vm ware - city clinic case study

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VMWARE CASE STUDY INDUSTRY Healthcare LOCATION Sofia, Bulgaria THE CHALLENGE Building an open telemedicine platform for mobile medical examination rooms, capable of accommodating any kind of standards-based medical instruments and integrating it with Electronic Medical Records systems. THE SOLUTION Aossia’s Sphere of Care solution based on vSphere for Desktop and Horizon View VDI software as the core enabling technology. THE BENEFITS • a leap in medical examination availability and quality, especially for small communities and rural areas • more patients served with existing budget and resources • productivity gains and reduced cost per patient • flexibility from easily adding extra resources • reduced waiting times, public service obligation fulfilled • lower risk and cost from early diagnosis and treatment • easy cross-examination with many doctors available online • fast and cost-effective access to new markets • numerous options for revenue and profit growth • better service for chronical conditions and the elderly • avoiding unnecessary patient transportation and related cost City Clinic taps VDI technology to save lives and cut costs City Clinic implements an innovative cloud-based mobile telemedicine solution combining state-of-the-art medical instrumentation and proven virtual desktop technology from VMware to expand the reach and lower the cost of medical examination. Applications include disaster response, prevention programs, chronic condition monitoring, distributed first-contact care, home care and many more. City Clinic blazes the trail for both private and public healthcare organizations, gaining the ability to provide high quality care to more people, faster and cheaper – all at the same time – and with existing human resources. For all the hype it gets, telemedicine is often just that, a hype. The reason is simple: most solutions have limited features accompanied by high price tags and thus, little chance for broader adoption. This is, however, not the case with Aossia’s Sphere of Care. The challenge As an IT solution integrator Aossia works with a large number of technologies using them to build industry-specific solutions for customers. One of them is City Clinic, the leading healthcare provider in Bulgaria who recently tasked the company with developing a solution for remote medical examination. The reason was City Clinic doctors’ frustration while evaluating various telemedicine solutions available on the market. In short, in their view, most of them did not deliver on the initial promises of productivity improvement and long-term cost-efficiency gains, while also imposing compromises in other areas, such as openness or mobility. “We were not interested in integrating many single-purpose, often proprietary solutions. Rather, we wanted to see an open platform enabling us to perform a multitude of medical examination procedures as well as tests remotely. That essentially meant having one solution integrating many medical instruments. We also stressed the need to tightly integrate remote examination with centralized, standards-based Electronic Medical Record systems. Without such integration, the solution would not be much of an improvement for our doctors’ productivity” – explains Ilian Grigorov, CEO, City Clinic. Aossia took all those remarks home with the aim to give the idea a serious try. After further consultations, technology tests and investments the company came up with a solution being exactly what City Clinic hoped for. “Internally, we developed a set of projects, each with goals addressing specific challenges on the way to the envisioned solution. These were, for example, device integration, interoperability and standards, security, compliance, management, teleconferencing, usability, mobility, cost and a lot more” – explains Miroslav Ivanov, Sales Manager, Aossia. The solution “Working with City Clinic we have developed, tested and productized a general purpose remote medical examination solution. It enables hospital-type medical examination just anyplace with a cellular or fixed Internet connection. Combining any IoT medical

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Page 1: VM Ware - City Clinic Case study

VMWARE CASE STUDY

INDUSTRYHealthcare

LOCATIONSofi a, Bulgaria

THE CHALLENGEBuilding an open telemedicine platform for mobile medical examination rooms, capable of accommodating any kind of standards-based medical instruments and integrating it with Electronic Medical Records systems.

THE SOLUTIONAossia’s Sphere of Care solution based on vSphere for Desktop and Horizon View VDI software as the core enabling technology.

THE BENEFITS• a leap in medical examination

availability and quality, especially for small communities and rural areas

• more patients served with existing budget and resources

• productivity gains and reduced cost per patient

• fl exibility from easily adding extra resources

• reduced waiting times, public service obligation fulfi lled

• lower risk and cost from early diagnosis and treatment

• easy cross-examination with many doctors available online

• fast and cost-e� ective access to new markets

• numerous options for revenue and profi t growth

• better service for chronical conditions and the elderly

• avoiding unnecessary patient transportation and related cost

City Clinic taps VDI technology to save lives and cut costs

City Clinic implements an innovative cloud-based mobile telemedicine solution combining state-of-the-art medical instrumentation and proven virtual desktop technology from VMware to expand the reach and lower the cost of medical examination. Applications include disaster response, prevention programs, chronic condition monitoring, distributed fi rst-contact care, home care and many more. City Clinic blazes the trail for both private and public healthcare organizations, gaining the ability to provide high quality care to more people, faster and cheaper – all at the same time – and with existing human resources.

For all the hype it gets, telemedicine is often just that, a hype. The reason is simple: most solutions have limited features accompanied by high price tags and thus, little chance for broader adoption. This is, however, not the case with Aossia’s Sphere of Care.

The challengeAs an IT solution integrator Aossia works with a large number of technologies using them to build industry-specifi c solutions for customers. One of them is City Clinic, the leading healthcare provider in Bulgaria who recently tasked the company with developing a solution for remote medical examination. The reason was City Clinic doctors’ frustration while evaluating various telemedicine solutions available on the market. In short, in their view, most of them did not deliver on the initial promises of productivity improvement and long-term cost-e� ciency gains, while also imposing compromises in other areas, such as openness or mobility.

“We were not interested in integrating many single-purpose, often proprietary solutions. Rather, we wanted to see an open platform enabling us to perform a multitude of medical examination procedures as well as tests remotely. That essentially meant having one solution integrating many medical instruments. We also stressed the need to tightly integrate remote examination with centralized, standards-based Electronic

Medical Record systems. Without such integration, the solution would not be much of an improvement for our doctors’ productivity” – explains Ilian Grigorov, CEO, City Clinic.

Aossia took all those remarks home with the aim to give the idea a serious try. After further consultations, technology tests and investments the company came up with a solution being exactly what City Clinic hoped for. “Internally, we developed a set of projects, each with goals addressing specifi c challenges on the way to the envisioned solution. These were, for example, device integration, interoperability and standards, security, compliance, management, teleconferencing, usability, mobility, cost and a lot more” – explains Miroslav Ivanov, Sales Manager, Aossia.

The solution“Working with City Clinic we have developed, tested and productized a general purpose remote medical examination solution. It enables hospital-type medical examination just anyplace with a cellular or fi xed Internet connection. Combining any IoT medical

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VMWARE CASE STUDY

devices with the latest medical and information technology innovations, the Sphere of Care gives City Clinic new service delivery options as well as radical cost savings”– says Ivaylo Petrov, CEO, Aossia.

Conceptually, the solution imitates a medical examination room in a clinic or hospital, the key di� erence being both the patient and the doctor can be anywhere in the world, teleconferencing in real time. The patient is attended by a nurse who acts the ‘doctors’ hands’, physically operating medical instruments e.g. a stethoscope, a heart monitor, a blood pressure monitor, an ultrasound scanner, a glucose-level meter or a laparoscope set. In fact, any digital medical device can be used as long as it can transfer data over a USB, Wi-Fi or Bluetooth to a laptop (Windows, Mac OS), a tablet (Android, iOS) or even a smartphone (Android, iOS) running VMware Horizon View 6 software.

The VMware vSphere for Desktop and Horizon View are VDI, or Virtual Desktop Infrastructure software products which are the core enabler for the Sphere of Care solution. Both the nurse and the doctor use it to access their virtual desktops running in Aossia’s cloud.

“VDI is a crucial part of the solution because medical desktop applications often require a lot of computing

resources and high speed networking available as well as some special operating system. These, of course, may be hard to get under truly mobile circumstances. Centralizing desktops is also essential because of information security and compliance requirements. With vSphere for Desktop and Horizon View, no data is stored on a remote location – it is only displayed while constantly residing in the security vault in the cloud. We have chosen VMware’s VDI technology for its fl exibility, reliability and proven track record worldwide” – stresses Aossia’s Petrov.

Secure access to patient information is based on dedicated server software, distributed hardware security modules and user’s smart cards. The solution assumes two separate HD screens are used – one for the patient-doctor teleconferencing using telepresence software and the other for imaging and medical applications. In the case when a tablet or smartphone are used for urgent cases, screen switching is inevitable, but it is still very usable. As for connectivity… “Any decent broadband can handle the connection. The bandwidth requirement is 5 Mb/s or more. In the case the connection slows down the solution automatically drops the frame rate while keeping the picture and voice quality intact. The solution reliably works even over a 3G cellular

“We were not interested in integrating many single-purpose, often proprietary solutions. Rather, we wanted to see an open platform enabling us to perform a multitude of medical examination procedures as well as tests remotely. That essentially meant having one solution integrating many medical instruments. We also stressed the need to tightly integrate remote examination with centralized, standards-based Electronic Medical Record systems. Without such integration, the solution would not be much of an improvement for our doctors’ productivity”

Ilian Grigorov, Chief Executive Officer, City Clinic

SOFTWARE• vSphere for Desktop

• Horizon View 6

“Any decent broadband can handle the connection. The bandwidth requirement is 5 Mb/s or more. In the case the connection slows down the solution automatically drops the frame rate while keeping the picture and voice quality intact. The solution reliably works even over a 3G cellular data link which speaks volumes about the robustness of the Horizon View 6 and its PCoIP remote protocol”

Roch Norwa, Lead System Engineer, VMware who validated the architecture

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VMWARE CASE STUDY

data link which speaks volumes about the robustness of the Horizon View 6 and its PCoIP remote protocol” – declares Roch Norwa, Lead System Engineer, VMware who validated the architecture.

Indeed, the mobility is a game changer for the patient. The quality of diagnosis and adequate care during the fi rst 60 minutes often determine the results of all further e� orts doctors undertake. “Within these 30 or 60 minutes we can adequately react and we can base treatment and diagnostics on accurate facts and information about the patient” – City Clinic’s CEO, Ilian Grigorov explains.

Initially, City Clinic considered the Sphere of Care as a disaster response solution to be used just about anywhere. This required the whole set to be put into a dome-shaped environment-resistant tent of special material, with special fl ooring etc. Anywhere means… anywhere, after all. The characteristic spherical shape of the tent inspired the name, even though the ‘tentless’ use scenarios now seem to be even more prospective for City Clinic.

The benefi ts“Whether the doctor is in the hospital or in some other location he has access to current medical information, at any time, and at any stage of the patient’s treatment” – notes Ilian Grigorov.

It doesn’t take much imagination to envision a broad array of use cases for the Sphere of Care. Working with Aossia, City Clinic has crystalized real-world requirements for telemedicine and essentially blazed the trail for many new initiatives, including in public healthcare. “Public healthcare faces ever mounting demand for services while budgets and human resources are already very strained. Long waiting times even for basic public medical service have become a norm across the world. We believe we can help local governments address the ever mounting cost and resource-shortage issues” – City Clinic’s CEO, Grigorov argues.

These arguments are fair but obviously, this is just a tip of the iceberg in terms of optimization opportunities. “The Sphere of Care provides a practical means to solve a long list of problems. For example, better prioritizing patients in time critical situations, avoiding unnecessary medical transport, speeding up diagnosis and preventing deterioration, better serving the chronically ill and the elderly as well as enacting prevention programs. Being able to quickly consult many doctors in real time reduces the risk of inappropriate diagnosis or treatment which is highly desirable not only by patients but doctors as well” – Aossia’s Petrov adds.

This is not to say City Clinic stops being a private healthcare provider. Just to

“Whether the doctor is in the hospital or in some other location he has access to current medical information, at any time, and at any stage of the patient’s treatment”

Ilian Grigorov, Chief Executive Officer, City Clinic

“AOSSIA IT Healthcare Innovations, working closely with End User Computing solutions from VMware, has developed “Sphere of Care”, a revolutionary and world-leading mobile healthcare delivery solution that can be rapidly deployed to rural areas, areas of emergency need such as natural disasters, large scale outdoor events, military and refugees camps and etc. Well, you don’t have imagine any longer as the remote medical examination is no longer in the realm of science fiction”

Miroslav Ivanov, Sales Manager, Aossia

Page 4: VM Ware - City Clinic Case study

VMware, Inc. 3401 Hillview Avenue Palo Alto CA 94304 USA Tel 877-486-9273 Fax 650-427-5001 www.vmware.comCopyright © 2016 VMware, Inc. All rights reserved. This product is protected by U.S. and international copyright and intellectual property laws. VMware products are covered by one or more patents listed at http://www.vmware.com/go/patents. VMware is a registered trademark or trademark of VMware, Inc. in the United States and/or other jurisdictions. All other marks and names mentioned herein may be trademarks of their respective companies. Item No: 16Q1 Aossia's Sphere of Care at City Clinic UK ALT

VMWARE CASE STUDY

“VDI is a crucial part of the solution because medical desktop applications often require a lot of computing resources and high speed networking available as well as some special operating system. These, of course, may be hard to get under truly mobile circumstances. Centralizing desktops is also essential because of information security and compliance requirements. With vSphere for Desktop and Horizon View, no data is stored on a remote location – it is only displayed while constantly residing in the security vault in the cloud. We have chosen VMware’s VDI technology for its flexibility, reliability and proven track record worldwide”

Ivaylo Petrov, CEO, Aossia

the contrary, the hospital stands to potentially gain many more benefi ts using the telemedicine solution for business development. “For any private healthcare provider growing the potential patient base is a long-term imperative. With Aossia’s Sphere of Care we can quickly and cost-e� ectively enter new markets. Setting things up takes less than a day, even with the dome. A remote point of presence can bring revenue stream directly from services rendered as well as indirectly, by marketing and selling services provided centrally” – Grigorov remarks.

That said, human resource e� ciency and cost management clearly are central to telemedicine’s future which City Clinic’s case defi nitely confi rms.

Meanwhile, Aossia sees even more advanced scenarios looming.

“Private healthcare providers can o� er premium services to patients who want to implement Sphere of Care at home. This would probably include a limited set of medical devices due to signifi cant cost but… there are people who can a� ord even the full set. On the other hand, in many typical cases, especially with chronic conditions, one or two specialized devices would be enough. In terms of long-term operational e� ciency and profi tability, home-based service delivery coupled with subscription-based business model is preferable. I can easily imagine device subsidies o� ered, telco style” – Ivanov opines.