University of South Florida Health

University of South Florida Health: Achieving IT Efficiency, User Mobility, and Patient Care Goals

Unidesk and VMware are enabling USF Health to give its 3,000 doctors, nurses, students, professors and staff mobile access to more than 180 applications, including Epic EMR.

USF Health

"Our POC worked well until we started to scale. We quickly had so many base images for 100 VMs and a handful of apps that scaling to 3,000 users was unimaginable. And the complexity would have required an army of IT people we don't have. Unidesk solved both issues. Their layering technology is fantastic for getting management of apps and images under control. The combo of Unidesk and Pure Storage for VDI is just unbeatable."

Richard Savage
Senior Systems Administrator, USF Health

VDI Success with Use Case Diversity

When USF Health embarked upon an effort to move its 3,000 doctors, clinicians, and staff to virtual desktops, it knew there would be challenges.

Use case diversity is common in healthcare, but even more so at USF Health. The Tampa, Florida institution is unique in that it brings medical staff together with a variety of students and experts from the medical and public health departments at the University of South Florida (USF). This partnership with the USF medical schools - Morsani College of Medicine, College of Nursing, College of Public Health, College of Pharmacy, School of Biomedical Sciences, and School of Physical Therapy and Rehabilitation Sciences - creates a broad set of use cases. Due to the sheer variety of activities, students and professors, practicing physicians in the clinic, operating rooms, procedure rooms, and administrative staff all need their own tailored desktop instances.

The combination of Unidesk and Pure Storage, along with VMware Horizon, is helping USF Health meet all of its desktop transformation goals: greater efficiency for IT, enhanced mobility for doctors to better meet USF Health's high standards for patient care, and a more flexible, agile end user computing environment for students, faculty, and staff

Drivers for Desktop and Application Virtualization

Initially, USF Health started on its VDI journey to enable doctors and nurses to use applications quickly from anywhere. The ability for doctors to log in to a system in an exam room and have instant access to a desktop cuts down on the time a patient has to wait for an exam, delivering a better experience for the patient.

Explains Richard Savage, USF Health senior systems administrator and VDI technical lead, “The doctor can come into the exam room, pull up a VDI session and, within seconds, be talking to the patient and focus more on the interaction. That’s much quicker than logging in to a PC, opening the right applications, waiting for them to come up, and finally finding the patient’s record."

Savage and the USF Health IT team were also interested in the cost savings associated with VDI, specifically the reduction in IT effort to deliver desktops and keep Windows and applications up to date. Given the institution's rapid growth, they knew this effort would only increase if they stayed with physical PCs.

Another driver for VDI was the enhanced patient privacy and data security that would come from moving data off of edge devices and into the data center, a key requirement for most healthcare organizations.

Overcoming the App Delivery and Windows Management Hurdle

USF Health's initial VDI pilot targeted 100 users, including many on the IT team.

Says Savage, "We used ourselves as guinea pigs. Most of us in IT are power users, so if VDI could work for us, it could work for everyone. Our CIO was one of the first to get a virtual desktop."

But even with only 100 desktops, the IT team soon found themselves dealing with 10 different desktop configurations. The goal was to cut down the amount of work required to patch and maintain systems, but supporting the requested configurations resulted in more work for the IT staff.

Adds Savage, “The management quickly got to the point where it was an all-day affair to just deal with Windows updates or an application having to be configured and installed. It became quickly obvious that, at scale, this would not work.”

To solve the problem, Savage looked to layering technology from Unidesk, which turns the operating system and applications — and the changes they make during installation — into software building blocks that can be added piecemeal to build a customized virtual desktop for every user. The technology allows users to personalize their systems, but each building block only has to be managed and patched a single time, dramatically cutting down the time and cost to administer VDI. A personalization layer saves any changes users make while they are using their desktop.

Explains Savage, "With Unidesk as our app management solution, we have one Windows OS layer to manage, and every application is another layer. Our desktops have become a combination of the Lego blocks of these layers, and I don’t have to create a whole new image just to add an application that someone needs. Unidesk does a great job of making sure that all the different layers work together as if they've been locally installed, so we don't have any interoperability issues with dependent applications or plug-ins. We've been able to achieve the install-once, patch-once efficiency that has previously been a myth, even as we've scaled from 100 users to 3,000."

The cost of provisioning a new desktop is also much lower.

Comments Savage, "Administrators don't have to travel to a physical system anymore, and building a desktop doesn't require any imaging. Even though we have a mix of desktops for our different use cases, they are all built the same way with the same layers. We just select which layers we want. Every user can have the tailored desktop experience that their use case requires, but we're only managing one set of layers."

Overcoming the Storage Hurdle

The IT group at USF Health also had to dodge problems caused by the massive I/O requirements of VDI. Although the group thought it had over-provisioned the storage needed for the 100 desktop pilot nearly maxed out its capabilities,

Says Savage, “We quickly realized that we needed to look at ways to fix the storage problem, because spinning disks were not going to do it for us."

To solve the storage problem, USF Health bought an all-flash array from Pure Storage. Although flash drives are more expensive than their spinning disk counterparts, Pure Storage deduplication in combination with Unidesk layers reduces the amount of space needed for USF Health's desktops by a factor of 10. Desktops that would otherwise require 40-50 GBs of disk space now require less than 4 GBs.

Adds Savage, "Pure Storage is enabling us to deliver desktops that are faster than the old PCs, which has really helped with VDI acceptance. Our users want to make the switch because the virtual desktop experience is better."

Desktop rebuild times with Unidesk on Pure Storage are also exceptionally fast.

Explains Savage, "Sometimes we need to push out an app mid-day if there's an urgent need. The Pure Storage all-flash array is so fast that adding and removing Unidesk application layers only takes a few minutes, without any impact on the rest of the running desktops. We can have any app delivered at a moment's notice."

Facilitating the Move to Epic EMR

USF Health recently decided to migrate to Epic for outpatient management. Epic is one of the leading electronic medical record (EMR) systems in hospitals and academic medical centers, with highly integrated solutions for managing inpatient, ambulatory, and specialty clinical systems, as well as access and revenue solutions for practice management, billing, and managed care.

By delivering Epic as an app layer, the IT team is able to easily accommodate the side groups that need access to the EMR application, but that need slightly different configurations. Without Unidesk, the IT team would have had to install Epic in a base VM for each different configuration, requiring up to a full day for each group. With Unidesk, IT simply assigns the Epic app layer to any virtual desktop that needs it in a few minutes.

Confirms Savage, "Since this project was on a short timeline from the beginning, we were able to deploy Epic to all groups very quickly just by adding the layer to existing VMs and restarting them. That time savings gave our small admin group sufficient time to focus on solving other issues with the deployment that made it as smooth as possible. It really isn’t exaggerating to say that Unidesk has saved the EMR migration project for us a few times now."

All Desktops Virtualized and All Goals Met

USF Health has been able to achieve its end goal of delivering virtual Windows workspaces to all 3,000 users. While the reduced management overhead and costs have made the solution a boon to USF Health’s IT staff, Pure Storage and Unidesk have also delivered a better experience for users.

Concludes Savage, "Not only do users have a higher-performing desktop, but we are also supporting Bring Your Own Device. BYOD gives our users and remote workers access to the same desktop no matter where they go and no matter what device they use for access. We have given our clinicians freedom in how they interact with their patients. In the end, cost savings is an added bonus. What we really wanted was technology that works better for our users."

Deployment Details

  • Application Management
  • Server
  • Storage
    Pure Storage
  • EUC Platform
    VMware Horizon
  • Users
  • Application Layers
  • More Info
  • 1 Windows 7 OS layer for production use, with a few others for dev/test
  • Key applications layered separately by Unidesk: Epic EMR, GE Centricity plug-ins for PACS, Visual C++, Visual Studio, .NET, Firefox, Google Chrome, Office, SAS, Pharos, ArcGIS

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