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Helping our Partners transform the cost, quality and delivery of patient care via the Cloud

Mission

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Market Factors – Executive Summary

Business Issues How VMware Addresses

Safely accelerate critical EHR projects: Rationalize, consolidate and modernize infrastructure via the Cloud.

Low clinical adoption rates for new EMR systems. Meaningful Use reimbursements as risk.

Hospitals must meet 2015 federally mandated EHR Meaningful Use targets or face significant penalties

ISV’s straining to deliver net new EHR product to an increasingly IT savvy, educated and competitive market place

Comply with new federally mandated HITECH regulatory compliance guidelines.

Centralize and secure critical data and systems while increasing the availability and recoverability of EHR systems.

Reduce TTM & TCO of ISV products and enable delivery via Cloud

Provide an exceptionally better end user experience that is simple, secure and increases mobility.

Must transform the cost, quality and delivery of patient care

Clinical Infrastructure Rationalization; Improve Clinician Workflow; ITaaS

$51 Billion

© 2009 VMware Inc. All rights reserved

Industry in Cloud Context

Healthcare Cloud = Connected Care

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Who Really Cares About the Cloud? –Healthcare

Top Drivers to the Cloud- Speed to Implement- Higher IT utilization- Cost reduction- Deployment flexibility- Agility- Scalability across locations

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Patient

VMware Healthcare Cloud = Connected Healthcare

Providers

Life Sciences

Payers

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Healthcare Forced to Accelerate/Skip

Mainframe

PC / Client-Server

Web

Cloud

Computing

Existing legacy applications and data must be brought safely forward with little to no disruption to the clinical staff’s workflow.

Our solutions can provide a path forward that is….both non-disruptive (evolutionary) and transformational (revolutionary)

Timeline/Journey

1980

Today

2015 -17

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COST EFFICIENCYCOST EFFICIENCYQUALITY OF SERVICE

BUSINESS AGILITYBUSINESS AGILITY

The Virtualization Journey – Healthcare Providers

Ownership/ Sponsorship

Business Value

Approach

Key Capabilities

Phase IT Production

IT

Reactive

Shared resource pools Elastic capacity

CAPEX

OPEX

Business Production

IT / Clinicians

Selective

Zero-touch infrastructure Increased control +

service assurance

CAPEX

OPEX

Availability

Responsiveness

Stages of Adoption and Maturity

IT as a Service

CIO

Proactive

Service definition Self-service Chargeback

CAPEXOPEX

AvailabilityResponsiveness

Compliance

HealthcareToday

Planned 2011 Investments

Strategic Impact of Healthcare Transformation

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Significant Obstacles for Healthcare IT Leaders

Meaningful Use, ARRA/HITECH, HIPAA/Breach…..• Time to delivery, Complexity, Compliance, Skilled Staff - Visibility

Clinician Productivity & Satisfaction• Access, Experience, Mobility, Management

Application Support and Rationalization• Performance and Reliability

Inflexible & Fragile Datacenter Infrastructures• Overwhelming Complexity & Costs

• Enforcement of IT Standards and Security

• Disaster Recovery – Expensive, Complex & Unreliable

How to Prepare for and Leverage Cloud Computing Affiliated Physicians, Telemedicine, Rural/Remote Facilities Health Information Exchanges, Mergers/Acquisitions

* HIMSS & VMware National Healthcare Virtualization Focus Groups

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The Status Quo Will No Longer Do

Albert Einstein

"We can’t solve problems by using the same kind of thinking we used when we created them.....”

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Private Cloud

Clinical Infrastructure Rationalization

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Clinical Application Deployment. Today

Typical HIS Application

DevTest

• Typically 2x’s Server count for “better” availability

• Increased complexity, lower availability, expensive

• Test / Dev typically matches production 1:1 • Infrastructure sits idle most of the time, expensive

…and this is only one small application!

Citrix

# of Servers*: Annual Energy Cost*:3 $2,421.006 $4,842.0015 $12,105.0018 $14,526.00

* Based on VMware Green Calculator

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Healthcare IT: Complex Infrastructure of “One-Off’s”

Production

Production

Development

Test

Production DevelopmentTest

Development

Citrix

Citrix

Citrix

Vendor A

Vendor B

Vendor C

“…the number of applications we have to support is staggering…and not getting smaller anytime soon….” Focus Group Feedback

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Healthcare IT: Complex Infrastructure of “One-Off’s”

App-Prod

App-Prod

App-Prod

App - DevApp - Test

App - DevApp - Test

Test/Dev

TS-Citrix

TS-Citrix

TS-Citrix

Vendor A

Vendor B

Vendor C • Infrastructure of Application Silo’s and One-Offs’• Bloated, Expensive Siloed Terminal Server Farms• So much Variance Increases Risk and Support Costs

This complexity stifles investment, innovation and drains resources from more strategic patient care investments

This “thinking” is no longer sustainable

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Clinical Application

Clinical Applications

Too Complex, Large Server Footprint

HA and Clustering Hardware, SoftwareProcedures

Little to no Automation

Disaster Recovery Almost Impossible

Totally Separate Architecture Silos for Client Application Deployment

High Availability

VirtualizedDesktops

Disaster Recovery

Automation

Server Consolidation

Compliance

CloudInfrastructure

Development

VMware vSphere

Reduce Complexity & Footprint

Integrated HA and Clustering

Security / Compliance

Increase Quality & Supportability

Reliable Disaster Recovery

Fat, Thin, Web & Legacy SupportAlternative to MSTS/Citrix

Cloud Delivery Platform

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VMware vSphere

The Journey to the Private Healthcare Cloud

Storage Compute Network Clients Applications

EMR, CPOERIS/PACS

The Private Cloud

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VMware vSphere

The Journey to the Private Healthcare Cloud

Storage Compute Network Clients Applications

EMR, CPOERIS/PACS

HIT Datacenter Engine

The Private Cloud

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VMware vSphere

The Best Platform for your Clinical Applications

Reduce Costs by Consolidating Datacenters, Rationalizing & “Archiving” Applications

7x24x365 EHR systems require Robust, Highly Available Compute Platforms for Patient Safety

Reliable Disaster Recovery is No Longer a “nice to have”

Increase Compliance while Reducing Variance & Complexity

Modular HIT Datacenter Engine

The Private Cloud

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Become an assistant in better patient care. Spend more time with the patient.

End User Computing

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The Desktop in Healthcare Is Changing…

PC is viewed as less strategic…

• Hard to manage

• Resource drain

• Low levels of service

• Expensive

• Not secure

Compute model moving to End User Centric

By the end of 2012, 60% of all enterprise PC configurations will use at least one technology that is considered desktop virtualization*

*Predicts 2010: PC End-User Issues, Gartner – Dec. 2009

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OPEXCAPEX

For every $1 spent on hardware, companies spend $3 to manage

$1

$3$3

The Cost of Desktop Management Is Staggering

Incr

easi

ng

IT C

ost

s

Source: IDC Study 2009Are the needs of IT and end-users being met?

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Needs And Requirements Different

The Clinical Desktop

Users: Fast access to applications and

data from any terminal Ability to roam their session as

they move High availability Familiar look and feel Secure remote access

IT : Simplify management Quickly roll out new applications

or services EMR/EHR Maintain compliance and protect

sensitive data Satisfy end users Reduce costs

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Virtualization Breaks Down the Desktop Components

Persona

Applications

Operating System

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Modernizing the Desktop – A Managed Service Model

Persona

Applications

Operating System

Centralized Management

DesktopDelivery

ModernDesktop

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Follow Me Desktop – Example with SSO

Streamline Workflow – Tap and Go• User taps badge or swipes finger to reconnect to desktop

• Single click SSO to all Clinical Applications

• User disconnects from desktop with card tap

• Desktop maintained on server as user roams

Wireless WOW

Thin Client

Laptop

Remote Physicians Office

Nurses Station Desktop

Also Includes•Password Management/Reset

•Automatic Compliance Reporting

•Support for various authentication modalities

•Reauthentication support – i.e. drug dispensing

Improve Workflows

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Meets the Needs of the Provider

Always On

Follows User

Any Device

Familiar Interface

Apps all Work

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And the Needs of Healthcare IT

Quickly Provision

Easily Manage

Maintain Security

Lower Costs

High Availability

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Traditional PC vs VMware ViewTCO Comparison

Breakthrough TCO and Acquisition Cost

Source: IDC White Paper 2009

Acquisition Cost Per User

$200

$400

$600

$800

$1000

$1200

2010Time

Reduce Costs

Traditional PC With VMware View$0

$200

$400

$600

$800

$1,000

$1,200

$1,400

$1,600

Device IT - Admin IT - Install

IT - HelpDesk Downtime Server

Storage Software Professional Services

40% less TCO

$585 lessper user per

year - IDC

40% less TCO

$585 lessper user per

year - IDC

$1450$1450

$865$865

Average Corporate PC

sub-$500

$250Datacenter Infrastructure Cost

Acquisition cost sub $500 per userAcquisition cost

sub $500 per user

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Reach out and extend the reach of your care organizations

Cloud Services

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VMware Cloud Director

Physicians Practices- Offering Multi-Tenant Hosting Service

Practice A Practice B

VMware vSphere + vCenter + vShield

Company A Company B Company C

Practice C

Solution – vShield Edge, VMware vCloud Director

• Guarantee full confidentiality and protection of tenant apps and data with built-in firewall and VPN

• Use enterprise directory services for security policies• Accelerate compliance by logging all traffic information

on per-tenant basis• Lower cost of security by 100+% by eliminating purpose

built appliances and by increasing utilization and VM density

Requirements

• Host potentially hundreds or thousands of tenants in shared infrastructure with:

• Traffic Isolation between the tenants• Complete protection and confidentiality of tenant

apps and data• Integration with enterprise directory services (e.g.

Active Directory)• Complying with various audit requirements

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The Cloud: Extending Services and Care

Hospital - Datacenter Hospital

InternalRadiologist

Remote Radiologist

Private Cloud

Remote Radiologist

2 Hour Drive VMware ViewPC-o-IP

© 2009 VMware Inc. All rights reserved

Final Thoughts

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Healthcare Cloud Solutions

RationalizeConsolidate

Private Cloud

o Deliver IT infrastructure as a service over a private cloud to build a flexible and efficient virtual infrastructure.

o Deploy applications and resources when and where you need them for the ultimate control over service levels.

Improve WorkflowSecured Mobility

Desktop

o Improve clinician efficiency, satisfaction and quality of patient care with "follow me" desktops.

o Provide standardized desktops as managed service while providing a superior clinician experience over traditional methods.

Extend/ShareServe

o Leverage the power of cloud computing while retaining the flexibility and open standards to support your existing IT infrastructure.

o Package and provide clinical applications and services to the market. Quicker, cheaper and more secure.

EHR/HISSaaS

Cloud Services

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Healthcare Partner Growth Opportunities

HIT/CPEHR Certifications• HIMSS

Best Practice for HC Providers$1M/year per Provider – Maintenance/Service/Support

$10K/year per Physician – Maintenance/Service/Support

TechMed Alliance• Value Added Programs & Support

Solution Sell• $55K VMware Licenses + $560K Other Product Drag = $615K Total

• Cloud Services = Managed Monthly Recurring Revenue Services

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Helping our partners transform the cost, quality and delivery of patient care via the Cloud

Thank You!