The Katholische Kliniken Ruhrhalbinsel was formed in 1998 through the merger of three health institutions: the St. Josef Hospital in Essen-Kupferdreh; the adjoining nursing home St. Josef; and the St. Elisabeth Hospital in Hattingen-Niederwenigern. The combined organization has been working as an efficient network, which includes 10 specialty branches, two departments, as well as the Kupferdreh rehab and a radiological group, all practicing as partners and offering medical care at a high level.

Just as the employees of the three health institutions have their patients as the focus of all activities, the IT department orients itself to the requirements of the user. “We are in constant contact with our users and try to make the work as easy as possible for them,” said IT Director Ralf Rennings. “The less time they need for administrative activities, the more time they have for their actual responsibilities –- the care of patients.”

The Challenge: Administration of IT Workstations in Three Locations

Approximately two years ago, for example, the IT department had to solve performance problems that affected the work of the employees at St. Elisabeth Hospital: the location in Hattingen-Niederwenigern was still connected over a 2-Mbit dedicated line to the central server room in Kupferdreh, so that the hospital information system, ORBIS, ran very sluggishly most of the time. The exchange of data between the local clients and the database servers took too much time due to the relatively narrow bandwidth –- the result was long waiting times for the user.

“In this situation, we first decided to install a central solution for application delivery,” said Rennings. All applications, which previously ran on local terminals in Niederwenigern, were centralized in Kupferdreh on five Citrix Presentation Servers with the assistance of IT partner ERGO Computersysteme, a Silver Citrix® Solution Advisor, and were made available to the users virtually. Both users and IT personnel were equally satisfied with the results.

“On the one hand, there has been a marked improvement in application response times, since only a few data streams are transmitted over the Citrix ICA protocol,” explained Rennings. “On the other hand, the administrative requirements for us have been reduced: we no longer have to install applications and updates on the terminals in Niederwenigern, just in the central server farm instead. We can even carry out user support remotely from Kupferdreh to a large extent: the Citrix technology gives us the ability to mirror user sessions with the consent of the users. In this way, we can solve problems and answer questions as if we were actually sitting in front of the user’s PC ourselves.”

Application Streaming for Special Applications

In the next step, the IT department of the St. Josef Hospital and the adjoining nursing home switched over to the centralized Citrix architecture. The goal was to decrease the effort required for application delivery here, as well. However, not all applications were able to be integrated into the Citrix Presentation Server™ environment immediately; specific applications continued to be operated on individual terminals, since they were either not compatible with Microsoft® Terminal Services or centralized delivery was not worthwhile due to the low number of users. From an administrative point of view, therefore, there continued to be parallel application environments, either provided centrally or installed locally.

This situation was the deciding factor for Rennings to upgrade the server farm to Citrix Presentation Server, Platinum Edition early. “With the new application streaming technology from Citrix, we were able to close the holes in our central IT strategy and say goodbye to local software installations entirely.”

With streaming technology provided by Citrix Presentation Server, applications are transmitted to the terminal on demand and run there in an isolation environment. Local installation of the application does not take place; however, offline use of the application is still possible. In addition, the isolation environment prevents possible conflicts with other applications on the user device.

Better Availability, Less Administration Effort

The prerequisite for application streaming is application packaging: an image of the application is created one time with the configuration desired by the administrator. “Ideally, the packaging should be carried out on a newly installed PC, which runs with the same operating system as the workstation computer,” advised Rennings. The packaged application can then be made available for various target systems. With all updates, the advantage of the centralized Citrix architecture becomes evident again: at each start-up, the user terminal automatically retrieves the most current application profile from the server.

The Katholische Kliniken Ruhrhalbinsel now uses Citrix streaming technology for a large variety of applications: for example, image processing and image management software, which are necessary in plastic and aesthetic surgery, along with EEG software for neurophysiological examinations, as well as the graphics software Adobe Photoshop.

Rennings is also satisfied with the system’s stability. “In the case of a hardware malfunction in the user device, the user can continue to work on another workstation in a very short period of time without us having to install the software locally first.”

Quick Workstation Change and Single Sign-on

Changing from one terminal to another in hospital operations is not only standard in emergencies, but is also a part of everyday life for doctors and healthcare providers. The IT department is now able to comfortably support these employees with Citrix SmoothRoaming™ technology from Citrix Presentation Server, which makes it possible for the user to simply move their current session to another terminal. If, for example, a doctor begins an evaluation on a computer in the treatment room and subsequently logs on to his PC in the office, the already opened application will appear immediately. The closing and restarting of applications is not necessary –- this saves users time and they can continue to work seamlessly. “As soon as the user logs on to another computer, not only is his user session redirected, but he is also automatically logged off of the previous workstation,” explained the IT director.

Access to the workstation computers is protected through a smartcard-based authentication process. Since a few applications require an additional, secondary logon, the Katholische Kliniken Ruhrhalbinsel has also introduced single sign-on powered by Citrix Password Manager™, which is included in the Platinum Edition of Presentation Server. Through the use of the single sign-on solution, the user only has to log on to the network one time –- all other logon processes are undertaken by Password Manager. This process is very helpful for writing discharge and referral letters. Previously, the doctors had to enter their password over and over again for verification in the corresponding software dialogs –- now they can use Password Manager for these interim steps. “The feedback on this new solution has been markedly positive,” reported Rennings: “Sometimes, it is only two or three mouse clicks that we save our users in a process –- but with just that, we provide them significant relief in their daily routine responsibilities.”

Performance Monitoring with Citrix EdgeSight

Increasing user satisfaction is the goal of the next IT project for the Katholische Kliniken Ruhrhalbinsel. The team is currently planning the implementation of application performance monitoring functionality powered by Citrix EdgeSight™ as a component of the Platinum Edition of Presentation Server. This technology gives the administrators an overview of the response times and availability of applications from the point of view of the end user. Rennings explained, “With this tool, we will be able to respond more quickly to possible performance bottlenecks, ideally before the users even notice them in their work.”

©2008 Citrix Systems, Inc. All rights reserved. Citrix®, Citrix Presentation Server™, Citrix XenApp™, Citrix Password Manager™, Citrix EdgeSight™ and Citrix SmoothRoaming™ are trademarks or registered trademarks of Citrix Systems, Inc. and/or one or more of its subsidiaries, and may be registered in the United States Patent and Trademark Office and in other countries. Microsoft®, Windows®, Windows Server® and Internet Explorer® are registered trademarks of Microsoft Corporation in the U.S. and/or other countries. All other trademarks and registered trademarks are property of their respective owners.