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When applications are slow or don't work, it costs users' productivity. And when those problems crop up in hospitals, it can be devastating because the health of patients is on the line.
Universal Health Services (UHS), a hospital management company that covers 25 hospitals and other health facilities, uses Citrix XenApp to deliver its electronic medical records (EMR). Cerner, a large health IT provider, hosts the records, meaning UHS did not have the visibility it needed into its XenApp deployment, the underlying infrastructure or the cause of performance problems that were leading to slow application loading times, connection issues and even application failure.
"We really want the nurse and the physician to spend less time dealing with technical problems and more time in front of the patients," said Justin Monnig, general manager and senior director at Crossings Healthcare Solutions, a subsidiary of UHS based in King of Prussia, Penn.
UHS takes matters into its own hands
To address the problems, UHS turned to Goliath Technologies, an IT operations software company in Conshohocken, Penn., for its VDI monitoring tools, Goliath Performance Monitor and Logon Simulator. The IT department at UHS had already used Goliath Performance Monitor to keep tabs on virtual desktops that a specific set of remote employees used to process patients' medical charges. UHS wanted to apply the success of the VDI monitoring tools there to its EMR that doctors and nurses access, Monnig said.
The company applied Goliath Performance Monitor agent to several hundred of its server farms at Cerner to gain insight into how the Citrix apps were performing, including information on logon times, server performance and session properties. The agents also delivered access to all Cerner's metrics such as CPU and memory use, as well as swap memory.
Joe Alexandersoftware architect of information services, UHS of Delaware Inc.
UHS went even further, looking for a way to alert IT admins when an unexpected issue occurs so they can fix it as fast as possible. UHS teamed with Goliath and its Logon Simulator to build a plug-in directly into the company's VDI monitoring tools. The plug-in goes through a series of routines that imitate the workflow of UHS clinicians, and it alerts IT to allow them to resolve any app performance issues before they affect end users, Monnig said. It performs 15,000 application launches a day to make sure when a doctor or nurse goes to use an application it works properly.
"Instead of getting an alert at 7:30 in the morning when a doctor first logs on from the exam room, you get an alert at 4:00 in the morning," said Thomas Charlton, chairman and CEO of Goliath Technologies. "You've now got three and a half hours of buffer time to fix an issue before it fails."
How monitoring continues to help
Just last month, Cerner contacted UHS because it was getting alerts from its own suite of Citrix monitoring tools about a swap space issue where memory utilization spiked from 20% to 70%, resulting in end-user connection disruptions for UHS' end users. The Cerner staff could not identify the root cause of the problem with the Citrix tools alone, said Joe Alexander, software architect of information services at UHS.
Using Goliath Performance Monitor, Alexander was able to determine that the applications were having trouble talking to the SQL server back end, which created the connection issues. He and his team identified a set of McAfee updates that Cerner had pushed to its servers as the culprit, causing the rise in swap space consumption.
Without Goliath's VDI monitoring tools, it would have been very difficult to identify what was going wrong, Alexander said.
"Being able to cull through all that information and figure out where that problem actually is has been really beneficial," he said.
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