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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.

VMware RDS Hosted Applications Announced as Target Platform for Epic 2015

VMware Solution Passes Wide Range of Usability, Performance, and Scalability Tests for Application Delivery

VMware RDS hosted applications is now included in the Epic 2015 Target Platform list.  Target Platform helps guide healthcare organizations to choose validated architectures and platforms for the delivery of the electronic medical record (EMR) vendor’s software. VMware RDS hosted applications becomes the seventh VMware product to be included in the Target Platform list. Customers who currently use VMware and Epic can now utilize VMware’s software-defined data center platform and the VMware Digital Clinical Workspace™ to host, deliver, monitor, and manage their EMR from the data center to the point of care, helping to ensure high-quality patient care and improve outcomes at lower costs.

Historically, application remoting has been how most healthcare IT organizations have chosen to deliver the EMR. Since VMware Horizon was added to Target Platform in 2013 for delivery as an installed application directly in the virtual desktop, there has been a shift away from virtualizing just the application. Installing within the gold image for clinical desktops brings efficiencies in terms of hardware, licensing, support, and maintenance, helping to free up IT resources and budget. But there are absolutely still use cases where delivering just the application, and not the full desktop may be the better solution. This includes Community Connect use cases, remote coders, and potentially remote access for providers (although in all of these use cases the provider or coder may require other applications as well which would make the full desktop the better choice).

VMware customers now have a complete, single validated platform that delivers efficiencies in management, monitoring, and of course, cost.


Outside of Target Platform requirements, VMware is actively engaged with joint customers in testing and supporting VMware App Volumes™ to further simplify application updates and deployment for both the virtual desktop infrastructure (VDI) and hosted application delivery models. (healthcare organizations can contact their Epic representative for more information) Moreover, there is strong uptake in mobile applications being delivered and secured through VMware AirWatch®. Earlier this year, Epic enabled the central configuration of Haiku, Canto, and Rover through the AirWatch console.

Reasons to deliver VMware healthcare solutions include:

  • A Single Complete Platform for Delivering EMR functionality: VMware solutions for healthcare have achieved seven Target Platform designations from the EMR provider for components across the data center to the point of care
  • Support for any Kind of Desktop and Application Delivery: VMware provides a broad choice of desktop, application, deployment, and mobility scenarios
  • Simplified Management and Analytics: VMware vRealize® Operations for Horizon® and VMware Care Systems Analytics™ for Epic extends monitoring visibility into infrastructure and provider workflows, providing complete visibility into performance across all aspects of the EMR platform and supporting infrastructure
  • Transformational Clinical Mobility: VMware AirWatch, part of the VMware Digital Clinical Workspace, provides healthcare IT with a single platform to manage all devices through a variety of ownership models. Bring-your-own (BYO), hospital-owned, check-in/check-out, and single application modes provide flexibility in how devices can be managed and used
  • Enhanced Security: VMware and its robust partner ecosystem helps reduce data theft, malware, and ransomware threats while improving overall security postures
  • Simplified Storage: VMware Virtual SAN™ is a software-defined storage solution that enables healthcare IT teams using Horizon VDI to deliver better performance for much less cost

Details and documentation for the testing and support for VMware RDS hosted applications can be found on User Web, Epic’s customer portal.

Find the latest healthcare stories from VMware

Application Centric Storage in Healthcare

Datacenter storage costs can be as high as 50% of healthcare capital budgets.  Storage Policy-Based Management (SPBM) saves capital cost, providing a higher level of performance at a more manageable cost.  Clinicians rely on the VMware platform for their applications, which are required to deliver care.  It is our responsibility to continuously provide a better platform and improve patient experience.

Traditional and Tiered Storage Models


In the traditional storage model, logical storage volumes are created.  In most storage arrays, this is a single type and speed of storage. For many years, storage and virtualization teams focused on moving workloads between storage tiers, and overbuilt the storage to provide expected performance.  This is similar to a hospital where patient rooms may be awkwardly shaped with unusable space for patients and providers.  From an architectural perspective, this is less than ideal.

With tiered storage, the ability to move workloads within an array was introduced.  Sometimes a single virtual machine might be spread across different types of storage within the storage array.  This was more efficient, but requires high performance storage for the entire amount that may need to be available based on projected workloads.  You never want to be in a situation where the high performance tier is undersized.  Compare this to an emergency room; where providers should be productive and not idle, keeping in mind there needs to be enough providers on site in case you have a high volume of trauma patients.

Storage Policy Based Management


Storage Policy-Based Management (SPBM)  introduces the idea that the characteristics of the storage should be presented to the virtual environment.  From the time the virtual machine is created, it is given a set of characteristics, or policy it should have, such as snapshots, replication, performance tiers, etc.  The system can then ensure appropriate placement, and if the characteristics on a specific storage system change, the virtual machine is then moved to meet the required policy.  If the administrator or the system make a change to the policy, the virtual machine is moved as needed to maintain compliance.

SPBM is similar to how a patient might be moved through a hospital during his/her stay.  When he/she comes in through intake, he/she is given a patient identification, which is essentially a policy.  The patient is placed in the appropriate area for his/her needs; trauma patients to the emergency room, surgical patients to the surgery center.  As needs change, the patient is moved; post surgery, recovery, etc.

From a storage perspective, we have now introduced the storage system to vCenter.  They are sharing information, and working together, much like a patient care team might work together to give that patient, the virtual machine in this case, the best possible care.

Software Defined Storage Versus Storage Arrays


Applying this to healthcare data centers; how does this look when we are faced with so many array vendors, and now with Virtual SAN, VSAN from VMware?  Simply put, SPBM, is independent.  Placed in front of a Virtual Volumes enabled storage array, it will look similar to a VSAN datastore.  SPBM is the engine which sits between the storage and the virtual machine to ensure policies are complied with.

This is akin to the hospital administrators who are often between the providers and the patients.  Rarely do they need to interact, but they are there making sure the experience is a smooth one, and the details are seamless.  Without the administrators, the rooms might not be cleaned as thoroughly, and food services may be less efficient.
VSAN is production ready, and a number of large enterprise healthcare organizations are taking advantage of it today for their most critical workloads.  In nearly every case, it is not a matter of software defined storage versus array based storage, but rather determining the right storage for the right application.  VSAN can easily coexist and provide an additional layer of performance storage at a significant cost savings, and a path to better provider experiences and patient care.

Storage Policy-Based Management saves capital cost, providing a more efficient storage management model for Healthcare IT.  Stuart Gerson, a former acting Attorney General, stated, “Changes in the status quo threaten people who are wedded to the status quo.”  As we work to improve patient care through technology, it is imperative that we find new ways to solve problems, and keep costs down.

How hospitals can protect against phishing while embracing remote work with VMware and Imprivata

Guest Post by Dan Borgasano, Imprivata

Healthcare users are increasingly mobile. Now their secure two-factor authentication options are mobile too. VMware and Imprivata have further strengthened their partnership by integrating Imprivata Confirm ID for Remote Access into VMware Digital Clinical Workspace  environments. The solution enables VMware Workspace ONE users to use the same Imprivata DEA-compliant authentication methods they use to login and also e-prescribe securely and conveniently while working remotely.


Why healthcare has unique authentication needs:

As remote work becomes increasingly popular in healthcare, secure remote access poses challenges for security-conscious organizations. Healthcare organizations are becoming high profile targets for phishing, whaling, and spear phishing attacks that trick healthcare users into revealing their passwords to hackers. Hackers then use those credentials to mount ransomware attacks, steal patients’ personally identifiable information, and sell Social Security Numbers and other sensitive identity data on the black market. In response, healthcare organizations are introducing strong two-factor authentication requirements into their remote workflows.

Two-factor authentication requires users to provide two forms of identification to access patient data. These forms, or factors, should include a combination of two of the following:

  • Something you know – such as a username and password combination
  • Something you have – such as a mobile device, a soft token, or a hard token
  • Something you are – such as a fingerprint scan or other biometric identifier

Two-factor authentication can significantly improve security. According to the Annual Report to Congress on the Federal Information Security Management Act, up to 65 percent of cybersecurity incidents could have been prevented with strong, two-factor authentication. However, many of the traditional two-factor authentication methods, though secure, pose additional challenges for remote users because they can be clunky, inefficient, and inconvenient. These kinds of user experience challenges pose unique problems in healthcare environments in which users often need to authenticate as quickly as possible in order to provide time-sensitive care to patients.


How Imprivata and VMware address healthcare’s unique authentication needs:

Imprivata Confirm ID for Remote Access addresses the unique challenge of balancing security and convenience in healthcare settings by combining strong authentication with convenient workflows for all healthcare enterprise users, including clinicians, administrative staff, affiliates, and contractors. Confirm ID integrates directly with VMware Identity Manager and critically, offers a broad range of  DEA-compliant authentication options, including Hands Free Authentication, push token notification, fingerprint biometrics, SMS messages, and conventional software tokens. By providing a DEA certified encryption algorithm, providers are able to use the same workflow for their initial login to access patient information as well as any subsequent EPCS order signing workflows simplifying training keeping providers focused on patients, not technology.


By providing flexible, user-friendly two-factor authentication options in mobile virtualized environments, Imprivata and VMware provide the technology healthcare organizations need to out-smart hackers and avoid becoming the targets of the next high-profile healthcare security breach.

To learn more about how Imprivata Confirm ID can complement your VMware Horizon environment and protect your organization from phishing attacks, visit www.imprivata.com/remote-access or download our latest whitepaper https://www.imprivata.com/resources/whitepapers/choosing-right-two-factor-authentication-solution-healthcare

VMworld 2016 Healthcare Sessions and Events

Every year preparing for VMworld is a mad race to get the best content in front of customers, partners, and fans.  This year at VMworld, we have a number new sessions, and also will be introducing our first VMworld Healthcare Hands on Labs.


Breakout Sessions and Quick Talks

Breakout sessions are a great way to not just learn new information but to have the chance to talk to the field and product teams who work hard to bring VMware solutions to our customers.  Quick talk sessions are more of a business or non-technical session, a great place to get new ideas, bring up some of your own thoughts, and meet some of the thought leaders around the technology space.


Date/Time Title Description
Sun, Aug 28, 4:00 p.m.-4:30 p.m. Running Epic with VSAN – Modern Architecture for Healthcare [STO9988-QT]
This not to be missed session will show how moving to a software defined storage model in the healthcare environment is not simply technically valid, but also frees funding for new project, and more importantly improves provider experience and patient care.
Mon, Aug 29, 1:00 p.m.-2:00 p.m. Modernizing Healthcare IT with the Public Cloud, Your Way! [HBC9164] Public Clouds offer immense agility and flexibility and can improve patient care, come to learn how vCloud Air addresses the needs of healthcare, the primary use cases that we address, and best practices for getting started.
Tue, Aug 30, 5:30 p.m.-6:30 p.m. Protect the Edge: Secure IoT and Medical Devices [EUC7864] Connected healthcare is a vision of a fully integrated system. Learn how VMware and AirWatch are securing the edge to help our customers.
Wed, Aug 31, 1:00 p.m.-2:00 p.m. Achieving Unprecedented Availability, Security, & Cost Savings with VMware Virtual SAN and NSX [STO9157] Baystate Health, has leveraged VMware’s Software-Defined Data Center (SDDC) to meet ever increasing demands for high availability and security while facing IT budget cuts. Learn about these solutions than from someone who has hands on experience designing and implementing them.
Thu, Sep 01, 1:30 p.m.-2:30 p.m. Healthcare: The Security Awakens [SEC8081]
When looking at security in healthcare, it is often forgotten that security is not a single product, or set of products, but a design principle.   From standardized deployment through micro-segmentation and configuration management, security requires input from everyone in the process.

Customer Panels and Hands On Labs

In our customer panel category, we will have several customers on stage sharing their struggles, and more importantly how they are improving healthcare IT.

Date/Time Title Description
Tue, Aug 30, 11:30 a.m. – 12:30 p.m. Group Discussion: Hyper-convergence in Healthcare with Mike Feld [CTO10748-GD] A group discussion on current trend in healthcare datacenter infrastructure to a tightly bound integration of storage, computing, and networking elements resulting in a hyper-converged platform. Addressing the financial implications, scalability, resiliency, and alignment with a variety of modern infrastructure solutions.
Tue, Aug 30, 1:30 p.m.-3:00 p.m. Securing and protecting a Healthcare VMware Horizon environment with VMware NSX Workshop [ELW-1741-USE-1] For the first time at the VMworld Hands On Labs, we will have Healthcare specific labs, with an expert led session by the creators of the lab, David Coleman and Kevin Moats.  This is an opportunity to get hands experience and meet the experts.
Thu, Sep 01, 12:00 p.m.-1:00 p.m. Zero Downtime, 20K+ VMware vSphere 6 Upgrade [INF8374] Learn from a team who has done one of the largest vSphere 6 upgrades in a healthcare IT industry.


Healthcare Events 

     No VMworld is complete without networking events and the fifth annual Healthcare Reception.  Join VMware Healthcare and Imprivata, Monday August 29th from 6-8pm at the Mandalay Bay, Aureole Swan Court for a time to talk with the experts, and to network with your peers in a relaxed environment.

The VMware healthcare team will also host two birds of a feather sessions, one on Monday August 29th from 12-2pm will be for Epic customers, and the second Tuesday August 30th from 12-2pm.  During these private lunches, attendees will share best practices and discuss tips and tricks with their fellow peers running Cerner or Epic systems. Joining the conversation will be VMware Healthcare experts and Cerner and Epic representatives.  Click here to register for all three events.


One of the best parts of VMworld is the networking, come by the booth, come to the events, join us at the sessions and networking events, and make VMworld a valuable time for you to grow your career, and your knowledge.  We look forward to seeing you there.

How VMware NSX Secures and Simplifies M&A

Why Use VMware NSX for Mergers and Acquisitions?

The trend of mergers and acquisitions (M&A) is on the rise for healthcare providers and it is not slowing down. As MACRA is defined over the next few years and reimbursals are modified, we will see continued pressure to consolidate healthcare organizations. There will be impact to staff, systems, and to all aspects of the combined organizations. Merges take quite a bit of time to integrate systems and migrate patient data to a central system. What is the opportunity cost of that time to patient care, outcomes and the bottom line?  Often times clinical outcome improvement initiatives, capital investments and improving operational efficiency is delayed until leadership decides how they will integrate the organizations. This plan will then fully consume resources, budgets and can take years to complete. These organizations are still working in a legacy hardware based approach and thought process.  Shifting to a software defined architecture approach allows for a simpler and quicker integration of organizations and shared services.

What if there was a way to leverage all existing network and data center hardware between the acquiring or acquired, maximize data center efficiency and utilization across locations, while maintaining security policy and control? Yes, you can with VMware NSX!  NSX can be a significant part of your M&A plan and the run book for on-boarding ambulatory centers, doctors offices, urgent care centers, and other healthcare services.  You are now moving to a streamlined and automated policy based methodology.

UntitledThe use cases demanded by the business determines the features and services you need  to enable with VMware NSX.  You can be selective in what steps you take, your on-boarding approach and where you need to apply specific solution components. Once integrated in your environment, NSX software defined capabilities are always available for insertion and immediately available to serve the business requests.  For example, in a virtual desktop deployment or for a business critical applications architecture you can enable security based only aspects with micro-segmentation, where it is not required to enable the NSX software defined networking capabilities. You can also start with software defined networking but I will discuss why you may want to secure your workloads prior to connecting to unknown entities.


The NSX Methodology for M&A

The following four categories layout an approach for an M&A methodology supported by VMware NSX.  The order is important since we are leveraging the NSX platform to reduce risk while providing the ability to move faster than other approaches.  I have outlined the ASCII (Assess, Secure, Connect, Integrate/Ingest) approach below and I will elaborate on each section in future posts.


Screen Shot 2016-06-28 at 9.26.30 AMliveflowAssured security enables organizations to adopt and operate distributed security models such as micro-segmentation, across data center, across organizations and the cloud. Most organizations do not have the details of application flows between the various application modules.  All flows including East-West data center flows need to be analyzed and categorized.  These categories will be the basis for security groups where security modeling and object based security policies are created to achieve a Zero Trust security model for  your most critical EHR and PCI applications.


isolationSecure the applications with micro-segmentation where workloads are locked down in a zero trust model, while you apply policies around the components of an application, specific workloads, a security quarantine tag, or apply a policy for an entire organization. Policy enforcement moves from static line entries to object level based automated enforcement. You define the policy and the workloads are dynamically protected. The data center is now protected inside the perimeter where your own internal data center infrastructure and east-west traffic is secured.  This lessens the risk that a compromised system integrated during the M&A process can infect your existing systems.  As part of the M&A process you can extend this protection into the acquired data center prior to connecting them to your network.  This allows you to add another level of security by micro-segmenting the acquired data center and gaining greater visibility into their environment.


Screen Shot 2016-06-28 at 4.03.33 PMA secured data center allows you to connect to other data centers or offices with a reduced attack footprint while mitigating and reducing risk.  IP connectivity is all you need between hosts wherever they are located.  There are multiple options to connect at the Layer 2 or Layer 3 level allowing workloads to move without requiring an IP address change.  In many cases there are legacy applications with hard-coded IP addresses where you need to maintain or extend the same segment across data centers.  You can leverage the Internet while waiting on data center interconnects without adding hardware.   You can even start to look at SD-WAN alternatives and reduce your monthly recurring WAN costs. Applications can move freely to where the resources are available.  You can spin up all the components for the connection without needing additional hardware by using NSX Edge Services Gateways.  Now you are turning a manual and tedious process into a run book you have created easily replicated using NSX.


Screen Shot 2016-06-28 at 4.01.23 PMYou have a securely connected environment and you can use it with the great efficiency. Workloads can be moved or migrated to the primary data center as virtual workloads or as a P2V migration. You can start to offer high availability at the application layer while offering BC/DR services much easier than before. You now have planned migration options as well as the ability to spin up on demand security policies, distributed routing and switching and software load balancing from a centralized management platform.  QA, Test, and development platforms can co-exist on the same physical hosts using distributed firewalls, distributed routing and NAT.  The barriers where workloads are segmented between racks or data centers no longer exist and your utilization of assets will increase.


Healthcare organizations can leverage NSX for increased speed, agility, and security, in addition to deep CapEx and OpEx savings. The M&A conundrum using a software defined network and security provides significant savings over traditional physical integration approaches while ensuring application connectivity and data security.  Reducing risk, simplifying the operational component of mergers and driving down costs are all powerful benefits of NSX.

Please also see Securing and Simplifying M&A with NSX by Blane Clark.

Value through commoditization – parallels across devices

Value is such an important topic in Healthcare these days. As we transition from fee for service to fee for outcomes and our technology and data requirements per patient increase, stretching the output of technology capital spend is critical to success: funds not spent today can be invested in expansion and new care solutions.

There is so much hardware that is common out there across most datacenter technologies. The value comes from the software. Since hardware represents the largest portion of many solution investments, minimizing hardware cost is essential.

Inside every cell phone is a nearly identical processor. That’s what the chip and associated peripherals were designed to do, so it emerged as the standard even across chip manufacturers. The differentiation in the market whether you use Android, iPhone IOS, or Windows Mobile is mostly the packaging and software. Now you cannot change the OS on your phone, but those are really design and licensing choices rather than technical limitations. The point is: the difference in the experience comes almost completely from the software.

Inside your laptop is an Intel processor and interface chips from a handful of common manufacturers. Whether you use a Mac or a Windows/Linux machine from a host of vendors, the underlying hardware is almost identical, and it is possible to change the OS: you can run OSX on non-Apple hardware, and you can run Windows or Linux on a Mac (though it will require some skills and time). The difference in the experience comes from the software.

I shopped for a new wifi router this morning. There are a dozen brands, but inside almost all home routers are similar processors and a small handful of wireless chipsets. Nearly all of the functional differentiation comes from the software. There is router software that will work across different brands (dd-wrt, openwrt, tomato), which allow you to change what capabilities are available on the same hardware. ASUS makes a router for $300, but Trendnet makes one for $200 that has EXACTLY the same hardware specs. If I’m going to run the same software regardless of the brand, why would I pay more?

I ordered that $200 router, and it’s going to give me the most service per dollar.

The same thing is true in the datacenter: inside all of those branded servers is an Intel processor and peripherals from a handful of vendors. Whichever compute vendor you choose, once you put vSphere on it, like hardware of different brand delivers exactly the same outcomes. So if you want to maximize your output, you must choose the value hardware.

These trends are happening all over the datacenter:

  • Compute is commodity: it delivers resources to applications, and like hardware delivers like performance.
  • Storage is emerging as a commodity: no matter what storage you buy, it delivers capacity and performance — space and speed, and there’s a clear trend to maximize Terabytes and IOps per dollar.
  • What about network ports? Ports deliver throughput for data. That’s it. They all follow codified standards of interoperability. Prices per port vary as much as 60% across vendors for equivalent performance. Is a network port really different vendor to vendor? Many have already concluded that a port is a port.

So where does this leave us? It leaves us tasked with doing the math.
For all technology decisions, there are value calculations we can do:

  • Compute: Cost per VM
  • Storage: Cost per Terabyte, Cost per IOps
  • Network: Cost per port

Once we have those, then we can consider whether there are other decision criteria like reliability or support. And then we can make a truly informed value-driven decision to make the best use of our capital and operating dollars and allow the savings to be repurposed for our real pursuit: better care.

Monitoring Electronic Medical Records systems using Care Systems Analytics

Downtime in healthcare costs on average nearly $10,000 per minute.  Event correlation in Electronic Medical Records EMR, systems prevents downtime, saving money, and providing a better patient experience.  Healthcare IT professionals must understand the total cost of downtime for the EMR systems they support.  Measuring and understanding these costs prevents outages, in turn preventing costly troubleshooting and resolution.



Most EMR Vendors provide real time, or near real time, monitoring of some type.  This works well when there is an administrator sitting at the screen monitoring, but doesn’t provide the big picture.  Trending data in an EMR system, helps to identify what normal operations look like, as well as what historical trends have been.  By understanding what is expected behavior, trending over longer periods of time, using more data points, the healthcare IT professional is equipped to prevent problems.  Using Care Systems Analytics for this trending helps to prevent false positives which tend to create alert fatigue, presenting only actual potential problems based on real data.  This assists application and infrastructure teams to look at the data to plan project upgrades, and project future capacity needs.

Screen Shot 2016-06-01 at 2.50.55 PM

End to end analytics

Most technology monitoring tools are great at monitoring one thing.  In many healthcare IT organizations, each group is separated into “silos” based on discipline.  When there is an issue with an application, it often requires a representative from each discipline to look at their individual system for the problem, with the event correlation between systems being done as a human interface.  This makes for a tedious process, looking at different data and trying to determine a reason for the problem.  Care Systems Analytics gives a single end to end view of the system from application to the hardware.  Correlating the data and putting it into context allows each group to look at the same information, see the same problems, and quickly address them.  Root cause analysis can be determined by bringing application and infrastructure data together and displaying what events lead to the problem.


Dashboards and reports for everyone

We live in a data driven world.  Everything is generating information, we are at a point of near information overload.  Those in the healthcare IT industry, responsible for maintaining the systems that store, manage, and secure that data have a compelling need for data to be relevant and aggregated.  In healthcare minimizing the lag time of the technology being used enables providers to move more quickly, spend more time with patients, and drive a better patient experience.  By providing healthcare operations staff reports on login times, and workflows; dashboards to alert on potential “hot spots” which could lead to outages, or slowness, IT can become a part of the patient care process.   For application owners, especially the EMR system administrators, reporting and dashboards allow them  to optimize the system.  This not only shows the value they bring to the team, but allows them stay ahead of problems, and demonstrate they are complying with healthcare regulations on EMR usage.  For infrastructure teams, rather than taking calls about an application being slow, dashboards can cut research times, and reports can be customized for clinical units to gain confidence that their IT departments are providing them the best possible experience.



Event correlation in Electronic Medical Records EMR, systems prevents downtime, saving money, and providing a better patient experience.  Benjamin Franklin once said, “An ounce of prevention is worth a pound of cure”.  As EMR update projects are undertaken, or simply as the need is identified, healthcare IT departments should be checking with their local VMware healthcare team.  Get more details today on how Care Systems Analytics can provide the best possible care for patients, and the best possible experience for those providing that care.  

Hyper-converged makes Fujifilm Synapse PACS a Snap

Fujifilm’s Chief Storage Architect Esteban Rubens is delivering a very compelling architecture to improve patient care by simplifying their imaging platform using hyper-converged infrastructure powered by VMware SDDC.

By using VxRail, new systems can be deployed in minutes, the ongoing maintenance is greatly simplified, and the total cost of the system is lower than alternative architectures.