of Dragon Medical One from anywhere. This has occurred because of its compatibility with Citrix Virtual Apps and Desktops. With the ability to perform dictations from any device, the physician workflow became more efficient by allowing providers to perform dictations right in the room as opposed to having to go to a dedicated PC for dictations.
At this point, the team also has completed another important initiative: managing email on a cloud platform. Microsoft Exchange mailboxes have been moved to one Office 365 Exchange online tenant.
One other thing is noteworthy. The group is going one step farther with its consolidation and simplification initiative by moving to Dell EMC VxRail and VxRack hyper-converged infrastructure (HCI) platforms.
Citrix Workspace: purpose built for modern healthcare workers
Citrix Virtual Apps and Desktops are essential components of Citrix Workspace, an intelligent workspace platform that is purpose-built for the modern healthcare worker. Users will capitalize on Citrix Workspace capabilities in each new stage of this initiative.
Users will have the ability to collaborate and directly access Workspace App
Another part of the team’s transition plan is to “front-end” OneDrive for Business with Citrix Content Collaboration, a cloud-based file sync and sharing solution.
The team also has an on-premises Citrix Endpoint Management instance that it plans to move into the cloud. Additionally, they plan to put a ShareFile connector -- Drive Mapper -- inside of the environment so that users can actually get to OneDrive for Business files without synching.
Sometime after November 2019, the end goal is for all of the users in respective partner hospital domains to be consolidated into one unified Active Directory domain. Once migrated into that new domain, they will be able to directly access Workspace App.
The team will begin to migrate users to the new Workspace App domain in 2020. Providing users a new look and feel with integrated desktops, apps (virtualized, SaaS, web ect…) SSO, files, and more. By 2020, everything will be available to users from one pane of glass.
Mobile Device Management and Mobile App Management
Mobility will also be making its way to the cloud. Currently UVMMC is using Citrix Endpoint Management (CEM) to manage between three and four thousand users. Most of their users are MAM enrolled. For the MAM use case, UVMMC has integrated Citrix Endpoint Management with Microsoft Intune to manage and deliver Office 365 apps, internal apps, and Citrix Secure Mail in one container. This gives UVMMC additional security capabilities and allows users to seamlessly work between MAM only apps. The team is also looking forward to implementing the newest Intune integration which will allow them to connect CEM with Microsoft Intune APIs for conditional access.
Users that want to do more than email on their device, like access the UVMHN virtual desktop environment, will have the option to MDM enroll in Citrix Endpoint Management. Doing so will provide the user with an easy and secure method of accessing such resources.
The Miller Building protects sensitive info and facilitates communication
Traditionally at UVMMC, inpatient floors have had double-occupancy rooms, which created privacy concerns regarding accessing and using sensitive patient information. UVMMC recently opened The Miller Building, a new facility in which patient rooms will be single-occupancy. The next step in the transformation of their facilities will be to retrofit the older part of the hospital to convert rooms in that section to single-bed rooms as well.
N-Computing Citrix Ready workspace hub devices will be used in these areas to power Epic whiteboards outside of the rooms that can display pertinent patient care information such as quarantine information and other care-related concerns. Crucial information will be entered into an electronic monitor in the new environment – doctor, nurse, emergency contact and so on. Workspace hub devices will serve as the front ends. Displayed data will be controlled by Epic but the hardware is a Workspace hub connected to Citrix Desktops to auto-launch the Epic monitors.
The Miller building will house 130 rooms. That means that a total of 260 Workspace hub devices will connect to Epic monitors to display information for the staff.
Sessions move as clinicians roam
Each room will be equipped with a set-up of a thin client, monitor, keyboard and mouse. Clinicians will badge in and their virtual desktop sessions will follow them, initiating right where they left off in the previous room. “Epic is really smart about all of this,” Lisa explains. “If I go from Patient Room A to Patient Room B, the chart that was opened in Patient Room A automatically closes when I reconnect from the thin client in Patient Room B.”
The Workspace hub devices also lend themselves to the use of Citrix Casting. Citrix Casting makes it possible for users to securely and seamlessly move virtual app and desktop sessions from a mobile device to a Citrix Ready workspace hub.
Takeaways
Today, the UVMMC transition is well underway. Ultimately, consolidation will revolutionize the entire health network’s operations. More than that, soon it will bring a four letter word to mind: T I M E. Consolidation will free up clinicians’ time. And in the end, this spells better patient care.
About UVMC Health Network
The University of Vermont Medical Center (UVMMC) is an academic medical center located in Burlington, Vermont. It is part of The UVM Health Network comprised of UVMMC Medical Center and other affiliates including Central Vermont Medical Center (CVMC) in Berlin, VT, Champlain Valley Physician's Hospital (CVPH) in Plattsburgh, New York, and Porter Medical Center (PMC) in Middlebury, VT. Also part of the network are Alice Hyde Medical Center (AHMC) in Malone, NY, Home Health and Hospice in Colchester, VT, and Elizabethtown Community Hospital in Elizabethtown, NY.