Matt Douglas, chief enterprise architect at Sentara Healthcare, uses virtualization technologies to support thousands of employees working from home.

Jun 30 2020
Digital Workspace

Virtualization Efforts in Healthcare Support a Massive Remote Workforce

Safe and scalable tools allow employees to work from anywhere without sacrificing quality care or exposing valuable data.

As the coronavirus pandemic gathered steam in early March, health systems around the country braced for a predicted surge in critically ill patients. But there was also another challenge to address: Enabling nonessential staff to safely work from home.

Sentara Healthcare was ready. 

The Norfolk, Va.-based organization had begun exploring the possibilities for remote work using virtualization tools earlier this year — insight that proved invaluable amid an unexpected public health crisis. 

“We were fortunate because we were actually prepared,” says Matt Douglas, chief enterprise architect at Sentara, which employs more than 30,000 people across 12 hospitals and more than 200 outpatient sites in Virginia and North Carolina. “We had everything in place to go remote right away.”

Their solutions: Windows Virtual Desktop, a desktop and applications virtualization service hosted in Microsoft Azure and available through Microsoft 365. Teams also use remote desktop services hosts on VMware vSAN, hyperconverged infrastructure software that extends virtualization to storage.

By using software to deliver network resources traditionally deployed through on-premises hardware, virtualization allows healthcare teams to perform important job functions — accessing medical records or delivering telehealth visits, for example — regardless of a user’s device or location.

Prior to COVID-19, Sentara’s IT teams were still in the pilot stage of determining how virtualization might help support remote workflows and save money. 

“So, when it hit, we just moved from that point-of-contact environment to a full deployment, and it all happened fairly instantaneously,” Douglas says. “Our call centers, our financial department, human resources, marketing — every nonclinician group we have. Within a couple of weeks, we’d sent thousands of people home.”

Virtualization Can Offer Centralized Support

Despite its newfound necessity, virtualization isn’t new. Many healthcare systems already have leveraged the technology to address hurdles such as increased security requirements, a shortage of skilled IT professionals and an ongoing need to cut costs. 

“It allows them to be more flexible,” says Ray Mota, CEO and principal analyst with ACG Research. “In a traditional office, you might have all these different appliances for security, load balancing, voice and other pieces. With virtualization, that support can be centralized, and that gives you the opportunity to be a lot more agile.”

At Sentara, IT teams have relied on vSAN and hyperconvergence (a software-defined infrastructure combining computing, networking and storage) for nearly two years, primarily to improve management of the computers clinicians use to access the organization’s electronic health record system.

“We could patch those devices, take servers out, bring them back in to expand the pool; all of that became very easy once we decided to virtualize,” Douglas says.

With virtualization, nurses and doctors could leverage the EHR system and other functions securely, no matter where they happened to be. After the pandemic pushed Sentara to mobilize a remote workforce, that existing groundwork set them up perfectly for home-based employees to access critical applications from their own computers. 

Douglas’ team also went remote without incident. 

“They’re not only safe working in their homes — which, of course, was our top priority — but their productivity is better than it’s ever been,” he says.

Strong Connections Make for Better Remote Work Experiences

Prior experience with virtualization has also benefitted Legacy Health

After a major snowstorm in 2017 prevented scores of staffers from getting to work, the Portland, Ore., nonprofit organization opted to ramp up several projects already in progress — including a systemwide rollout of Office 365 and a Citrix deployment facilitating access to their EHR system, which is supported by the Epic platform.

Isaiah Nathaniel, CIO, Delaware Valley Community Health
We can continue to provide high-quality services to our patients during this time when they need us the most because we have the bandwidth and the capabilities.”

Isaiah Nathaniel CIO, Delaware Valley Community Health

The move allowed “any provider to get into Epic from any computer,” says John Kenagy, senior vice president and CIO at Legacy Health, which employs 13,000 people across six hospitals in Oregon and southwest Washington. All that it required was for users to download Citrix Receiver, software that allows client devices to connect to Citrix’s desktop virtualization services (the product is now known as Citrix Workspace).

Still, most hadn’t done so before the pandemic. 

“Virtual capabilities had basically just augmented their regular work: They’d be at home and they’d want to check email, or they’d need to look up a patient’s record,” says Kenagy, who notes that a “meteoric” change happened almost overnight. “We went from 15 mph to 65 mph in a very, very short period of time.”

Key to Legacy’s success was a concerted effort by the IT team to guide staff logging in remotely for the first time. 

IT director Jeff Olson and his group developed a cheat sheet to help navigate Citrix connectivity basics. They also established a dedicated support line and a Microsoft Teams channel so users could troubleshoot in real time with IT administrators. 

“This really was an all-hands-on-deck moment,” Olson says. “Our focus became getting people up and running, because we knew that was going to be critical for the business.”

There's Long-Term Potential in Hyperconvergence

Maintaining business continuity in the eye of the COVID-19 storm was also top of mind for Isaiah Nathaniel, CIO at Delaware Valley Community Health

The private nonprofit, which operates eight federally qualified health centers in southeastern Pennsylvania and employs just over 300 people, didn’t have the infrastructure to handle a mass shift to telehealth and remote work

LEARN MORE: Get advice from healthcare leaders for business continuity during the pandemic.

“The challenge for us was how to scale our operations,” says Nathaniel, whose team purchased the software-defined infrastructure solution Nutanix AHV before the pandemic, but only began using it once the crisis began.

“Migrating to Nutanix was a big deal because it gave us hyperconvergence,” Nathaniel says. “For me, that’s what tipped the scale — the fact that you can have virtualization down to the storage layer.”

The enterprise-level hypervisor (software that creates and runs virtual machines) offers integrated virtualization capabilities that include core virtual machine operations, resource scheduling and live virtual network management. 

Learn how Sentara Healthcare is making the most of its virtualization strategy.

Deployment was fast and easy. Delaware Valley migrated to Nutanix over the course of a weekend in mid-March, and at least 75 percent of the organization’s employees were equipped to work from home by Monday. 

The result compelled Delaware Valley leaders to meet via teleconference to discuss the road ahead. 

Their consensus: Even when staffers do return to their offices and more patients seek routine appointments, telehealth and telework will remain a central component of care delivery thanks to virtualization. 

“We began rewriting all of our policies, all of our procedures and all of our IT requirements,” Nathaniel says. “We can continue to provide high-quality services to our patients during this time when they need us the most because we have the bandwidth and the capabilities. This is the new normal; there’s no way we’re going back.”

Photography by Jonathan Timmes

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