Transcript of a BriefingsDirect podcast from VMworld 2011 on how a large health-care organization is using the cloud and virtualization to put vital data into the hands of employees.

1. VMworld Case Study: CharterCARE Health Partners
Leverages Cloud and VDI to Aid Digital Records Management
and Regulatory Compliance
Transcript of a BriefingsDirect podcast from VMworld 2011 on how a large health-care
organization is using the cloud and virtualization to put vital data into the hands of employees.
Listen to the podcast. Find it on iTunes/iPod. Sponsor: VMware
Dana Gardner: Hello, and welcome to a special BriefingsDirect podcast series coming to you in
conjunction with the VMworld 2011 Conference.
I'm Dana Gardner, Principal Analyst at Interarbor Solutions, and I’ll be your
host throughout this series of VMware-sponsored BriefingsDirect discussions.
[Disclosure: VMware is a sponsor of BriefingsDirect podcasts.]
Our next VMware case study interview focuses on CharterCARE Health
Partners and how virtualized desktops and thin clients are helping with digital
records management and healthcare industry compliance and privacy
requirements.
We'll learn how Rhode Island-based CharterCARE has embraced private cloud and virtual
desktop infrastructure (VDI) to support its distributed, 579-bed community-based health system.
The organization operates the Roger Williams Medical Center, Our Lady of Fatima Hospital, and
several other caregiver facilities. We'll hear how the tag team of
private cloud and VDI has provided better data management, security,
reliability, and regulatory auditing capabilities.
The infrastructure modernization has also helped CharterCARE move
to electronic patient records and has helped improve their processes for clinicians.
Here to dig into more detail on the CharterCARE IT infrastructure improvement story, is Andy
Fuss, Director of Technology and Engineering at CharterCARE Health Partners. Welcome to the
show, Andy.
Andy Fuss: Well, thank you very much. Good to be here.
Gardner: I'm interested why data management has been a primary driver for you, as you've
looked to adopt both the private cloud and VDI. What is it about the data equation that’s made
this look like a good solution for you?
Fuss: We need our data to be accessible everywhere, at every time, no matter what provider is at
what facility. Even from an engineering and technology standpoint, no matter what system

2. analyst, what network engineer may sit down wherever they are to troubleshoot an issue, we
need that common set of tools.
Common repository
We need the common repository of information for a caregiver. That would be the electronic
medical information. It could be the x-rays, the slides, the CT scans, or the
results that were dictated by a radiologist. Whatever it might be, that
information needs to be available in a flexible manner and delivered directly to
the deskside experience.
Now, if that’s a desktop, it needs to be on a regular PC, but if we're talking
about a tablet, we need to accommodate the tablets that people bring in and
have come into the facility and are now actively being used, or zero client
technology.
We have all the different technologies and pieces. We're trying to promote these pieces to be used
and trying to be flexible with accommodating them and getting people to the information that
they need so they can take care of the first priority, which really is patient care.
Gardner: Tell me about the extent of your distributed campus and environment. Not only are
you dealing with many different types of data and many different endpoints, but you're also
distributing this across a multitude of different environments.
Fuss: Absolutely. We have two main acute hospitals that we're dealing with. We have a nursing
home, a cancer center, outpatient care offices, and several different offices all around the
community. So the data truly needs to not be resident in one spot.
We also needed to have a secured disaster recovery (DR) facility, so that if anything were to
happen to our primary data center that’s on one of the campuses, we could flex seamlessly over.
So building a cloud for us made total sense. That cloud hovers between one of two data centers.
One is at one of the acute facilities, and then 100 miles away in another state, we have another
data center. Our cloud roams between the two, and we have data flowing from each area.
So the connection really is no longer about where it’s physically located by any restriction. It’s
more of just gaining access to the internet and being able to make connections. Where you're
accessing that data from or where you're using it is seamless to the end user and provides a solid
customer experience.
Gardner: You've used the term cloud, and as you know, many people have differing descriptions
and definitions for cloud. When you talk about this moving back and forth across facilities that
really to me gets as the heart of what I think of as private cloud. Maybe you could fill us in. What
do you mean by private cloud in this case, and why is that important for you to manage it in such
a dynamic way?

3. Fuss: Private cloud, by its very definition, would be that data just roams around between one
place and another. So the cloud is just out there.
I tell people to look up in the sky. You might see a rabbit in the cloud, you might see a
Volkswagen Bus, or it might be a turtle dove, whatever the image that comes to your head is.
That’s really what the data is. It’s just moving, but you can always see it and it’s always there.
Same principle
Take the same principle. We're doing the daydreaming and making animals in the sky as you did
when you were a kid laying in the middle of the field. You know where the data is. You know the
restrictions of where the cloud rolls to. So the security factor is there.
But you also know that you can access it, whether it be from your home, whether it’s from
McDonald’s, if you're stopping for a Happy Meal with the kids and you need to access some
critical piece of data, or whether it’s anywhere else that you are. That data is always ready,
always available, always online, and always secure.
One of the primary concerns for our electronic medical record is that it’s patient data, financial
data, PCI, and HIPAA. All the different compliance standards that we need to abide by are all
satisfied with the ways that these machines are locked down, by the way the cloud is moving,
and where we allow it to move to.
There are a lot of people who can embrace different types of clouds. You've got hybrid clouds,
private clouds, public clouds, all with different offerings. For us it made sense to do a private
cloud. For others, it may make sense to do hybrid type cloud.
As we move towards the future, I can see that we might be able to offload some of our services
towards the public cloud. As we increase the size of some of our data and we have patient care
cut over to the side, there might be some other data that does not follow the same guidelines. We
can put that into a secure public cloud and attach everything.
VMware is coming out with those tools and using those tools to make that kind of continuation
project possible to look at. We're very excited about some of the initiatives that we've seen at
VMworld -- the vCloud Director, with security, the different layers built into that that could
make some of the public cloud usable for us for specific applications.
Gardner: Some folks deal with security and think of the public cloud only, but it sounds as if
your private cloud has allowed you to improve security, gain control, and deliver this data as
needed to a variety of devices not in a stateful, but in a stateless way so that you can control the
access. Correct me if I am wrong, but it sounds as if private cloud to you means better security?

4. Fuss: Oh, it does, most definitely. I'm no longer worried about the endpoint device walking away
from us. I'm not worried about theft of an individual device, because the device has nothing more
on it than some connectors to get somewhere.
When we were first embracing zero client technology in a lot of places, we did some studies. We
talked to some different people who had already embraced it. One particular hospital I spoke to
said they had on video someone stealing a zero client device, perhaps thinking that they had
stolen some great new utility tool for home, a new PC. They were all excited.
They also have them on video, bringing it back the next morning, because they couldn’t do
anything with it when they got to their house. Using cloud, using the technologies that ride in the
cloud, like VMware View and access to the data through VMware View, really helps to lock
things down and it helps to prevent things.
No data leakage
In the past, somebody could have taken a PC, and let’s say that PC could have had metadata on
it or could have had some files on it that were saved in someway. It was comical to hear that
story from another person who was in a similar situation as us, where there was no data loss or
data leakage, even if that device had never come back. So the cloud really has tightened things
down for us.
Gardner: And the cloud wouldn’t have the security benefits if it weren’t for the VDI and that
zero client benefit. So are they separate to you, are they intrinsically linked, symbiotic? How do
you view private cloud and VDI -- separate, distinct, together? What’s the relationship?
Fuss: They're definitely together. They have to be together. In my opinion, it’s what makes sense.
We want to see the data tight. We want to see the integration tight. We can have a cloud where
the data roams back and forth, but the connection into the cloud actually uses that data.
As I sit here on a device, a personal device at the office that is connected to my virtual desktop
instance, this device doesn't even have to be on my network. I'm utilizing a public network that
we have here at the hospital system and I've connected into my virtual desktop. I have full
accessibility. I'll flip over here in a few minutes when I go into another meeting. I'll bring my
iPad with me, another personal device, and I'll be connected right to that same virtual desktop.
So the cloud has allowed me, with View, to seamlessly move between all these different devices.
I no longer am tied to something. I'm no longer tied to a specific physical location, a physical
anything. I really am completely mobile. I can work anywhere at any time and have that same
common set of tools.
It doesn't matter if I'm working out of the DR site. I should no longer call it disaster recovery. I
should call it our second data center because even though it really is 100 miles away, I can still
sit there and work all day long just like I'm anywhere else. That ability is really the value that
using a cloud and using View gives you.

5. I want a physician in his office, out on the road or wherever they might be, at home, in a practice
have access to that same data and have a similar look and feel every time they connect from
whatever device. That's what these solutions that we've opted for have provided for us.
Gardner: So the synergy between the private cloud and the VDI has provided you with better
data management security adhesion and compliance requirements adhesion, and now you're
talking about DR. So this is yet another snowball-like benefit from adopting this particular kind
of infrastructure. How far into the DR phase are you?
Fuss: We're quite a bit down the road. We've implemented SRM part of VMware. We were
excited about the changes coming in SRM 5, but we still have our current implementation
running. We can flex our domain controllers over to the other data center. We actually do have
some servers running out of there -- hot like I've said. We'll be running all of our mail servers out
of their -- hot -- very soon.
Break away from location
But the whole procedure, the whole concept, everything that we're doing allows us not to focus
on location, and that's the big thing. We break away from location. So where is the data center? Is
it going to be affected by the next hurricane coming up the East Coast? Well, if we have a fear of
where the hurricane is, we can move our data center 100 miles inland. Or if we think that inland
is going to be more affected, we can keep it in Rhode Island, which is right on the ocean.
So we have that ability, and nobody knows where that data is other than the IT department. We
know it's within the system, within the security, but nobody would ever notice the difference or
question where the data is running or residing. They might ask, and we could tell them, but
nobody says, "Wow, that's slow" or "I can see a difference." None of those kind of calls comes in
as the cloud flexes.
Gardner: At VMworld, you've had a chance to look over View 5, I assume and the PC-over-IP
benefits there; is that something that’s in your pipeline?
Fuss: Absolutely. We’re blessed to be in the VMware 5 beta test user group and we’re loving
what we see. We like the performance. The PC-over-IP expansion is amazing. They’ve written a
great protocol there with their partners, and that is the technology that’s going to continue to
drive the reinvention of the desktop.
We’ve gone through the reinvention of the desktop a few times in my career, from somewhat
dumb terminals to smart terminals to client server. We seem to be making our way back to where
we’re keeping our data safe in data centers and in silos. We’re giving people a great end-user
experience to give them a full PC feature-set. We’re doing it all securely and we’re doing it all
with products that integrate seamlessly with one another, and that’s really the goal.

6. We want the user to sit down and feel comfortable with whatever technology they use, and to
have a way to take care of our patients that need our help and take care of what other important
administrative business they may do, so we can keep moving forward.
Gardner: Let's look at how the end-user experience is benefiting you. When your clinicians
have the opportunity to reach this data through a variety of different endpoints regardless of
where they are, how have they adapted to that? How have they made that a part of an improved
process or adapted workflows that take advantage of that. Has that benefited the organization
appreciably?
Fuss: We can already see the expansion, the use of that technology in different areas. We have
some physicians with iPads working throughout the facility, visiting the patient’s bedsides,
looking at their charts, all that kind of flex room is great.
I've seen it in our administrative areas, our human resource officer using iPad remotely. We’ve
had our Chief Information Officer using an iPad, using a PC at home, and connecting through the
View client to her machine.
We’ve gotten support not just from forcing the technology out there, but by people asking for the
technology. That’s how you can tell you have a good product. People asking, "Can I be moved to
this new product, because the flexibility of my supervisor, director, whoever is using is what I
need."
Hit a home run
If the director calls saying, "I need this employee to have this flexibility," you know you've hit a
home run with the technology. I haven’t had anybody call asking for another PC at another
location for the same person to work. I have people calling saying, "I really need to get them
onto this technology as soon as it’s possible, because it's made this employee so efficient. I need
to do that for everybody else."
So the benefits are there, and they’re just growing now, as it's integrated and being used more in
the clinical areas. We’ve seen some growth recently. Even our pharmacy staff is starting to carry
iPads around, when they’re doing inventories of some of the medication machines and being able
to get that information right there, but on a device that’s secure. If they were to leave it behind,
nobody could connect to anything, and that data all sitting safe inside the data center.
So the adoption is there, the benefits are already there, and it's just growing and growing. Every
time I turn around, we’re bumping another 50, another 75, virtual machines, into another pool of
machines for a new purpose, and that’s the expansion that I keep wanting to encourage.
Gardner: That’s a very intriguing story, and I'm really impressed with how you've been able to
take these modernization activities for infrastructure, put them into real-world use, and expand
that very rapidly throughout your organization.

7. We’ve been talking about how virtualized desktops and thin clients are helping with digital
records management and healthcare industry compliance and privacy requirements. We’ve been
discussing this with Andy Fuss. He is Director of Technology and Engineering at CharterCARE
Health Partners. Thanks so much for your time and insights, Andy.
Fuss: Thank you. Pleasure being here.
Gardner: And thanks to our audience for joining this special podcast coming to you in
conjunction with the 2011 VMworld Conference.
I'm Dana Gardner, Principal Analyst at Interarbor Solutions, your host throughout this series of
VMware-sponsored BriefingsDirect discussions. Thanks again for listening, and come back next
time.
Listen to the podcast. Find it on iTunes/iPod. Sponsor: VMware
Transcript of a BriefingsDirect podcast from VMworld 2011 on how a large health-care
organization is using the cloud and virtualization to put vital data into the hands of employees.
Copyright Interarbor Solutions, LLC, 2005-2011. All rights reserved.
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