Modernize Clinical Desktops with

VMware View and ThinApp

Tisa Murdock, Product Line Manager, VMware View Healthcare

2009 VMware Inc. All rights reserved

The Desktop in Healthcare Is Changing

PC is viewed as less strategic
Hard to manage
Resource drain
Low levels of service
Expensive
Not secure
Compute model moving to End User
Centric
By the end of 2012, 60% of all enterprise
PC configurations will use at least one
technology that is considered desktop
virtualization*

*Predicts 2010: PC End-User Issues, Gartner Dec. 2009

EHR Driving Additional Desktops; WOWs, COWs, Tablets, etc.

Trends in Electronic Healthcare Records and Related Technology Vendome Publishing, Dec. 2009

The Cost of Desktop Management Is Staggering

$3
$3

$1
CAPEX
Source: IDC Study 2009
4

OPEX

Increasing IT Costs

For every $1 spent on hardware, companies spend $3 to manage

Are the needs of IT and end-users being met?

The Clinical Desktop

Needs And Requirements Different

Users:
Fast access to applications and
data from any terminal
Ability to roam their session as
they move
High availability
Familiar look and feel
Secure remote access
5

IT :
Simplify management
Quickly roll out new applications
or services EMR/EHR
Maintain compliance and protect
sensitive data
Satisfy end users
Reduce costs

Current Clinical Desktop Challenges

Current Clinical Desktops are Complicated and Take Time Away from the Patient

Long log-in times, many passwords

Upsetting workflow and rounds
Manual batch entry of patient data
Terminals devoted to individual applications
IE Browser 6 Java v 1.74* (GE radiology)
IE Browser 7 Java v 2.1* (AGFA Cardio)
Citrix delivered Applications A and B
Locally Installed Applications

No Remote Access

Can vary between floors, rooms, stations, user-task, end point

device, hospital location, vendor, etcetc.etc.

Medical Application Procurement

# of Servers*:

Annual Energy Cost*:

3
15
6
18

$12,105.00
$4,842.00
$2,421.00
$14,526.00

Typical HIS Application

App - Test

Typically 2xs Server count for better

availability
Test / Dev typically matches production 1:1
* Based on VMware Green Calculator

App - Dev

Term - SBC

Increased complexity, lower availability, expensive

Infrastructure sits idle most of the time,

expensive

and this is only one application

Delivering and Managing Clinical Desktops Today..

Adding More Applications? More and more and siloed Citrix farms!

App-Prod

Test/Dev

TS-Citrix

Vendor C

App-Prod

App - Test

App - Dev

TS-Citrix

Vendor B
App-Prod

App - Test

App - Dev

Vendor A

TS-Citrix

Not sustainable..

This architecture
is no longer
TS-Citrix sustainable
Test/Dev

App-Prod

Bloated, Expensive Siloed Citrix Farms

Cost of managing clinicians desktops and
applications is out of control
App-Prod

TS-Citrixcause
App
Vendor
App - Dev requirements
- Test application
compatibility issues and wreak havoc on support

Inefficient Workflows low levels of service

App-Prod

TS-Citrix
App
Large
help desk calls
Appof
- Dev
- Testvolume

Security and Compliance

REMINDER: Visit the Exhibit Hall f or m ore discussions and demos

Use Virtualization to Breakdown the Silos

App-Prod

Test/Dev

TS-Citrix

VMware vSphere

10

App-Prod

App - Test

App - Dev

TS-Citrix

App-Prod

App - Test

App - Dev

TS-Citrix

Virtualization Breaks Down the Desktop Components

Persona
Applications
Operating System

11

Modernizing the Desktop A Managed Service Model

Persona
Applications
Operating System

12

Modern
Desktop

Centralized
Management
Desktop
Delivery

Meets the Needs of the Provider

Always On
Follows User
Any Device
Familiar Interface
Apps all Work

13

And the Needs of Healthcare IT

Quickly Provision
Easily Manage
Maintain Security
Lower Costs
High Availability

14

Build upon VMware Foundation to Create Internal Private Cloud

HIT Services
VMware vSphere

Storage
15

Compute

Network

Desktops Applications

Modernize Clinical Desktops The Journey

16

Phase 0

Phase I

Phase II

Assessment
Application

Virtualize
Applications

Modernize
Desktops

Desktop

Standardize
Delivery

Standardize Image

VMware View Solution

Modernizing Clinical Desktops and Applications

17

Deliver desktops and apps as a managed service

VMware View 4.5
Platform
Platform
VMware vSphere
vSphere for
for
VMware
desktops
desktops

Management
Management
VMware View
View Manager
Manager
VMware
Vmware View
View Composer
Composer
Vmware
VMware
ThinApp
VMware ThinApp

User Experience
Experience
User
PCoIP
PCoIP
Print
Print
Multi-monitor display
display
Multi-monitor
Multimedia
Multimedia
USB redirection
redirection
USB
18

Why VMware View for Healthcare

APP

APP

APP

OS

OS

OS

VMware vSphere

Improved
Improved
Workflows
Workflows
End User Flexibility

19

Best
BestEnd
EndUser
User
Experience
Experience
Broadest Range of
Use Cases

The
ThePlatform
Platform
Matters
Matters
Scalability & Availability

Reduced
Reduced
Costs
Costsand
andTCO
TCO
Breakthrough

Improve
Workflows

Fast Access to Desktops

Simplified Sign-on

Single Sign On Authentication to

Virtual Desktop
Windows Username/Password
Proximity Cards
USB connected biometric devices

Integration with MS AD
No Domain change, schema change,
password change

Integrates with 3rd Party SSO

vendors
Imprivata, Sentillion, HealthCast

Us
e
Pa rnam
ss
wo e:
rd
:

Connection
Server

20

Improve
Workflows

Follow Me Desktop Example with SSO

Nurses Station
Desktop

Wireless WOW

Laptop

Thin Client

Remote Physicians Office

Streamline Workflow Tap and Go

21

Also Includes

User taps badge or swipes finger to reconnect to desktop

Password Management/Reset

Single click SSO to all Clinical Applications

Automatic Compliance Reporting

User disconnects from desktop with card tap

Support for various authentication modalities

Desktop maintained on server as user roams

Reauthentication support i.e. drug dispensing

Improve
Workflows

ThinApp: Application Virtualization

Allow applications to co-exist on same
desktop Huge workflow improvement
Update app at server level in minutes
and push to users no downtime

Operating System
IE 6.1
6.1 Application
Application
IE

IE 66 Application
Application
IE
App
Files

App
Files

Run ThinApped apps from shared drive

reduce size of image
Guarantee all users up to date and in
compliance
Ability to run IE6 applications on
Windows 7

App
Files

Application
Application

sandbox
sandbox

VOS
VOS

App
Files

Application
Application

sandbox
sandbox

VOS
VOS

Operating System

22

Improve
Workflows

All Applications Available on Clinical Desktop

With familiar interface

Example of Cart with View

Applications include:

HPF Web- Horizon Patient Folder

Web
Web Version
Version

HED- Horizon Expert

23

Documentation w/Admin Rx
Radiology PACS Image Viewing
Healthcare
Healthcare Scheduling
Scheduling
Cardiology
Web
Cardiology Web
Radiology Manager
Surgical
Surgical Manager
Manager
Business Objects Reports
Physician Portal
LMSLMS- OB
OB Fetal
Fetal Monitoring
Monitoring
Clinician
Clinician AccessAccess- Quadramed
Quadramed

Kiosk Mode
Overview
Support for public or shared end-point
Automatic login no credentials required to access
desktop
Authentication done through the application if needed

Benefit
Simplified user experience auto login, auto USB
redirection, no Windows error messages

24

Improve
Workflows

Location Based Windows Printing

Details

Improve
Workflows
Floor 3

Automatically connect View desktop to

closest printer
Simplify Windows printing for end users
Satisfy compliance requirements
Simple GUI interface for Administrators
to link devices to printers

Floor 2

Floor 1

25

Breakthrough User Experience

PCoIP - Built for desktops

Adaptive protocol designed
for LAN and WAN
Rich Graphics and
Multimedia
Support for True MultiMonitor and pivot support
End-to-end software solution
with optional hardware

26

User
Experience

Zero Client Optional Hardware Acceleration

27

User
Experience

View Client with Local Mode

User
Experience

Check-out virtual desktop to

physical devices
Support devices like laptops that
can lose network connectivity
Extend security and encryption
policies to offline users
Heartbeat back to the
datacenter
Synchronization
Update
Remote Expiration

28

View Manager

User
Experience

Expanded Use Cases with PCoIP

Point of Care
Desktops

Modernize HC
Desktops

Remote Access
Clinical Imaging

Remote Offices/
Mobility

Medical and Productivity Applications

Rich Media and Accelerated Graphics
LAN
WAN

29

Tier1 Datacenter for Desktops

Platform
Matters

Reduce downtime for

desktops

High Availability (HA)

VMotion
Storage VMotion
Fault Tolerance

Protect critical data and

information
Tuned and Optimized for
Desktop Workloads
Industry Best Scalability and
Density

30

Increased desktop VM
density 16-20 VMs/core

Increase Desktop Availability

Breakthrough TCO and Acquisition Cost

Traditional PC vs VMware View

Acquisition Cost
Per User

TCO Comparison
$1450
$1,800
$1,600

$865

$1,400

40% less TCO

$585 less
per user per
year - IDC

$1,200

$1200
$1000
$800

$1,000
$800

$600

$600

Average Corporate PC

$400

$400

$200
$0
Traditional PC

With VMware View

Professional Services

Software

Storage

Server

Downtime

IT - HelpDesk

IT - Install

IT - Admin

$200

Acquisition cost
sub $500 per user

Time

Device

Source: IDC White Paper 2009

31

Reduce
Costs

Datacenter
Infrastructure Cost

sub-$500

2010

$250

Reduce
Costs

Breaking the acquisition cost barrier with partners

Sub $40 Enterprise
Storage for View
Largest Windows 7
Migration Practice
60% increase in desktop
performance

ce
n
re
e
r
e
f
u
Re tect
i
h
c
Ar
Sub $40 Enterprise
Storage for View
50.000 seat View
Deployment Architecture

ce
n
re
e
r
e
f
u
Re itect
ch
r
A
32

ce
n
re
re
e
f
u
t
e
R
ec
t
i
ch
r
A

HP Reference Architecture
for VMware View, Reference
Architecture Brief

Solution Cost

Dell Virtual Remote Desktop

Featuring VMware View,
Reference Architecture Brief

ce
n
re
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f
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Re itect
ch
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A

Case Studies

33

Standardize Application Delivery

Business Drivers
22,000 student University and Teaching Hospital
-300 Beds

8 10% failure rate updating practice mgmt

software

Updates took hours of scheduled downtime

7000 ThinApp Seats

No additional infrastructure or changes, no client to
maintain

0% failure rate for software updates, high availability

Over 35 applications ThinApped including Allscripts
Misys Vision, McKesson Pathways and Horizon
Performance Manager

Used ThinApp for 6 months before moving to View

Currently have 1200 View Desktops
34

ThinApp makes it
easy to push out
applications and then
update them with no
downtime.
Josh Spencer
Team Lead, Desktop
Development Group,
University of Toledo

Improved Clinician Workflows Citrix Replacement

1200 View Desktops
Replaced Citrix Clinicians wanted to be
able to access more than one app from
terminal

Applications: Meditech C/S, McKesson

PACS, some Office Apps

Results:
Reduced help desk calls by 92%
Easy to use "follow me" desktop with no
application compatibility issues

Upgrades accomplished in a fraction of the

time

Able to upgrade applications with no user

disruption

Our physicians could

go to a thin client,
login, access a patient
list and then walk
down the hall to
another thin client,
and their patient list
would be right where
they left it. The staff
recognized the benefit
of that capability
immediately.
Brian Cox
Director of Customer
Service, Norton Healthcare

35

Accelerate EMR Adoption - Huntsville Hospital

1600 View Desktops
Rolling out Electronic Medical Records (EMR) solution would have taken
months and required replacing more than 1,600 of its 3,300 PCs

Driving desktop architectural decisions

Choose to deliver EMR using a virtual desktop

Results
Provision desktop in < 15 minutes
Saved 600,000 by repurposing existing PCs
ROI 122% and payback in 6 months
Start building private internal clouds
We decided we wanted one uniform desktop
across the hospital, and when we priced it,
virtual desktops were far more cost effective
than physical desktop replacements,

36

Shawn Scott, a network specialist at

Huntsville.

Internal Cloud
EMR

Remote Clinical Imaging and desktop delivery

Challenge
Upgrade desktop environment across 25
sites in 3 New York counties

Solution
VMware View 4.5
Supporting MEDITECH EHR, Allscripts
ED., eClinical works and Amicas PACS
applications

Results
Saved immediate $45K in capital by
migrating to thin clients from PCs for
desktop pilot

Reduced bandwidth requirements by 66%

by switching from RDP protocol to to
PCoIP

Increased accessibility to applications

37

With VMware View, our

physicians dont just have
access to lab reports, they
can see actual X-ray
images, access
emergency department
records and even monitor
biofeedback if a patients
in a critical care situation.
All the applications they
need are right there at
their fingertips, giving
them a more global picture
of their patients than ever
before.
Cathy Crowley CIO ,
Columbia Memorial Hospital

Next Steps
Virtual Desktop and Application Assessment Services
Lakeside or LWL Assessment Tool available through VMware Representative
For More information on VMware View and Healthcare
http://www.vmware.com/products/view/
http://www.vmware.com/solutions/industry/healthcare/
Follow us on Twitter
@VMwareHIT

Use our TCO Calculator

www.vmware.com/go/tcocalculator
Download 60 Day Evaluation of VMware View
www.vmware.com/go/tryview

38

Thank You!

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