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When Parkland Health & Hospital System in Dallas built a brand new 2.5 billion square-foot hospital campus, Parkland's CIO, Matthew Kull, knew the system's digital strategy had to change.
"It was the largest, to my understanding, single-site hospital construction project in the history of the country," Kull said. "With that comes a whole lot of technical challenges on what do we need to implement to support our new facility not only at its opening but over the next 60 or so years?"
With hallways the length of nearly three football fields, having centralized work stations that nurses and doctors run to and from wouldn't work anymore.
"We needed to come up with an alert management and a desktop management environment that would allow our users to move freely about such a large work area," Kull said. "And make sure that they were in constant contact with the patient, with the patient's needs and with the patient's monitor."
The solution was healthcare virtualization.
Although Parkland utilized several technologies to make this happen, one of the most important was VMware's Horizon Enterprise, Airwatch and vCloud Suite which allowed them to create a virtualized desktop environment, Kull said. Using VMware allowed for a roaming desktop profile for each doctor and nurse in Parkland, as well as a centralized management environment. It also implemented workstations where a user can simply tap their badge on a sensor on the workstation and their desktop -- including whatever apps are open and where they left off in those apps -- would appear.
"This has created an environment where physicians are spending more time focused on the patient, far less time focused on logging in and out and opening applications, and making sure that they're closing the computer to ensure that there's a high level of security," Kull said.
Desktop virtualization means only logging in once
Matthew KullCIO at Parkland Health & Hospital System
Kull explained that when a doctor or nurse comes into the hospital for work in the morning, they walk up to a computer -- any computer -- they tap their badge on the sensor, the computer prompts them for their login credentials, they log in and a session is created that will last for the next 24 hours.
"Upon that creation of that session, that is their desktop for the rest of the day and it resides on a server in our data center," Kull said.
As the doctor or nurse moves around the hospital --"from zero client to zero client," as Kull puts it -- they tap their badge on the sensor at the workstation they're about to leave and they walk to another room with another computer, tap their badge again and "up comes the screen, within one second, of exactly where they left off," Kull said. "So there's no re-logging in throughout the day; the only thing that's happening is they tap when they walk up to a client and they tap their badge against the sensor when they walk away from it."
Benefits of healthcare virtualization
Healthcare virtualization provides multiple benefits, Kull said. But, at Parkland, he's noticed that it's helped when it comes to the patient experience and saving time.
"If you think about what happens when a physician would historically walk into a patient room in a standard environment, they would walk into the patient room, say hello to the patient, turn away from that patient, log in to a computer that's in the room, bring up Epic, bring up whatever ancillary technology or applications are required, whether they're going to look at a third-party lab result or they're trying to view a radiology image," Kull said. "While they're bringing up all these applications, they're not engaged with the patient; the patient is waiting."
At Parkland, healthcare virtualization has changed this interaction because physicians only have to enter their login credentials to various applications and systems once. Then, in every room they enter and at every computer they use from there, they simply need to tap their badge.
"They're never taking their eyes off the patient; they're consistently engaged," he said. "It's not until they actually need to look at data in the EMR that they are looking away from the patient."
Kull believes this has greatly improved the patient's experience.
In addition to this, Kull said healthcare virtualization has helped each physician at Parkland save approximately 15 minutes per day because the need to log in to various applications and systems and find where in those applications and systems a physician left off multiple times throughout the day has been eliminated.
"When you have a hospital with 900 beds and … many physicians that are in and out of patient rooms all day, that 15 minutes per provider over the course of a year translates to hundreds of hours of more patient time as opposed to computer time," Kull said.
Virtualization adds a layer of security
Healthcare virtualization also brings added security to the table, Kull said, because, first, all protected health information (PHI) is stored and kept in Parkland's secure data center. Second, it allows for segmentation of the various connected devices in the healthcare organization, and, third, using zero clients at the workstations makes desktop support much easier.
Kull explained that instead of storing patients' PHI on any of the thousands of workstations throughout Parkland, it is all stored in their secure data center.
Furthermore, virtualization allowed Parkland to "segment and create a smaller subset of our environment through virtualization software as opposed to hard networking equipment," Kull said. "Being able to carve out our clinical environments from non-clinical environments certainly has an opportunity to reduce risk."
Kull said this is helpful when it comes to segmenting medical devices from other environments within the healthcare organization. Especially given that attackers are beginning to focus on medical devices as entry points, he said.
"Being able to segment medical devices outside of our clinical data environments, being able to segment our data stores and our data warehouses from potential breach through other areas of our environment, is certainly where we're putting our focus now that we've created what we believe to be [a perfect] desktop environment," Kull said.
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