Transforming Desktop Delivery for Clinical Users

Have you ever asked yourself how you will implement the “virtualization” everybody is talking about? You have probably wrapped your arms around server virtualization and even implementing a highly complex electronic medical records (EMR) system is not as scary as it used to be.

How about Desktop Virtualization? What does it entail and how do you implement it? It may sound complex, but it’s actually not bad if approached the right way. Let me just start by saying that desktop virtualization is distinctly different from server virtualization and just VDI (which is a special case of desktop virtualization where an individual’s desktop is simply virtualized and moved to a datacenter).

Many EMR implementations are already running on virtualized platforms - be it a simple terminal services or thin client implementation or a more sophisticated application and desktop virtualization implementation from Citrix Systems.

Different business needs call for different technical solutions. Citrix just released the Desktop Transformation Model, which provides clear definition of the different phases of desktop transformation and provides a few actionable steps any health CIO can take today to get the thought process started.

Let’s have a look:

The four phases of desktop virtualization are:

• Traditionally Managed Desktops - nothing new here. This this the plain old distributed computing model.
• Centrally Delivered: In this phase, organizations deliver virtual desktops or applications from a central location. This meets many security needs and enables the health CIO to more easily comply with the HIPAA provisions that mandate that any patient data be removed from any computing device before the device is decommissioned or discarded.
• Optimally Managed: The optimally managed virtual desktop provides a clear leap over its centrally delivered predecessor. Organizations introduce single image management, simplification, lower storage requirements and greater system scalability into the environment.
• Transformed: At the pinnacle of desktop virtualization, organizations provide user self-services, high degrees of process automation and monitoring and sometimes usage-based charge back models.

For most healthcare implementations, the centrally delivered model alone provide tremendous advantages. Even if it just means to deliver the EMR app via Citrix XenApp to the workstations in the offices and on clinical floors, this step can significantly ease the burden associated with application management and regulatory compliance.

Should an organization desire to deliver an entire virtual desktop, it will be best advised to select at least the optimally managed route or aspire to implement that model eventually. Most healthcare desktops require little personalization and run the same set of clinical applications, which makes them ideal candidates to work off the same centrally provided desktop image for all users.

Before we jump to conclusions and get into the technical weeds of the discussions, there are three important first steps that any health CIO should go through:

1. Establish Business Priorities. This relatively simple exercise maps out various business drivers such as reducing costs, increasing data security, enabling a virtual workforce, etc. and prioritizes them according to your organization’s needs.
2. Assess the time to value. You will find that desktop virtualization provides values that map directly to the business priorities set earlier. How quickly you can realize those values depend on a number of factors, including careful user segmentation and getting an idea of scope of the technical implementation.
3. Develop a technology roadmap: Based on the business priorities, organizations should start with virtualization projects that provide a high business impact at a relatively low time to value. This is a fancy way of saying that organizations should go for quick win first and then tackle the more complex virtualization projects at a later time.

These steps are mapped out in greater detail in a recently published whitepaper.

In the case of healthcare  EMR implementations, the clinical users are an important group. If the organization rolls out a an integrated EMR application that contains all the required module, the scope of the project may just revolve around a single application.

Doctors and nurses constantly roam from patient room to patient room and may also wish from home or when on the road. Therefore, the “virtual workstyles” will probably be high on the list of priorities. Since EMR implementations are major projects by themselves, many CIOs will try to focus on cost containment or cost reductions relative to a traditional desktop model..

These two attributes lead IT decision makers to pick a centrally delivered, optimally managed virtual desktop environment for clinical users. This can often be accomplished by using Application Virtualization for the EMR app, or providing hosted virtual desktops that are either based on a shared Windows server and on a common server or desktop image.

These broad attributes enable IT decision makers to assess the time to value, or the time it will take to design and implement the delivery of the EMR app or its desktop to end users. The importance of medical apps require diligent testing and validation procedures, but the overall effort probably pales in comparison to moving from paper-based charts or outdated green screen systems to a modern EMR implementation.

Medical CIOs can use the experiences gained in the delivery of the EMR desktops to transform the desktop management of many other functional areas as well. Why let this experience go to waste? Once you get a taste for the immense flexibility that virtual desktop computing offers, you will probably not want to maintain a traditionally managed, device centric desktop computing model.

Florian Becker

Twitter: @florianbecker

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