How VITAS Healthcare moved to UEM

VITAS Healthcare is three-quarters of the way to providing iPhones and iPads to its 12,000 employees -- and the company will be able to manage all of the devices with just six people.

Cloud Computing - Unified Endpoint Management U[EM]

VITAS Healthcare, a Miami-based a hospice and palliative care company with more than 12,000 employees and about 19,000 patients across 14 states, went on a six-year journey to create a mobile-enabled workforce and the unified endpoint management (UEM) system needed to handle their devices.

UEM allows IT to remotely provision, control and secure everything from cell phones, to tablets, laptops, desktops and now, Internet of Things (IoT) devices; some vendors even allow management across a variety of operating systems.

Because VITAS's workforce doesn't operate in a traditional healthcare setting, such as a hospital or clinic, and workers often travel to their patients, the company decided to arm clinicians, doctors, nurses and home health aides with iPhones or iPads.

"And that is their clinical workstation," said Patrick Hale, CIO at VITAS Healthcare.

VITAS is an Apple shop. Along with Mac desktops, the company has deployed 8,000 mobile devices to staff and plans to add another 3,000 mobile and desktop end-points over the next two-and-a-half months, according to Hale. He estimated device-related costs for a clinical work station have dropped by more than 35%, saving VITAS nearly $1 million a year.

So far, the effort has netted VITAS $2.2 million in savings.

"It was a lot of hard knocks, a lot of trial and error, a lot of mistakes, but we found our way to an application suite and strategy that resonates with our clinicians and allows them to spend the maximum amount of time on patient interaction, and that all surrounds mobility," Hale said.

At the start, VITAS had a group of home health aides that did not have mobile devices, something the company wanted for everyone who worked directly with patients. But it steered away from a bring-your-own-device (BYOD) policy, focusing exclusively on corporate-issued iPhones and iPads so it could better control the user experience.

Choosing to issue devices to thousands of employees also gave VITAS negotiating power with its mobile provider, AT&T, and cost 50% less than what it would have spend giving employees BYOD stipends, according to Naresh Samlal, assistant vice president for IT Support at VITAS.

"We're able to really offer a service that's much better than we could with a BYOD stipend," Hale added. "Secondarily, we buy them because we have to control the user experience."

VITAS, which provides end-of-life care through 47 hospices and at-home programs, began its transition to a mobile-first enterprise began about six years ago. But half-way through the project, it realized it needed to virtualize its entire data center infrastructure.

The only reason VITAS has been able to deploy thousands of end-points in a few months is because it transitioned to software-defined data centers with commodity hardware and a virtual desktop infrastructure (VDI) before fully adopting UEM. Additionally, configuring the end-point devices and training employees to use them has been streamlined through software tools and automation, Samlal said.

Today, almost all patients are admitted to hospice care via a mobile device; all prescriptions are written and submitted on mobile devices; and clinicians can scan paper documents to attach to patients' records with their devices.

"The amount of time it takes to train clinicians on our processes has dropped 20-fold," Hale said. "You take an Apple device out of the box, type in your name and credentials, the device automatically self-configures and presents you with an application that's so intuitive it looks like a patient chart. In less than an hour, you're ready to see patients."

The struggles most IT shops encounter deploying VDI and UEM are largely based on hardware restrictions, Samlal said. Nevertheless, adopting a software-defined data center model and UEM was "very gutsy when not a lot of other people were doing it," he said.

Just as many enterprises do, VITAS's IT shop first attempted to start by managing its end points using MDM.

"We thought about having a phenomenal desktop and mobile experience and put in place a complex combination of tools... and we very quickly learned the lesson that if we're going to get to where we need to, we're going to have to virtualize that entire workload, including the compute layer, the network layer and the storage layer," Hale said. "Our goal is not to catch up to mediocrity."

Even today, very few enterprises fully rely on UEM, but a good number are piloting it, or in the process of moving to a converged mobile/PC management, according to Phil Hochmuth, vice president of enterprise mobility research at IDC. Only about one in four enterprises has deployed a fully-baked UEM strategy, according to Gartner Research.

"Anecdotally, based on client interest, we see about 25% to 30% of organizations using UEM to the exclusion of other PC/traditional endpoint management tools for non-mobile devices," said Chris Silva, a vice president of research for mobile and endpoint computing at Gartner.

As workforces continue to gain enterprise-level mobility, however, creating adoption of UEM is also expected to soar. Gartner predicts that 80% of work will take place on a mobile device by 2020.

Worldwide, the unified endpoint management (UEM) software market saw $3 billion in revenue in 2017. The market is forecast to grow to $4.5 billion by 2022 at a compound annual growth rate (CAGR) of 8.7% for the five-year forecast period.

Hochmuth agreed UEM uptake is set to take off, saying that within three years, very few firms will manage their mobile and desktop environments exclusively on separate platforms, "with a good percentage of firms going full UEM, and many others on the journey."

By 2024, Hochmuth said, nearly three-quarters of enterprises will be either completely, or mostly, on UEM platforms.

UEM mobile uptake IDC

There remain significant challenges to getting there. For example, feature parity – can a UEM platform cover all PC management use cases, polices, etc. – is seen as the biggest issue. A second significant issue involves organizational hurdles such as combining the smartphone and desktop management teams, Hochmuth explained.

Unifying all corporate devices under a single management console can increase efficiency and cut costs, he said. But successful rollouts take time and are likely to be hampered by the transition away from legacy apps, retraining for IT staff, and likely pushback from users.

As VITAS went through its mobile evolution, its IT shop learned to like the management power it enabled over endpoints; that evolved into a significant focus on deploying VDI, which is still under way.

VITAS partnered with VMware for both its software-defined data center and mobility strategy, rolling out VMware Workspace ONE UEM that's powered by AirWatch mobility management software. Workspace ONE manages all of VITAS' endpoints, including Mac laptops, through a single-screen view. VITAS leverages Apple Business Manager to enable Apple Device Enrollment Profile (DEP) and Volume Purchase Program (VPP), easing the onboarding and app distribution of new Apple devices.

VMware Content Locker provides a single point to access and share information across devices and networks while providing security, such as encryption in transit and at rest. VITAS can now manage its entire end-point environment of more than 8,000 devices with just three employees. It expects to add just three more staffers to manage the additional 3,000 devices it will deploy by the end of the year, Hale said.

"One of the big mistakes people make is they start with the end-point," Hale said. "They start thinking about UEM as a management tool they're going to layer on top of everything and it's actually a much deeper problem."

About halfway through its UEM journey, VITAS' IT team realized it needed to start from the bottom up to make its return on investment work and enable VDI.

"We certainly had to take a lot of steps forward and then pause as we realized we needed to refocus to get things right. So, it's taken several years and I think that's why a lot of people struggle with it," Samlal said. "We had to take a step back and look at these foundational components at the data center layer. That allows us to propel forward."

Those foundational elements included rolling out VMware's NSX network virtualization platform fully enabled through its leaf-and-spine network architecture, with compute and storage assets fully virtualized across VITAS's nationwide hosting centers.

"That gave us enough headroom to be able to grow enough and expand enough at a cheap enough cost to tackle full-scale virtualization of end points, and that includes our mobile devices," Hale said.

Rather than buy huge storage towers or top-end Cisco Nexus 7,000 switches, VITAS's software-defined data center allows it to use more commodity hardware spread out across its ecosystem.

"We have more commodity switches than traditional switches now, but if you add up the commodity switching in our spine-and-leaf network versus our more traditional network, you're talking about a cost savings delta of 30% to 40% off of the investment we would have had to make," Hale said. "We saved $2.2 million just on hardware devices.

"We work for a company that allows us to take some of that cost savings and reinvest it," Hale continued. "We have a philosophy where every dollar we spend on IT is a dollar we don't spend at the bedside, so we try to be very good stewards in the spend we're given. That's how we've paid for a lot of this."

VITAS's IT budget over the six years Hale was been CIO has remained "relatively" flat with the exception of a "slight increase" due to the purchase of more mobile devices for workers.

Along with hardware savings and enabling mobility, Hale's three-person UEM team is also in charge of managing end-user billing each month – both through bundled AirWatch tools and separately purchased tools from MobiChord.

"You can imagine what your personal cell phone bill looks like. Well, we have 11,000 of those cell phone bills," Hale said. "We take those 11,000 bills and it's one of the greatest sources of information about our workforce, because we can tell who hasn't been logging in much, we can tell if they've been struggling with a particular application."

Separately from their contract with VMware's AirWatch, VITAS purchased mobility management tools from MobiChord, which is certified to integrate with AirWatch Enterprise Mobility Management and wireless carrier information, generating a single system of record on mobile devices, assets, and expenses. Hale said it allows user mobile device bills to become "an intelligence center, that also tells the CFO where we're spending our money."

Now, the company is working on bridging the gap between the experience office employees have on desktops and those in the field using mobile devices.

Mastering mobile and understanding it as an end-point was essential to VITAL's growth in managing from a single console. "If you're really looking for a unified platform, you have to be well versed in mobile," Hale said.

"We really want to change the face of healthcare in the country," Hale said, "and if we're going to do that, we can't have infrastructure and management concerns of it be a boat anchor that stops us from innovating. We have to create a nimbleness for that."

Copyright © 2019 IDG Communications, Inc.

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