44: IGEL Weekly: Further Enhancing Clinical Workflows with IGEL, Imprivata and Citrix

WEBVTT

1
00:00:02.700 –> 00:00:10.260
Andy Whiteside: Everyone welcome to episode 44 I job weekly i’m your host Andy whiteside, this is a one of our corporate blog to get christiane with me, Chris how’s it going.

2
00:00:10.980 –> 00:00:14.219
Chris Feeney: Going great man, I hope, you’re doing well spring has arrived.

3
00:00:14.969 –> 00:00:16.470
Chris Feeney: yeah wonder whether.

4
00:00:17.190 –> 00:00:26.430
Andy Whiteside: i’m traveling again so sorry about the background noise i’m going as much as possible as as you talk through your blog back in Orlando, I guess, we were here last week with him.

5
00:00:27.180 –> 00:00:38.820
Chris Feeney: yeah literally as soon as I saw your background come up on the zoom calls like I think that’s Orlando because I recognize those levels of the Sheraton hotel or wherever that is the the airport, but.

6
00:00:39.540 –> 00:00:48.150
Andy Whiteside: This is a thing my fourth week in a row somehow ending up in Orlando for at least a day or two before heading home we’re heading back some couldn’t somewhere else.

7
00:00:48.840 –> 00:00:56.610
Andy Whiteside: So it’s a good time of year to be here, I guess, everything is happening in this area summer will happen and things will be happening other places.

8
00:00:57.390 –> 00:01:06.360
Chris Feeney: yeah my impression was it was spring break so last week we had both spring break and hymns going on, but the airport was absolutely jam packed.

9
00:01:08.010 –> 00:01:16.500
Chris Feeney: I mean not as full as i’ve seen it in years past, but it was pretty full i’d say people are out and about again so it’s.

10
00:01:16.800 –> 00:01:18.750
Andy Whiteside: good to see the crowd and hymns.

11
00:01:18.990 –> 00:01:19.470
Andy Whiteside: You know I.

12
00:01:20.550 –> 00:01:22.020
Andy Whiteside: From your perspective was it.

13
00:01:23.400 –> 00:01:32.610
Andy Whiteside: Was it half vendors and half participants with think it was kind of that breakdown or wasn’t it was definitely better than it was six months ago in Las Vegas on the participation side.

14
00:01:33.570 –> 00:01:35.190
Chris Feeney: yeah I would agree um.

15
00:01:36.570 –> 00:01:50.070
Chris Feeney: i’ve done probably i’m estimating 13 to 15 hymns over the years, something like that it’s it’s a it’s a lot and so compared to last year’s in Vegas definitely bigger.

16
00:01:51.510 –> 00:02:02.940
Chris Feeney: When I was flying down last Sunday the guy sitting next to me actually worked for him and he said that they were looking at 25 to 30,000 I don’t know if that was what it ended up as but.

17
00:02:05.100 –> 00:02:11.820
Chris Feeney: I was mainly in the booth I didn’t really get around to what was going on in the sessions and stuff but I said we got some good traffic.

18
00:02:13.320 –> 00:02:28.980
Chris Feeney: So we’ll see what happens, I mean I had you know, I was conservative in terms, who I was scanning because we had other people scanning people that came by and and the ones that I did scan I felt were pretty pretty good opportunities to you know further the conversation so.

19
00:02:29.850 –> 00:02:36.090
Andy Whiteside: let’s let’s do this let’s get your blog is about hymns and when you guys are showing off in terms of the ministry so.

20
00:02:36.990 –> 00:02:47.610
Andy Whiteside: further enhancing clinical workflows with Joe and provided and citrix which I know you have been around a long time, and that is the Holy Grail and the healthcare space is getting.

21
00:02:48.180 –> 00:02:55.920
Andy Whiteside: getting better workflows more timely workflows and getting physicians and other medical professionals not wasting their time.

22
00:02:56.220 –> 00:03:07.980
Andy Whiteside: Getting in in and out of applications in technology, but actually doing their job and using the technology to improve their job what what what caused you to write the latest version of this blog.

23
00:03:09.300 –> 00:03:24.450
Chris Feeney: So that’s a great question um it’s in the story actually for me goes back probably a decade, if not a little bit more than that, it was when as an SE in the field with broad at the time.

24
00:03:25.800 –> 00:03:34.650
Chris Feeney: For the first few years we started getting to healthcare, I really wasn’t seeing epic specifically in my patch and then after 22,008.

25
00:03:35.280 –> 00:03:42.090
Chris Feeney: When they had the the market crash, and they put in this new new act I can’t remember all the all the names of it, but it really pushed.

26
00:03:42.840 –> 00:03:50.250
Chris Feeney: The healthcare organizations to incentivize them to get over to the electronic medical record not that they weren’t before but to really.

27
00:03:51.120 –> 00:04:02.400
Chris Feeney: You know, fast track that, and so we began to rapidly see them move ahead, and so the first customer that really kind of I came across this specific workflow we call persistent APP which i’ll talk about in a second.

28
00:04:03.510 –> 00:04:12.540
Chris Feeney: was actually here locally in raleigh and they were deploying epic for the first time after they had been a best of breed shop of all these different things and.

29
00:04:12.930 –> 00:04:23.400
Chris Feeney: And then they were consolidating on this one thing well the workflow in that situation is, you know, to get in and out of that application rather quickly.

30
00:04:24.750 –> 00:04:33.390
Chris Feeney: They would walk up on a windows machine they tap their badge authenticate and epic would either already be up and running, and then we just get logged right in.

31
00:04:34.050 –> 00:04:47.910
Chris Feeney: And then they could you know tap out in the next user could come back in, and it would just be a user switching very quickly in and out of the application all that’s well and good, and then a week before go live roughly.

32
00:04:49.230 –> 00:04:50.100
Chris Feeney: They said hey.

33
00:04:51.570 –> 00:04:58.470
Chris Feeney: We have to get to other applications on citrix that are not are not tied to just the shared kiosk machine here.

34
00:04:58.920 –> 00:05:14.760
Chris Feeney: And that’s generally a generic account it’s not Chris finis user that’s logged in to set up that citrix session with epic it’s generic workstation one whatever and then you’re like well how are we going to do that, how are we going to get their applications.

35
00:05:15.900 –> 00:05:29.520
Chris Feeney: If if the citrix session is already established under this shared workstation account, and it was a mystery, but the customer said hey i’m I came across this API thing with citrix I wonder if that could be used.

36
00:05:30.780 –> 00:05:43.680
Chris Feeney: Thankfully, in those early years I had a developer with me on site and we looked at it and we were able to actually get it working and we didn’t have to pause the go live, and so what I thought was initially a one off.

37
00:05:44.850 –> 00:05:57.030
Chris Feeney: Later on, it kept coming up, and more and more accounts got to about 10 to 12 and we had to scripted solution that that really kind of solved this problem, and so it.

38
00:05:58.290 –> 00:06:05.160
Chris Feeney: that’s kind of where it started, for me, and this is really kind of getting a true understanding of what would really fully enhance the customer.

39
00:06:21.930 –> 00:06:23.880
Chris Feeney: Make sure that the emr stays up.

40
00:06:26.040 –> 00:06:33.960
Chris Feeney: There other stuff does not stay up and it gets you know disconnected cleanly, and so the next user has a clean workspace to use so.

41
00:06:36.300 –> 00:06:37.860
Chris Feeney: So that’s kind of how it started.

42
00:06:38.880 –> 00:06:40.590
Andy Whiteside: For Christmas that was that a matter of.

43
00:06:40.980 –> 00:06:45.330
Andy Whiteside: Getting the user logged into the local operating system and then passing that through into the promoting.

44
00:06:46.050 –> 00:06:47.430
Andy Whiteside: Promoting APP and the remote.

45
00:06:48.720 –> 00:06:54.600
Andy Whiteside: session you so you walked in there with the idea okay if they’re going to we’re going to use them for voter we’re going to use this.

46
00:06:54.960 –> 00:07:05.490
Andy Whiteside: single identity single sign on with enabled through a smart card reader or something and that’s going to get them into the ios and then now we need to pass that through to the presentation session.

47
00:07:06.300 –> 00:07:21.240
Chris Feeney: So this was really in healthcare, a lot of the workstations are set up as a shared kiosk, meaning that the user john Smith, for example, is not actually logging into the Microsoft os.

48
00:07:22.740 –> 00:07:28.200
Chris Feeney: it’s already logged in under a generic workstation ID usually workstation one and that’s.

49
00:07:29.100 –> 00:07:44.580
Chris Feeney: And then the bravado would have their what they call their shared workstation agent would then lock the machine and then they would be asked to identify themselves and that’s where they will walk up and tap their badge, for example, to make it easier to login versus password.

50
00:07:46.680 –> 00:07:51.090
Chris Feeney: Now that you have identity, then you can say all right well john just logged in.

51
00:07:52.800 –> 00:08:04.950
Chris Feeney: What do I do with that information and that’s where using single sign on passing that information to through that session that citrix session for epic in this case and then that gets.

52
00:08:06.300 –> 00:08:09.390
Chris Feeney: taken by the API mechanisms and just logs user right in.

53
00:08:09.960 –> 00:08:21.210
Chris Feeney: Very seamlessly and then, if they need to get to other applications that they might need to check some other web APP or some other application, maybe it’s installed locally, maybe it’s all through citrix whatever.

54
00:08:22.530 –> 00:08:33.210
Chris Feeney: You have that functionality, where you can still allow them to get to the emr and other things could be a virtual desktop it could be published Apps doesn’t really matter and.

55
00:09:12.240 –> 00:09:13.890
Chris Feeney: In point until now.

56
00:09:15.990 –> 00:09:18.840
Chris Feeney: So that’s why very excited that we got it we got it the market.

57
00:09:19.920 –> 00:09:21.810
Chris Feeney: At this past this past week so.

58
00:09:22.740 –> 00:09:29.850
Andy Whiteside: It Chris one of us may be having network Nick I assume it’s me clowns but i’ve got a pink test running in the background i’m not i’m not dropping the packets are getting delayed so.

59
00:09:30.360 –> 00:09:39.750
Andy Whiteside: We go back and listen, we may find them the recording those little gap here so hopefully that doesn’t persist, but so prior to the healthcare initiatives.

60
00:09:40.350 –> 00:09:50.850
Andy Whiteside: In the citrix world I think people were just solving that by using anonymous logins they would get into the application and then from within their maybe they logged into the application further or maybe just everybody shared their credentials.

61
00:09:51.810 –> 00:10:04.230
Andy Whiteside: When the government got involved that’s not gonna that’s gonna cut it that’s when the need to have specific user logins into the presentation session and into the application became very relevant right.

62
00:10:04.560 –> 00:10:13.740
Chris Feeney: yeah it’s a great point because a lot of what was going on to is especially going into some of these healthcare settings they were sharing credentials.

63
00:10:14.310 –> 00:10:24.540
Chris Feeney: You know, it was you know nurse would log in as Dr you know not, not because they were trying to be nefarious it was more just convenience, you know it’s always been the the the.

64
00:10:25.350 –> 00:10:44.190
Chris Feeney: marriage between security and convenience and and so, but what came down as a result of this this incentive by the government to move rapidly to adopt your emr also came enforcement of security requirements such as individual usernames and passwords well.

65
00:10:45.300 –> 00:10:53.520
Chris Feeney: In provided was in a really good position there, because they already were solving that issue, and so they had a solution to help with that and then that kind of.

66
00:10:55.200 –> 00:11:10.470
Chris Feeney: ended up working very well in a healthcare setting because they had many passwords to deal with they had a lot of you know, need to get in and out rather quickly, so these a lot of that was applications often very much delivered by citrix, for example.

67
00:11:11.790 –> 00:11:12.450
Chris Feeney: And so.

68
00:11:14.370 –> 00:11:15.510
Chris Feeney: You began to see.

69
00:11:16.830 –> 00:11:24.090
Chris Feeney: Of on the screen here if you’re watching the this is from last year’s hands and we kind of introduced this concept and so.

70
00:11:26.160 –> 00:11:36.330
Chris Feeney: What you have here is a common machine right that’s a shared workstation it could be a wild card like you see in the video or it could be a machine inside of a patient room or.

71
00:11:37.740 –> 00:11:45.720
Chris Feeney: Outside in the hallway on the wall i’ve seen those kind of concepts, or just a little work open nurses working station, or whatever doctors.

72
00:11:46.290 –> 00:11:59.820
Chris Feeney: You know, but it’s basically any machine where multiple people could come and go at any given time and and use the machine it’s not tied to you know me sitting kind of my desk in the office and nobody else comes in, during the day when i’m done I leave.

73
00:12:01.260 –> 00:12:06.090
Andy Whiteside: If i’m looking at the DEMO now i’m looking at a system that’s got a screen up and then it’s got.

74
00:12:06.690 –> 00:12:21.750
Andy Whiteside: What I guess are in provider prompts so at that point is the local I Joe operating system is it logged into at this point with some kind of credentials, or just anonymous and then now we’re relying on the application to take us to the next step.

75
00:12:22.230 –> 00:12:30.690
Chris Feeney: yeah so you’ve got I just booted up and behind this login screen very similar to a windows machine and the shared kiosk mode is.

76
00:12:32.910 –> 00:12:47.010
Chris Feeney: Basically, this application epic in this case that’s ready for somebody to log in, and then they can just take those credentials and log them in so, but you have to first establish yourself, who are you and that’s what you see here on the screen.

77
00:12:49.320 –> 00:12:52.980
Andy Whiteside: Okay, so you said booted up I think what you really mean right as booted up in this log into.

78
00:12:53.310 –> 00:12:55.260
Chris Feeney: The operating system right correct.

79
00:12:55.560 –> 00:13:06.360
Andy Whiteside: And when you say epics in the background, it means a session is actually running there in the background it’s connected to you just going to now inject who you are into that session.

80
00:13:06.720 –> 00:13:16.350
Chris Feeney: Correct so we’ve what we’ve done is behind the scenes on the agile side we’ve we’ve started a citric session under generic accounts this case you know let’s take it’s this.

81
00:13:16.560 –> 00:13:18.780
Chris Feeney: You know hymns DEMO station one, whatever the.

82
00:13:19.260 –> 00:13:27.510
Chris Feeney: endpoint name is, which is an active directory account with a password of whatever kind and that’s what we use to start the citrix session.

83
00:13:27.900 –> 00:13:41.670
Chris Feeney: For for epic the persistent APP that’s going to stay connected to this machine so you’ll see this doctor login here and there’s the application already ready to go and put very quickly we logged them right in and so.

84
00:13:42.690 –> 00:13:45.120
Chris Feeney: They did not have to do anything but just tap their badge.

85
00:13:46.590 –> 00:13:55.830
Chris Feeney: And so that applications up, they can they can do what they need to do and what’s really cool is if this isn’t an outpatient setting.

86
00:13:57.030 –> 00:14:10.230
Chris Feeney: Where they do a lot of you know nurse somebody comes in preps the chart and then the doctor comes in, and instead of having to navigate when they login with that chart go.

87
00:14:10.890 –> 00:14:15.780
Chris Feeney: epic has a feature called secure and you could either tap your badge.

88
00:14:16.350 –> 00:14:25.200
Chris Feeney: To see you know and basically instead of logging out of epic it secures epic and then, when the next user comes in, with the same user they’re basically right where they left off.

89
00:14:25.800 –> 00:14:31.620
Chris Feeney: So if i’m looking at your chart or maybe your child’s chart whatever and I have to step away for a second I come in.

90
00:14:32.520 –> 00:14:47.640
Chris Feeney: As soon as I log back in i’m still looking at your chart and I don’t have to navigate through the application to figure out where is that chart it’s right there, and so that is extremely powerful it’s very fast, and so what this does is allow for that functionality.

91
00:14:49.140 –> 00:14:50.460
Chris Feeney: In various settings.

92
00:14:50.490 –> 00:14:59.670
Chris Feeney: So and we’re basically taking what was a very popular workflow in a windows world, and now we brought it to a jailhouse.

93
00:15:00.600 –> 00:15:07.530
Andy Whiteside: I guess there’s a couple things happening right number one, a lot of technology, where the the emr in this case has gotten smarter.

94
00:15:09.090 –> 00:15:12.810
Andy Whiteside: Where I Joe is getting smarter and improvise data.

95
00:15:13.440 –> 00:15:13.830
Andy Whiteside: In order.

96
00:15:13.860 –> 00:15:23.070
Andy Whiteside: To get that information to the application session I just gotten smarter and now we have the application running in the background, but not actually connected, even just not actually.

97
00:15:23.760 –> 00:15:31.920
Andy Whiteside: With the actual user until the moment here you go here’s the user that’s coming in here’s a user that’s going out and then, so the application that the ios and the.

98
00:15:32.490 –> 00:15:43.620
Andy Whiteside: citrix agent and the I Joe use with the agent is smarter and I guess, one of the other things that you mentioned earlier, which I think is probably really important is that the Organization has to standardize on emr.

99
00:15:44.400 –> 00:15:53.220
Andy Whiteside: So that they’re not used to just using the best of breed for every single process and the hospital because chasing this across all those different applications would be nearly impossible.

100
00:15:53.940 –> 00:15:54.840
Chris Feeney: yeah and that’s just.

101
00:15:56.010 –> 00:16:00.120
Chris Feeney: For those that have been unhealthy for a long time that this is that’s the trend that I began to see is.

102
00:16:00.450 –> 00:16:07.140
Chris Feeney: As they would you know they would standardize on cerner they would standardize on on epic, for example, but then, slowly but surely, anything that they were using.

103
00:16:07.830 –> 00:16:25.110
Chris Feeney: For maybe best of breed the module for that new emr would replace it, and they would begin to add more functionality and therefore those older applications would basically be dedicated and everything would more or less be accessible from one application so.

104
00:16:26.310 –> 00:16:32.130
Chris Feeney: As we continue the video what the other thing here is very important, on a shared kiosk is what if I need to get to other stuff.

105
00:16:32.760 –> 00:16:41.850
Chris Feeney: Besides this generically logged in citrix session for epic I want to check my email, I want to get to a virtual desktop and so as the video is playing.

106
00:16:42.510 –> 00:16:50.430
Chris Feeney: I launched a virtual desktop and that’s tied to me the user that badged in and so that’s coming up i’m getting logged in.

107
00:16:51.060 –> 00:16:56.940
Chris Feeney: And then what’s also really cool is you can kind of continue to automate some of the steps the user might necessarily take.

108
00:16:57.720 –> 00:17:06.570
Chris Feeney: And if you’re watching the video and the blog you’ll see that I all I do is tap my badge that launched or click the launch the virtual desktop as the virtual desktops coming up.

109
00:17:07.410 –> 00:17:18.600
Chris Feeney: we’re auto launching an application another application for the user and then single sign on logs the men, so the user has physically never touched the keyboard at all All they do is walk up that their badge they’re in.

110
00:17:19.080 –> 00:17:23.670
Chris Feeney: And then they click a mouse and in their end of this other workspace so you can kind of see that playing out.

111
00:17:24.300 –> 00:17:39.030
Chris Feeney: And so, all that is a citrix delivering the workspace and the applications inside of that single sign on from involved in this case login the user in taking away the need to type in passwords and stuff and just making it much more seamless.

112
00:17:39.480 –> 00:17:48.210
Andy Whiteside: and Chris you like in the in the epic example you didn’t have an icon for the citrix workspace APP or any other desktops but.

113
00:17:48.540 –> 00:17:59.280
Andy Whiteside: Because of the configure ability of I gel you were able to put the start area, the APP launcher down in the corner and if the user was trained, they would know if I need other things going on here it’ll all.

114
00:18:00.210 –> 00:18:05.610
Chris Feeney: Right there’ll be some training, of course, for this, but that’s correct anything that they’re entitled to.

115
00:18:06.120 –> 00:18:08.400
Chris Feeney: They could just access it from the start menu there.

116
00:18:08.550 –> 00:18:17.790
Chris Feeney: Now some would say what about shortcuts on the desktop we’ve heard that request we’re entertaining it trying to figure out how we would want to do that, but.

117
00:18:19.230 –> 00:18:19.830
Chris Feeney: As far as.

118
00:18:21.360 –> 00:18:26.760
Chris Feeney: Initial functionality it’s there for the taking it’s it’s actually building on a feature that provider brought to.

119
00:18:27.840 –> 00:18:30.180
Chris Feeney: I gel in this case Linux os.

120
00:18:31.320 –> 00:18:46.500
Chris Feeney: A few years ago it was actually citrix my first citrix synergy which was 2018 they just delivered published applications, so now, this is basically public published application support on steroids for health care, specifically so.

121
00:18:48.300 –> 00:18:48.960
Chris Feeney: So this.

122
00:18:50.040 –> 00:18:58.770
Chris Feeney: Is a little diagram and in the blog there that kind of walks you through sort of how does this all come about, we won’t necessarily go through each one of those steps, but.

123
00:18:59.790 –> 00:19:01.800
Andy Whiteside: We can’t actually want you to some degree.

124
00:19:02.160 –> 00:19:02.490
yeah.

125
00:19:03.690 –> 00:19:13.350
Andy Whiteside: But before I think i’m still lost on and maybe I just missed it, but what exactly is a persistent APP and why it’s important that’s part of what your titles here in the blog.

126
00:19:13.800 –> 00:19:14.130
yeah.

127
00:19:15.630 –> 00:19:34.740
Chris Feeney: yeah so persistent would be in the example here an application that is tied to and needs to be up and running or remaining hot, if you will, to the shared workstation so that when a user walks up in authenticates they, especially if it’s delivered virtually.

128
00:19:35.010 –> 00:19:36.090
Chris Feeney: In this case it is.

129
00:19:37.020 –> 00:19:48.600
Chris Feeney: It doesn’t have to get disconnected closed fired back up all that takes time and time is money and time is very precious so that persistent APP remains connected.

130
00:19:49.200 –> 00:20:03.870
Chris Feeney: As you saw on the video and so i’m we’re basically keeping it hot and it’s in this case, just one APP it’s not five Apps it’s just one and that’s really the main key one, which in this case is that emr.

131
00:20:05.640 –> 00:20:06.180
Chris Feeney: Does that help.

132
00:20:07.530 –> 00:20:15.750
Andy Whiteside: It does is so is that the features citrus came out with a bunch of years ago, is that something in Nevada specifically doing, in addition to citrix to keep that APP.

133
00:20:16.170 –> 00:20:25.680
Andy Whiteside: You know at the ready it’s hot it’s connected it’s just not the user is not pass through to the actual user for the application, but the citrix session has a live session.

134
00:20:26.700 –> 00:20:28.620
Chris Feeney: it’s kind of a combo I would say.

135
00:20:28.860 –> 00:20:34.710
Chris Feeney: More specifically, on the ladder sign within provider, taking advantage of functionality that citrix could provide.

136
00:20:35.850 –> 00:20:52.110
Chris Feeney: Where I could start up an application and have it ready to go but that’s great, but if you don’t want to have to type in usernames and passwords all the time, how do you do that, in a world where you can just walk up and have a badge and also users coming and going.

137
00:20:53.190 –> 00:20:55.140
Chris Feeney: You know there’s a security aspect there.

138
00:20:55.200 –> 00:21:05.490
Chris Feeney: which you have to marry it with the convenience factor, so in provider brought a lot of that functionality as well, and so that’s what we’ve kind of delivered here.

139
00:21:06.990 –> 00:21:13.740
Chris Feeney: So I need to get you a better picture of that unfortunately it’s kind of blurry but let’s walk through this step by step.

140
00:21:15.510 –> 00:21:18.840
Andy Whiteside: So starts with starts with step zero yesterday.

141
00:21:19.500 –> 00:21:20.010
So.

142
00:21:21.210 –> 00:21:23.970
Chris Feeney: You obviously have an ideal operating system on a thin client.

143
00:21:26.040 –> 00:21:41.490
Chris Feeney: And provider has their software they call it prove it embedded agent so that has to be installed onto the device, and then you set up the policies for for the workflow so that’s step number one you get that going and then that kind of leads in or zip zero.

144
00:21:41.700 –> 00:21:47.880
Andy Whiteside: Sorry, so real quick, when you say installed is this part of the idol operating system under the custom participate and how do you get it on it.

145
00:21:48.840 –> 00:21:49.980
Chris Feeney: All great questions.

146
00:21:50.940 –> 00:22:01.050
Chris Feeney: So it is not part of the idol os the pie agent is on the appliance the improvised appliance, and so what is part of I jealous.

147
00:22:01.710 –> 00:22:08.340
Chris Feeney: there’s a setting to point to the appliance and that’s we call that a bootstrap and then it just basically you click on it set it up and then.

148
00:22:09.030 –> 00:22:15.210
Chris Feeney: It connects to the appliance and then, once that is established, it downloads the pie agent and installs it.

149
00:22:16.020 –> 00:22:27.540
Chris Feeney: In and then, of course, you have a policy that says how am I supposed to behave and, in this case, we say well just install and then, when it’s there put a login screen up on and that’s what you see in number, the step number one.

150
00:22:28.800 –> 00:22:37.770
Andy Whiteside: So so as an angel guy i’m actually kind of confused by it so i’m not used to anything installing Nigel i’m used to laying down a partition or being part of the layers of the operating system.

151
00:22:38.040 –> 00:22:50.160
Andy Whiteside: So, when you say the improvised appliance there’s an appliance living on your network and you point your eye gel device to it downloads and installs every time it boots up or it does it one time, and it remains persistent.

152
00:22:51.420 –> 00:22:53.370
Chris Feeney: The agent once its installed remains.

153
00:22:54.900 –> 00:22:56.280
Chris Feeney: But what’s really cool is.

154
00:22:57.060 –> 00:23:00.030
Chris Feeney: The way that it was designed by ivana it was that if.

155
00:23:00.240 –> 00:23:06.930
Chris Feeney: let’s say you gotta upgrade to your imperato environment which includes a new version of the pie agent.

156
00:23:08.340 –> 00:23:23.250
Chris Feeney: That agent can be installed when the devices idle it doesn’t require reboot so it can see you go into the next version if it’s available it’ll download it and just in the update that agent without a reboot and a lot of cases.

157
00:23:25.530 –> 00:23:30.600
Chris Feeney: But you have to have something there to identify the user and that’s what that is so.

158
00:23:33.390 –> 00:23:42.240
Andy Whiteside: Okay, so my idol os is not it’s it’s booted it’s logged into locally or domain, I guess, either ones fine right.

159
00:23:42.780 –> 00:23:49.200
Chris Feeney: There is no local login on the eye gel there’s I mean we really technically as an ios we have two accounts.

160
00:23:49.260 –> 00:23:50.160
Chris Feeney: user and route.

161
00:23:51.090 –> 00:23:57.000
Chris Feeney: So there’s no local log into a domain it’s not attached to the domain never needs to be attached the main.

162
00:23:58.140 –> 00:24:02.430
Chris Feeney: The equivalent would be a windows machine that is not attached to the domain just a local.

163
00:24:03.480 –> 00:24:07.620
Chris Feeney: boot up whatever and there you have a local machine, with no, no, no domain information.

164
00:24:07.830 –> 00:24:13.140
Andy Whiteside: So it boots up and then it’s going to just start right into the ui as.

165
00:24:14.250 –> 00:24:17.700
Andy Whiteside: some type of generalized user local user.

166
00:24:19.050 –> 00:24:25.650
Chris Feeney: Right and then, then you see this login screen and your and at that point you’re ready to have a user walk up and authenticate.

167
00:24:26.280 –> 00:24:36.630
Andy Whiteside: So there has to be something technical to happen there right, so this thing’s going to boot up in somewhere in that process there’s the agent must start running and the user, then walks up and sees the screen with.

168
00:24:37.650 –> 00:24:40.980
Andy Whiteside: I didn’t really catch in the video but there’s a box on the Left box on the right.

169
00:24:41.550 –> 00:24:48.180
Chris Feeney: yeah they’re basically tiles on it, you know one is a username and password login the other one is tap your badge.

170
00:24:49.110 –> 00:24:49.590
Chris Feeney: You know.

171
00:24:49.680 –> 00:24:53.490
Chris Feeney: If you plugged in a fingerprint reader you’d see a layer finger down it’s very similar so.

172
00:24:53.520 –> 00:24:59.220
Andy Whiteside: Okay, so you don’t have to have a badge if you didn’t have a badge you could username password ultimate result will be the same.

173
00:24:59.790 –> 00:25:00.240
Correct.

174
00:25:02.130 –> 00:25:02.730
Andy Whiteside: alright.

175
00:25:03.570 –> 00:25:15.930
Chris Feeney: So, now that we’ve got the login occurring user walks up user number one in authenticates taps their badge and usually at the beginning of the day they’re going to be prompted for a second factor type in your password or pin.

176
00:25:18.120 –> 00:25:25.980
Chris Feeney: behind the scenes what we first from a citrix licensing perspective, this is what I think you’ll find interesting right if you have a citrix session always up and running.

177
00:25:27.240 –> 00:25:39.570
Chris Feeney: it’s going to take up a license you know full stop so if that unit let’s say it’s a maternity Ward that was not very busy, and then a full moon comes out or the snow storm hits and all of a sudden.

178
00:25:40.410 –> 00:25:49.500
Chris Feeney: You know, we got we got babies being born, believe me, it’s happened twice for me so i’m sorry out there it’s true.

179
00:25:50.640 –> 00:25:56.670
Chris Feeney: anyways so they have to spin up right Well, now we need to make sure that when you know is such as sessions are ready to go.

180
00:25:56.970 –> 00:26:10.200
Chris Feeney: So user starts login and then behind the scenes that persistent APP in this case epic is fired up for the very first time now that it’s up and running user gets logged in and then it’s going to stay up and running as users come and go.

181
00:26:11.580 –> 00:26:21.570
Chris Feeney: And unless they use her closes the APP or there’s a citrix timeout usually behind the scenes like let’s say it’s been idle for six hours or whatever.

182
00:26:22.770 –> 00:26:28.170
Chris Feeney: You know that’s but behind the scenes, the out of the application is going to be up and running, every time a user comes up and logs in.

183
00:26:29.370 –> 00:26:36.450
Andy Whiteside: What step you’ve got 0123 is the actual citrix connection made and they license used.

184
00:26:37.230 –> 00:26:38.010
Chris Feeney: Step two.

185
00:26:39.960 –> 00:26:45.060
Chris Feeney: So the you know step in the diagram it’s I don’t like the way they numbered it but it’s.

186
00:26:46.740 –> 00:26:47.670
Chris Feeney: That third.

187
00:26:48.870 –> 00:26:58.560
Chris Feeney: thing there on the other things so user to you to use a walks up authenticates the persistent APP is started up the citrix sessions established and then users logged in.

188
00:26:59.790 –> 00:27:03.480
Chris Feeney: And then we move on to the next phase, which is on the right.

189
00:27:04.320 –> 00:27:11.040
Andy Whiteside: So the user experience some type of slow down waiting on the session to connect there or is it already kind of active in the background.

190
00:27:11.370 –> 00:27:16.200
Chris Feeney: But notice yeah initially, they would the first user would would experience you know.

191
00:27:18.180 –> 00:27:31.290
Chris Feeney: where’s epic right well it’s firing up now, you know as well as I do that how quickly that session could come up depends a lot on the network and a whole bunch of other stuff that is oftentimes out of our control so.

192
00:27:32.340 –> 00:27:35.100
Chris Feeney: let’s presume that you know epic comes up in just a few seconds.

193
00:27:36.210 –> 00:27:42.720
Chris Feeney: And then they get logged in so that first user might take initial hit let’s just say it’s less than 10 seconds not not terrible.

194
00:27:44.790 –> 00:27:52.470
Chris Feeney: But it’s up and running now and now it’s going to stay up and running as users come and go and that’s what that persistent is referring to.

195
00:27:53.520 –> 00:28:00.660
Andy Whiteside: Okay, so that user isn’t going to have a session waiting for them and it’s going to follow them around as they move throughout their day.

196
00:28:01.710 –> 00:28:09.600
Chris Feeney: So that’s another great point, so the the persistent APP is not going to follow them because it’s not tied to john Smith login or susie Jones.

197
00:28:10.080 –> 00:28:23.970
Chris Feeney: It is tied to the generic we logged in machine that you have here so that’s going to stay on that machine and it’ll just as users come and go it’ll it’ll be there, but if I had launched that you saw on the video my virtual desktop.

198
00:28:24.930 –> 00:28:29.160
Chris Feeney: That can follow me because that’s tied to me, and so, if I.

199
00:28:30.360 –> 00:28:36.780
Chris Feeney: walk up I tap in here and I get to my emr and then I said i’m gonna check my desktop and I check my email and stuff and.

200
00:28:37.950 –> 00:28:47.130
Chris Feeney: And then i’m like all right i’m good and then I tapped out behind the scenes that virtual desktop is getting disconnected but the epic application in this case remains connected.

201
00:28:47.700 –> 00:28:47.910
Andy Whiteside: yeah.

202
00:28:48.360 –> 00:28:49.380
Chris Feeney: And then, if I pull up.

203
00:28:49.380 –> 00:28:56.370
Andy Whiteside: The shortcut for the Apps am I going to tap again to tell the Apps who I am or is it going to use that previous tab of who I am.

204
00:28:56.970 –> 00:29:05.700
Chris Feeney: that’s a great thing I love I love this conversation so what’s going to happen is if I walk back up and I, and I must say I had launched my virtual desktop previously.

205
00:29:06.150 –> 00:29:09.120
Chris Feeney: And I tap back in and you’ll see this in the other hints DEMO.

206
00:29:09.690 –> 00:29:15.420
Chris Feeney: Is my virtual desktop is is still disconnected but it says hey Chris just log back in.

207
00:29:16.590 –> 00:29:22.260
Chris Feeney: A fire that reconnect them to that virtual desktop and it comes right up in just a few seconds.

208
00:29:24.090 –> 00:29:35.820
Chris Feeney: So it knows that i’m you know authenticating and other places let’s say i’m at this well card my badge in I get into epic and then I said, let me check my virtual desktop it comes up for the first time.

209
00:29:36.330 –> 00:29:45.360
Chris Feeney: I tap out and then I go upstairs check on another patient I badge in my virtual desktops going to get reconnected and and come right back up yeah.

210
00:29:45.450 –> 00:29:51.120
Andy Whiteside: I think we just talked about a couple things where we have fast user switching, which is an epic add going from machine to machine to machine.

211
00:29:51.450 –> 00:30:00.090
Andy Whiteside: And then, at the same time you have smooth roaming where you’re going from machine to machine machine and the whole entire sessions and to be connected as as you enter that virtual desktop.

212
00:30:00.540 –> 00:30:03.450
Chris Feeney: yeah so it’s sort of a best of both worlds, if you will.

213
00:30:03.960 –> 00:30:07.560
Chris Feeney: And yeah and so that that’s what.

214
00:30:08.640 –> 00:30:23.760
Chris Feeney: In a windows world that’s what I ran into in that first situation i’m like wait we’ve got to solve this problem, how can we do it and thankfully citrix had some functionality built into the receiver at the time and we basically just leveraged it in a scripted fashion back then.

215
00:30:25.650 –> 00:30:30.360
Chris Feeney: And over the course of time, this particular feature made its way into the imprimatur product.

216
00:30:32.490 –> 00:30:44.550
Chris Feeney: And it’s just over a year ago, we came across the fact that they had built this for Linux and provide a had, and so we had multiple customers asking for this type of flexibility and functionality.

217
00:30:45.150 –> 00:30:49.620
Chris Feeney: Because they wanted to they couldn’t upgrade their existing machines, as you know, the agile story.

218
00:30:50.400 –> 00:30:57.210
Chris Feeney: To the next version of windows, where they wanted to maybe save money on a hardware refresh so by switching from a windows endpoint where they had this workflow.

219
00:30:57.960 –> 00:31:08.490
Chris Feeney: To an ideal world machine, how can I retain that functionality, or I wasn’t able to deliver it before I want to do it now that’s kind of where this is all going.

220
00:31:09.300 –> 00:31:18.330
Chris Feeney: Is maintain that functionality and have customers have the ability to switch and keep that, because if you don’t you got to use her train again and doctors, nurses they’re not going to like that.

221
00:31:19.410 –> 00:31:28.830
Andy Whiteside: Well, yes, I did another thing that’s important here and that’s the adoption of Linux and citrix evolving their features, to be on par with what’s in their windows application and then.

222
00:31:29.130 –> 00:31:39.300
Andy Whiteside: In this case, in Nevada making the same functionality available on Linux that’s the that’s The other element here is the vendors really taken on Linux as a first class citizen endpoint.

223
00:31:40.530 –> 00:31:48.360
Chris Feeney: You said it man I it’s been a long time coming, I don’t think anybody really kind of at least I didn’t see necessarily the.

224
00:31:50.250 –> 00:31:54.510
Chris Feeney: Linux becoming as popular but let’s face it, Nice kind of point this out in the blog.

225
00:31:55.500 –> 00:31:57.210
Chris Feeney: Linux is a much more secure.

226
00:31:57.780 –> 00:32:05.580
Chris Feeney: At least I Joe Linux for sure easier to manage all those things that still play out in the normal idle story, but what if you’re coming to health care.

227
00:32:06.240 –> 00:32:18.660
Chris Feeney: If you don’t have functionality that meets the workflow needs it’s a losing proposition and a lot of cases, because not everybody’s going to need badge and get to a virtual desktop there’s certainly that it’s popular.

228
00:32:19.170 –> 00:32:26.040
Chris Feeney: yeah but if it’s just about Apps Apps Apps or Apps and desktops now we’ve kind of got all the above.

229
00:32:27.150 –> 00:32:36.510
Andy Whiteside: Well that’s interesting is I go live in Charlotte North Carolina have two major health care providers, and I still every time I go to the doctor I looked over at the screen and still there still running windows have some time.

230
00:32:37.290 –> 00:32:45.480
Andy Whiteside: To access all this and I think that’s because of the legacy affordability of the various applications and I bet because of this adoption.

231
00:32:45.840 –> 00:32:56.310
Andy Whiteside: At some point i’m I look around the corner and and there’s going to be a Linux device sitting there kind of has to happen for the T the configure ability, the man’s ability and the security of the devices.

232
00:32:57.930 –> 00:33:00.390
Chris Feeney: yeah absolutely I mean I.

233
00:33:01.470 –> 00:33:03.000
Chris Feeney: I know this this.

234
00:33:04.920 –> 00:33:14.970
Chris Feeney: there’s more we could probably talk about here, but but but being able to allow customers to switch from windows to another os in this case gel Linux.

235
00:33:16.680 –> 00:33:21.270
Chris Feeney: And more functionality flexibility workflows that you can provide them that they had before.

236
00:33:22.470 –> 00:33:29.550
Chris Feeney: It hopefully will become a no brainer Of course I wanted more secure easier to manage and I can repurpose this existing equipment.

237
00:33:30.360 –> 00:33:41.190
Chris Feeney: not however refresh if I need a hardware refresh like that beautiful LG you know all in one that we had on the DEMO by all means you know we’ve got it already vendors.

238
00:33:41.790 –> 00:33:52.950
Chris Feeney: That have a purpose built devices for healthcare and like cases and could run it all just fine and also have built in readers and stuff that in bravado supports and so it’s a.

239
00:33:54.060 –> 00:33:59.070
Chris Feeney: it’s a coming together of a lot of technologies for the benefit of the industry.

240
00:34:00.660 –> 00:34:10.770
Andy Whiteside: let’s finish our diagram here so we’ve got our user they’re using the application they’ve got to go out of the room for a second or they gotta go to the next room, they are then going to tap out now if they didn’t tap out.

241
00:34:12.150 –> 00:34:14.970
Andy Whiteside: there’s going to be some time out at some point, that will.

242
00:34:15.270 –> 00:34:16.020
Chris Feeney: And that’s an act.

243
00:34:16.200 –> 00:34:16.770
Andy Whiteside: That session.

244
00:34:17.280 –> 00:34:28.170
Chris Feeney: This is cali your tea and everything a free man I love it so um if you can’t tell them uber excited, and the reason i’m is because, yes, there is a as an activity time and we actually had it on display.

245
00:34:29.760 –> 00:34:34.920
Chris Feeney: At hymns this past week we didn’t do it for the video that we recorded, but the longest trip, it is.

246
00:34:35.610 –> 00:34:45.630
Chris Feeney: On a windows endpoint same thing right you improve on I had developed in inactivity kind of fade away sort of walk away security thing people walk away i’m still logged into that emr.

247
00:34:46.320 –> 00:35:00.420
Chris Feeney: Well that’s dangerous if I walk up and i’m not you know I have access to stuff that is yours, or I have access to that patient chart right hey tiger woods just checked in, let me check out his chart that’s happened, and some people got fired for checking on that, a few years ago.

248
00:35:01.830 –> 00:35:02.400
Chris Feeney: true story.

249
00:35:03.810 –> 00:35:12.510
Chris Feeney: So there is a walk away security function that you know begins to you know fade and block the screen and then, if nobody comes in.

250
00:35:12.930 –> 00:35:20.940
Chris Feeney: It locks the machine so that piece does exist, and you can have some flexibility with when that occurs, but let’s just say the machine is now locked.

251
00:35:21.720 –> 00:35:33.300
Chris Feeney: Either the user tapped in or tapped out whatever so now we’re back to the login screen, the next user walks up, they need to get in they tap their badge.

252
00:35:34.680 –> 00:35:41.310
Chris Feeney: And then the emr that was previously logged in as user a is now still there and it’s logged in as user be.

253
00:35:42.300 –> 00:35:53.160
Chris Feeney: And remains, and then the user can go about if they don’t need to do anything else other that they can finish in a you know if they’re a good person good user they just have their badge and they’re out.

254
00:35:54.000 –> 00:35:59.130
Chris Feeney: And, and then we are back to the login screen at that point.

255
00:36:00.360 –> 00:36:07.350
Andy Whiteside: Of what what application is doing the activity log out or disconnects and that’s.

256
00:36:08.160 –> 00:36:10.710
Chris Feeney: So that would be a function of the bravado.

257
00:36:11.160 –> 00:36:14.250
Chris Feeney: agent there’s a policy setting that.

258
00:36:16.440 –> 00:36:34.200
Chris Feeney: When you walk away security is kind of part of the policy and just you can say when do you want to start to lock this based on no activity mouse keyboard no function that type of thing, and so I think by default it’s like five minutes, but you can drop it down below that or whatever.

259
00:36:37.020 –> 00:36:48.120
Andy Whiteside: So in this case a user loser taps out either be walks up the session is still the citrix session is still active this whole time in the background, or is it not i’m asking.

260
00:36:48.480 –> 00:36:49.260
Chris Feeney: yeah so.

261
00:36:50.490 –> 00:36:52.440
Chris Feeney: So the the emr is still.

262
00:36:52.680 –> 00:36:54.450
Chris Feeney: attached the persistent APP.

263
00:36:55.800 –> 00:37:06.930
Chris Feeney: If let’s say the first user had not just got into the emr but also launched that virtual desktop or some other application that was tied to them that has been disconnected.

264
00:37:08.250 –> 00:37:21.630
Chris Feeney: When they log out or another user is logging in behind them and say, well, we need to get, we need to disconnect chris’s virtual desktop because that’s not yours your Andy not Chris, but we need to leave the emr up and running.

265
00:37:26.280 –> 00:37:37.440
Chris Feeney: And just use your switch in that application do a nice clean disconnect, of the other applications that are not that are not yours so.

266
00:37:38.610 –> 00:37:45.840
Andy Whiteside: That makes sense, it does yeah and then user be does does what they do and then hopefully when they’re done they tap out and they keep plugging along.

267
00:37:46.440 –> 00:37:55.860
Andy Whiteside: The next room or the next patient and meanwhile this constant really fast world of getting in and out the Apps it’s happening all over the place.

268
00:37:56.310 –> 00:38:03.900
Andy Whiteside: And you know we’re doing this with applications that are hosted on the back end for other speed and security reasons, so you kind of bring the best of all together.

269
00:38:04.470 –> 00:38:12.570
Chris Feeney: yeah at him, so the DEMO video, which will hopefully please feel free to post it when you put this podcast up.

270
00:38:15.480 –> 00:38:23.340
Chris Feeney: We were running that virtual desktop windows 10 in this case on ssd so when we connected it, it was extremely fast, which is a beautiful thing.

271
00:38:24.540 –> 00:38:27.630
Chris Feeney: So you know, the world of vdi in general, as you know, with.

272
00:38:28.410 –> 00:38:31.020
Chris Feeney: You know converse hyper infrastructure, whatever is.

273
00:38:31.620 –> 00:38:43.230
Chris Feeney: it’s you know from the Mount where it was 10 years ago it’s definitely gotten and that speed factor if you can get that thing up and running rather quickly whether its initial login or reconnect.

274
00:38:44.250 –> 00:38:48.480
Chris Feeney: And it’s let’s say 15 seconds or less hopefully 10 or less.

275
00:38:49.890 –> 00:38:54.570
Chris Feeney: you’ll get high fives and doctors and nurses hugging you as you walk the hallways.

276
00:38:55.230 –> 00:38:59.190
Andy Whiteside: Christmas for clarity, you say hyper converge in this case ssd you’ve done at the back.

277
00:38:59.190 –> 00:39:09.510
Chris Feeney: End correct yeah we’re that workspace is coming from right and we all know, obviously the success that new tannic has had, for example in bringing.

278
00:39:10.050 –> 00:39:23.550
Chris Feeney: You know hdi into the world and in the speed factor, and all this other stuff that goes with it i’m not an expert in that realm but I certainly saw their growth and a big part of it was you know speed speed speed.

279
00:39:24.810 –> 00:39:37.830
Andy Whiteside: So that an optimal configuration, you know profiles using things like fs logics and citrix well or other vendors profile management solutions and getting rid all that junk all that stuff still applies.

280
00:39:38.160 –> 00:39:38.370
yeah.

281
00:39:39.750 –> 00:39:46.950
Andy Whiteside: But this is a persistent APP once it’s connected on that device is there and then it’s a matter of fast user switching within the application so.

282
00:39:47.520 –> 00:39:51.720
Chris Feeney: right and it could be that that’s the only scenario, you need for that.

283
00:39:52.710 –> 00:40:06.720
Chris Feeney: or but, but if you did that or option or your later on introducing vdi into the customer, I mean you have that option now because we have this workflow available so.

284
00:40:07.950 –> 00:40:16.800
Chris Feeney: there’s a lot of upside i’ll just say that, but the fact is, this is extremely popular workflow, especially of those listening to the podcast and I hope there’s a lot of those.

285
00:40:17.580 –> 00:40:27.840
Chris Feeney: If you were running this workflow on windows, it was often called an imprimatur world multi APP I need to get to epic and other applications and it’s actually a setting in their thing.

286
00:40:28.740 –> 00:40:40.500
Chris Feeney: very popular way of deploying on windows share workstations now that has come to ios so certainly reach out to our friends Andy it is INTEGRA we’d love to.

287
00:40:41.160 –> 00:40:44.160
Chris Feeney: Have that conversation with you all and in exploring.

288
00:40:44.280 –> 00:40:45.450
Chris Feeney: and show you how this works.

289
00:40:47.490 –> 00:40:55.620
Andy Whiteside: All right, Chris well, I appreciate you putting up with my travel schedule and writing this blog and the stuff you guys are doing to him last week and always the references to us and.

290
00:40:56.250 –> 00:41:07.620
Andy Whiteside: You know I it’s great to see the clinical experience continues to evolve, I mean I kind of want to say, this is it right it’s all there now and now it’s just a matter of implementing it and leverage i’m sure there’s more.

291
00:41:08.370 –> 00:41:11.850
Chris Feeney: Oh yeah there’s stuff I cannot talk about, but I will just say this.

292
00:41:13.140 –> 00:41:22.560
Chris Feeney: Inner eye gel is innovating and we’ve got some really cool stuff that we were in some respects, showing it hands, but we couldn’t really publicly talk about it but i’m just telling you.

293
00:41:24.120 –> 00:41:24.900
Chris Feeney: Things are coming.

294
00:41:25.110 –> 00:41:27.390
Chris Feeney: And we’re gonna have fun this year so.

295
00:41:27.660 –> 00:41:28.410
Andy Whiteside: Keep an eye on.

296
00:41:28.890 –> 00:41:29.580
Chris Feeney: Keep an eye out.

297
00:41:30.210 –> 00:41:35.040
Andy Whiteside: Alright, Sir, well, I appreciate the time and we’ll do it again next week with a Community edition.

298
00:41:35.550 –> 00:41:38.100
Chris Feeney: Yes, Sir, all right take care man have a great day.