Touro, Citrix and NVIDIA: 3D graphics and the future of dentistry

There’s something new on the horizon in the Hudson River Valley: it’s the first dental school to open in New York in half a century. Touro College of Dental Medicine, which shares a campus with New York Medical College, is located in Valhalla, New York. The college not only provides state-of-the-art dental education, but also, its mission is to make quality dental care available to the surrounding community. That vision is inextricably tied to technology from Citrix and NVIDIA.

Healthcare and dentistry share similar challenges

Citrix technology is proven and extremely prevalent in the healthcare provider market, which includes healthcare systems, teaching hospitals, rehab facilities and clinics. This is because of its ability to meet the unique needs of highly mobile clinicians and caregivers. Dentistry and healthcare share many of the same technology requirements. Among them are secure access to electronic health records (EHRs), secure transmission of sensitive patient files, carefully governed access to protected health information (PHI), and compliance with government regulations. Dental schools and clinics also must deliver and manage evolving technology to an ever-changing mobile user base and ensure compatibility with the variety of devices chosen by users. These similar requirements were top-of-mind for Touro’s IT team, a group comprised of experts from Hudson River CIO Advisors. They chose to implement Citrix Workspaces as the dental school’s virtual technology platform.

Throughout the facility, the simulation laboratory, and the operatories, virtual desktop infrastructure (VDI) stations are connected to HP thin clients. Most of them are Linux-based and some run on Windows. All the applications that students and faculty members need are available right from the Citrix Workspaces.

Citrix + NVIDIA: Virtual images that focus on the future of dentistry

Managing physical graphics workstations and the apps necessary to run them is expensive. This is why Citrix and NVIDIA partnered twelve years ago in 2006. Through the partnership, Citrix and NVIDIA have found ways that consumers could reap financial and user satisfaction benefits in managing their GPU accelerated virtual desktop infrastructures. The idea was to deliver more efficiency and cost-effectiveness than that which could be realized with a comparable physical infrastructure equivalent.

Today, Touro is a great case in point. Ten of the hyperconverged appliances that reside in the Touro data center are equipped with NVIDIA® Quadro® Virtual Data Center Workstation (Quadro vDWS) software and NVIDIA® Tesla® M10 GPUs. This technology enables users to get a workstation-like experience -- high-performance rendering with simplified desktop management. At the same time, users enjoy the consistent comfortable experience that comes with using Citrix Workspaces. Thanks to the joint technology, dental school faculty and students have access to an infinite palette for delivering high resolution 3D models of teeth and facial cavities, accessible even on thin clients.

Citrix App Layering alleviates the need for making new master images

The Touro Dental IT environment is comprised of many different groups of users who have diverse requirements. The list spans administration, faculty, students in various stages of learning and aspiring dentists in need of different applications for their studies. Couple that with a complex list of licensing and compliance requirements. Add the fact that dental software often has very strict and costly per-user licensing, so the IT team must be very selective about which groups of users get access to what applications. The net result is that the Touro Dental IT environment is complex, to say the least.

Citrix App Layering significantly adds value in managing these challenges. App Layering separates the management of the operating system and apps from the infrastructure. Not only does app layering enable IT teams to efficiently handle all of these requirements, but also, it facilitates quick handling of the random upgrades and bug fixes that are inherent in the software world.

"Citrix App Layering is magical. I can’t imagine how people manage their image update process without it," explains Mike Schreibman, co-founder and managing director, Hudson River CIO Advisors. His team manages 30 layered applications for the dental school, yet only has to patch one copy of the Windows OS to do so.

"Having Elastic Layers enables us to deliver apps with strict licensing restrictions to only the appropriate users," he continues. What’s more, his team can easily segment QA and production versions of applications.

Learning and providing care onsite

The school’s technology infrastructure makes a huge difference in another area, too. After a requisite number of years, medical students go out to hospitals for practical internships. Dental students, on the other hand, typically learn the art of patient care in-house. For this reason, Touro College of Dental Medicine’s technology platform must support its onsite dental clinic.

First and second year students work on one floor of the college that is equipped with 115 workstations and dental dummies. They practice drilling the mannequins’ teeth and learn by providing risk-free care to these willing "patients" in preparation for the real thing – live patient interaction in the third year of education.

Another floor houses the dental clinic, which sports 81 dental chairs now, and will double in size next year. Each workstation features two thin clients and three monitors. Dentists work from two of the monitors, while patients view progress and treatment options on a third one.

Touro College of Dental Medicine’s dental clinic opened its doors to the first patients in January 2018. Ultimately, the plan is to serve over 400 patients daily.

Scalability is key

Many healthcare provider environments are enterprise-level. While the Touro College and University system has 38 colleges in the United States and 90,000 students, the dental school is small by comparison. Touro College of Dental Medicine has 342 students today. The school is expected to quickly grow to as many as 600 students, faculty, and administrators.

Citrix VDI technology will support this incremental growth. It will enable the IT team to quickly provision more apps, add new features, handle new software releases, onboard new students and manage other aspects of a bigger user community. Citrix VDI powered by NVIDIA virtual GPU solutions enables workstation-like performance of graphics-intensive 3D dental applications. Now students can take their VDI sessions with them on thin clients and pick up where they left from anywhere on campus – from simulation labs to dental workstations to their on-campus clinic. At the same time, IT can cost-effectively scale VDI to address the growing student population.

Outsourced IT

Hudson River CIO Advisors, a managed service provider, is responsible for all of the IT associated with the dental school. The team’s role includes design, engineering, deskside support, server and network infrastructure, and all matters relevant to technology in Touro College of Dental Medicine. The only IT-related function Hudson River does not manage is the Active Directory, which is managed by Touro College and University System.

Technical Takeaways

The implementation at Touro College of Dental Medicine has revealed a number of noteworthy technical takeaways:

  • Many of the technical challenges in a dental environment mirror those in a healthcare provider/teaching hospital environment: compliance, security, diverse groups of users, and mobility. Citrix technology is proven in major healthcare systems for its ability to simplify EHR delivery, transform clinical workflow, make IT more agile, and keep patient data secure.
  • The combination of Citrix VDI and the NVIDIA Quadro virtual Data Center Workstation software and Tesla M10 GPU delivers a cost-effective, manageable platform for the 3D graphics needed in modern dentistry. The Touro team provides not only a digital workspace experience to faculty and students, but also a 3D graphics platform that enables visualization and intraoral dental design and 3D fabrication by staff, students and the patients they serve.
  • Citrix App Layering enables IT to package apps once for on-demand (elastic) or base image delivery, enabling app and sharing across on-premises and hybrid cloud environments. App layering simplifies the management of multiple groups of users with diverse requirements.  

About Citrix
Citrix (NASDAQ:CTXS) aims to power a world where people, organizations and things are securely connected and accessible to make the extraordinary possible. Its technology makes the world's apps and data secure and easy to access, empowering people to work anywhere and at any time. Citrix provides a complete and integrated portfolio of Workspace-as-a-Service, application delivery, virtualization, mobility, network delivery and file sharing solutions that enables IT to ensure critical systems are securely available to users via the cloud or on premise and across any device or platform. With annual revenue in 2016 of $3.42 billion, Citrix solutions are in use by more than 400,000 organizations and over 100 million users globally. Learn more at

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Citrix App Layering is magical. I can’t imagine how people manage their image update process without it.
Mike Schreibman
Co-founder and Managing Director
Hudson River CIO Advisors


Key Benefits

  • Cost-effective, manageable platform for the 3D graphics needed in modern dentistry
  • IT packages apps once for on-demand (elastic) or base image delivery
  • PHI (protected health information) is secure

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