Designing Fast Virtual Desktops for Healthcare



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Designing Fast Virtual Desktops for Healthcare

What is VDI* and why is it important to healthcare? = Cost Savings * VDI - Virtual Desktop Infrastructure Shared computing resources.. Ease of use.. Quick app updates.. Security + others

IDC estimates that Metro Health will realize almost $2.75 million per year in benefits from higher revenue and employee time savings that are being transformed into business benefits for the hospital.

Metro Health Hospital is a non-profit 208-bed general acute care hospital serving West Michigan. Hospital services include inpatient and outpatient services, emergency, surgery, intensive care, cancer, rehabilitation, childbirth and community education, among others. Metro Health employs more than 2,325 full-time staff members Metro Health has more than 500 employed and independent physicians Metro Health Hospital s innovative approach to health care, technology and green thinking has earned it numerous awards, including the 100 Top Hospitals National Award (teaching hospital category) from Thomson Reuters three years in a row.

Desktop Virtualization Timeline Jan 2007 Oct 2007 v1 Feb 2010 v2 Feb 2011 Oct 2011 v3 Dec 2012 V3.5 May 2014 V4 MetroAnywhere Development Begins MetroAnywhere Go Live when Metro Health Moves into its New hospital MetroAnywhere With TCX Video playback USB support Cisco VXI Purchase MetroView MetroAnywhere VMware View V4.6 MetroView VMware View V5.1 HP Integrated VDI AlwaysOn Point of Care VMware View V5.3 1100 PCs 900 Thin clients 1400 PCs 1100 Thin clients 300 Laptops 1020 PCs 1800 Zero clients 310 Laptops 1480 PCs 1650 Zero clients 352 Laptops

Metro Health IT Vision Statement: "Our Passion is to Lead and Support the Improvement of the Health and Well Being of our Communities through Innovative and Efficient Information Technology" Quantify the vision: Our VDI must perform equally or better than a standard PC including graphics! There is one thing stronger than all the armies in the world; and that is an idea whose time has come. Isaac Newton

Design Strategy The solution must seamlessly empower the entire healthcare workforce. http://www.projectcreate.com.au/category/blog/page/3/ It s all about the application & enabling it to run on any device. http://12b3059.wordpress.com/

Other Interrelated Strategies Hardware Strategy Graphics processing Image management Printer management User profiles & Personna mgmt Application Management Strategy

New VDI Specs Boring.. BUT VITAL! MUST HAVE Snappy Performance < 10-second reconnects VMware Always On Point of Care Global Load Balancing Full motion video support Designed for Windows7 & Epic 2014 Multi-monitor support at 1920x1080 resolution Cost is at or below current spend Solution must scale in increments Solution must be granular to support new technologies Support 3GB RAM per session Support a 30GB image Must support 3D graphics and CPU offload capabilities Must provide latest Intel Ivy Bridge processors Full solution recomposes completed in 6 8 hours SAN Storage is to be based on SSD to support linked clone performance SAN solution must provide in-line deduplication to improve storage performance Average 50 IOPS and <6ms latency per session Plus more specs regarding video performance And more specs for session performance And more And more..

Snappy! A right click on an icon opens up the context menu are less than one second. A right click on an email attachment opens up the context menu are less than one second. A virtualized application initiates the application to stream in less than one second. Average responses when Enter is pressed or the mouse is clicked are less than one second. There is no keystroke delay/latency while typing and displaying letters on the screen. A browser window opens up, not the actual web site or web app, are less than one second. A Windows Explorer window opens up when requested in less than one second. When a window is dragged, it moves smoothly, quickly without any ghosting or latency. When a window is resized, the action is performed with no user perceptible delay.

Things to focus on: Interconnected flash memory chips 5 10ms vs ~ 0.1ms

Things to focus on: Controller Multipathing 2-node, Active/Passive 4-node, Active/Active Completely load balanced

Things to focus on: The transport protocol that virtual desktops use requires network tuning to perform as expected. These protocols help provide the video, sound and peripheral experience for remote desktop users. Network tuning and WAN optimizations need to be considered. - Number of users - Applications with graphics/video requirements must be known Consult the protocol tuning guides!

Things to focus on: We have 20 cores/ server * Effective immediately, Epic has updated its purchasing recommendation for hosts for running Hyperspace (either via VDI or via virtual Citrix XenApp servers) as well as multipurpose hosts for web and service servers. We recommend purchasing two-socket servers with Intel Xeon E5-2697 v3 processors for these purposes.

Things to focus on: Increase RAM - option to add more Over 2.5x more memory/server v3 v4 * For VDI hosts, we recommend you purchase servers with at least 512 GB of RAM.

Things to focus on: Single Sign-On Persona Management Application Packaging/Streaming

What Differentiators have we experienced: EPIC System Pulse - Before and After

What Differentiators have we experienced:

Near Future Performance Improvements: Memory cache Application distribution Anywhere application computing

Graphics: Video processing and graphics and Virtual Desktops Resolution 1920 x 1080 Many healthcare apps are requiring graphics Plus Browsers are evolving Our PACS and Cardiology apps specify NVIDIA graphics support Video playback? Video conferencing needs to be fixed/improved. CPU & vgpu Offload

Which healthcare dept apps require graphics support? Obvious Departments: Radiology Cardiology Laboratory/Pathology Surgery Sleep Lab Neurology PT/OT Sports Medicine Wound Clinic Assisted Breathing Center Endoscopy Obstetrics Oncology Medical Education Telemedicine Non-Clinical Departments: Marketing Quality Security Facilities Maintenance IT Training (Operational & Dept specific) These common applications too: Browsers HTML5 Epic/OnBase Microsoft Office - 2013 Email Adobe Acrobat Teleconferencing

Task worker & Power user Healthcare No Distinction VNIDIA & VMware 3D Graphics Solutions Presentation 2/12/15

http://www.teradici.com/docs/default-source/resources/whitepapers/teradici-apex-2800-performance-whitepaper.pdf?sfvrsn=2 Things to focus on: CPU Offload - Hardware Acceleration cards up to 44% reduction No ESXi 6 driver for APEX offload card yet!

VDI = Shared computing resources

Better Together: & 3D Virtual Workstation Set Up Doesn't Have to Be So Hard 2/11/15 Randy Groves reprinted with permission

vgpu Experience: One display @ 1366 @ 768 Two monitors Each @ 1920 x 1080 Three monitors Each @ 1920 x 1080

vgpu Experience - NVIDIA SMI

vgpu Experience: isite Streaming Videos NVIDIA_VMware

Challenges: Expand on 32 VM limitation per board This is a Kepler architecture limitation 3D Graphics Setting Issue Enable support for the RDP protocol at the session level Currently RDP is disabled at the pool level for 3D graphics support How successfully can a vgpu enabled VDI session be vmotioned? vmotion is not supported at this time. Enable dynamic VM vgpu allocation/use per board Release vgpu when app shuts down, not at the session level When can a View session on one server be allocated unused vgpu on another server?

Snappy! A right click on an icon opens up the context menu are less than one second. A right click on an email attachment opens up the context menu are less than one second. A virtualized application initiates the application to stream in less than one second. Average responses when Enter is pressed or the mouse is clicked are less than one second. There is no keystroke delay/latency while typing and displaying letters on the screen. A browser window opens up, not the actual web site or web app, are less than one second. A Windows Explorer window opens up when requested in less than one second. When a window is dragged, it moves smoothly, quickly without any ghosting or latency. When a window is resized, the action is performed with no user perceptible delay.

Contact Information: Aivars Apsite Technology Strategist aivars.apsite@metrogr.org

HP Multi Site Solution Each Site Solution Base Includes: HP 3PAR StoreServe 7450 4 x 7450 Controller Nodes 32 GB Cache (8) 8GB FC ports 32 x 920GB SSD Drives 28TB Usable capacity View Session hosts (16) DL380 Rack Servers E2697v2 Dual 10 Core 2.8 GHz Ivy Bridge procs 512 GB Memory expandable to 768GB 4 GB micro SD Boot ESX 5.5 (8) Teradici Apex 2800 CPU offload cards (8) NVIDIA K1 cards Management hosts (2) DL380 Rack Servers E2697v2 Dual 10 Core 2.8 GHz Ivy Bridge procs 192 GB Memory expandable to 768GB 4 GB micro SD Boot (1) HP 2920-24G switches (24) 1GB ports (2) HP 5900-48 switches (48) 10GB ports (2) HP SN6000B switches (?) 16GB FC ports (24) 8GB SFPs (2) F5 Loadbalancers Stratusphere UX (1250) licenses Test System (2) VDI Hosts - HP DL380 Gen8 svrs (10) core Ivy Bridge 2.8GHz procs Each with 512GB RAM (4) GB Flash media - ESXi local boot Each server will have one each: - Teradici Apex 2800 CPU offload card - NVIDIA K1 card (1) 3PAR 7200 array (1) HP SN3000B 24/12 FC switch

What Differentiators have we experienced: Epic 2010 Epic 2014 Windows XP 1 vcpu 2GB RAM Windows XP 2 vcpu 3GB RAM Windows7 32bit 2 vcpu 4GB RAM