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“With Centreon, we completely redefined how IT monitoring is done. Rather than reacting to issues, we can now prevent them. Our IT system’s reliability has improved and so did our peace of mind, monitoring a multi-site and multi-platform environment. Our availability rate is now reaching 99.8%. The drop in IT incidents is helping safeguard our brand reputation. And these improvements are directly connected to the use of Centreon. » - Philippe Lefebvre and Sylvain Badouard, Database System Administrators—GHT de l’Estuaire de la Seine

 

The project in a nutshell

Strategic objective: managing the monitoring of a multi-site, multi-platform environment

  • Ensuring access to data for the various applications dotting the care journey
  • Contribute to the care journey’s fluidity through maintaining a high level of IT availability
  • Pooling resources, technical platforms, and expertise

IT objectives: improve responsiveness through professional-grade IT monitoring

  • Enhance the reliability of various IT systems and optimize on-call duty management
  • Deploy a single monitoring platform across the consortium’s hospitals while preserving local autonomy
  • Adopt common monitoring practices across the consortium
  • Optimize the alert management system so issues are prevented rather than countered. 
  • Ensure the security of data flows transiting through the hospitals’ various applications

The solution: Centreon Business Edition

Main benefits

  • New areas for improvement are being found
  • Significant gains in terms of time and reliability
  • Monitoring is systematically built in each IT deployment
  • On-call management optimization
  • Alerts and incidents management is improved
  • Local autonomy for the various consortium’s sites thanks to a distributed architecture and ACLs

 

Summary

IT availability is critical in the healthcare sector, both for operational performance and reputation. Comprising a total of eight healthcare institutions, the regional hospital consortium GHT de l’Estuaire de la Seine strives to maintain IT availability at superior level. To achieve this, the GHT’s IT team adheres to a rigorous on-call policy, ensuring seven hospital sites and over 500 virtual servers run at their top condition. As uninterrupted IT availability is a crucial part of delivering quality health services, IT monitoring has been established as a pillar strategy in ensuring a frictionless patient journey. For this strategy to be successful, the GHT’s IT department completely overhauled their approach to IT monitoring aided by the Centreon monitoring platform and the support of an IT monitoring expert and technological partner, Orsenna.

 

The full story

The GHT de l’Estuaire de la Seine is an eight-hospital consortium which was formed with the objective to simplify and optimize the care journey, as underpinned by high reliability IT systems. The team adheres to a rigorous on-call duty schedule for constant watch over seven sites and more than 500 virtual servers, ensuring optimal operational conditions. As such, IT monitoring has become part of the strategies employed to provide a frictionless and quality care journey. To get there, the IT department successfully undertook a complete overhaul of its IT monitoring approach, opting for the Centreon solution and aided by their technological partner Orsenna, an IT monitoring expert.

The GHT de l’Estuaire de la Seine: Meeting the need for optimal IT 

The GHT (standing for territorial hospital grouping) of the Seine Estuary, a region in Normandy, France, employs 4,500 people, including 500 medical staff. It combines 7 healthcare institutions including the Groupe Hospitalier du Havre and four regional hospitals serving 5 communities, as well as an assisted living facility for the elderly (EHPAD).  

The GHT’s main business objective is to create frictionless patient journeys through shared medical and nursing programs that are adapted to patient conditions. The GHT was implemented to provide equal access to safe, quality care to local communities.

IT systems are a crucial means for delivering upon these business objectives, and thus IT service quality and availability are a fundamental part of patient care fluidity and impact the institution’s reputation, as Philippe Lefebvre, Database System Administrator for the GHT de l’Estuaire de la Seine, explains.

“Any slowdown, any moment IT service is unavailable directly impacts the patient care journey. It bogs down the flow: you get queues, the ability for the staff to serve patients is constrained, and there’s the risk of a tainted experience for patients and families, which in turn affects our reputation.”

The strategic objective: Optimizing the management of hospital IT services and on-call practices

The Centreon open source solution had been originally deployed in 2002 at the Centre Hospitalier du Havre to monitor the IT health and promote a high level of IT service availability. But in 2019, the team was looking to benefit from advanced IT monitoring automation capabilities. As well, the institution’s management wanted to standardize IT monitoring tools and practices within the consortium of hospitals. A consultation was then launched to provide the GHT with a monitoring solution that could meet all their criteria, in particular helping manage the increased complexity resulting from hyper-convergence and the multiplication of VMWare virtual servers across the various sites. Sylvain Badouard System and Database Administrator explains:

“We’re committed to rigorous standards in terms of 24/7 availability and on-call duty. With an ever-expanding and increasingly critical IT system, monitoring is the lifeline enabling us to better plan capacity and anticipate future needs.  In the wake of the GHT creation, it became imperative for us to promote advanced IT monitoring capabilities and practices within our establishments.”

The requirement for high availability IT service, as well as the previous solution’s limited automation capabilities were constraints for technical teams in terms of on-call duty. The new IT monitoring system sought to provide more flexibility, lighter touch configuration, all the while preserving the autonomy of each partner establishment, through more granular authorizations and alert management, on top of realizing significant gains in terms of IT service reliability.

ITOM objective: A modernized monitoring strategy to improve reliability and automate processes

IT monitoring expectations made the team revisit how the activity was managed, seeking to optimize the relevance of alerts. Therefore, implementing a single, centralized monitoring solution to oversee all of the GHT's IT systems, the team considered the need to preserve local team autonomy using ACLs, enhance IT reliability, and provide IT teams with superior issue anticipation capabilities. Philippe Lefebvre explains:

“We decided to completely overhaul the platform with the objective of consolidating the monitoring of a multi-platform and multi-site environment, bringing together different IT departments, resources, and stakeholders, and providing them with a range of access rights. The same IT monitoring solution was deployed throughout the GHT’s institutions, but we did preserve each site team’s autonomy and visibility, through granular access right management.”

The teams were soon seduced by Centreon's ergonomics, its user community, its connectors (Plugin Packs), and the ability to define access rights for each user category. As Sylvain Badouard recalls:

“Centreon naturally stood out from the pack, notably because our main choice criteria was deployment and use simplicity. Moreover, the Auto-Discovery engine perfectly met our expectations in terms of reliability optimization.”

The team quickly decided. Their new monitoring platform was to be the Centreon Business Edition. Orsenna, Centreon’s technological partner, monitoring and infrastructure specialist was tapped to aid in the new solution’s deployment. As well, the GHT’s IT teams chose to include an expert from Centreon to contribute to making their Centreon Business Edition deployment future ready, reliable, and agile.  

The project: a single solution across the GHT providing real autonomy to each member institutions 

The solution’s architecture was designed to include a main server deployed on the larger hospital center and 5 pollers to cover the regional healthcare institutions and the nursing home that comprise the GHT. Therefore, the same IT monitoring was used throughout the GHT but individual institutions were preserving their autonomy in managing their own monitoring.  Administration for the IT monitoring solution is centralized at the level of the largest hospital center while granular access rights management which Centreon enables, allows each site team within the GHT to visualize their own establishment indicators, views that were created using Centreon’s mapping module.

Deployed since March 2020 with Orsenna’s help and used by about fifteen people, the Centreon solution has already met the primary objectives of IT reliability and alert management optimization, as Philippe Lefebvre explains:

“As a first step, we deployed IT-focused monitoring to optimize alert management and enhance reliability. We monitor networks, databases, systems, virtualization, and storage, as well as the technical components of business applications and web servers, with a focus on application flows that support the transfer of medical files from one healthcare application to another.”

The GHT's IT teams have thus adopted standardized and automated processes which enable them to anticipate the monitoring of new IT assets. In terms of virtualization, all the tools are integrated and can easily and seamlessly be deployed.

Results: Improved reliability, optimized on-call management and enhanced IT performance

The first results are convincing: IT reliability has been improved, the team can now resolve problems guided by the longer-term vision rather than on an ad hoc basis. Managing on-call duty has significantly evolved, which Sylvain Badouard is very pleased about:

“We have changed how monitoring is done, generating time savings. From 5 people needing 3 hours to monitor 500 virtual servers each morning, we are now at one person needing only an hour. Alerting is now really efficient. We completely rehauled our alerting system, refining thresholds. We’re now left with only 10 to 15 alerts daily, which are easy to manage and track. Our team can now refocus their attention to work on the cause of a problem rather than on the symptoms. Reliability has increased and we are detecting previously unseen anomalies through more insightful reports. We are finally reaching the hard-to-detect issues.”

Centreon can manage heterogeneous environments, which provides IT teams in each of the GHT institutions the autonomy to monitor their own equipment. Since reliability has significantly increased and the number of incidents has decreased, the teams save time and can focus on tasks with higher added value, which Philippe Lefebvre particularly appreciates: 

“We have increased our availability rate to 99.8%. The drop in incidents is noticed beyond the IT department. It contributes to safeguarding our organization’s reputation, promoting a fluid care journey and work experience for medical staff. Such IT reliability gains can be directly attributed to the use of our Centreon platform.”

The collaboration with Orsenna, a Centreon certified partner, has been fruitful. Both the deployment and the configuration were successful as Sylvain Badouard explains:

“We worked with Orsenna, a Centreon certified partner, to migrate the IT monitoring data from the previous open source version with maximum efficiency. Orsenna supported us throughout the project, and this collaboration enabled us to make the most of our Centreon platform.”

Looking forward: Business-oriented monitoring

Philippe and Sylvain's team plans to evolve the current platform towards business-oriented monitoring. This involves finer alert calibration, the monitoring of business applications, and setting up dashboards that provide visibility on IT performance to business stakeholders. Another key benefit of business-oriented monitoring is the ability to demonstrate the added value of the IT department, as Philippe Lefebvre explains:

“For business stakeholders, IT may seem to be a black box with hefty costs. We want to be able to communicate the value the IT department adds and demonstrate that superior IT availability delivery makes for a strengthened care journey.”

Centreon-certified partner Orsenna’s advice for deploying monitoring in a business-critical, multi-platform and multi-site IT environment

As a Centreon certified partner, Orsenna has specialized in the integration of network and security infrastructure since 1998. The IT service company helps organizations evaluate needs, select, and engineer the end-to-end solutions that will drive them forward. Supporting the GHT de l'Estuaire de la Seine with the migration of its open source monitoring platform to the Centreon Business Edition, Orsenna uncovered a few best practices. Thomas Piedefer, project manager and Centreon specialist at Orsenna shares some insight:

“The flexibility Centreon provides is particularly welcomed in a hospital setting, where IT systems tend to be heterogeneous, complex, and critical. Centreon's ease of use, combined with its openness, allows health institutions to benefit from a solution that is both easy to maintain and aligned to their specific technical needs.”

Thomas believes a project’s success is highly dependent on the approach that is chosen for it. “You must think of the project before you even start thinking about technology. Users' needs need to be understood prior to discussing the technical aspects. The procured solution must meet the project’s aim, and for the GHT, Centreon was the solution that best met user expectations.”

The challenge was first and foremost to simplify centralized monitoring configuration across multiple sites and in a heterogeneous environment. Thomas shares some of the best practices deployed in this context: “Unifying the monitoring platform while preserving the various sites’ autonomy was achievable through Centreon’s architecture which comprises pollers, the centralized web monitoring console housed at the main hospital site, and the granular access right management (ACLs). The latter is an essential element, and one that highlights Centreon’s additional value. Access rights can be customized with superior precision to provide access to various levels of functionalities and types of views. Thus, in the case of the GHT, each hospital site owns its custom views.

Another project challenge was to deploy the solution quickly in a heterogeneous environment, and Plugin Packs provided the most suitable solution, combined with a key best practice: listing the equipment already in place and the most critical business applications. Thomas particularly adheres to this principle: “In a hospital, IT is a crucial enabler for frictionless patient journeys and quality user experiences for staff. For example, should the prescription software become unavailable, the entire hospital will be slowed down. Information will need to travel back and forth and be manually processed.  At the GHT, we first mapped the underlying equipment before deploying the monitoring.”

“Plugin Packs (connectors) are life-changing for IT teams and they provide a formidable advantage to using an open-source solution. No need to spend time searching or building code. You make your shopping list, you pick what you need, and the Plugin Packs (connectors) do the rest!”

 

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