Improved IT operations benefit patient care

Published: June 2007

"The security element is important, it gives us visibility whereas before we were trusting people to do the right thing. Now we can see through reports exactly what is going on."
- Gavin Sinanan, IT Support Manager, The Royal Hospitals

Summary

The Royal Group of Hospitals in Belfast is made up of four linked hospitals, spread over a 70 acre site. It treats more than half a million people every year and has 6,000 staff. With only basic alerting and monitoring tools the IT function was largely reactive. The challenge was to create a more proactive environment that could maximise the efficiency of the inhouse IT skills.

Situation

Managing the IT operations across Northern Ireland’s biggest hospital is the responsibility of a small team of IT people. Like most public sector bodies, the challenge is to deliver world class services efficiently with a finite set of resources.

IT service health is paramount in an environment where the ability to provide a rapid, agile response to IT events can make a fundamental difference to the way the hospital delivers patient care.

The IT team had been using various monitoring solutions to support 160 production servers and 2,500 desktops/laptops. "We had limited success because they were very difficult to set up and gave us a lot of unnecessary information," said Gavin Sinanan, IT Support Manager.

With only basic alerting and monitoring tools the IT function was largely reactive. The challenge was to create a more proactive environment that could maximise the efficiency of the inhouse IT skills.

With BT as the Microsoft channel partner the Royal Hospitals deployed Microsoft Operations Manager 2005 (MOM). As a predominantly Microsoft house, it was a natural next step to have a software solution that was best-of-breed for Windows and applications hosted on the Microsoft platform. MOM gave the IT department control over the disparate servers, but it still offered relatively limited visibility over the environment as a whole from an end user perspective.

Solution

The big change came when the Royal Hospitals was introduced to Microsoft’s Infrastructure Optimisation Model. This is a four step framework that helps organisations explore their existing IT infrastructure and move from a manual, reactive state of Infrastructure Management to a more proactive approach thus improving security and management.

Having been impressed by the model the Royal Hospital was keen to move to a rationalized infrastructure, which is the third step along the Infrastructure Optimisation Model. With this in mind Royal Hospitals was invited to participate in Microsoft’s Technology Adoption Programme (TAP), to work on the deployment of System Center Operations Manager 2007. Participants in the scheme receive support and technical advice directly from the Microsoft product development team, in addition to access to local consultancy expertise.

Microsoft has dramatically enhanced the MOM capability with Operations Manager 2007. Built to deliver end-to-end service management with greater efficiencies and more control, it is also optimised as the best-of-breed manager for a Windows platform environment. Gavin Sinanan explained the evolution: "MOM2005 gave us a status view on each server. With Operations Manager this progressed to an overall service view, from the server to the client, integrating all the different services at each level within the organisation. You can build up a nice holistic picture of what IT elements make up a service to the end user." The move away from silo-based server monitoring, which only identified when an individual application was down, to an end-to-end monitoring solution opened up new possibilities.

"The real benefit of Operations Manager is that it helps you look at technology as a business service," said Darren Dillon, Microsoft’s Engagement Manager for the Royal Hospitals project. "Most other similar products look at a server or application and tell you whether it’s working or not based on fairly rudimentary logic. Operations Manager looks at all the components of the service, from switches and routers, through antivirus and firewalls and along the way to application and database servers, thereby providing a business view rather than just an IT perspective."

One particular objective was to find a solution that could deliver line of business application monitoring. Setting up service views of key hospital processes was considered paramount for improving hospital care. Critical applications around patient treatment in A&E and the dispensing of drugs in the pharmacy unit could be managed more proactively, ensuring higher levels of availability that would directly benefit the patient experience.

The multiple hardware and software components that make up a process such as drug dispensation encapsulate everything from network switches and servers, to database components and operating systems. On the top layers are the actual application layer and the web-based user interface. If one component fails, the end to end solution will likely fail and the service to the end user will suffer.

All of these elements are managed by Operations Manager to provide a single service-based view from a single intuitive interface. A potential problem can be seen and resolved before it impacts on the end user productivity.

Distributed applications can also be centrally monitored. In the enterprise IT environment a service as fundamental as email is made up of many servers, applications and network devices that run across the organisation. With Operations Manager, an administrator can define the components and create a service model that can be managed from a single view.

"Operations Manager looks at things in a different way which is more useful to the business, explained Dillon. "The components of services are defined from a user’s point of view and Operations Manager will report on the health and availability of that user service. This is in line with ITIL concepts, whereby IT solutions are defined, monitored and managed as a service as opposed to a set of discrete components. The users do not care if a component is failing, they just care about whether or not they can do their job."

Microsoft extends Operations Manager’s monitoring scope right down to the client level, the crucial last mile in true end-to-end service management. An agent is deployed to a client system and, based on pre-defined rules, events and performance are constantly determined by automating synthetic transactions. As a result, administrators can step in to the seat of end users, report on simulation of their desktop experience and carry out trend analysis on the performance of key applications as experienced by the user.

The product also improves security management and compliance. Operations Manager has the ability to store security logs in real time from all managed devices, reducing risk throughout the organisation by providing a centralised secure source of all audit trail data, which can then be reported on by auditors.

"The security element is important, commented Sinanan. "It gives us visibility whereas before we were trusting people to do the right thing. Now we can see through reports exactly what is going on."

Operations Manager is also supported by over 50 Microsoft Management Packs whichprovide the building blocks for extending the reach of the product. They contain best practice knowledge to discover, monitor, troubleshoot, report on and resolve problems around specific technology components –this knowledge is provided by the Microsoft product teams and support experts for the specific product.

Benefits

The Royal Group of Hospitals was the first customer in Ireland to deploy System Center Operations Manager 2007 in a full production environment. As a consequence, the IT management function has been transformed, moving from a reactive support team, responding to alerts and faults, to much more proactive monitoring of infrastructure and applications, with the added value of looking at IT from a business perspective

"With MOM 2005 they discovered many problems but didn’t have the free time available to fix them. The situation was compounded because many of the alerts were generic, which meant their importance was overlooked since the source could not be relied on" said Dillon. "Operations Manager has eradicated these types of issue because it can look at the wider environment and self-tune a problem."

An alert warning of limited disk space, for example, could be inaccurate if the system is unable to identify the capacity of the server. "Operations Manager makes the call on the context and tunes itself," explained Dillon. As an example, a generic alert could be defined as a disk having less than 10 per cent available capacity. This could be a critical issue on a 36GB OS volume, whilst on a 5TB SAN volume this is of less importance. Operations Manager has in-built logic to address these types of scenarios around core network, storage, memory and processor capacity alerting – thereby resulting in lower implementation time and faster return on investment.

Uptime for business critical processes is now exceeding 98 per cent as a minimum. This has been achieved using the skills that already existed inhouse without having to take on extra IT staff – a key factor in itself.

The relationship with Microsoft has saved the Royal Hospitals money and resource effort while providing a holistic view of the end-to end environment with tools that are easy to use. Operations Manager has increased efficiency by building on existing knowledge skills, whilst adding scale in terms of the numbers of servers and applications that are proactively supported by the team.

Security has also been improved. Rather than simply entrusting people with complying with written policies and procedures, the IT department now has the visibility to reduce risk and enforce compliance whenever an audited event takes place.

The IT service function at the Royal Hospitals has become more proactive, ensuring the optimum environment for world class healthcare.

John Molloy, the BT Technical Consultant who has been working with the Royal Hospital since MOM was installed in 2005, said there was clear evidence that the new environment had made a huge difference: "Since it has been up and running there has been a dramatic drop in the number of service desk phone calls. A small IT department serving lots of users is now reaping the rewards from a proactive approach."

Going forward, Operations Manager will play a pivotal role as the Royal Hospitals looks to centralise more of its IT service provision. Forefront, Microsoft’s line of businessantivirus solution, has already replaced disparate security products. Operations Manager integrates with this software suite, monitoring and reporting on the whole environment, turning security operations into another centralised and more manageable task.

Going forward, the plan is to extend an application virtualisiation pilot using Microsoft SoftGrid. In this scenario, applications will run locally without having to be installed on the desktop. "The plan is to reduce the complexity of the PCs and centralise the applications and services. Whilst this has a lot of value in terms of support and deployment overhead, you have to pay much more attention to the central environment with this kind of delivery model," said Dillon, "so Operations Manager will have an increasingly important role to play in ensuring availability and capacity targets are met or exceeded."

Microsoft Infrastructure Optimization

With infrastructure optimization, you can build a secure, well-managed, and dynamic core IT infrastructure that can reduce overall IT costs, make better use of resources, and become a strategic asset for the business. The Infrastructure Optimization Model—with Basic, Standardized, Rationalized, and Dynamic levels—was developed by Microsoft using industry best practices and Microsoft’s own experiences with enterprise customers. The Infrastructure Optimization Model provides a maturity framework that is flexible and easily used as a benchmark for technical capability and business value.