Healthcare organizations are migrating to new virtualization platforms because of financial burden and the complexity of today’s infrastructure.
Virtualization allows organizations such as health systems to access applications virtually from a single machine while distributing to other computing environments. Components of virtualization include the hypervisor layer, networking, storage, backup, monitoring and identity management.
Virtualization was “low-drama infrastructure” for many years, but now healthcare IT leaders face challenges such as steep price hikes and being forced into bundles, according to Scott Ragsdale, vice president of healthcare, state, local and education sales at Nutanix.
“Healthcare organizations are migrating to different virtualization providers because of financial necessity and a desire for modernization,” Ragsdale says.
He adds, “The real challenge is that a virtualization platform isn’t just a single piece of software; it’s a decade of standard operating procedures, technical debt and architectural decisions.”
DISCOVER: Apply virtualization best practices to achieve your strategic objectives.
Virtualization migrations are complex because of the intricate process of managing alert thresholds, backup windows, security baselines and the type of latency that is acceptable. In addition, virtualization migrations can be difficult because of the challenges around varying load-balancing levels.
As organizations undergo a virtualization migration and move from one tech stack to another, balancing the impact to patient care is key, Ragsdale notes. He recommends moving workloads in “phased waves” according to how they will impact patient care and a health system’s business.
What a Virtualization Migration Entails
To protect patients’ safety, a virtualization migration should be rigorous, Ragsdale says.
“In a hospital, there’s no room for ‘oops!’” he says.
Understanding an organization’s applications and virtual machines is a key step, according to Stephen Manley, CTO of data security provider Druva. That includes understanding the context of business applications, not just looking at VMs.
“This is not just an IT migration. It’s also a business migration,” Manley continues. “You need to understand both the technical dependencies (identity, security, backup) and business dependencies (downtime windows, risk profiles) so you can create a migration plan that staggers risk and complexity.”
Health IT leaders should conduct a “deep audit to find hidden interdependencies,” Ragsdale advises. Then establish a baseline of what the “end state” of the migration should entail.
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Here are some virtualization migration components to consider:
Tool Selection and Testing
Choosing a migration toolkit such as Nutanix Move helps minimize manual work, according to Ragsdale.
“We focus on making sure the transition doesn’t increase the manual workload on an already stretched-thin healthcare IT team,” he says.
Nutanix Move automates VM cutovers with little downtime and provides flexibility on environments to migrate from platforms such as VMware vSphere Foundation, Microsoft Hyper-V and Amazon Web Services.
Once health systems select the tools, they must validate them.
“[Conduct] rigorous testing with both the customer and application vendor so there are no surprises during the actual migration process,” Ragsdale advises.
Host Sizing
Consider the load required for the health system; don’t simply “copy and paste” old specs, Ragsdale says. Instead, be aware of the actual clinical load.
Engineers should understand the size of their organization’s electronic health record (EHR), picture archiving and communication system (PACS) and other healthcare and business applications, he suggests.
In addition, Ragsdale advises that health IT leaders not assume that all platforms handle load-balancing or high availability in the same way.
READ MORE: Healthcare organizations need to modernize their virtualization and hypervisor strategy.
Cluster and Storage Layout
“Think of a cluster as your resiliency team,” Ragsdale says. “In a provider environment, we plan these so that if a host fails, your EHR or PACS imaging doesn’t skip a beat.”
Health systems rely on vendor partners such as Nutanix to determine if they want single or multiple clusters, or if they should segregate workloads — such as end-user computing, unstructured data or databases — into their own environment, he adds. Another option is to colocate these workloads based on performance and availability, Ragsdale says.
Workload Phases
Workload phases include “clinical criticality” and “technical complexity,” Ragsdale says. Approach workload phases by starting with low-complexity apps to “build muscle memory with the new system,” he advises.
“You don’t tackle the core EHR until you’ve proved the environment can handle the ‘spaghetti’ of network and security rules that support it,” Ragsdale says.
Best Practices for Managing a Virtualization Migration
Keep security and data protection top of mind when performing a virtualization migration.
“Moving a workload without understanding the interdependencies — such as security baselines, data protection tools and supported processes related to security baselines and alert thresholds — can add significant risk,” Ragsdale says.
Maintaining a clear map can help when performing a virtualization migration.
“Don’t guess what your dependencies are; use discovery tools to find them,” Ragsdale says.
Here are some additional best practices to consider during a virtualization migration.
Consider Alternatives to One-to-One Migrations
Pursuing a virtualization migration may involve other options besides a one-to-one migration, according to Manley.
“For example, some customers have migrated the data in virtualized file servers to Microsoft 365 SharePoint Online, network-attached or object storage,” Manley says. “That way they have fewer VMs to manage and migrate.”
EXPLORE: Build a future-proof virtualization strategy.
Work With a Partner
Rely on a trusted partner that specializes in healthcare for virtualization migration. Partners can help health IT leaders understand how healthcare workloads work and ensure that clinical performance concerns are addressed, Ragsdale says.
Back Up Your Applications
Back up your applications for your VMs before you migrate them to a new platform, Manley advises.
“In an ideal world, you will be able to use the same backup solution to protect the VM before and after migration, so you have recovery you can trust,” Manley says.
He explains that even if you back up your applications, parts of the migration may go wrong because infrastructure could be decades old. Ensuring that you have a safety net is key.
“You will encounter surprises,” Manley says. “As long as you have a safety net, you will be OK, but make sure the business is aware of the complexity, challenge and recovery path.”
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