To give its doctors more time to treat patients, the U.S. Army is converting its desktop health care patient record application system to a virtual desktop infrastructure.
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The project takes advantage of tiered storage with RAM, solid-state drives (SSDs) and hard drives. It includes NetApp storage arrays, Atlantis Computing's ILIO Diskless virtual desktop infrastructure (VDI) storage optimization software, Hewlett-Packard (HP) blade servers with SSDs, and Citrix Systems' XenDesktop and XenApp software to virtualize desktops and applications.
Lloyd Havekost, virtualization architect for the Army's Medical Information Technology Center (USAMITC), said the Army is converting the Armed Forces Health Longitudinal Application patient record system from a standard desktop application to a XenDesktop 5.6-based virtualized desktop. It is part of the Army's Clinical Application Virtualization (ACAV) project. The USAMITC is also working with St. Louis-based systems integrator World Wide Technology Inc. on the ACAV project.
The VDI project is part of a pilot program run by eight U.S. Army hospitals. Army doctors typically have about 15 minutes for each patient. Delays spent logging on to the patient record system means doctors end up spending less time with each patient. Using VDI storage with solid-state has reduced login times from 3-to-5 minutes to less than 30 seconds in early implementations.
"This project was conceived because the patient record system has gotten very slow," Havekost said. "And it has become very inefficient for the doctors to see patients.
"By bringing VDI into the equation," he added, "you give [a doctor] that roaming profile capability … and the patient record system is available to him no matter where he travels within that hospital."
The Army deploys ILIO Diskless VDI software on HP BL460c G7 Servers with 100 GB SSDs within each physical host. The servers are connected to racks with NetApp arrays, ranging from 18.8 TB to 72 TB per rack.
ILIO Diskless VDI uses RAM instead of disk drives to boot images in non-persistent Citrix or VMware Inc. VDI deployments. Using RAM speeds performance and reduces the amount of dedicated storage needed for VDI.
The ILIO Diskless software and non-persistent virtual desktops run on the physical host's RAM, while VMware's vSphere server virtualization software and the other applications use the SSDs. That prevents virtual desktops and hypervisors from competing for storage resources. The Xangati software monitors server RAM so it can be reallocated when needed.
To improve connections to remote clinics, Havekost uses Riverbed Technology Inc.'s Steelhead WAN optimization appliances.
Havekost said the addition of SSDs allowed him to use 30% less spinning disk. Using ILIO software with server RAM resulted in another 20% bump in performance, he said. He puts the desktops of typical knowledge workers on the SSDs and uses system RAM for doctors who need to view large and detailed images.
The Fort Carson Army hospital near Colorado Springs was the first hospital to install the VDI racks in late 2012. Fort Carson has approximately 100 health care providers on the VDI system. Overall, the project currently has approximately 600 users. The remaining seven hospitals participating in the project are in the continental United States, Europe and Hawaii (for the Army's Pacific Rim installations). The plan calls for the project to eventually include more than 11,500 users.
Havekost said he is happy with early results, especially with logon times. "[It means] less time involved on the desktop and more time for [health care] providers to do their work," he said.