How Sunrise Health Region is Improving the Clinician Experience Through Secure and Simple VDI - Update Sheranga Jayasinghe Director of IT Sunrise Health Region Keith Olshewski Senior IT Analyst Sunrise Health Region Sponsored By:

About Us 1 of 13 regional authorities 120,000 people served 18 facilities 5,000 staff 2,700 devices 14 IT staff members

Current Setup (simplified) Provincial Citrix Farm Local Citrix Farm User

Challenges Centralized hosting of applications causing longer log in times (sessions between two Citrix farms) Multiple sign-in credentials Sharing of user credentials Required to log back in from one location to another Challenges in default printer mappings; printers do not change based on location

Solution: Patient First Desktop Virtualization Retrieve clinical information faster Encourage greater use of EMR Increase security with two-factor authentication, stop non-clinicians from accessing information – Use of Smart Card +Pin, eliminate the long user name and password Introduce Single Sign On Provide anywhere, anytime access to information from any device (“Follow Me Computing”) Simplify desktop management Reduce boot times, save energy with zero clients

Deployment Results - Then 530 Virtual Desktops (1000 users) 249 Persistent 281 Non-Persistent 92 Application Layers 1 Gold Windows OS layer 5 GB Disk Space per Desktop

Deployment Results - Now 845 Virtual Desktops (2000 users) 344 Persistent and 771 non-pers. (1115 current) 225 Persistent and 620 non-pers. (845 after opt.) 2 Gold Windows OS layers (1 after optimized) Projected 1500 VDIs for 3000+ users Est. 1 VDI for every 2-3 users 25% to 33% persistent; 66% to 75% non-persistent 1 Persistent and 8 Non-Persistent Pools 152 total layers used in production 88 unoptimized; 64 optimized After optimization complete will be 60 layers

Deployment Results - Now VDI Specs Before Optimization: 1CPU/2GB Mem After Optimization: 2CPU/4GB Mem Daily backup of Persistent Personalization (2 day retention) 5GB user space Weekly Unidesk Appliance and Layer backups Simple 1 CP -> 1 ESX Host -> One Datastore relationship 16 ESX Hosts in a DRS cluster; 3 new ESX hosts to be added

Our Clinical Environment AllScripts SCM – (Acute EMR) WinCIS – (Admission, Discharge and Transfer System) WinRECs – ( Transcription , CIHI stats system) RIS \PACs – (Philips \ Cerner – Diagnostic Imaging system) Accuro – (Clinician EMR) Microsoft Dynamics – (Financial Application) Microsoft Office 2007 Various Labeler and Scanners (Handheld and Desktop) Many custom one-off applications

Deployment Times Layer Creation + Testing: VDI Creation Simple/Average layer = 0.5-2 days Complex layer = 1-2 weeks (mostly trial and error/testing) VDI Creation 1 VDI can take 15-30min depending on complexity of the layers Multiple VDIs can be created at same time Ex: Our environment can create over 50 at a time

IT Staff Resources 2 Dedicated Technicians to research plan and migrate locations from workstations to WYSE devices + VDI. 2-4 Help Desk technicians (not dedicated to VDI) 3 Server Team Analysts (not dedicated to VDI) Troubleshooting (Average) Times Simple Issues: 15 minutes Medium Issues: 30 minutes Complex issues: ranges from 1 hr to 1 week or more depending on complexity

Why Unidesk ?

For the IT department Simplified the move from WinXP to Win7 and eventually to Win10 Centralized/easy method for testing, deploying and updating desktops/apps Reliable Baseline for every update Can easily wipe and restart updates. No mess like with uninstalls. Less variation in how desktops are configured making troubleshooting easier Break-fix for a desktop with Unidesk rollback done in less than 20 mins Can easily clear any user persistent data to return to baseline Simplified desktop management One Image \ Single layer reduces the update time for patches \ updates

For the IT department Ease of use Moving between application versions/OS updates Adding/removing applications Deploying changes to large groups of VDIs Upgrading Unidesk software Submitting logs Reporting/Analysis tool Very responsive and knowledgeable in both planning with Architects and troubleshooting with Support

For the CFO \ Finance department Single image – less storage – reduction in storage cost Increase productivity – reduction in end user “downtime” – User gets access to a new desktop or re-imaged desktop in less than 30 minutes compared to a week or so in the past Reduction in PC vs. Zero Client cost – The cost reduction was so high that we were able to hire two new full time IT staff members

For the End User Increase productivity - “Follow-me Desktop” allows reconnection from any device as well as bed side charting Reduction in end user “downtime” – User gets access to a new desktop or re-built desktop in less than 30 minutes compared to a week or so in the past Increase turn around for new application request. Consistent access \ experience across multiple desktop platforms. ( IOS, Windows, Android) – Same Shortcuts, app settings (Unidesk Personalization) Access to a full Virtual Desktop ( Unlike one or two virtual apps, the user gets access to the entire desktop, files, settings, apps, etc)

Why Imprivata? Determined to be the best fit based on Provincial RFP Highly Available architecture More user friendly than the Citrix SSO we used in the past Customize credential learning for most applications/logins Works with published application servers (ex: XenApp)

Why Appsense? Fits the “Follow Me” Desktop strategy. Ability to save/transfer users settings between computers Wide variety of tasks that can be performed at different stages Computer startup, user login, application execution… Set/Adjust a wide variety of settings Execute programs or scripts Set licenses, registry, GPO, map drives or other settings Create/copy files and folders

Challenges we faced with VDI….. Initial planning was not optimal Layer creation and documentation was not optimal creating issues troubleshooting Some Apps could not be virtualized due to software and/or licensing Focused too much on persistent VDIs Resistance to change from employees

What we have learned so far… Planning is key Keep things simple Avoid unnecessary pre-requisite layers Don’t join domain when creating layers unless necessary Avoid connecting devices (ex: USB) unless necessary Keep detailed documentation of layer creation/update steps Consistency: Templates are your friend Have proper test users for each application If you make a mistake during layer creation/updates, start over. Don’t uninstall your mistakes.

Try Unidesk in Your Cloud Thank you Learn more about our sponsors: www.appsense.com www.imprivata.com www.unidesk.com Questions ? Connect with Sheranga Sheranga.Jayasinghe@shr.sk.ca Try Unidesk in Your Cloud Connect with Keith Keith.Olshewski@shr.sk.ca