Desktop Virtualization A Remedy For Hospital

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Hospital Uses Desktop Virtualization To Improve Healthcare

The cost of managing desktop PCs is spiraling for St. Vincent Catholic Medical Centers. They're spending too much time and money on maintenance, software upgrades, calls to the help desk, and electrical power.

St. Vincent's is solving the problem by replacing its PCs with a new category of "zero client" desktop. Windows desktop software runs virtualized on servers in the hospital data center, accessed over the network from the desktop. Users get the same, familiar Windows tools, and IT gains increased flexibility, efficiency and reduced cost.

St. Vincent's has about 40 locations in the five boroughs of New York, with about 3,000 to 5,000 PCs and notebooks which are, in computer terms, positive antiques, at three to five years old.

The organization is deploying the zero-client devices in its hospital in the West Village section of Manhattan. The hospital has a 140-year tradition of providing healthcare to the poor. It's a not-for-profit that gets money from government, charitable fundraising, Medicare, and Medicaid -- "the regular shebang," said Kane Edupaganti, director of IT operations and communications for the organization.

St. Vincent's faces fairly typical problems dealing with PC maintenance. Because the systems are old, they're temperamental. Users make frequent calls to the help desk. Hardware problems and some software problems require time-consuming visits to the user's desk, which runs up support calls.

The first option the company considered to solve its problem was repurposing the old PCs as thin clients, launching a remote-desktop session to a virtual machine running in the data center. That would have solved a lot of problems, but would have left a lot of problems still in place, Edupaganti said. "We didn't want to go down that route because we didn't want a fat PC out there sucking up 130-160 watts of power, and we didn't want a Windows operating system out there that we had to manage, even though it wasn't visible to the user," he said.

The organization then looked into thin clients, but those devices still had operating systems, either Linux or Windows CE, still requiring some maintenance.

St. Vincent's then discovered zero-client devices from vendor Pano Logic. The Pano Device is a small, rectangular box that connects to the network, and into which the user plugs a keyboard, mouse, and display. The zero-client devices get their name because they have no operating system, and no disk drive or other moving parts -- the device just boots off the network, and accesses a VMware virtual machine running on the server in the datacenter.

St. Vincent's launched a pilot in its emergency department, which runs on the Verizon NPLS network. That department complained about lag using the old, fat PCs in conjunction with the slow network. Users weren't able to access patient charts and other data fast enough, leading to a backlog. The bottleneck was affecting patient flow and cash flow too, as billing was delayed.

As part of the speed-up, St. Vincent's switched to a more responsive Electronic Virtual Private Link network from Verizon, for more responsiveness.

St. Vincent's also swapped its ancient PCs running Windows 2000 Professional on 256-512 MB RAM and a Pentium 4 chip, for virtual Windows XP machines, each of which has 1 GB of RAM and a new dual-core processor. All the software runs on servers in the data center. "All that's moving back and forth is the screen scrapes," Edupaganti said.

The Pano Logic devices took about an hour to get running. The new machines led to immediate improvements for emergency room productivity. "They were able to catch up to 200-300 backed-up charts in a matter of two weeks," Edupaganti said. No backed-up charts meant no backed-up billing and improved financial performance.

The new machines also saved money on electrical power. While the traditional PCs consumed 130-160 watts each, the Pana Logic devices each consume 3-5 watts.

St. Vincent's now has about 250 of the devices deployed. They're working with the New York State Energy Research and Development Authority (NYSERDA) to get government funding to roll out an additional 300 units by the end of the year.

Benefits of the Pano Logic devices are numerous. The company saves energy, billed at 20 cents per kilowatt. The Pano Logic devices take about a half-hour to come online, compared with 2.5-4 hours for standard PCs, done by a PC tech with an average salary of $22 to $25 per hour, Edupaganti said.

Centralized management solves many problems. Nothing can be saved locally, so IT doesn't have to worry about migrating data to a new PC when upgrading. And the centralized storage protects data integrity. Hospitals are by nature lacking in physical security, with throngs of people coming and going at all times. "What if someone walks in and picks ups a PC and walks out with it?" Edupaganti said. With a standard PC, the thief would get all the data located on that system's disk, but if a thief were to steal a zero-client device, the data would still be safe in the data center.

Hardware upgrades are trivial, just reset the virtual machine for more RAM usage and ask the user to reboot. Likewise, upgrading the operating system and apps can be done centrally, in one location, and propagated out to the desktops as soon as they reboot.

The virtual machines run on five Hewlett-Packard DL580 standalone servers and 700C blades. The company is now installing a Cisco Unified Computing System blade chassis, based on the Nehalem processor, which St. Vincent's hopes will prove to be more power-efficient and run cooler than its existing servers. When the organization is done rolling out the additional 300 desktops, it will have 8 servers running 600 virtual machines.

The devices do have problems and special requirements. "If your network is not configured properly and optimally running, you'll see some glitches," Edupaganti said. That's because the devices are network-intensive. St. Vincent's had to devote extra attention to network maintenance.

Likewise, users were frustrated because they couldn't perform a hard reboot by pressing and holding down the power button. That reset the desktop device, but did nothing to the virtual PC running on the other side of the network in the data center. The short-term solution: Users have to call IT to get them to reboot the virtual PC manually. St. Vincent's is working with Pano Logic to get them to write scripting capability into the desktop devices, so that when the power button is pressed and held, the device sends a signal over the network to reboot the remote PC.

Also, the Pano Logic devices do not support dual monitors, so St. Vincent's had to buy two devices to support dual-display desktops. An upcoming version of the device will support dual-monitor displays.

Blue Cross of Northeast Pennsylvania, the University of Louisville School of Medicine, and a range of large and small healthcare providers are using mobile apps to improve care and help patients manage their health. Find out how. Download the report here (registration required).