SUNY Upstate Medical University in Syracuse, NY, is the only academic medical center in central New York. The affiliated Upstate University Health System serves 1.8 million people, often the most seriously ill and injured, and includes two hospitals and numerous satellite sites.
Three and a half years ago SUNY decided to adopt electronic health records (EHR). Chris Loughlin, Citrix certified administrator and Epic Client Systems Manager, was brought in along with two others to manage the Windows and Citrix infrastructure for the project.
Upstate chose the Epic solution from Epic Systems Corporation as its EHR software, and runs it as a server-based, Citrix-published application. Upstate has more than 30 Citrix servers with Epic Hyperspace applications installed. End users go to any web browser and launch the Epic Hyperspace application, which then links to a variety of Epic auxiliary applications. “Epic is, by far, the health system’s most widely used application, with between 2,700 and 3,500 concurrent users depending on the time of day,” Loughlin explains.
According to Loughlin, Epic requires load balancing – to handle the load as more people come online, to allow updates without affecting users, and to balance the traffic among Epic’s frontend and auxiliary applications. Epic Systems leaves the choice of the load balancer up to its customers. At the same time, New York State provided funding for green initiatives, which led Upstate to decide to virtualize as much of the EHR system as possible, including load balancing.