A Division of Entisys Solutions, Inc.
Children’s Hospital of Orange County - Case Study
Profile
Children’s Hospital of Orange County is dedicated to providing the highest quality of care, as well as offering
specialized programs and services to meet the individual needs of the children and their families.
Since its inception in the 1960’s, the hospital has provided the highest quality medical care to children. Its
regional health system includes a state-of-the-art main hospital facility, a secondary hospital, and five community clinics — plus over 100 additional programs and services. With admissions growing by 90% over the
last eight years, the regional facility is ranked as the 15th busiest children’s hospital in the country.
The Challenge
The hospital’s IT infrastructure runs Windows 2000 Domain with about 60 servers, 20 of which are Citrix
MetaFrameXP with AppSense software and 5 of which are Presentation Server 4.0. The main application in
use is the Cerner Application Suite, a leading healthcare IT solution, which doctors use throughout the day
to obtain information from various applications. The hospital’s medical staff also access email, job-specific
applications, and position-oriented content delivered via Citrix as well.
Thin-client terminals are installed in several nursing stations as well as in certain hospital areas for quick
access by staff. There are also a number of mobile thin clients on wheels that doctors or nurses can take with
them on their patient rounds. Users log into the thin client devices with a user account designated by hospital location, then launch Internet Explorer to gain access to the hospital’s internal Web Interface site, which
provides users with access to their specific application set. This offers a standard method of access for hospital users, which was especially important in enabling remote access for the staff from other hospitals or their
homes.
The problem: via the existing Web Interface, hospital staff waited an average of 30-45 seconds to get the
information they needed. In the demanding environment of the hospital, this process simply took too long,
and kept medical staff from spending their time on the most important thing – patient care.
The hospital set a goal to reduce the average login time to no more than five seconds. At the same time, the
hospital sought to utilize a new subset of servers to deliver this specific functionality not only to its doctors,
but to any users with a valid Cerner login. This would also help users who needed to use the Cerner applications only, without accessing email or other Citrix-provided resources in the hospital.
The Solution
The hospital turned to its trusted IT partner, Agile360, to put the new technology in place at the main hospital, and set the stage for expanding it to the hospital’s other locations. Agile360 provided solution design,
testing, and implementation assistance, as well as extensive knowledge transfer and training to the hospital
staff.
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A Division of Entisys Solutions, Inc.
At the core of the solution provided by Agile360 was the creation a new Citrix Presentation Server 4.0 farm,
to be used solely for the new Cerner application. This allowed the hospital to utilize the CPU and Memory
management features of Presentation Server 4.0 to deliver the same or better user experience – without the
added costs associated with licensing the AppSense suite. The new Citrix Presentation Server farm also laid
the groundwork for a complete Citrix migration from MetaFrame XP to Presentation Server 4.0, for which
Agile360 documented new build procedures to support the migration. In addition, Agile360 replaced the
existing nFuse servers with Web Interface 4.2, enabling users to access both the MetaFrame XP and Presentation Server 4.0 farms simultaneously.
To ensure the “five-second rule” for application login, Agile360 had a choice between offering the hospital a
published desktop icon via the Citrix Program Neighborhood (PN) Client, or via PN Agent. After carefully
reviewing the options, it became clear that the PN Agent created a higher risk of service interruption due to
its use of Web Interface servers as a connection point to the Presentation Server farm. This would have
meant that only two Web Interface servers would be available to ensure redundancy. Instead, the PN Client
connects directly to the any of the 5 Citrix servers that are available, guaranteeing the highest level of application availability.
The Benefits
Since implementing its new solution, the client has seen a tremendous impact on productivity. The hospital’s
critical medical staff now spends more time with patients, and less time with the computers. This is critical to
the hospital’s commitment to delivering better patient care.
Hospital physicians also have the ability to enter clinical information on demand – whether at the patient’s
bed side, remotely at home or office, or any where this is an internet connection.
With the solution up and running at the main hospital, implementation is already underway at one of the
client’s partner hospitals, and will continue across all of the main hospital’s other facilities.
About Agile360
The professionals at Agile360, Inc. have years of individual and combined experience, unparalleled commitment, and proven processes that identify business issues and define technology solutions to address them.
We are experts in virtual data center infrastructure and actively partner with our clients to implement and
manage full lifecycle integration. Agile360’s sales and consulting teams are experts equipped with the
methodology, tools and business practices that enable them to not only deliver business and technology
consulting services, but provide comprehensive solutions for disaster recovery, business continuity, systems
management and optimization through Secure Access, Virtualization and Advanced Infrastructure strategies. Agile360’s team of experts can also address corresponding needs for security, internetworking and
storage. For more information, visit www.agile360.com or call (949) 253-4106.
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