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Collaborative approach guides virtual desktop infrastructure project, supporting caregivers’ efficiency and satisfaction

by Childrens National Hospital

Published on 4/5/2021

Health care leaders don't often get the opportunity to redesign their digital infrastructure, especially during a pandemic. But that's exactly what teams at Children's National Hospital in Washington, D.C., and their counterparts at the Bear Institute for Health Innovation — a pediatric technology partnership between Children's National and Cerner — did in 2020.
As the Cerner ITWorksSM client's existing infrastructure aged, it slowed system performance and limited the organization's capacity to implement new technologies. Children's National leaders decided to completely overhaul the system.
Children's National and Bear Institute teams ordered, designed, configured and built redundancy into new hardware. They created a new virtual environment for desktops and servers, and a new Citrix farm for CernerWorksSM-hosted applications. As they migrated to the new virtual desktop infrastructure (VDI) environment, they replaced hundreds of devices while reconfiguring and installing new applications to support clinical process improvement initiatives.
At every step in the design process, project teams consulted clinicians and clinical leaders.
"Key strategies for the success of VDI implementation included early clinician engagement and an iterative design, testing and piloting process that resulted in a standardized, coherent design that met the needs of all users," said Simmy King, chief nursing informatics and education officer.
By redesigning the system and transitioning from traditional desktops to VDI desktops, the organization boosted system performance and helped improve end-user satisfaction. Login time from Children's National sites decreased more than 66%.

Employees noticed the difference. From 2019 to 2020, the percentage of Children's National employees who rated login time as acceptable rose 40%.2 The portion of employees who rated system performance acceptable, in terms of how quickly screens load, increased 22%.3
Using Cerner Instant Access™, clinicians utilize their encrypted identification badges to log in and access clinical applications. The process brings location awareness to clinical applications and supports smooth session roaming as clinicians move between devices during their shifts.
"We want technology to feel supportive and unobtrusive," said Matt MacVey, vice president and chief information officer. "When it works well, you hardly notice it. This project helped eliminate some pain points and make progress toward that goal."
Providers can access their virtual desktops from anywhere with an internet connection, promoting work continuity and mobility in a time when COVID-19 can make work schedules and locations unpredictable. And because each user has their own virtual desktop, employees can count on a consistent experience each time they log on.
"I'm able to arrange the desktop for easy access to the applications I use most," said Maggie Finke, nurse manager. "I don't waste time clicking excessively, looking for what I need on the shared desktop."

VDI supports security because patient data isn't stored on local devices, and the new infrastructure allows IT staff to maintain systemwide security compliance without requiring downtime for patching. IT staff can also deploy new applications and product updates simultaneously across virtual desktops, helping Children's National implement new capabilities at the pace of innovation.
“We've laid the foundation for a flexible future, with a positive effect on caregiver experiences," MacVey explained. “Every second saved represents an opportunity to reallocate time to what's most important — our patients and their families.”

To learn more about best practices for Cerner Instant Access, visit our Model Experience page.

1 Comparing average login time of 80.23 seconds from Dec. 23, 2020-Jan. 20, 2021 in Children's National's old environment, still in use for a subset of laboratory users who have not yet migrated to VDI desktops, to an average login time of 26.76 seconds for VDI users at Children's National hospital and clinic sites from Jan. 1, 2020-Jan. 31, 2021.
2 Percentage of survey respondents who somewhat or strongly agreed that login time was acceptable increased from 30.6% in 2019 to 43.0% in 2020. Annual survey is open to all Children's National employees. 
3 Percentage of survey respondents who somewhat or strongly agreed that performance (loading of screens) was satisfactory increased from 37.8% in 2019 to 46.3% in 2020. Annual survey is open to all Children's National employees.  

Client outcomes were achieved in respective settings and are not representative of benefits realized by all clients due to many variables, including solution scope, client capabilities and business and implementation models.