NHS organisations are rightly risk averse, they have overloaded IT teams, and the weight of information assurance compliance bears heavily down. No wonder, then, that whole-estate upgrades are rarely a high priority. But with the deprecation of Windows XP, that is directly ahead on the horizon. How can trusts yield new value out of this necessary process?

In under 500 days (and barely 300 workdays), Microsoft will cease to support Windows XP, the workhorse operating system for many healthcare Trusts. Machines won’t suddenly switch off, but there will be no new security patches or fixes released. The potential for informational risk (data problems) and clinical risk (devices and applications ceasing to function properly) will, of course, increase. It is crucial that Trusts begin the process of mapping an upgrade path immediately, if they have not done so already.

Alastair Dick, Microsoft’s Chief Technology Officer, NHS, says there are good reasons to upgrade. “For IT managers, Windows 7 & 8 are easier to deploy and manage; they reduce IT helpdesk calls; and they repair, self-heals and manage themselves exponentially better than any previous operating system. Every clinical user can expect to log on in a fast and timely manner, on any device. Their applications, data and user settings will arrive instantly. Windows 7 and 8 also support the rapidly changing working practices within the NHS, such as total mobility with seamless remote and offline working, too.”

A Windows 7 Action Plan

Dick points out that the headaches of Trust IT are not insoluble. “The good news is, it’s a well trodden path. Millions of organisations have upgraded from XP to a current version, and we have rafts of documentation, reference architectures, and an experienced partner network, all of which mitigates or eradicates the risk to NHS organisations. Additionally, there is an ever-growing library of third-party applications which have been tested and validated for use in both the Windows 7 and 8 environments.

To deploy the latest versions of Windows effectively across as complex an estate as an NHS  Trust requires refreshingly little physical effort; but only if an effective strategic plan has been put in place. Mat Chase is Microsoft’s Technical Strategist for Health and Life Sciences; and he recommends the following action plan:

1)      “Understand the clinical workforce, and put them in a small number of cohorts – typically five to ten”. Chase says everyone has different needs, but catering to every nuance is akin to “boiling the ocean” – it just won’t work. Most trusts can sketch employees’ IT needs for the execution of their duties into no more than ten groups.

2)      “Prioritise and understand the applications they use”. Most trusts will have up to 500 applications – maybe more if you include fragments like databases or templates, or indeed “unofficial” software. Chase says these must be rationalised. “Choose 30-50 priority applications on which to nail your reputation. Apply structured and independent testing methodologies to them, to ensure that they are compatible with Windows 7/8. Don’t forget that many will already be certified, and many of the remainder will have newer Win-7 or Win-8 compliant versions direct from the manufacturer”. This is your core application suite, and it should not cost the earth to migrate.

3)      “Then apply lighter management to a further 100-200 applications”. These will be more specialist tools, so have them migrated in active use by small groups of users who have a vested interest in seeing them deliver value.

4)      Match your priority software catalogue to the cohorts, and then deploy them using the flexibility afforded by System Center. “With System Center, password resets, for example, are completely self-serve. Similarly, role-based access to applications – across the estate – mean that clinical or line-of-business decision makers can authorise access to applications, on the simple basis of business need. Nobody in IT need be involved in these deployments at all. This all serves to cut helpdesk calls by over 80%.

Chase adds, “Far from constraining users, a rationalised application set with role-based access controls on a current version of Windows with System Center gives users real flexibility to do their jobs. It dispels the myth of one-size-fits-all IT. Because I can understand you as an individual user, because I can understand the machine you’re using, and where you’re using it, I can decide with absolute confidence what services and security options to deliver to you: seamlessly, safely, and within the expectations of a trust’s compliance regime.”

A new opportunity for IT teams

Dick sees the upgrade opportunity as far more than a requirement of circumstance, an unwanted extra job for IT staff with already challenging workloads. Instead, he says it is time a direct correlation was recognised between that workload and real missed opportunities for improved health outcomes. “This is a classic example of the 80:20 rule: NHS IT resources are skewed to spending 80% of their time keeping the lights on. Most NHS IT managers will have spreadsheets of resources available in one column and another column will be a list of IT requests from front-line staff; well-informed people who want to improve health outcomes for citizens. Those projects are, of course, evaluated. And most will be put aside because there just aren’t enough team days available.  The move to Windows 7 or 8 is not just a desktop upgrade project; it’s a chance to change the way infrastructure is managed and automated, in order to free up IT resources and make a real difference to outcomes.”

By Nick Saalfeld
Journalist, Microsoft Health Team