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Let Storage Sell Itself

Michael Mickey, MBA- CTO, LCMC Health

It’s no secret, over the last few decades storage has been a hard sell, as with most of the IT technology in your datacenter. Whether you use storage for PACS, file server, mail server virtualization or a virtual desktop environments, selecting and funding storage architecture should an easy sell. Through my career, I’ve often focused on business value and with the hefty cost associated with a new/replacement storage architecture, I found that I’ve always had to tie a storage purchase to a new strategic implementation such as PACS or EMR. What value is Storage bringing to your organization and how are you selling it is key to acquiring a best of class storage architecture instead of settling on one that meets your budget constraints. How do you tie it to the business and easily measure its impact to the revenue and patient care.

Physicians all too often remind us of how many clicks it takes to care for a patient and how IT affects their day to day care for patients. Purchasing the right storage for your environment can bring measurable wins to your Physicians. Time-to-chart was a metric that I’ve used for over the last 5 years to measure what in the datacenter impacts the time between when a physician walks up to a workstation and actually see patient data. There are many things that impacts this time. Organization that does the bare minimum will see a 2 minute time to chart experience. Those that invest in technologies such as tap-and-go and spend significant efforts on the details such as Login Script Maintenance and Master Image (VDI) tuning will see sub minute logon times. Finally, the organizations that truly have a sound understanding of the ins and outs of their infrastructure components, such as Active Directory and LAN/Wan will see time to chart metrics between in the 40-55 seconds time frame. The huge benefit from my experience has been the storage, application delivery, and compute in the datacenter. If you are running a VDI platform and have accomplished these hefty task of incorporating this technology in your environment, put the icing on the cake by evaluating how your storage architecture affects your physician environment.

Whether it’s Netapp, Pure, Hitachi, or any other vendor that taught an all flash array specifically for VDI, none of them has had the greatest impact on my time-to-chart improvements such as the extreme IO product from EMC. If you plan to purchase additional shelves for an existing architecture or you have budget for a new SAN, spend the time to measure the environmental variables that impact the physicians time-tochart. Below is an illustration that fits most VDI environments and it has been my experience that these items impact your VDI Time-to Chart performance:

Many Technologist utilize kiosk mode in their physician desktop area which I believe presents a security vulnerability and cannot be used as a fair comparison to a logon sequence (Time-to-Chart)

 In my analysis, I’ve found that storage plays a hefty part in the performance of VDI environments. It is the single largest item that impacts the Time-to-Chart performance. If your storage architecture is not healthy or cannot meet the boot storm demands or the day to day operations of a VMWare View environment, your physicians are experiencing a 25% increase in logon times and desktop response. If you are using a storage environment for your VDI environment that is utilizing spinning disk versus Flash HDD by a product such as EMC Extreme IO, It’s time for a conversation with your EMC Representative

The Sell

In most scenarios’ introducing or tuning your storage environment can shave 30 seconds (25 percent) off of a physician’s 2 minutes log-on. As many times a physician logon to a VDI device in a healthcare setting, from floor to floor, patient room to patient room, this is single piece provides a huge savings in their Timeto-Chart and which gives them the ability to treat more patients. Provide for better security buy doing away with the KIOSK mode entirely.

I have built VDI architectures utilizing many storage solutions and have the initial logon down to 5-7 seconds by focusing on all of these components but more importantly the storage architecture.

Not only for the purposes of VDI, the extreme IO all flash array is a supported technology for the major HIS systems such as CERNER and EPIC. If you look at the illustration above the second biggest impact is Application Delivery. Having your Cerner or Epic Cache databases housed on an Extreme IO can play a huge part in not only in overall Time-to-Chart, but application performance. I’ve seen Jobs in both a Cerner and EPIC environment that took 4-5 hours to run, down to 10 mins buy introducing an EMC Extreme IO.

Storage can play a huge part in most application scenarios, while focusing on improving physician satisfaction, it plays are large part in the Virtual Desktop Environment that is #1 tool of delivering the EMR/HIS to the physician. By utilizing Time-toChart metrics, you can better manage your physician experience and focus on the impactful components in the VDI environment. It affects their access, physician satisfaction with IT, security and overall user experience of the physician.

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