4-page Case Study
Posted: 1/26/2012
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Beth Israel Deaconess Medical Center Hospital Improves Availability and Speeds Performance to Deliver High-Quality Care

Beth Israel Deaconess Medical Center (BIDMC), a world-class teaching hospital, is widely recognized for its innovative use of information technology. The hospital wanted to simplify a high availability and disaster recovery solution that triggered downtime and manual work during quarterly drills. Based on extensive experience with using Microsoft technologies for mission-critical applications, BIDMC deployed Microsoft SQL Server 2012 in a private cloud based on the Hyper-V technology in Windows Server 2008 R2. The live migration feature in Hyper-V eliminates planned downtime, and SQL Server 2012 AlwaysOn availability groups automatically fail over all of an application’s databases. Once fully deployed, the solution will reduce manual workloads for IT and information workers, and its performance-improvement features will speed and simplify data analysis.


Beth Israel Deaconess Medical Center (BIDMC), a major teaching hospital with a Level I Trauma Center, is located in Boston, Massachusetts. The medical center has more than 600 beds and its medical staff sees about 250,000 patients per year. The hospital maintains more than 3 million medical records.

* With SQL Server 2012, we expect to achieve 99.999 percent availability for all of our mission-critical applications. *

Don Wood
Manager of Database Administration

Well regarded for its surgical and clinical expertise, BIDMC prides itself on the creative use of training and technology to protect patient safety and deliver high-quality care. The BIDMC IT department, which relies on Microsoft technologies to support many of the hospital’s mission-critical IT systems, was designated as the most innovative healthcare IT organization in the nation—and ranked number 12 across all industries—in the 2011 InformationWeek 500. “Our IT department likes to stay on the leading edge of technology,” says Don Wood, Manager of Database Administration at BIDMC.

BIDMC was using Microsoft SQL Server 2005 and SQL Server 2008 R2 data management software for most of its approximately 200 application databases. These technologies met its requirements for the high availability and powerful disaster recovery that are essential for critical patient-care applications, but BIDMC was interested in further strengthening various capabilities of its data management solutions.

For example, BIDMC was using a combination of database mirroring and failover clustering to achieve high availability and support disaster recovery for its SQL Server databases. The hospital runs many multidatabase applications, however, and its existing solution did not support the automatic failover of more than one database at a time. “During disaster drills, our database administrators had to make sure that each application is reconnected to its databases,” says Wood. “This resulted in about two hours of manual work to execute a disaster-recovery exercise each quarter.”

Another availability improvement that BIDMC wanted to make was to isolate instances of SQL Server from each other. “We were installing multiple instances of SQL Server on each physical machine, but we couldn’t truly dedicate resources to those instances,” says Wood. “If one instance had a problem, or if there were an operating system crash, all of the instances on that machine would go down.” It was also difficult to move instances of SQL Server from one server to another, and fulfilling requests for new instances was labor-intensive, according to Wood. “If I had a new request for SQL Server, it would take me days to complete the build and configuration processes.”

In addition, the hospital wanted to reduce the manual work related to its analysis and reporting. “Our analysts knew the data very well, but they were engaged in a lot of duplicated effort because of the difficulty of sharing the spreadsheet-based tools they were using to extract and analyze the data,” says Wood. “Also, maintaining some monthly reports required employees to spend several workdays running queries and importing data.”

BIDMC wanted a new data management solution that would further strengthen high availability and disaster recovery, ease management, and offer enterprise-ready business intelligence (BI) and reporting tools.


BIDMC decided to deploy a new solution based on Microsoft SQL Server 2012. “We’re committed to Microsoft technology because it has proven to be very reliable, and it’s very easy for our users to work with,” says Wood. “Also, Microsoft is always working to further improve its tools, interfaces, and interoperability, and that helps our users become even more productive.”

* By creating a SQL Server 2012 AlwaysOn availability group for each multidatabase application, we … reduced the time needed for failing over those applications. *

Don Wood
Manager of Database Administration


The hospital started the project in December 2010, and the new solution went into production in October 2011 for a multidatabase application that supports billing and financial analysis. “If this new solution works out well for this application—and I have no reason to believe it won’t—we will phase it in for most of our other applications within 12 to 18 months.

The solution runs in a private cloud based on the Windows Server 2008 R2 operating system with Hyper-V virtualization technology. “We have more VMware than Hyper-V in our environment,” says Wood. “But we decided to use Hyper-V for this solution to further minimize the complexity of these critical, patient-care Databases.”

BIDMC used Hyper-V to create virtual machines on which it deployed instances of SQL Server 2012. It is also using Microsoft System Center Virtual Machine Manager 2008 R2, which can help it build virtual machine templates, provision new virtual machines rapidly without compromising IT control, and load-balance virtual machines across multiple host servers. BIDMC also has access to the live migration feature in Hyper-V, which supports failing over virtual machines with no effect on application availability.

To support high availability and disaster recovery, BIDMC is taking advantage of SQL Server 2012 AlwaysOn, an enhancement of database mirroring that supports as many as four secondary databases, including two synchronous secondaries. BIDMC assembled the billing application’s databases into a SQL Server 2012 AlwaysOn availability group, a logical collection of databases that automatically fail over—even across subnets—as one unit. This group is replicated in two other locations, providing geographic redundancy. BIDMC can use these read-only secondaries to achieve near-real-time reporting, reduce demands on the primary database, improve resource utilization, and reduce hardware idling.

BIDMC is also using Microsoft SQL Server 2012 Analysis Services, which now includes online analytical processing (OLAP) and the xVelocity in-memory analytics engine and the Business Intelligence Semantic Model. With the BI Semantic Model, developers can choose between tabular and multidimensional formats for data modeling; multidimensional expressions (MDX) or data analysis expressions (DAX) for business logic; and cached or pass-through modes for storage and data access. The user experience remains the same for all analytics, reporting, scorecards, dashboards, and custom applications. BIDMC business users can now use Microsoft SQL Server 2012 Reporting Services to create reports and explore data with familiar tools and interfaces. Analysts can use templates and existing objects to build reports without needing technical knowledge about data structures.

SQL Server 2012 also offers several performance enhancements. The new xVelocity in-memory technologies greatly speed query performance—especially star-join queries—by storing index data in columns rather than rows. Improved compression capabilities in SQL Server 2012 can cut data volumes by as much as 50 percent, and the SQL Server 2012 Resource Governor can help BIDMC define resource usage to achieve predictable performance for mixed and concurrent workloads. Administrators can further strengthen the solution’s performance by using familiar management tools to monitor database activity, analyze query execution plans, and optimize indexes and data structures.

For the billing application, the solution stores 125 gigabytes in four databases. The largest table holds 160 million records and has hundreds of millions of rows. About 1,000 financial analysts and billing support specialists will access this data, including about 15 concurrent online transaction processing (OLTP) users. The solution runs on HP ProLiant DL380 G7 server computers.


By deploying a Microsoft solution in a private cloud, BIDMC has simplified and improved its availability and disaster recovery capabilities, reduced workloads for both IT staff and users, and enhanced its ability to find value in its data. Simply by switching to SQL Server 2012, BIDMC is experiencing faster performance, and the hospital can improve its performance even more by taking advantage of new tools and features. By using Microsoft technologies to both populate and manage its private-cloud environment, BIDMC has simplified management and streamlined support.

* With the automated processes in SQL Server 2012 and in SQL Server 2012 Analysis Services and Reporting Services, we’ve cut the time needed to maintain some reports from one or two days to a few hours per month. *

Don Wood
Manager of Database Administration

Improves Availability

The new solution simplifies high availability and disaster recovery, making it even easier for the BIDMC IT department to avoid application downtime. “Before, failovers of multidatabase applications required manual intervention by database administrators,” says Wood. “By creating a SQL Server 2012 AlwaysOn availability group for each multidatabase application, we eliminated the need for the manual interventions. That reduced the time needed for failing over those applications, minimizing both the outage that users experience and the manual work that administrators must perform. With SQL Server 2012, we expect to achieve 99.999 percent availability for all of our mission-critical applications.”

By running SQL Server 2012 in a private cloud, BIDMC can further reduce unplanned downtime by ensuring that each SQL Server 2012 instance has the resources it needs. “By deploying SQL Server 2012 on virtual machines, we are able to keep problems with one instance from affecting any others,” says Wood.

With live migration in Hyper-V, BIDMC can also cut planned downtime. “Our tests of Hyper-V live migration verified that we can move virtual machines without affecting application availability or interrupting our users,” says Wood. Virtualization also supports faster deployment of new SQL Server instances. “With our old solution, the build process and configuration for a new SQL Server instance might have taken days. With SQL Server running in the private cloud, I only need a few minutes to deploy a new instance.”

Hyper-V live migration also provides an additional layer of high availability protection. “Because we can use clustering inside the Hyper-V environment, the loss of a host machine will just cause all of the virtual machines to fail over to another host,” says Wood. “So, not only are we achieving high availability with SQL Server 2012 AlwaysOn availability groups, Hyper-V live migration is also reinforcing that availability.”

Reduces Workload for IT Staff and Information Workers

With the new solution’s more intuitive analysis tools, information workers no longer need assistance with custom queries. “The self-service analysis capabilities in SQL Server 2012 will help us empower information workers to create their own reports, without needing to depend on IT,” says Wood. “As a result, IT workers can concentrate on more valuable work.”

The new solution also saves time for information workers. “Not only does SQL Server 2012 help us create reports more quickly, but it drastically cuts the time needed to maintain those reports,” says
Wood. “With the automated processes in SQL Server 2012 and in SQL Server 2012 Analysis Services and Reporting Services, we’ve cut the time needed to maintain some reports from one or two days to a few hours per month.”

Unlocks More Value in Data

The new solution greatly reduces technical obstacles to analyzing the hospital’s data, helping analysts find valuable business information more quickly and easily. “The SQL Server 2012 solution simplifies the relationship between our IT staff and our users,” says Wood. “With the SQL Server 2012 Analysis Services BI Semantic Model and the xVelocity in-memory analytics engine, it’s much easier for us to create data models that our business analysts and other information workers can understand and analyze on their own. And locally created custom reports can be brought into the SQL Server 2012 Analysis Services, dataset where all users can query them. The SQL Server 2012 solution is really helping us move from personal BI to corporate BI, and that will improve our analytical capabilities, increase productivity, and further strengthen patient care.”

Speeds Performance

The new solution will significantly improve performance. “We began by copying our existing SQL Server 2008 R2 environment into SQL Server 2012, and simply by taking that step we saw faster performance,” says Wood. “That was exciting, because we knew that the new solution offered several new tools and features that could help us speed up performance even more.” A test of one of those features showed especially promising results. “We tried SQL Server 2012 xVelocity on a 160-column table, and the total execution time dropped from 53,841 milliseconds with our old solution to 6,343 milliseconds, an 88 percent improvement. xVelocity will help us greatly improve patient volume reporting from our data warehouses.”

Simplifies IT Management and Support

BIDMC simplified management and support by deploying an integrated Microsoft solution. “Because the tools and interfaces are so similar in Microsoft technologies, it’s very easy for IT employees to learn and maintain any new solution,” says Wood. “That’s one reason we used Hyper-V to virtualize, rather than a third-party product.” The other reason was to streamline support. “Once our tests are complete, this solution is the model we will use for mission-critical databases. By deploying only Microsoft technologies end to end, I know that we will have strong support and no finger pointing between vendors if there is ever any problem.”

Microsoft Server Product Portfolio

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For More Information

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For more information about Beth Israel Deaconess Medical Center (BIDMC) products and services, call(617) 667-7000 or visit the website at:

This case study is for informational purposes only. MICROSOFT MAKES NO WARRANTIES, EXPRESS OR IMPLIED, IN THIS SUMMARY.
Solution Overview

Organization Size: 8000 employees

Organization Profile
Boston’s Beth Israel Deaconess Medical Center (BIDMC) is known for medical and technological innovation. BIDMC employs about 8,000 people.

Business Situation
Boston’s Beth Israel Deaconess Medical Center (BIDMC) is known for medical and technological innovation. BIDMC employs about 8,000 people.

BIDMC tested Microsoft SQL Server 2012 in a private-cloud environment based on Hyper-V technology. It is also using SQL Server 2012 Analysis Services and Reporting Services.

  • Improves availability to 99.999 percent
  • Reduces workload for IT staff and information workers
  • Unlocks more value in data
  • Speeds performance
  • Rapidly provisions new virtual machines with IT control
  • Simplifies IT management and support

HP ProLiant DL380 G7 server computers

Software and Services
  • Microsoft SQL Server 2012
  • Microsoft SQL Server Analysis Services
  • Microsoft System Center Virtual Machine Manager 2008 R2
  • Windows Server 2008 R2
  • Microsoft SQL Server 2008 R2 Enterprise
  • Microsoft SQL Server Reporting Services
  • Microsoft Hyper-V

Vertical Industries
Health Provider

United States

Business Need
  • Business Intelligence and Reporting
  • Cloud & Server Platform

IT Issue
  • High Availability
  • Private Cloud