Obstetrics and Gynecology of Indiana serves approximately 90,000 patients a year through nine offices in central Indiana. Founded in 1993, the practice has 38 physicians. It uses PrimeSuite® from Greenway Health® for its electronic health record (EHR) and practice-management applications, running on a Microsoft® SQL Server® database. Its servers are virtualized using VMware® ESX® and about 200 end-users are supported by Citrix® XenApp® to deliver virtual apps and secure remote access.
The practice had been using a spinning-disk storage-area network (SAN), but it was running out of capacity, and the vendor had announced it would no longer be supporting VMware. “So we had no choice but to buy a new storage system,” said Paul Stage, IT Director. Key selection criteria were high performance, so doctors and other clinicians would have timely and reliable access to patient files, and ease of management, which was critical to an IT staff consisting of only two people.
Stage looked at all the technology options – spinning-disk, hybrid, and flash – and determined that “flash was the way to go. From a cost standpoint, it didn’t make sense to stick with spinning-disk or hybrid.”
Stage said he knew that any solid-state storage device would deliver the performance he needed in terms of IOPS. “The key for us – as an IT staff of two – is that we don’t have time for someone to be just a storage administrator. We needed something that was hands-off, for the most part.”
Stage arranged 30-day proof-of-concept trials with two vendors, one of them Pure Storage. The entire production environment was loaded onto each device and evaluated on a number of criteria, including latency, which had been a big concern for Stage. “We were seeing latencies of anywhere from 10 ms to 30 ms. This threatened the quality of the end-user experience, and that’s the last thing we want. Our goal is to not only provide leading-edge technology to improve patient outcomes, but to do so transparently.”
At the end of the POC trials, Pure Storage was the clear winner. “Pure Storage offered all-flash at less cost than hybrid, it gave us all the performance we could ever want, and it was much easier to configure and expand.” A FlashArray//m20 was installed in April 2016.
Once the EHR system was running on Pure Storage, “I saw an immediate impact on my SQL database,” Stage noted. “It’s a complex database, and all the extra performance in the Pure Storage array compensates for the flaws in the database.”
End-users saw quicker responses to requests for patient files and other transactions, thanks to a dramatic lowering of latencies on the storage array. Latencies that had ranged between 10 ms and 30 ms were now consistently 1 ms or less. That impact is most felt by the roughly the 200 end-users on Citrix XenApp. “Screen refreshes are almost instantaneous. And a report that used to take 2 minutes or more is now available in less than 30 seconds.”
Stage reported similar process improvements inside the IT operation. “My VMware reports typically required 5 minutes to run, and now they’re finished in 5 seconds. It’s remarkable. And the time it takes to recover or move a virtual machine has been cut by half.” File restores are faster, too, now taking 3 to 5 minutes instead of 15 minutes or more.
The data-compression and de-duplication features of the Pure Storage array “has helped dramatically,” Stage reported. “We have a 2.3:1 reduction across the board, and without SQL it’s 10:1. That means we have been able to shrink our data-center footprint by half, which saves both time and money.”
Stage’s most important criterion for a new storage system – ease of management – has been satisfied completely. “The management is quite minimal. Since we set it up, I honestly have not had to do anything with it. It just works.”