“The HP AlphaServer GS1280 system will
save us a lot of money because the capacity
far exceeds our expectations. We originally
thought we would have to double the size
or add another server. Now, because of the
performance we are seeing, we are quite
confident that we will be able to get through
this year and into next before we have to
add more database capacity.”
— Lee Oettinger, Manager of Technical
Services, Aurora Health Care Success story: Breakthrough performance of new HP system
exceeds capacity needs of Aurora Health Care

Finding a better way
Every organization welcomes growth, but not necessarily
the growth pains that go along with success. When
Aurora Health Care hit the capacity ceiling with its
database server, an HP Next Generation OpenVMS
AlphaServer GS1280 system relieved the pain by
delivering a quantum improvement in performance. Aurora Health Care is a not-for-profit health care system
and a national leader in efforts to improve the quality of
health care. Serving the eastern third of Wisconsin, Aurora
provides services along the entire continuum of care, from
disease prevention through treatment and rehabilitation. Aurora Health Care was formed in 1984 with an affiliation
between two Milwaukee hospitals and has been on an
impressive growth path ever since. The organization was
created around a single idea: There is a better way to
provide health care. Aurora strives to give people better
access to care, better service and better results than they
can get anywhere else.   The organization’s primary application is
Cerner Millennium^™, a comprehensive solution that
enables health care providers to capture all patient
information in one electronic medical record. Aurora
runs Cerner Millennium and the Oracle^® database on an
HP OpenVMS AlphaServer cluster. Capacity headaches
“Our biggest challenge,” says Oettinger, “is to provide
the computing capacity to continue to implement the
Cerner application in all of our hospitals and clinics.” Aurora runs a centralized IT environment at the
organization’s headquarters in Milwaukee. The entire
Cerner production environment runs on four AlphaServer
systems — three servers host the application and one
hosts the Oracle database. Eight additional AlphaServer
systems make up an elaborate test and certification system
that supports the production environment. “We have one terabyte of data for production,” says
Oettinger. “Of that, 750 gigabytes is live data. We have a
total of approximately six terabytes of storage. Our entire
storage architecture is HP StorageWorks. Our production
storage is on a SAN with EMA12000 arrays and four
disk arrays that support our production environment. We
will be moving our production database to two EVAs.” While storage capacity can be added incrementally,
database capacity could not because the Cerner and
Oracle combination currently requires that the database
run on a single server. “The database machine was the bottleneck in our
architecture,” explains David Harrold, Senior Systems
Engineer at Aurora. “We were averaging utilization of
85% to 87% with spikes of 100% utilization, which was
slowing down the application and inhibiting our ability
to roll out Cerner Millennium in new facilities.” The right prescription
“The solution to our capacity challenge was an
AlphaServer GS1280 system,” says Oettinger. “On the
first day in production, it averaged 16% utilization. During
prime time utilization, it has not exceeded 25%. So with
this single system, we have gone from 90% utilization to
25% utilization. Now our users are happy, and we can
sleep at night.” Aurora is the second largest OpenVMS user within the
Cerner customer base. “Cerner considers us to be on the
cutting edge in capacity planning,” says Oettinger.
“We spend a lot of time planning for future capacity
requirements and trying to stay ahead of the game.” Aurora worked closely with HP to configure a system that
would meet its hefty capacity needs. Harrold explains,
“We were hoping for a two-and-a-half to three-times gain.
In effect, we got a four to four-and-a-half times gain.
Before we saw what this server could do, we thought that
we would have to upgrade to 32 CPUs in several months.
But I am now confident that the current configuration will
last at least a year as we add three more hospitals and
20 to 30 more clinics to the system.” “Aurora is always looking to find a better
way, and to do that we’re looking toward
the most current technology in the health
care field. We are committed to HP
technology, and we also work with Cerner
Corp., a leader in totally integrated health
care systems.” — Lee Oettinger, Manager of
Technical Services, Aurora Health Care

“Scarily easy” upgrade
There were no headaches when it came to upgrading
from the older AlphaServer system to the next generation
AlphaServer GS1280 system. Harrold explains, “We
had the machine about a month before we put it into
production. The upgrade was scarily easy. During our
normal Sunday outage window, we shut down the
AlphaServer GS140, changed the configuration so that
the AlphaServer GS1280 booted in that node in the
cluster, booted it up and we were off and running.” Before the upgrade, users were experiencing slow
response times during periods of peak utilization. “There are a lot of people who are happy with the way
the application runs now, and they are using it more,”
comments Harrold. Harrold says that HP has helped with capacity planning.
“We have a very good relationship with our local
account team. They do a very good job of getting us
information about what’s going on and what’s coming.
We work closely with the OpenVMS engineering group
and they’ve been very helpful. We also have a good
team in the local field service office, and they installed
the new server for us. We work well together.” Staying ahead
To maintain 24x7 availability, Aurora has a standby
system for planned and unplanned outages. At those
times, the IT team switches users over to a separate
read-only database running on a separate cluster. Another capability Aurora has just implemented is web
access to the Oracle database.  “I think we are one of
the first Cerner users to be able to provide read-only
web access to the database,” says Harrold. “We
designed and set it up as part of an outage contingency,
but now people are using it from their offices and homes
on a regular basis. It’s much more popular than we
initially thought it would be.” Oettinger adds, “Cerner will probably have web access
within a year, and we will take full advantage of that.” In the meantime, the IT team’s directive is to roll out the
Cerner application to all Aurora facilities. “Cerner Millennium is allowing us to have a totally computerized patient record where virtually all the patient data is in
one place and available at every Aurora location,” says
Oettinger. “We currently have Cerner installed at 50% to
60% of all the Aurora facilities. Our key goal is to roll out
the computerized medical record to every Aurora location
and have everybody using it. The beauty of HP is that we
can maintain the same operating system, application and
database — we just add more hardware.” The hardware roadmap for Aurora looks like it will lead
to the industry-standard Intel^® Itanium^® architecture. “I’m
sure that in the future we will move to the Itanium^®-based
platform,” states Harrold. “We will probably run a mixed
environment for a while, which OpenVMS clusters will
allow us to do.” As a matter of course, HP technologies will continue to
support Aurora’s mission to find a better way to deliver
health care. “I’ve been working with OpenVMS for
about 15 years, and there’s no other
operating system that can touch it in my
opinion because of the stability that’s been
evidenced over the years and the security
that’s built-in. And the clustering is one of
the best technologies that’s ever existed.
Nobody else can hold a candle to what
OpenVMS clusters provide as far as
scalability and reliability.” — David Harrold,
Senior Systems Engineer, Aurora Health Care

Adaptive enterprise solution overview: Increase performance to satisfy capacity demands Challenge • Create an infrastructure that enables the organization to stay ahead of
capacity demands • Make the electronic medical record available at every facility • Provide the flexibility to align the IT platform with changing business needs • Implement Cerner Millennium and Oracle database running on
next generation EV7-based HP
AlphaServer systems and the OpenVMS
operating system • Employ OpenVMS clusters to ensure high availability, security and stability • Achieved four to four and a half times performance increase • Improved stability and reliability • Provided scalability to meet future growth Solution Results At a glance • Name: Aurora Health Care • Headquarters: Milwaukee, Wisconsin • Founded: 1984 • URL: www.AuroraHealthCare.org • Products/services: A not-for-profit heath care system, Aurora Health Care encompasses Aurora Medical
Group with more than 600 physicians practicing at
78 clinics, 12 acute-care hospitals and one psychiatric
hospital, more than 130 community pharmacies, the
state’s most comprehensive home health and family
service agencies, and several long-term care facilities
and retirement communities. With 24,000 employees,
Aurora is Wisconsin’s largest private employer. Technology highlights • Hardware: production environment of four HP AlphaServer systems running in an OpenVMS cluster;
testing and certification environment of eight
AlphaServer systems   • Operating system: HP OpenVMS v7.3-1 • Storage: StorageWorks SAN consisting of EMA 12000 arrays and two EVAs with approximately
6 TB disk space • Services: Gold Support from HP Global Services For more information on how working with HP can benefit you, contact your
local HP service representative or visit us at www.hp.com Cerner Millennium is a trademark of Cerner Corp. Intel and Itanium are registered trademarks of Intel Corp.
in the U.S. and other countries. Oracle is a trademark of Oracle Corp., Redwood City, California The information contained herein is subject to change without notice. © 2003 Hewlett-Packard Development Company, L.P. All Rights Reserved. Reproduction, adaptation or transla-
tion without prior written permission is prohibited, except as allowed under the copyright laws. 5981-8872EN [an error occurred while processing this directive]