Healthcare Organizations and Virtual Desktop Solutions:Kindred Healthcare – A Case Study

Rob RhodesKindred Healthcare

Laura ArmisteadKindred Healthcare

Tommy Walker, VMware

Agenda

Virtual Desktop Infrastructure (VDI) OverviewKindred Healthcare Case Study

WoW Factor (Workstation on Wheels)Virtualization with VI3HealthCare Solutions

HIPAA and ComplianceQ&ALearning More About VDI…

VMware Desktop Product Line

Managed DesktopsIndividually Administered Desktops

Server-based Desktop

Virtualization

VDI

Secure, Managed Desktop

Virtualization

ACE

Free Virtual Machine

Run-Time

Player

Desktop Virtualization for IT Professionals

Workstation

VDI – Overview

VDI leverages Virtual Infrastructure 3 and a remote control protocol such as RDP to provide users access to a standardized remote desktop.

Thin Client or PC

Virtual Infrastructure 3 Server

VMware’s Virtual Desktop Infrastructure enables server-hosted enterprise desktops. Unlike other solutions it delivers full desktop environments thatare always on, accessible from anywhere, and centrally managed.

The Virtual Desktop Infrastructure (VDI)

VMware’s Virtual Desktop Infrastructure (VDI):

Consolidates and centralizes complete desktop environments within the data center

Virtualizes, optimizes, and manages server resources to host and deliver secure, isolated desktops that are always-on and accessible from anywhere

Is built on VMware’s market-leading Virtual Infrastructure technology and leverages the significant benefits of desktop virtualization

Benefits of a Virtual Desktop Strategy

Remote access to complete desktop environments Access virtual desktops via remote client connection from anywhere, and from any device Instantly access virtual desktops at anytime -since they are always on and availableEnable remote connection to a desktop via a browser

Standardize desktops on common virtual machine imagesVirtual machines are always connected and powered on enabling easy & timely software updates Complete hardware independence –Host any desktop OS/ app on any shared x86 h/w resourcesImproved resource mgmt eliminates underutilized PC CPU cycles

Manageability Accessibility

Easily provision entire desktops by simply creating or copying a new virtual machineQuickly recover desktops from disasters or crashes by deploying a new virtual desktop to a userTroubleshoot desktops through virtual machine snapshots and quickly resolve or reprovision new desktops

Responsiveness

Key Features of Virtualization for Desktops

Hardware Independence

Run a virtual machine on any server without modification

Partitioning

Run multiple virtual machines simultaneously on a single physical

server

Isolation

Each virtual machine is isolated from other virtual machines on the

same server

Encapsulation

Entire virtual machine is saved in files and can be moved and copied

by moving and copying files

VDI - The Building Blocks

Enterprise Server Infrastructure

The VMware Virtual Desktop Infrastructure

VMware ESX Server

VMware Virtual Center

User Management(Connection Brokering / Session Management)

Remote Access Protocol(RDP)

VMware VIMSDK

Systems Integration Services

Devices Operating Systems

Desktops Laptops Thin Clients

Kindred Healthcare – The WoW Factor“Workstations on Wheels” Rob Rhodes

Technical Consultant

Laura ArmisteadManager Unix Support

One of the largest long-term healthcare providers in the U.S. 80 Long-term Acute Care Hospitals in 24 states253 Nursing Centers in 28 states39 Institutional Pharmacies in 24 statesContract Rehabilitation Services Business

Headquartered in Louisville, Kentucky

Kindred Healthcare“Taking care of people who cannot take care of themselves”

Kindred Healthcare

Provide a mobile workstation to hospital caregiversSolution must be manageable and easy to implementLeveraged technologies must be transparent to the usersHigh availability

Problem/Requirement

Kindred Healthcare

Possible Solutions

Solutions IssuesTablet PCs Difficult to use when

administering patient care

Laptops on Mobile Carts Larger mobile carts due to power requirementsIssues with Patient Care application on a wireless network

Thin Clients on Mobile Carts and Citrix

Patient Care application not Citrix friendly

Thin Clients on Mobile Carts and Blade PCs

OverkillTied to a specific hardware vendor

Kindred Healthcare

Why Hosted Desktops on ESX Server

Quickly provision WorkstationsAbility to use Thin Clients:

Easier installation and implementationProvides familiar user interfaceLower Power Consumption = Smaller Mobile Cart = Happier Nurses

Hardware independenceHighly available Better use of Computing Resources vs. Blade PCs

Kindred Healthcare

Architecture (Overview)

Kindred Healthcare

768 kb/s

Neoware e370 Thin clientXP Embedded

HP DL3602 CPU8 GB RAM

Stinger Industries #6050 Cart

ESX 2.5.3Virtual CenterVMotion

Windows XP SP2

Cisco Wireless NICCisco WAP

CLARiiONCX700

Architecture (Detail)

Kindred Healthcare

The WoW Evolution

WoW V1.0 WoW V2.0 WoW V3.0

BAD BETTER BEST

Kindred Healthcare

Challenges

CostThin Client + SAN Storage + ESX Server (Enterprise)IT has had to absorb addition cost vs. traditional PC• Evaluating move from rack mount servers to blade servers• Evaluating move to cheaper SAN technology or possibly local

storage• Evaluating move to ESX Server (Starter)

• Introduces requirement for some type of load balancing for redundancy. Will not be applicable in all situations.

Virtual Machine DensityManagement activities severely impact ESX Server (e.g., SoftwareDistribution)• Move to Multi-core processors• Move to ESX Server V3.0

Kindred Healthcare

Future Possibilities

Replacement of In-Room Workstations – Currently becoming a realityKIOSKSDesktop replacementsDisaster Recovery

Kindred Healthcare

Virtualization With VI3

Tommy WalkerSpecialist Systems Engineer

Resource PoolsAggregate collections of disparate hardware resources into unified

logical resource pools

Customer ImpactFailed server mean less resources not a failed applicationDedicated (virtual) infrastructure for each business unit; central IT retains control over hardwareDelegation of resource and virtual machine management down to the business unit Management of an entire SOA application stack as a single entity

Servers, Storage, Networking

Business UnitPhysicians & Nurses Administrative Staff

Aggregate Resources

Resource Pool 2CPU 36GHz, Mem 58GB

Priority HIGH

Resource Pool 3CPU 12GHz, Mem 22GB

Priority LOW

CPU 48 GHz, Mem 80GB

Resource Optimization - DRS

What is it?

Dynamic balancing of computing resources across resource pools

Intelligent resource allocation based on pre-defined rules

Customer Impact

Align IT resources with business priorities

Operational simplicity; dramatically increase system administrator productivity

Add hardware dynamically to avoid over-provisioning to peak load

Automate hardware maintenance

Dynamic and intelligent allocation of hardware resources to ensure optimal alignment between business and IT

Resource Pool

Business Demand

Centralized Management With VirtualCenter

Provision and boot virtual machinesMonitor system availability and performanceAutomated notifications and email alertingIntegrate SDK with existing management toolsSecure the environment with robust access control

Protect Data With VMware Consolidated Backup

What is it?Centralized agentless backup for virtual machines• Move backup out of the virtual machine• Eliminate backup traffic on the local

area network Pre-integrated with major 3rd-party backup products

Customer ImpactPerform backup in the middle of the day

Centralized file level backup enables easy & reliable data protection for compliance

CentralizedData Mover

HealthCare Solutions

Tommy WalkerSpecialist Systems Engineer

HealthCare Challenges

Healthcare IT organizations are being challenged by the following when delivering physician access:

Providing a convenient, secure method for physicians to access hospital systems at any point along the continuum of care, including patient rooms, ambulatory clinics, and even remote officesEnabling staff to efficiently roam between patients in the hospital while maintaining persistent access to electronic medical records and other applications Streamlining access by reducing login/logoff time on shared workstations and kiosks in the hospital Simplifying support for various devices, including those owned by the physicians Compliance issues - HIPAA

VDI Connections

VDI Solutions for HealthCare

Instead of IT staff taking weeks to configure every PC, laptop or wireless device in your hospital, applications are installed just once on a virtual machine and cloned for rapid deploymentSession roaming capability that allows clinicians to switch easily between devices and move around at the point of care without interruption to their individual sessionCommon management platform that allows IT to deploy, manage, control, monitor, and measure application and information resources as IT servicesDoctors and staff may work from the hospital, remote offices or from their home

HIPAA and Compliance

HIPAA addresses two primary concerns in healthcare: PortabilityAccountability

HIPAA’s Three RulesPrivacy Rule - Compliance deadline April 15, 2003Transactions and Code Set Standard - Compliance deadline October 16, 2003Security Rule - Compliance deadline April 21, 2005

The following slides are for informational purposes, and are not intended, and should not be interpreted, as legal advice or a definitive explanation of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”). HIPAA and related laws create numerous complex legal issues that constantly evolve and vary by jurisdiction and individual circumstances. Anyone potentially affected by HIPAA is strongly encouraged to obtain the advice of competent legal counsel.

HIPAA - Portability and Accountability

Title I protects health insurance coverage for workers and their families when they change or lose their jobs

Title IIthe Administrative Simplification provisions, requires the Department of Health and Human Services (HHS) to establish national standards for electronic health care transactions and national identifiers for providers, health plans, and employersAddresses the security and privacy of health data

HIPAA Rules

Privacy RuleTransactions and Code Set StandardSecurity Rule

Physical Safeguards

Physical Safeguards

Restricting access to EPHI (electronic protected health information)

Mechanisms required to protect electronic systems, equipment and the data they hold, from threats, environmental hazards and unauthorized intrusion

Retaining off site computer Backups

HIPAA Rules

Privacy RuleTransactions and Code Set StandardSecurity Rule

Physical SafeguardsAdministrative Safeguards

Administrative Safeguards

Information access management Access authorization — Enables IT administrators to give users personalized access to applications and data based on logon identity. Users see only the applications that they are allowed to access.

Security awareness and training Log-in monitoring is supported.

HIPAA Rules

Privacy RuleTransactions and Code Set StandardSecurity Rule

Physical SafeguardsAdministrative SafeguardsTechnical Safeguards

Technical Safeguards Required

Access controlUnique user ID — Supports unique user identification by allowing administrators to assign a separate Windows user account for each individual user. Users receive a personalized view of all the applications they have authorization to accessEmergency Access — Enables administrators to assign back-up Windows user accounts for emergency access to applications and informationAutomatic Logoff — Allows administrators to automatically log users out after a period of inactivity

Audit controlsMaintains audit logs of successful and failed attempts to connect to applications and data. Administrators can identify which users are logged on and what applications they are using Person/Entity authenticationSupports user ID/password authentication to applications and information. Also provides smart card support and two-factor authentication through integration with third-party authentication solutions

Transmission securityProtects data using standards-based encryption technologies (SSL/TLS). Users get secure access to applications and data via the Internet.

Virtual Desktop Benefits For Compliance

Desktop Environments are configured and managed on central servers rather than on users’ computers.Workers connect over a network to centralized environments, and view and work with them in real time as if they were running locally.Centralization keeps all application processing and data on the server.The solution is secure by design—only the user interface, keystrokes and mouse clicks are transmitted across the network, and this minimal information is encrypted.Real-time monitoring, auditing and reporting give IT end-to-end visibility to the entire business.

Q&A

Questions from the Audience?

Today’s Speakers:

Rob Rhodes, Technical Consultant, Kindred Healthcare

Laura Armistead, Manager Unix Support, Kindred Healthcare

Tommy Walker, Specialist Systems Engineer, VMware TWalker@VMware.com

How Do I Learn More About VDI?

Attend Other VMworld Sessions and Labs on VDI:MED0062: How Collier County Public Schools Deployed the LargestVirtualized Desktop Environment in the World, Tuesday 11/07/2006 @ 11:45 amMED9518: Best Practices for Building and Securing a VDI Implementation, Tuesday 11/07/2006 @ 2:00 pmMED3499: Building a Scalable, Dynamic Call Center using VMwareVirtual Desktop Infrastructure, Wednesday 11/08/2006 @ 11:45 amMED9913: Healthcare Organizations and Virtual Desktop Solutions: Kindred Healthcare – A Case Study, Wednesday 11/08/2006 @ 2:00 pmMED3757: VDI Customer Panel, Thursday 11/09/2006 @ 9:30 amPlus many more partner sessions on VDI…

Visit www.vmware.com/VDI

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