Increase Efficiency by Migrating an EHR System to a VDI Environment

July 25, 2021

Challenges in the Migration

Many hospitals use an Electronic Health Record (EHR) system. While hospitals formerly developed their EHR systems by themselves, it is more common to purchase EHR software from a supplier. The transition to an EHR supplier can relieve the burden on a hospital’s IT department because it takes care of technical support and regular system updates.

However, EHR software suppliers generally fail to deliver a system that performs adequately. As a result, the end-users in the hospitals are confronted with unforeseen performance issues, whereas hospitals need to depend on their EHR system being available 24/7. Suppose an EHR system performs inadequately or is unavailable. In that case, patients cannot get treated, and physicians cannot invoice their work, which leads to inefficiency and even life-threatening situations.

Many IT departments combine the transition to new EHR software with the implementation of a new IT environment. This new IT environment involves new hardware and new software such as Windows 10, Citrix, and VMware to implement and manage a VDI environment. This involves a complex transition in which both hardware and software need extensive testing and optimization before the system can go live.

The following steps are encouraged to take when migrating an EHR system:

• Draw up a solid test plan that includes the end-user experience (EUX)
• Conduct performance tests on the separate components as early as possible. Use the feedback to implement improvements before the actual migration begins
• Test performance outside of Citrix or VDI. Focus the tests on the EHR, functionality, and the underlying hardware and infrastructure. Conceive use cases that involve as many of these components as possible

Challenges During the Migration

Testing is a critical aspect of the migration process. Testing is about more than only functional tests of the environment and the application; it is also essential to test whether the infrastructure is robust enough to handle the intended number of sessions. Often this is not the case, leading to awkward tensions between IT managers.

After the environment has gone live, the next phase is to monitor maintenance and updates. The developers of EHR systems tend to implement new updates regularly. Many suppliers rule that you may only lag behind an x number of updates to continue receiving support. The result is a continuous stream of new updates, which doesn’t only apply to EHR systems; but also to Windows 10. It is essential that during the migration, to renew the functional components and the internal processes.

A process that many hospitals benefit from ensuring the secure installation of this continuous stream of updates is DTAP (Development, Testing, Acceptance, and Production). This process helps you keep control of your image and software management tasks. Following all of these steps results in a minimum risk of problems when the system goes live.

The process tests functional and performance aspects such as application start times, the time required to find a user in the EHR software, and the number of users that the system can handle simultaneously after the update.

The IT manager is much more in control of the environment. You can offer a much better performance guarantee when the image goes live. The result is fewer support calls, better performance, and – not unimportant – more time and money for other matters.

Challenges After the Migration

Once the environment is live, it remains necessary to monitor performance and EUX. It involves monitoring hard metrics and checking whether the server is online or offline. Still, performance is more than just CPU utilization or an IOPS. It is crucial to measure the end-user’s experience continuously.