Improved Infrastructure Stability with a Small Learning Curve

The pace of change in IT can be fast and furious, but some industries—such as healthcare—are notorious for moving slowly and being hesitant to change. In some ways, this is understandable; healthcare processes and workflows can be a matter of life and death, so IT departments would sometimes rather cope with known problems rather than potentially introducing unknown issues. Most new technology comes with a learning curve, and if there is one industry that cannot afford a lag in knowledge, it’s healthcare.

I came to Davis County Hospital & Clinics (DCHC) in 2017. During my onboarding, I discovered several infrastructure components here were stitched together as band-aids for problems, instead of taking a more holistic approach to the overall IT infrastructure. There is never enough time (and often, never enough money) for a complete overhaul of the system, so small changes grow into larger problems over time. This desensitization, coupled with a hesitance to change, made it easier to kick the can down the road on problems.  

But once we saw how much our support and performance could improve with a new solution, hesitance to change dramatically decreased, and we’re all better for it.

Critical Infrastructure Problems in a Critical Access Facility

DCHC is a rural critical access hospital built in 1947. The hospital and clinics provide both an economic hub for the community and healthcare services that residents can access close to home. The facility serves the community well, but when I arrived as IT Director, our IT infrastructure needed work. The equipment was dated. The environment was based on legacy three-tier VMware. Poor networking choices had been made regarding our virtual server infrastructure, and the storage area network (SAN) was far from optimized, making it less reliable.

While the majority of our operations and staff are on site, we do leverage a virtual desktop infrastructure (VDI) for remote access. Unfortunately, those factors created an unstable environment for both our virtual servers and VDI. The legacy system crashed regularly, sometimes daily. I suffered from high levels of anxiety trying to communicate downtime issues to our end users. By contrast, my team was largely numb because they had experienced frequent system failures for so long that it seemed like an inevitable part of their job. Morale was incredibly low because of the instability of the infrastructure.

The situation affected more than just our IT team. Our internal staff and employees experienced delays moving through service lines, which had an indirect impact on patients.

Change was desired, but there was some resistance to the idea. Like most rural hospitals, we struggle with the budgeting cycle and establishing the right balance of value and overall costs. We are also incredibly limited in our resources. Trying to balance those resources for other projects while making changes to our infrastructure was difficult because we didn’t have any resources to spare. Our IT team consisted of five people supporting 250+ users, and we were spread thin.

We don’t need to be on the bleeding edge of technology. What we needed was sustainable stability from a platform that we could manage with our existing resources.

A Potential Solution in Nutanix

Years ago, a former colleague of mine became a Nutanix engineer. We stayed close, and over the years, he provided informal insight that I might find relevant and useful in my environment. He was influential in my decision to bring Nutanix to the table at DCHC. 

I was already interested in moving DCHC to hyperconverged infrastructure (HCI). It was attractive that we’d only have to deal with one service provider for our hardware, software, and storage needs. But moving to HCI—and selecting Nutanix—wasn’t exactly cut and dry.

First, we had to address the hesitation of our IT team which included myself. We were concerned of losing the VMware knowledge and experience that we’d gained over the years, and were unsure of what we’d have to learn with a new solution. We were already so busy that we didn’t know how we would be able to make the time to learn something different. 

The other concern was the maturity of Nutanix compared to our legacy infrastructure. Team members were worried about whether our virtual appliances would be supported in Nutanix AHV, for example.

We considered other hyperconverged platforms, such as those from NetApp and Cisco or even upgrading the existing VMware hardware, but we felt there was a lot more uncertainty around their HCI solutions than with Nutanix. This was in part due to my former colleague, the Nutanix engineer. I had someone on the inside who I trusted feeding me great information, and we liked everything we saw and heard during our pre-sales experience and performed our due diligence comparing our options.

The Big Move: Deploying a New Solution

It was much easier to address the fears of the IT team once everyone saw that the core usability of Nutanix was far superior to VMware vSphere and VMware Horizon. Specifically, Nutanix Frame, a Desktop as a Service solution (DaaS) looked and felt like a secure experience, which was a huge improvement. Nutanix offered a stability that was unfamiliar to everyone at that point, and it would require low maintenance from a day-to-day operations perspective. The idea that we wouldn’t have to contend with regular downtime—and could, therefore, give the team back some time in their day—was a huge selling point. 

Once we made the decision to go with Nutanix, we established a two-phased approach to implementing the new system. Nutanix provided a framework for moving our virtual servers to the platform, and everything was performed seamlessly using Nutanix Move. Seeing the ease of the first phase spoke volumes about the platform’s simplicity, and it made people feel more confident as we moved into phase two. 

Given the number of concerns about virtual appliances and the learning curve, we stretched out phase two which was implementing Nutanix Frame. During this time, the Nutanix engineers were incredible, providing support and guidance that went well above anything we expected. We had separate engineering support for both phases of the implementation project, and were impressed by the engineering team’s willingness to move at our pace and to ease the fears that had initially been such a barrier. They were the biggest reason both for our success and why we are so eager to recommend Nutanix to others. Our sales team continued to stay very engaged as well during the implementation and provided deeper insight whenever called upon to assist on items as needed. 

A Whole New World with Many Familiar Elements

Currently, we run a typical hybrid environment, giving us the kind of stability and reliability that was severely lacking when I arrived. Our workloads on-prem are fairly standard for our size of facility which include several Windows file, print, and various application servers including and SQL along with several linux based appliances. Nutanix powers critical workloads like our nurse call system, IV pumps, virtual faxing, and EHR interfacing—among several other applications. There is a flexibility with Nutanix that means we don’t have to worry about the system at all. We can run our VDI machines using our private cloud on-prem in our Nutanix core infrastructure, which was a huge win.

In just one year, we’ve saved between 100–150 hours in soft costs with Nutanix Frame alone compared to the time we spent dealing with our legacy VDI solution. Before Nutanix, our end users took between 3–15 minutes waiting for a VDI session. Now, it takes approximately one minute to get a VDI session with Nutanix Frame. It’s a massive performance gain and a huge usability improvement that makes it easy to see why the change was necessary.

Our end users have also noticed and expressed how pleased they are with one consistent pool of floating VDI machines. The improvement in how Nutanix uses “enterprise profiles” eliminates our previous need and ongoing maintenance of persistent desktops in a 1:1 user to VDI desktop ratio. The IT team saves a few hours each month in troubleshooting alone as a result.

The biggest win? We’ve experienced 100% uptime since the implementation in April 2020. Everyone’s happier, and my anxiety levels have significantly decreased.

Change Isn’t Something to Fear

Nutanix proved that we didn’t need to worry about the learning curve. Yes, it’s different, and yes, Nutanix Frame totally changed the VDI experience. But IT people are intelligent and capable. The benefits of performance and flexibility far outweighed any hesitation we had in the beginning. Even the concerns around virtual appliances ended up being a non-issue.

Nutanix provided DCHC with sustained core infrastructure stability and the extreme flexibility to ensure that we can scale up more Nutanix Frame users at any time. If 2020 taught us anything, it’s that you never know when you will need a more robust IT environment, or when you will have to support more virtual users. We improved our security posture, and my IT team has sustained huge resourcing improvements year over year.

Ultimately, the role of the IT team at DCHC is to provide exceptional technology support and be subject matter experts for those who are caring for patients and families. Now, we can.