1. Gary Stronach Percy Gouchie Technical Service Delivery November 24, 2009 Virtually …transforming health care

2. Agenda An overview of HITS-NS Our Challenges Our Approach (VMWare) Benefits of Virtualization with VMWare Results (our environment/infrastructure) Lessons Learned Top Ten Tips Questions

3. Health Information Technology Services Nova Scotia (HITS-NS) enables Nova Scotia's health care community to use information technology to deliver better health care. HITS-NS manages a secure and private health care IT environment, for the benefit of all Nova Scotians. This is accomplished through our committed health care focused staff, integrated systems and 24/7 operational support. What is HITS-NS?

4. About Us Established in 2006, HITS-NS is an independent, permanent program funded directly by the Department of Health. Annual budget of approximately $15 million. As part of a national vision, we are helping Nova Scotia move toward one electronic health record (EHR) to enhance the quality of patient care.

5. Our Challenges Unpredictable resource demands as new services were required for delivering healthcare in NS Under-utilized servers with requirements for additional servers. Limited technical resources were stretched to the limit Constant requirement for more infrastructure servers. High demand for temporary/test servers. Server refreshes

6. Started slow Training Life Without Vmware: Testing Committing Deploying Upgrading S/W VMWorld Our Approach

7. Availability Efficiency Life With Vmware: Flexibility Manageability Hardware Independence Cost avoidance Environmental Benefits of our VMware Implementation

8. Our Environment 44 ESX Enterprise Servers version 3.5 update 4 1 Enterprise Virtual Center version 2.5 update 4 228 virtual machines 8 clusters on Dell 1955 and M600 Blades 3 tiers of EMC storage (low-end ISCSI, mid-tier ISCSI, High I/O Fiber Channel) 130 different data stores – 5.1TB ISCSI & 5.3TB Fiber

9. DC-SV-ESX2DC-SV-ESX1 Each Dell 1955 blade server has 4 NIC’s 2 on-board Broadcom GigE NIC’s provide redundant network connectivity 2 daughter-card Broadcom GigE TOE NIC’s provide ISCSI SAN connectivity Cisco 2960 GigE Switch EMC Celerra ISCSI Array (7.5 TB) Cisco 2960 ISCSI Switch NIC2NIC1 NIC3(toe)NIC4(toe) NIC1NIC2 NIC3(toe)NIC4(toe) IP Storage Network The NS80 Storage Array is connected with 4 redundant GigE Etherchannel uplinks IP Network ISCSI Setup

10. 1.Cluster size – use larger clusters of ESX hosts 2.Use tiered storage to reduce costs 3.Use resource pools where necessary 4.Use a separate database for VM updates 5.For fiber attached servers – check with your vendors for optimal settings 6.For ISCSI attached servers – use jumbo frames 7.For ISCSI attached servers – use a dedicated GigE network 8.Use the built-in vCenter performance graphs or ESXtop rather than relying on guest performance tools like perfmon 9.Use IOMeter to get baselines and monitor frequently 10.Must-have VI client plugins (and they’re free!) Top Ten List

11. Add-ons

12. Add-ons cont.

13. Get Senior Management commitment to Virtualization ‘Virtualize first’ policy will make purchases easier Still have to prove VM to vendors and developers Not everything should share resources – some 1 to 1 Get clients to buy vm license with hardware instead of multiple servers for test/dev and backup Virtualization is not free but it is freeing. Lessons Learned

14. ELA More applications / services - Target of 80% SRM Next Steps

15. Questions? HITS-NS Percy.Gouchie@nshealth.ca Gary.Stronach@nshealth.ca