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Managing the Healthcare Cloud

A Cloud Standards Consumer Council paper titled, “Impact of Cloud Computing on Health Care” states, “There is substantial growth in demand for health care services because of aging populations, the increasing prevalence of chronic diseases and comorbidities. Concurrently, there are cost pressures stemming from the need to do more and higher quality work with fewer and more costly resources and also reduced revenue.”  Cloud providers, both internal and public, must be abstracted from a user perspective.  Deploying and managing the cost and operations across providers becomes the primary concern for enterprise health care IT.


It all starts with deployment of resources

Health care is unique in our method of deploying and consuming applications.  While many health care organizations are developing applications, nearly all applications deployed by health care IT are commercial, off the shelf (COTS) products.  This often leads to the mistaken belief that automation is not necessary in health care.  When deploying a new health care application, especially when it is an Electronic Medical Records (EMR) major version, much of the deployment time is spent creating the environment, including compute, storage, and networking.


Efficiencies in application deployments are not limited to internal private cloud.  Leveraging the Advanced Programming Interfaces (APIs) provided by public cloud providers, vRealize Automation can deploy across multiple public and private clouds.  Test and development environments may be provisioned in public cloud resources for short term projects, while longer term production workloads may be deployed within the private datacenter, spanning multiple public and private clouds, all with a single request for resources.


Cost as a user metric

Health care IT is often considered a cost center, something needed, but challenging to fund.  Projects often fund infrastructure, but have limited means of tracking the actual value they are receiving from the acquisition.  When an application shares infrastructure and needs additional resources mid lifecycle,  reallocation is often required.  This creates significant problems with right-sizing the environment during project planning.


VMware’s vRealize Business enables health care IT to provide actual cost to project teams.  Costs can be gleaned from existing environments to forecast new projects.  For applications which can be deployed on public clouds, cost comparison can happen in real time with forecasting to determine the lowest cost provider meeting the requirements.  This also provides real time costing on migrating applications and resource reclamation as that becomes an option.  Application owners are presented with the cost they could avoid, by shifting unused resources to new projects.


Automating operations

When automating bad process, the speed of bad process increases exponentially.  One of the most often overlooked challenges in health care IT is the need for a better operational process.  Deploying applications and looking at cost is beneficial, but a majority of the operational cost and struggle occurs in the shift from design and deploy to operate and maintain.  Runbooks and instructions are helpful, but many of the operational tasks are repetitive, and tedious.  


Adding resources, predictive performance monitoring, and capacity management can be easily automated using VMware’s vRealize Operations with Log Insight.  Many functions can become self-documenting as lower level functions are abstracted.  Fewer operational staff are then required to manage the system; enabling more focus on projects and less “keeping the lights on”, providing greater value back to the organization and, most importantly, to the patient.


Managing the health care cloud is a challenging proposition, made all the more difficult by the changes in reimbursement models, changing technology, and technical debt.  Automation is one of the best ways to solve many of these problems but it must be treated as a complete solution, and one which accounts for future expansion and changes to technology.  By building out a solution with complete lifecycle management, cost, and operational efficiencies, Health care IT can provide a superior provider and patient experience, while continuing to remain relevant in an ever changing world.


New @ VMworld: Healthcare Industry Workshop & Showcase

How will the cloud, together with the modernization of the data center and ubiquity of mobile devices impact providers and patients? What does the future of healthcare look like?

Join us for two VMworld firsts:

  1. A half-day, pre-conference healthcare industry workshop on August 27
  2. An industry showcase featuring interactive healthcare demos, August 27–31

Pre-Conference Healthcare Industry Workshop

As part of our commitment to solving healthcare business challenges using VMware technology and services, we’re increasingly teaming with industry experts, solution providers, and associations. Meet them and your peers for keynotes and robust discussions about:

  • What healthcare projects are most successful in the cloud
  • Implementing a layered approach to healthcare security
  • How IT is changing to address millennial care providers
  • The vision driving the future of healthcare and how innovation improves the cost, quality, and delivery of patient care

Interactive Demos in the Industry Showcase

During the show, interactive demos will be on display during our industry showcase. See the latest in virtual networking and AlwaysOn Point of Care solutions. Discover IoT and AR innovations for improving patient care.

Learn more today to participate in this unprecedented opportunity to network with peers and industry experts during our Healthcare Industry Workshop and Showcase at VMworld 2017.

John Muir Health Extends Digital Clinical Workspaces to Its Provider Community

How does a large and diverse healthcare organization see VMware Workspace ONE, VMware Horizon virtual desktops, mobile devices and the cloud as transformative solutions to cut costs, deliver a digital workspace, simplify application access and management and generally delight their users? VMware’s James Millington recently sat down with Bill Hudson, former chief healthcare strategist at VMware and now associate CIO and VP of IT Operations at John Muir Health, to discuss approaches to healthcare tech. John Muir Health is a not-for-profit organization in Northern California, with a network of more than 1,000 physicians and close to 6,000 employees. Here are some highlights from their discussion.


wide ipad consult


James Millington: John Muir Health is planning to expand its existing VMware Horizon desktop environment and make the move to VMware Workspace ONE. What were the drivers for that decision?

Bill Hudson: As much as possible, we want to remove the technical obstacles in healthcare, and focus on supporting patient care. More and more of our environment is becoming cloud-enabled. We’ve already invested in virtual desktops and RDS applications across the organization in clinical spaces. Our clinicians are increasingly using cloud-based tools – for education, care, and quality. As these applications move to software as a service instead of on premises, how do I create a platform – a single workspace for my clinicians and my administrative organization – where they can work together using all these kinds of applications, in a single integrated pane that provides a unified experience? We looked ahead and said, Workspace ONE will be the tool that can help us do that. We’re bringing all those pieces together into that single place that makes it easy and intuitive for the user to be able to access whatever they need whenever they need.


“Workspace ONE provides that single pane of glass to get the best application experience whether I’m on a phone, a tablet or a 42-inch monitor. It will let me use the right device for the right task at the right time.” Bill Hudson, Associate CIO and VP of IT Operations, John Muir Health


Millington: We’re absolutely seeing a move towards mobile devices in healthcare. What are you seeing as the main use cases for mobile devices?

Hudson: Mobile devices are officially ubiquitous; if you’d asked me six or seven years ago about doctors or nurses inserting their own devices into the healthcare workflow, the definitive answer would have been no. Today we have clinicians that are embracing technology and pushing us, we’re seeing a huge drive towards the consumerization of IT – not just on the patient’s side, it’s happening on the clinician’s side as well. Clinicians want to use tools that they’re familiar with, that they already have; they don’t want to carry two or three devices. They also want access to everything and, we need to enable that for them in a way that is secure and manageable – we need to be able to manage that experience.

John Muir Health works with many physicians in the community. We don’t own their practice or have a formal IT relationship with them but, through our Community Connect program we extend our Epic instance, as well as related tools, so they can provide care for their patients. I look at Workspace ONE as a tool that we can use to extend the John Muir Health brand while extending our workplace applications to these remote users. Workspace ONE enables them to use the devices they already have, that they’re familiar with and, it gets my team out of the day-to-day business of managing our tools on those devices.

Millington: Tell me more about your vision for the day-to-day experience of Workspace ONE.

Hudson: It will help us look at our work differently. We’ve been very desktop focused in the past. Workspace ONE will provide a way to be more application- and workflow-focused – that will be a really good thing.

We use a core set of administrative and clinical apps on a regular basis. Ten years ago, it mattered what kind of workstation I was using, what operating system. Today it’s not about the operating system, it’s about what you’re trying to accomplish, what work that you’re trying to get done – work on a spreadsheet or care for a patient. It’s also about providing the optimal experience with any given application based on who you are, where you are and, what kind of device you’re on. Workspace ONE will provide that single pane of glass to deliver the best application experience whether I’m on a phone, a tablet or a 42-inch monitor. It will let our clinicians use the right device for the right task at the right time.

Millington: Is John Muir Health acquiring more mobile devices?

Hudson: Traditionally, we did provide the devices today, where it makes sense, we’re moving to a bring-your-own-device model, of course keeping in mind concerns about patient privacy and patient safety. Home health devices are a great example of the kind of device we will continue to own and control. However, increasingly, we’re getting out of the device business and empowering our clinicians to use the technology and devices they’re already familiar with, that they already own.

Millington: We’ve seen a gradual increase of trust in the cloud in healthcare. What’s your perspective on cloud adoption in healthcare?

Hudson: We’re looking at this problem in three layers/frameworks that will enable us to use cloud safely and securely. The first is security, the second is interoperability and data exchange standards and , the third is management and orchestration. So, when we connect to cloud providers, we need to make sure we do it in the most standard way possible, that it’s secure, that we’re exchanging the right data and that ultimately it meets the needs of our clients.

Millington: Identity must be a key part in making that simple for users to access these different sources.

Hudson: Absolutely, identity and authentication are two huge components of that. We must make sure that we are letting the right people in, they’re accessing the right things, we’re doing it in an industry-aligned security model and most of all, it’s simple for the clinicians – minimally impactful.

Millington: VDI has been a great fit for clinical desktops due to the time savings that can be realized when a provider is having to log in from different workstations 50 or 60 times a day. Now that the cost of VDI is at or below that of a physical machine, and web-based and SaaS applications are becoming more prevalent for all users in a healthcare organization, do you think the back-office operations and administrative functions can receive benefits by switching to VDI?

Hudson: Across healthcare IT we continually look for ways to manage costs and provide better services; there’s no reason we shouldn’t take the VDI model that’s worked so well for clinicians and move it to that back-office environment which, more often than not, is way less complicated. We’re also at the point that we can no longer support multiple devices for a single user – a single mobile device should be capable of meeting almost every use case – VDI can support multiple monitors, multiple user capable tuned for a specific user’s needs that can provide better uptime and more effective software management than traditionally deployed devices. We have the same cost and administrative challenges for PCs in the back office as we do in the front office. It’s silly for us not to think about them in the same way.

VMworld 2017 Session Voting Open

This year VMworld session voting occurs earlier than usual.  For many of us, customers, partners, and employees alike, this is our chance to get our ideas out in front of others, and share our successes, struggles, and even a few laughs.  For those of you not familiar with the process of submitting a session, I would encourage you to check out this post, and consider partnering with your local VMware team to share your story, or ideas.  While healthcare is unique and spans many different functional areas, many of the challenges and architectures are similar across environments.

The voting has changed slightly this year, we have now moved to a system of 1 to 5 stars with 1 being not recommended, and 5 being must see.  More votes means more focus on healthcare, and more focus on healthcare is good for all of us.  To find the healthcare specific sessions, go to https://my.vmworld.com/scripts/catalog/uscatalog.jsp?search=healthcare&showEnrolled=false.  You will need to log in with your VMworld account, selecting the best healthcare related sessions.  Please get involved and make sure you vote for as many of these sessions as you find relevant.

One final note, we will again have several of our healthcare team working in the VMworld Hands on Labs.  We are always excited to see customers and friends visiting us.  Please come join us, ask us questions, share your ideas and challenges, grab a whiteboard, and test your skills with our lab staff.  VMworld is a time to spend with peers and friends, help us make it a great experience, get the best sessions in, and come and be a part of the fun.  See you there.

Himss 2017: Modernization Security Mobility Innovation, and Socks

Himss 2017 was an engaging conference for the VMware team.  Conversations with curious customers and conference attendees, enthusiastic booth staff, and exceptional speakers provided significant opportunities for networking and learning for all.

Kevin Mitnick wows the crowds at the VMware Himss Booth.


VMware hosted “THE WORLDS’ MOST FAMOUS HACKER” – Kevin Mitnick – in our booth doing live hacking demonstrations and drawing attention to some of the ways hackers penetrate physically and socially.  Mitnick’s way of explaining everything in relatable terms resonated with the record crowds.  His live demonstration of hacking reminded the observers of the need for vigilance and a defense in depth approach.



In the booth, VMware showcased the unique narrative enabling healthcare Modernization, Security, Mobility and Innovation.  With the Microsoft Hololens virtual reality glasses managed and secured by VMware Airwatch, healthcare practitioners were able to get a glimpse of the future with a secure training experience.  Amazon’s Echo was used to obtain metrics from vRealize Operations, providing a new way to consume data, and manage environments.  VMware’s LIoTA agent demonstrated managing Healthcare Internet of Things devices, providing data in real time with full analytics.



Finally, one of the most unforgettable moments was our VMware healthcare socks giveaway.  Visitors to the VMware booth were treated to a pair of our inaugural VMware healthcare socks.   We asked wearers to post their sock pictures along their #HITJourney, seeing pictures next to pools, all around the conference, and even in cars on the way home.  This was one of the most lighthearted parts of the conference; talking, laughing, and having fun with other attendees, and building great connections.  If you were able to make the conference, please post pictures of yourself in the VMware healthcare socks with the hashtag #HITJourney on your social media.  If not, ask your Healthcare Account team about how you can show off a pair of your own VMware healthcare socks, join our #HITJourney.

Check out more about Himss on our Twitter and Facebook pages, and while you are there, tell us where your #HITJourney is taking you.

VMware helps hospitals make the most of IoT

By Mimi Spier; VP Internet of Things, Marketing, Business Development and Strategy at VMware

‘Connected Health’ is a rapidly growing aspect of healthcare. According to a 2016 survey by the Healthcare Information and Management Systems Society (HIMSS), 52 percent of US hospitals use three or more connected health technologies and 47 percent plan to expand their use in the next few years.[1]

Connected Health will feature prominently at this year’s HIMSS conference and exhibition, HIMSS17, to be held February 19–23 at the Orange County Convention Center in Orlando, Florida.

There will be an exhibition area dedicated to the Connected Health Experience focused on the Internet of Things (IoT), telemedicine, remote patient monitoring and next generation technologies, and more than 40 conference presentations on all aspects of connected health.

As a global leader in cloud infrastructure and secure business mobility VMware is well placed to support the connected health movement and the adoption of IoT in healthcare.

At HIMSS17 we’ll be making an important announcement to help hospitals securely manage, monitor and maximize usage of their connected health devices.

We’re partnering with VizExplorer, a leading provider of operational intelligence solutions to combine VizExplorer’s advanced analytics and visualization tools with Vmware products that manage, monitor and secure IoT from the edge to the cloud.

Our joint solution will enable hospitals to gain greater benefits from their myriad connected devices. They will be able to better understand how and where they are being used with visualization tools, real-time analytics and reporting. They’ll be able to increase the productivity of medial staff, improve equipment utilization and provide better patient care.

Come and talk to us at HIMSS17 and learn more about we can help you deploy, secure and manage IoT: from the edge to the cloud. You’ll find us in booth 3661.

The 2017 HIMSS annual conference and exhibition will bring together 40,000+ health IT professionals, clinicians, executives and vendors from around the world. You can find full details here.

[1]  http://www.healthcareitnews.com/news/connected-health-experience-himss17-feature-more-50-tech-vendors



Win an Amazon Echo Dot from VMware

Put your HIT knowledge to the test and be entered to win a new Amazon Echo Dot during our weekly random drawings.

Here’s how to win:

  1. Follow us on Twitter (@VMwareHIT)
  2. Reply to our weekly question with the correct multiple choice answer
  3. Tag your response with the hashtag #HITJourney

***Only those with the correct answer will be entered to win!***

Winners will be announced via @VMwareHIT on February 3rd, February 10th and daily winners February 13th – 17th.

By following us, not only will you find out about our daily Amazon Echo Dot contests, but you’ll also get up to the minute details on the happenings at the VMware booth #3661 at the HIMSS17 Conference in Orlando, Florida:                      

==Highlights of the VMware Booth @ HIMSS==            

  • Kevin Mitnick, the World’s Most Famous Hacker LIVE!!!
    • Kevin will open your eyes to the vulnerabilities in most networks through live hacking in our booth!
    • Take home a signed copy of his new book, The Art of Invisibility, releasing February 14th
  • Experience how VMware Healthcare Solutions can help you:
    • MOBILIZE your providers and engage patients -Walk through “A Day In The Life of a Healthcare Provider” enabled by VMware solutions -Deliver a platform for innovation in patient engagement, provider education and the healthcare internet of things
    • PROTECT patient data and safeguard your brand -Secure your organization from lateral threat movement across the datacenter and desktops using VMware NSX -Identify every connected device in your network in 15 seconds
    • MODERNIZE your infrastructure *Reduce complexity and grow with VxRail and Cloud Foundation -Optimize vRealize and Care Systems Analytics to plan and control your expansion. Move to the cloud with VMware and our cloud partners, including Amazon Web Services.

Don’t forget to follow up @VMwareHIT

See you in Orlando,
VMware Healthcare Team                        

No Purchase Necessary.  Limit one entry per person.  This offer is valid only in the United States.  Entries must be at least 18 years old.  VMware makes no warranties in connection with this promotion and VMware expressly disclaims any implied warranties, including, without limitation, any implied warranties of merchantability or fitness for a particular purpose.  This offer is valid from February 26, 2017 to February 17, 2017. Winners will be chosen by drawing on February 3rd, February 10th and daily drawings on February 13th – 17th. Entry need not be present at HIMSS to win.

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Understanding the cost of healthcare IT

There is sometimes a perception by healthcare technology users that virtual machines are free, and resources are unlimited.  We, as healthcare IT professionals, have a responsibility to properly set expectations with our application and financial teams, and to show them the true costs of the projects they undertake to help healthcare providers.

Cost of the private cloud

Cost of the private cloud

A key component of understanding private cloud deployments is cost.  Management consultant Peter Drucker stated, “What gets measured gets improved”.  This is incredibly true when looking at the components of a private cloud infrastructure.  Providing application and finance teams with raw output of utilization metrics gives a very limited value.  Virtual CPU counts and memory utilization are meaningful only in the context of someone who works with the infrastructure.  

Breaking down the costs by different applications or teams provides cost evaluation on the existing environment, but more importantly cost projections on future projects.  Using the vRealize Business tool from VMware, the cost of a new or upgrade project can be calculated with a much greater degree of accuracy than previously.  This becomes more important in healthcare IT environments with the number of vendor applications, many of which tie into the electronic medical records system.  By providing the cost data in advance, project budgets can be determined at the beginning of the process, and vendor expectations can be projected.

Business management for the cloud
Business management for the cloud

As healthcare applications evolve, where those workloads physically reside becomes less important.  Application owners can request the required resources, and the infrastructure team can then use the vRealize Business Business Management report to determine the most cost effective placement for the workload.

Once workloads are placed, regardless of location, budgeting becomes important.  Looking at costs over time, and comparing the cost of various internal or external infrastructure, allows teams to make better decisions on short and mid-term growth.  Capital expenditures can be delayed based upon financial modeling.

Healthcare financial management for IT


Healthcare Financial Management for IT


Many healthcare financial teams dedicate a number of resources to tracking costs and budgets within IT.  With the growing size of many health systems, managing these budgets centrally can become a monumental task.  Rather than providing yet another application to the finance team, vRealize Business can provide the healthcare financial team a view into the same data, in a format they can readily consume.  By using the same data, and feeding it into their existing systems, or better yet using the reports provided, finance and IT can work from the same numbers.

For long term budgeting, this is particularly important.  By bringing in previous costs, and projecting new projects, IT and Finance can take a longer view of the actual costs of IT.  Providing this cost back to individual application and patient care teams allows them to make more efficient choices with their allocated budgets, providing better outcomes to their constituents.

Cost modeling for the healthcare IT environment should not be an arduous task.  It is often times the best way to help application teams set appropriate budget and expectations for their customers.  By providing accurate and actionable financial data, healthcare IT can be an innovative partner in the patient care process.

Cloud Foundation: A Healthcare Infrastructure Baseline

cloud foundation

Cryptographer Ralph Merkle said, “The new technologies that we see coming will have major benefits that will greatly alleviate human suffering.”  Making those technologies available to care providers is the mission of healthcare IT.  VMware’s Cloud Foundation is the baseline for the healthcare infrastructure.  Healthcare IT must provide infrastructure to internal customers as a utility service, reducing friction between healthcare IT and their internal customers.

What is Cloud Foundation?

Deploying infrastructure is often a manual and tedious process, adding little or now value to the healthcare provider without applications.  Because infrastructure, in some form, is necessary to provide the application, any repetitive work should be automated.  Significant time is spent in most environments designing, deploying, and managing the infrastructure.  

Cloud Foundation aggregates the core infrastructure products of vSphere for compute virtualization, vSAN for storage virtualization, and NSX for network virtualization.  Enabling standardized deployment and management of the core infrastructure stack enables healthcare IT to focus on higher level tasks such as providing applications and moving new projects into production.

Abstraction of Hardware

Healthcare IT is in the business of providing applications to those who provide patient care.  For many years we spent far too many man hours managing hardware systems, focusing on interoperability of various components.  In the modern healthcare datacenter, abstraction of the hardware layer allows far more supported hardware permutations, and more highly available systems.  By abstracting the hardware, maintenance windows become less of a risk, and hardware refresh is simply a matter of moving workloads off a device.  Because all control is done in the software layer, decisions can be made closer to the point of origination, whether that is network routing or storage cache.  

From a deployment perspective, the hardware simply becomes a platform.  Select the supported hardware platform, and deploy the software defined infrastructure components as a single install.  This does not, however, negate the need for highly skilled and specialized teams; it simply shifts them to a more software focused role in managing the infrastructure at a higher level.

Abstraction of Cloud

The cloud is becoming more acceptable in healthcare.  The true value to the cloud in a healthcare environment is being able to place applications in the environment which provides the greatest value.  Redeploying an application each time it moves between datacenters or cloud providers does not provide application portability.  Rather, having the same software infrastructure stack across each cloud provider, including your internal private cloud, provides a simple method to move workloads without concern of compatibility.

The biggest pull of the cloud for many healthcare organizations is the ability to quickly test or run short term workloads.  Basing this infrastructure off of Cloud Foundation allows the healthcare IT teams the assurance if the workload becomes longer term, or if it needs to be brought back in house, the same standards in the internal datacenter will be available with the cloud provider.  Security in the cloud can be enforced with the same policy-driven approach that is required internally.


VMware’s Cloud Foundation is the baseline for the healthcare infrastructure.  Spend less time managing physical infrastructure, spend more time improving patient care; making technology work for the provider.  Technology continues to enable better patient outcomes.  As we become more reliant on technology in healthcare, we must find new ways to simplify the delivery of that technology.

Recent VMware Product Updates

To a care provider from a century ago, today’s healthcare would likely seem like science fiction.  VMware continues to innovate, enabling Healthcare IT to improve patient care through technology.  Over the past several months, we have introduced a number of improvements to existing products which provide new functionality; and a new deployment and maintenance model.  

Cloud Foundation

Standards in healthcare are critical.  We need look no further than the operating room checklists to see examples of how we work to simplify everything into a series of standard steps.  With the launch of Cloud Foundation, VMware creates a similar series of standards for healthcare IT.  vSphere for virtualized compute, VSAN for virtualized storage, and NSX for virtualized network and security provide the building blocks for the healthcare datacenter.  

In healthcare IT, with so many systems revolving around the electronic medical records system, maintaining a standard becomes a challenge.  Cloud Foundation provides a standardized deployment and patching of the core software defined infrastructure products.  A single sku for purchase, and a single deployment and patch for the core software defined infrastructure.  We are no longer required to manage dependencies on the core infrastructure side.

VM Encryption

Virtual machine encryption has long been a request of many healthcare security teams.  While there are third party solutions, native VM encryption provides a policy driven security solution.  Encryption is completely agnostic to the operating system, encrypting the components rather than using an agent.  Because it is policy-driven through the vCenter, encryption can become part VM lifecycle management, much like network and storage policies.  Policies can also restrict locations the VM may be moved to so that critical systems are always on systems capable of encryption.

Managing encryption raises a number of potential concerns for security teams and regulators alike.  To simplify management, while providing for separation of duties, VM encryption is designed to use an existing key management system, with additional roles in vCenter to separate administrators managing virtual machines from those managing encryption.  With the rise in identity theft, especially from medical records, encrypting critical systems answers security concerns and brings them into the virtual environment as a valued team member.

vCenter Appliance

In many healthcare IT environments, vCenter has become a critical application.  As more systems become managed through vCenter, high availability, virtual systems updates, and accessibility become expectations.  Since the introduction of the vCenter appliance, additional features have been moved toward a more integrated model.  With the latest update, native replication provides an active-passive cluster with a witness node.

Update Manager in vCenter is a critical component, especially in healthcare, to ensure that the virtual infrastructure remains current.  Including this within the vCenter appliance, there is again a single system to maintain rather than multiple components.  User experience and accessibility has been improved with the new HTML 5 interface, incorporating the latest update manager components.  Additionally, a new rest based API makes vCenter more accessible.


VMware continues to innovate, enabling Healthcare IT to improve patient care through technology.  This is a very small summary of some of the new announcements.  Please consult your local VMware Healthcare team for a discussion on some of the new innovations and how they can benefit your organization.