2010 Netopus Healthcare 2.0

8/9/2019 2010 Netopus Healthcare 2.0

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Anewhospital isnotbuild from

onedaytoanother.Backin1995

Orbis started investigating the

needfor

provisioning

adynamic

care environment to remain

competitive and to give content

to themissionofOrbis "ensure

continuity for healthcare

processes" It soon became clear

that this goal required a new

hospitalbuilding.Onceapproved

for construction by theMinistry

of Health in 1999, they started

developing their new included

assignment

;

the

design

of

the

hospitalforthe21stcentury

This means giving birth to new

processes, technology, organiza

tionenlogistics.

Apatient

oriented,

chain

organi

zation needs a suitable working

environment, where both the

buildingandtheautomated

workplace ispartof it. The con

struction started in 2006 and

after three years, in January

2009, Orbis Medical Centre

opened doors , and closed the

oldMaaslandHospitalsite.The

new hospital has 450 beds and

2,000

employees.

Orbis

Medical

Center ispartoftheOrbisMedi

calCareandCureconcern,which

alsoincludes OrbisDanikenHos

pice,Orbis

Home

care,

Orbis

Domestic Help, Orbis Mental

Health, Rehabilitation and nine

satellitecarecenters.Withactivi

tiesintheareasofcare,services,

housingandwelfareOrbishas12

locations in the south of the

Netherlands.

HealthcareboulevardThe

results

are

impressive.

After

parkingyourcar, youwalk,while

enjoying somemusic, in thedi

rection of the hospital. At the

entrance to the right and left

situatedisthebakerandthefirst

thingyousmellisfreshbread.

Nextyouenterthebigimpressive

hallwhere you get a good im

pression of the building. It feels

like a luxury shoppingmall,only

thereare

no

shops

and

escalators

butnursery,speaking andstudy

Whenopenedin2009,OrbisMedicalCenter standardizedallworkplacestoensureaflexibleandhighlydynamic environment.CombinedtechnologyfromDell,Siemens,HP,Citrix,RESSoftwareandVMwareensuresthatOrbisVirtualWorkPlacehasbecomereality.NetOpuswentontostudy thisinnovativeconceptinthenewmodernhospital.

Marcel Beelen


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rooms.Thegreathalliscalledthe

healthcare boulevard where

you can buy carerelated prod

ucts and medical devices. This

appearance is an importantpart

of theconceptof thehospitalof

thefuture.Thecustomercomes

first. Being ill and undergoing

testsortreatmentisbadenough,

so if you canmake thingsmore

comfortable,this

is

apositive

contribution for the healing

process.

Thehospitalhasa veryspacious

design , but because the areas

areefficientlysituatedandclassi

fied to operate for very well

streamlined care processes, the

surfaceareaof thenewhospital

isless thantheoldhospital.The design of the building also

ensuresthat

visitors

feel

com

fortable and relaxed, while the

figuresshowthatproductionhas

increased. This

means the

processes are

running

effi

ciently.

In OrbisMedi

calCenter,high

tech health

care combined

with innovative

ICT technology,

logistics and

hospitality pro

vide a total

differentexpe

rienceforpatientsandstaff.

"Wewantedtocreatea identical

and quick access environment

everywhere, to provide transpa

rent information anytime, any

where says JosDemandt,Head

ofICT

The new workplace was bap

tized:"OrbisVirtualWorkplace,"

Josexplains. Itsamodularand

easytocustomizeconcept

We combined Citrix XenApp vir

tual desktop technology with

VMware ThinApp application

virtualization. Combined with

management software from RES

thissupplies

avery

dynamic

and

manageable environment. Key

elements of the initial concept

where free seating, smooth

roaming, a quick login process

andsinglesignon."

FreeseatingThe most notable effort is the

concept free workplaces (free

seating).Doctors andother staff

membershavenoprivateoffices

and computers,but canuseone

of the total 2000 compact iden

ticalDelldesktopsinthebuilding.

ThePCsareequippedwith large

22 wide screens and special

softwareto

split

the

physical

display into two separate logical

screens, as they can read the

EPDfilesandseeimagessimulta

neously. Previously this would

requiretwophysicalmonitors.

Theseworkstations are available

inmany appearances ,including

lounge seats, lockable cockpits,

kiosklike desktops and open

office spaces separated by light

shielding. Different types of

chairs and benches, desks and

tables, some electronic height

adjustable,ensuringanergonom

icworkspace.

Eachemployee

has

alocker

(of

tenwithamailbox)tostorestuff.

Because the entire hospital gen


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implementandtheextradelay is

minimized . This smooth roam

ing,usingasmartcard,isratedas

verypositive bythestaffandthe

performance of connecting and

disconnecting the sessions and

the

applications

themselves

are

excellent.Becausethesmartcard

is also equipped with RFID its

alsoused togainaccess to spe

cific rooms or non public areas

soeveryonehastotakeitalways

withhim."

Therequirementforasinglesign

onsolutionhasbeenwithdrawn.

Because almost all data

processingtakesplaceinSAP,the

SAP

logon

is

next

to

the

log

in

thedomainwiththesmartcard

the most common login re

quired.

Becauseusersloginactually only

once aweek (onMonday) ses

sions keep running throughout

the whole week, single signon

would be overkill and rather a

disadvantage from management

perspective.

CriticalapplicationsOn the Citrix farm are running

around 150 applications, includ

ing some very critical applica

tions. The main application is

SAP.

All subsystems of the Hospital

Information System and all care

processes are interfacing or

communicatingwith

it,

from

the

ElectronicPatientRecord to the

controlofAutoGuidedVehicles,

whichhandlethelogisticsoffood

transport,medical and solidma

terials.Orbis has done every ef

fort to implement a duplicated

andredundantinfrastructure.

But there are other measures

taken to give the environment

extra stability. All 150 applica

tions

are

isolated

from

the

oper

ating system with VMware Thi

nApp and ensure stable Xenapp

servers because the software

doesnotneedtobeinstalled.

During the week, around 1900

simultaneous sessions on the

Citrix XenApp servers remain

active,becausetheemployeesdo

not

logout.

During

the

weekend

theserversincasearecleanedup

by a maintenance process. The

80 HP blade servers are, in and

automated process, removed

from the citrix farm on Friday

nightwhileduring theweekends

four separate XenApp servers

takeover the service. The serv

ers are maintained (defrag

mented,etc.)and rebooted,and

on

Monday

at

dawn

again

added

to thefarm.

EmergencyprocedureAlthoughthepotentialforsevere

disturbances is very small Orbis

decided to implement an emer

gencyprocedure for the2000 to

workstations.

Insteadof

true

thin

clients,

there

fore is chosen for PCs, primarly

configured as thin client device.

But the are also capable of run

ninglocalapplications

Thesixmostcriticalapplications

includingSAPgui isasaThinApp

package onall localPCsavaila

blebyRESWisdom.

If the Citrix farm or the Active

Directory domain experience

problems,then

enter

into

the

emergencyscenario.

Employees can hear via the

phone's the localpassword fora

generic localaccountonallcom

puters are created. Then they

can logonon thePC itself (with

out smartcard)and start the six

localapplications.

Theonlyprerequisite is that the

networkandthecentraldatabas

es

such

as

SAP,

is

operational.

If the problem is solved, the

password of the generic local

account on all workstations is

changedwithRESWisdom.

Running localapplications isalso

useful for specific applications.

For example Windows Media

Player is localy run in the

workstationtoplayvideo froma

DVD. This reduces the need for

specific

multimedia

components

on the citrix environmentRES

PowerFuse Workspace Extender

makes it possible to display

transparent local applications

within the centralized XenApp

session.

SpecialsBesides the Dell 2000 worksta

tions, there are specialized com

putersfor

example

in

Ophthal

mology. These workstations are

provided with hospital equip

ment and using software linked

specificallytothisequipment.

ThesePC'sareindeedincludedin

the care process but the IT de

partment is not able tomanage

alltheseseparateendpoints.

The supplier is responsible for

supporting these medical sys

tems..The

PCs

are

equipped

with

an virtualized ICA / XenApp

Client. In thisway, even highly


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divergent systems can be con

nected to Orbis Virtual

WorkPlace. Orbis calls this "in

ternalteleworking"similartothe

teleworking functionality which

inexactly the samemannerpro

vides

doctors

to

work

at

home.

There are also medical devices

connected remotely. On any

standardworkstation,aspecialist

can,fromtheCitrixsession,open

a session on a ECG workstation

withthe MicrosoftRemoteDesk

topClient forexampletolookat

ECG recordings. This is persona

lized by RES PowerFuse so that

only the person who is autho

rized

can

operate.

BedsideterminalAtOrbisMedicalCenterapatient

receives a private room with

private bathroom and a sofa on

whichanypartnerorparent can

stay overnight. Each room is

equippedwithabedside termin

al. This is a Linuxbasedmedical

(industrial) PC from Siemens,

consistingofatouchscreen,key

board and phone, with a large

swivelarmmounted to thebed.

De patint heeft een pasje

waarmee hij inlogt op de termi

nal.Thepatienthasasmartcard

tologon

on

the

terminal.

He

then

sees a central control panel to

adjust environment comfort

(light, curtains, temperature),

manage food ordering, use the

internet or watch TV. At the

nursedesk, nurses can monitor

theservicesofthedomoticasys

tem and if necessary remote

control the several items, for

example, shutoff the light if the

patienthas

fallen

asleep.

When a doctor puts his smart

card into a separate card reader

of the bedside

terminal, his

XenApp ses

sion is opened

and the ter

minalactsasa

standard

workstation.

The physician

can then dis

cuss the elec

tronic patient

record togeth

er with the

patient.

Fromthenurs

ingdepartmentwas thedemand

for

an

additional

display.

This

is

realizedwitha special,Windows

XP embedded, wireless con

nectednotebook so themedica

tion can be entered simulta

neously when the physician up

dates the treatment data.These

devices also proved suitable for

use in the rest of the building.

This resulted in another 200 of

thisspecialdeviceusedasmobile

workstations These also use the

standard Citrix XenApp environ

mentandcan log in immediately

after poweron with a generic

account, in a limited environ

ment. Its also possible to login

with a users private account

withoutusing

asmart

card

Because the thin clients run in

readonly mode, they are not

sensitive to disturbances. Just a

rebootwill return them in their

original state. TheWiFi network

is alsoused for telephony.Orbis

uses IP phones and VoIP for in

ternal calls to reachable any

where."Inhealthcareeverything

must be carry out under well

definedprotocols.

ICT

technology

inOrbisMedicalCenterbecomes

theengineforthecareprocesses

andprovidestafftimeandplace

independent access to allneces

saryinformation.

We virtualised IT as much as

possibleandsetupmodularsys

tem.Thiscreatestheopportunity

for dynamic en efficient man

agementwithout risks, Jos con

cludes."TheCitrixenvironmentis

inherently modular and servers

can be easily added or main

tained.

Because all applications are iso

latedwith

VMware

ThinApp

they

can be added or removed as

modulesonCitrixXenAppservers

andworkstations.RESPowerFuse

isactuallyamoduleofthework

space, so that the institutions

and rights to applications are

treated as separate entity. The

gluebetween allmodules isRES

Wisdom, which eliminates the

need for scripts and for both

server,deployment

of

ThinApp

packagesandcaresettings.

Within the hospital of the21st

century ,ICTdevelopmentsnever

stand still and currently benefits

of cloudcomputing concepts

fromCitrix,Googleorotherpro

vidersarebeinginvestigated.

PossibleOrbisVirtualWorkplace

is going to migrate into Orbis

virtualWorkspace

[email protected]

2010 Netopus Healthcare 2.0

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