Resolves a Patient Application Issue in Hours not Days or Weeks

“We received an urgent request from a Chief Nursing Officer at one of our hospitals. She reported that nursing staff were not receiving important patient information from a staffing application. The application vendor couldn’t pinpoint root cause. We called Goliath and within 30 minutes the UHS internal IT team and Goliath were able to resolve the issue.” — Justin Monnig, General Manager of Crossings Healthcare Solutions, a subsidiary of Universal Health Services, Inc.

Infrastructure

VMware, Citrix XenDesktop 7.x, Cerner

Challenge

User Accounts Mysteriously Disappearing

Universal Health Services, Inc. (UHS) uses Goliath Technologies to monitor and troubleshoot End User Experience, Citrix infrastructure, as well as critical underlying components that exist in each of the acute care hospitals that utilize Cerner Millennium™. In this user story, user accounts in the nursing staffing application were mysteriously disappearing from groups, impacting the ability for the appropriate staff to receive important messages. It was both troubling and puzzling for the IT team. Below are the action steps the IT team took to troubleshoot the user account problem and prevent the failure to deliver healthcare services from recurring in the future.

Solution

Finding the Root Cause in Minutes – Not Days

This issue was affecting the delivery of patient care, and finding a resolution was time-critical. Unfortunately, the vendor support channel for diagnosing and resolving this issue was proving to be ineffective. The ticket was escalated to the application vendor and the UHS team awaited a response. Simultaneously, however, they also escalated the issue to their internal Citrix monitoring, escalation & engineering team to see if they could resolve it more quickly.

The internal Citrix monitoring and IT team at UHS immediately leveraged the Goliath troubleshooting features. According to Joe Alexander (Software Architect at UHS),

“I contacted Goliath since I knew Goliath Performance Monitor captures Citrix XenApp and XenDesktop session information that would show us who is launching the specific application causing issues. I was able to prove this out by writing a quick SQL query to gather application process information but needed Goliath’s help to get a new monitoring rule built. We discussed the potential solutions and within 30 minutes Goliath had an email alert firing and configured an additional report to provide the needed information. These findings were sent to the hospital and they were able to use the information to prove that this was an end user issue and not a result of the application. So we were able to troubleshoot, identify the root cause and resolve the issue in less than 45 minutes. Before we heard from the application provider.”

The image above displays metrics from a single user session which helps quickly identify if the root cause of slow performance is isolated to a single user due to behavior or if it is a larger systematic issue related to the underlying infrastructure (Citrix) or application. In this example, it identifies that a slow connection speed (potentially from home WiFi) was causing the end user performance issues, not the application itself.

Results

By leveraging Goliath’s Citrix XenDesktop monitoring, the team at UHS solved a mission-critical issue that could have impacted patient care. Beyond simply providing the solution, Goliath allowed UHS to begin gathering data points and generating reports in 30 minutes. The ability to provide a solution gave the team at UHS the insight to troubleshoot and isolate the root cause before the existing application vendor could complete the research needed to deliver a possible solution.

Now, UHS has proactive Citrix XenApp and Citrix XenDesktop monitoring and alerting set for this specific condition so that, if it ever happens again at other hospitals, they will be alerted in real-time.

UHS currently has Goliath Citrix Monitoring technology deployed throughout their entire Citrix application delivery infrastructure, which they use to deliver Cerner Millennium™ to their hospitals. The scope of their deployment includes agents deployed within the Cerner-hosted datacenter, and the Goliath Application Availability Monitor at over 33 acute care hospital facilities across the United States. The technology is used by UHS for Citrix monitoring to anticipate, troubleshoot, resolve and, most importantly, prevent issues with accessing Cerner Millennium™ from impacting users’ ability to deliver healthcare services.