Universal Health Services, Inc.

UHS Resolves Citrix Accessed Oracle Health (Cerner) Millennium Availability Issues Impacting Nurses  

“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

Oracle Health (Cerner) Millennium, Citrix, VMware 

Availability, speed, and reliability are critical to healthcare organizations as there can be a direct impact to a clinician’s ability to deliver quality patient care. This became a real concern for the team at UHS. User accounts in the nursing staffing application were inexplicably disappearing from groups. This was impacting the ability of the appropriate staff to receive critical communications. The issue was a high priority due to potential patient impact. More concerning was the fact the IT team lacked the telemetry necessary to isolate and resolve the root cause. That was when the IT team at UHS decided to leverage Goliath.  

Challenge

Availability, speed, and reliability are critical to healthcare organizations as there can be a direct impact to a clinician’s ability to deliver quality patient care. This became a real concern for the team at UHS. User accounts in the nursing staffing application were inexplicably disappearing from groups. This was impacting the ability of the appropriate staff to receive critical communications. The issue was a high priority due to potential patient impact. More concerning was the fact the IT team lacked the telemetry necessary to isolate and resolve the root cause. That was when the IT team at UHS decided to leverage Goliath.  

Solution

Isolating Root Cause in Minutes – Not Days 

Since the issue was affecting the delivery of patient care, 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 Goliath’s advanced troubleshooting capabilities. 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. All before we heard from the application provider.” 

Example

The image above displays metrics from a single user session which helps to 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.  

Results

By leveraging Goliath’s Citrix CVAD (XenApp & XenDesktop) monitoring, the team at UHS resolved a mission-critical issue that could have impacted patient care. Beyond simply providing the solution, Goliath enabled UHS to begin gathering data points and generating reports within 30 minutes. Because of Goliath’s deep telemetry and unmatched data correlation, the team at UHS had the insight needed to isolate, troubleshoot, and resolve the root cause well before the existing application vendor could complete the research needed to deliver a possible solution. 

Now, UHS has proactive Citrix CVAD (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’s 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 speed & reliability issues before they impact clinicians, troubleshoot quickly when issues do arise, and document root cause so permanent remediation can be implemented, and clinicians can deliver uninterrupted patient care.