May 4, 2012 – Virtualization hasn't really taken the health care industry by storm, but in the past few years it's becoming increasingly commonplace for organizations large and small to either jump or dabble in storage, server and desktop virtualization by using software to divide physical servers and desktops into multiple virtual environments.
Nearly every health care provider over 150 beds has some form of virtualization in its IT ecosystem, according to Jeff White, a principal at Aspen Advisors, a health care consulting firm. That movement has picked up steam as health care executives-and vendors-have gotten over the FUD (fear, uncertainty and doubt) of trading physical iron for software to run key operations, he says."A few years ago many executives worried about the reliability of a virtualized environment, and many of those fears were based on health IT vendors being reluctant to support their applications in the environment," White says. "But the benefits of it in terms of management and controllability have really proven out, and virtualization has really started being embraced the past couple years."The reason for that change of heart of the C-level and HIT vendors wasn't based on an epiphany, but a reality: The stunning and accelerating growth of electronic data that needs to stored and processed makes purchasing physical servers to keep up a suicidal financial decision.Dick Csaplar, senior research analyst, virtualization and storage, at Aberdeen, a research and analyst firm based in Boston, recently surveyed end-users across a number of industries and found that electronic data is increasing 35 percent across the board, and for large organizations the data growth is 44 percent annually, effectively doubling their data every two years."Nearly every business process is being computerized, and no IT group in any industry can go to their executives and say they need to double their storage capacity every two years," Csaplar says. "Our surveys find that the No. 1 issue facing IT leaders across all the industries is how to handle the growth of data."However, virtualization isn't necessarily a slam dunk. One of its chief selling points has been the potentially enormous cost savings, but HIT leaders at organizations committed to virtualization say they haven't seen much in the way of lower infrastructure costs.And while those leaders have been effective in selling the other virtues of server and storage virtualization, there is still reluctance on taking the next step to desktop virtualization. In addition, cloud computing is starting to create significant waves in the health care industry, but organizations are still trying to figure out what, exactly, cloud computing is, and if the reliability and security issues can be worked out to enable them to move their data and operations into the cloud.First, costs. It seems apparent that if, instead of buying physical servers, you put a virtual software layer that enables you to use the processing power of your server farm to run all your applications, you're going to save a lot of money in a line-item expense that has increased dramatically over the years.But that's not how things work out, says Michael Minks, director of operations for the 11-facility Seton Healthcare Family, based in Austin, Texas. Seton Healthcare Family is part of the the Ascension Health not-for-profit network comprising more than 500 health facilities. "You just shouldn't go into virtualization expecting cost savings," Minks says. "The physical servers you have to purchase to run multiple virtual servers on are pretty high-end, expensive machines, and when you layer on the management tools and virtual server licenses, you might end up saving a little money, but not much." Ascension Health has about 40 percent of its servers virtualized, Minks estimates, and continues to consolidate its data center via virtualization.The real pay-offs are in efficiency, Minks and others agree. The old model was to run each application on its own physical server, which meant that data centers were crowded with servers that were using a sliver of their processing power. A virtual environment enables that physical processing power to be used to operate multiple virtual servers running different applications.Jerry Williams, the SQL DBA/Developer at CommuniCare Health Services, says that one reason efficiencies were so important for the organization is that HITECH, meaningful use and other federal programs and regulations have changed the game.CommuniCare manages several nursing and rehabilitation centers, specialty care centers and assisted living communities across five states. Before the wave of new reporting demands, the documentation at the facilities used to be done mostly during business hours, and mostly on paper. But now, Williams says, the applications, chief among them the HealthMEDX Vision system used for clinical documentation and host of other functions, are being used around the clock."In terms of documentation, we were basically an 8 a.m. to 5 p.m. organization, and the night shifts had very little interaction with our applications," Williams says. "But now we're a 24/7 organization and those users are banging at our systems day and night. Three years ago we had about 10 terabytes of electronic data, and now we have more than 20 terabytes." For back-end storage, the organization implemented the FalconStor Network Storage Server (NSS) to virtualize much of its environment and improve its disaster recovery abilities. On the server level, it deployed VMWare virtual machines to enable it to have about 10 to 1 compression for its application servers."The hardest part of virtualizing our server environment was figuring out what we really needed," Williams adds. "Our approach had been to find out what the specs were for each application and build to those specs, but in truth the application specifications were for a high water mark that was two or three times what those applications really needed."
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