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January 11, 2023: Move fast and be free in a multi-cloud world. How can you harness the power of multi-cloud to accelerate innovation and transform the way you do business? Whether you need help with security, modern apps, cloud or remote work, VMware can help. Raj Rana, Senior Director, Solutions Engineering - National Healthcare shares how to secure your infrastructure with multi-cloud edge to gain greater flexibility and control. And how to leverage your architecture to provide rapid recovery and resiliency. In healthcare today, a blueprint for creating an agile modern healthcare digital foundation without impacting the quality of care, is essential.

Key Points:

  • 75% of attacks actually occur through lateral propagation
  • At face value, new operating models appear to be incremental innovation, but really it’s implementing pretty significant changes that still allow you to leverage that technology
  • People won't like you if they don't trust you. And that's a challenge that's very, very difficult to quantify
  • VMware

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Today on This Week Health.

We're not your traditional security company, but we play a huge role in the security space. Right. And with regards to securing your entire environment. I think when you look at where VMware sits inside your infrastructure, we have a unique position in where we have visibility to all aspects, and our goal is not to necessarily add point solutions inside your environment for you to then tie together, but to leverage our position of visibility, our position of security. And where we are in the operational process to simplify management and to simplify securing your entire environment.

Welcome to a Solution Showcase. Today we are talking about how to harness the power of multicloud to accelerate innovation and transform the way that healthcare does business. Raj Rana, Senior Director of Solutions Engineering National Healthcare at VMware shares how to secure your infrastructure with multi cloud edge to gain greater flexibility and control, and how to leverage your architecture to provide rapid recovery and resiliency. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of this week Health, A channel dedicated to keeping health IT staff current and engaged. We wanna thank our sponsor for today, VMware, for making this content possible now 📍 onto the discussion.

All right. Here we are in Southwest Florida. I am with Raj Rana, the senior director for Solutions Engineering for Healthcare for VMware. That's correct. Great to be here. Wow. I I'm looking forward to the conversation. It's been a fun morning. We worked together here at one of the 2 29 events with security officers, and we got to hear from a lot of security officers this morning. Really interesting approaches. Not always the same. Yeah. Sometimes. Different bent on what they're trying to do and where they're going.

A lot of areas of commonality as well.

Yeah, it, it is really interesting. I'm gonna come back to that conversation, but I wanna start with VMware and security. So what's VMware's approach to security?

Yeah, Bill, I'm, I'm glad you asked. We're not your traditional security company, but we play a huge role in the security space. Right. And with regards to securing your entire. environment I think when you look at where VMware sits inside your infrastructure, we have a unique position in where we have visibility to all aspects, and our goal is not to necessarily add point solutions inside your environment for you to then tie together, but to leverage our position of visibility, our position of security. And where we are in the operational process to simplify management and to simplify securing your entire environment. environment.

Has that changed over the last, I mean, you guys made some acquisitions that's great. Brought some things together, plus the pandemic really changed how we function as healthcare. I mean, how's your. Approach evolved.

No, that's a, that's a great point. So absolutely it has evolved over time, right? Traditionally, we've been more in the data center, we've evolved more towards leveraging I'll call, generally call the access. So if you look at the, the flow, if you will, let's use ransomware as an example.

If you wanna follow that flow. It really starts out at the edge, right? Starts at the edge. These devices that are not only propagating just through general consumerism, but to your point, accelerate through covid, right? And then covid not withstanding even with that, as you start to push more and more towards care outside of the four walls of the hospital, these mobile devices, really are, are here to stay.

And they're a critical way of engaging with the health systems, which is an important part of us being able to manage and use that as that first line of defense. So once you get past that, you start to get into, you get into the core part of our business, right? Which is the infrastructure. So we actually just had a study where it showed that 75% of attacks actually occur through, through lateral propagation.

Right. So not only do we have solutions that help with micro segmenting your network to prevent that lateral isolation, but we've also got components around how can we ensure that you've got a known good state? and through all of this is leveraging the value and the power of the hypervisor to have a greater level of visibility to not just block things, but to be able to, validate the traffic.

So the second day we have topics we're gonna. and two of the topics that the CISOs put up there were resiliency and recovery. And when I think of VMware, one of the things we were doing back in the day was we were really starting to tap into your software defined architecture. And from a resiliency standpoint, we were able to stand up things very quickly, bring them back online.

The other thing is we could kill workloads that we knew had gotten infected. Exactly. Kill 'em off in a way we go, I. As we're moving towards resiliency, recovery and really measuring that in terms of minutes instead of months. Yeah. at this point, I mean, it's, it's kind of scary. I mean, we're talking at a point where I, I think the, hospitals for Common Spirit, I think a bunch of 'em are still offline.

It's tough. And I don't know if they're still on diversion, but they were on diversion early on in the process and. We talked financially this morning around what is the cost of a downtime? And we have some anecdotals. We have we have Sky Lakes at roughly around 30 million.

And we're talking a very small hospital. Right. Single hospital, 30 million. and I think the number that's been thrown around around scripts is a hundred to 130 million. That's crazy. Yeah. That's, that's a fair amount of money. Are we seeing the investment and the conversations really center around security yet, or is it still one of those afterthought conversations? I hope it's not an afterthought. As I'm saying it, I'm like, I'm hoping this isn't

well, so I think that it's, it's challenging, right? It's like insurance in the sense that you hate paying for it until you need it, in which case it's you wish you had more. I think what we're trying to do is really integrate that into the core of the conversation, right? And so when you look at You brought up a great point around downtime, right? So downtime obviously has a financial impact, but it has a impact to patient lives, to the clinician's overall wellbeing, mentally, physically, what have you.

But there's a great comment that was made that people won't like you if they don't trust you. And so I think that's a challenge that's very, very difficult to quantify is what is the impact of trust. And so for us when you look at. , to your point of bringing back environments back in minutes.

We also have, as the multi-cloud company, we have the ability to really bring to bear the power of the cloud. And so in that case, it's not necessarily about your backups, it's about how fast can you recover, And so how do we take this capability that, again, leveraging the infrastructure and, and the experience that your existing staff already has with managing your environment.

How can we take that over and leverage the benefits of the cloud? So this is about how can we not only, it's not only is as backers, but how do we accelerate recovery, right? Providing recovery as a service, if you will, which includes the ability to spin up not just your environment, but also things like isolated recovery environments to allow you an environment to spin up and start to have a controlled environment where you can start to replay back your log, you can start to build it back to a known good environment and not have to risk the existing infrastructure that's already on there, thereby accelerating that time ideally reducing the financial impact and increasing those trust

resiliency really is about your architecture going into it, isn't it? Absolutely. We heard one of the security officers today talked about their architecture and how they are standing up their clean area. Their clean rooms.

Yeah. For recovery they're already stood up and they already have a clean version of active directory and they're, I mean, they're ready. To go, I mean, that ransomware hits, this is their clean environment, which we all know is one of the steps in the recovery process. Absolutely. We can't trust this anymore.

it's, it's fascinating to me to to think about, but architecture, I keep going back to architecture cuz when people say what is VMware's security play? I say your architecture has to be sound and it has to be one. That's dynamic And identify the workload, kill it off, but then bring the, bring a workload back up that can replace that and almost instantaneously not have a downtime cuz we're identifying this threat over here that's happening.

And we're saying, you know what? That's, that's just a virtual machine, right? So we migrate that stuff over and whatever, and we were doing that. I mean, we were doing that eight to 10 years ago on VMware.

Well, and so, so that's a great point, right? That show me an organization, healthcare or otherwise, that has a glut of cyber resources, right? Right. That has a glut of IT resources or, or even infrastructure, resources. Exactly. It just, it doesn't exist. It's not out. There's such a high demand for this. So, so back to your comments around architecture. Obviously process and policies are critically important. I don't want to imply that they're not But with an architecture, back to your point of people who've got eight to 10 plus years of experience managing this environment, it's critically important for them to be able to leverage those skills that they have, the comfort that they have, and to be able to apply that into new domains.

In this case being rapid recovery in this case of leveraging environments to address those issues. Because there's just, we just, the, the manpower doesn't exist. There are not enough, there's not enough personnel.

And you talk, you talk about that skill. The other thing I I really appreciate about VMware is as I'm moving into the cloud, I mean, you give me the ability to do a cloud or multi-cloud kind of environment on that same set of tools. Correct. Which is, it's nice from a training standpoint. I just say to my team Hey, it's just another, it's just another data center essentially.

It it is I mean, there's, there are folks that have spent their entire careers. IT organizations right? And in healthcare. What we don't want is to necessarily I don't wanna say we don't want, part of the challenge we have is, is once you train people up, they move out to another organization.

But on the same token, you need to train them up to be able to capture the investment. This, this innovation that's occurred out in the market. And so this is, is really a best of both worlds. You still get the benefit of leveraging the innovation that has been developed by new operating models. We wanna help accelerate down that process and bring everybody along as opposed to saying, This is where we're gonna go and forget our history.

The innovation side is the other area that I've been keeping an eye on VMware because partnership with Invidia Yes. And whatnot. And so we're used to like, Hey, you virtualize these resources. We've done this with network storage, compute, and now you're doing it with these, GPUs and other things and bringing this really high powered set of resources to bear on research and on implementing AI and these models. and again, it's the same set of tools that we've been using for, for 10 years.

That's exactly right. It's, at face value appears to be incremental innovation. Right. But really what it is, it's pretty significant changes, but it still allows you to leverage that experience. You have, You brought up GPUs as an example. Absolutely. GPUs are, are a huge value ad. We just at our last conference we announced the abilities to, to actually leverage smart niches or DPU data processing units to be able to offload certain aspects of things like our, our networking stack.

in some regards, you will, you have, there's this huge push of the cloud. But in some cases there's gonna be environments that do not wanna move there. They still want, they still should be able to leverage a lot of those benefits, whether it's at an operating model, whether it's technical innovation, to be able to drive those workloads that add value to the health system.

It's interesting. I'm gonna put you in a weird spot because I, I just read an article about moving out of the cloud. Sure. I've been a huge proponent of the cloud since, well, actually since about 2008. So for me reading this kind of article, it caused me to sit back and say, Okay is the cloud right for every size organization?

And it's, it's right for if you need to be nimble, if you need to spin up a lot of resources very quickly. But once you get to that sort of steady state the case that was being made in this article is once you get to that steady state and whatnot. Incremental costs of resources in the cloud for the agility that you have almost don't need anymore now that your company's sort of at a, a steady state it makes the cloud sort of a too expensive for what you're getting for it.

It's been a while since I've really reevaluated it and I started thinking about it. I'm like that could define a lot of health systems.

Well, there's been this push towards, to your point, there's been this push towards cloud first, right? Right. That we have to go to the cloud. And don't get me wrong, there's a ton of value that's there. There absolutely is The challenge to exactly, to the point that you bring up. The challenge is that it's not uniform and it's not for everybody. And so our approach, because what, and it's not for every workload exactly. As you start to move towards cloud first, what you start to create is, is this environment of what we call cloud chaos.

And so what was intended to initially simplify your life has just exponentially increased the complexity in the chaos, which then tying it back to security is an issue. Tying back to skill sets, the ability to be able to drive anything, it's just a lot of complexity. Our approach really comes back to what we call cloud smart.

you should ultimately take a pragmatic approach towards the cloud. It is a technology. Ultimately what matters is the architecture. What we've done historically, if you look at our history, has been we create these layers of abstraction and the layers of abstraction separate. Whether it was originally separating the server from the operating system or the application.

We just kind of continue to. And what that allows you to do is move towards this operating model, towards this cloud operating model, which allows you to determine not only what cloud you want to use, but what workloads you want to, what you want to move where. And so that pragmatism is, is our benefit to be able to allow to the health systems, the ability to make their movements where they wanna move, but also do it in a way that's, that's not only sustainable, but.

Right. And has the ability to pull back if you need to pull back.

Absolutely. You've gotta have an exit plan.

the SaaS model makes sense for a lot of different things, right? We went to Workday and we're like, Yep, we did Salesforce. And it, it sort of made sense on those, on those mo In fact, there's no way to do sales Salesforce otherwise or Workday for that matter.

Right. And so there was a bunch of those applications and, and that is what it is. And then we looked at the, we looked at the rest of the applic. And a majority of them. When we moved to the cloud, we used VMware as the, the abstraction layer, as the underlying abstraction layer. we kept looking at cloud native, and you guys even have a play in cloud native.

If we're going to re-platform our apps, we can head in that direction with vMware as well,

So, Fantastic. Absolutely a great point, right? One of the challenges when you talk about innovation hand in hand with that is, Right, and there's a lot of folks that are out there saying that the hypervisor is going to die, and the reality is the number one person, the number one organization that's leading the charge is VMware.

If you want to go the route of maintaining your hypervisor because it makes the most sense, we are going to provide you the platform that gives you the greatest flexibility, the greatest value. If you want to move towards a cloud native environment, we will allow you to manage that both on-prem by building. A Kubernetes distribution is part of vSphere, but it also allows you, we also have capabilities to help develop new applications, right? I mean, when you look at things like Workday, you look at things like Salesforce. Ultimately what you're driving towards is yes, a new operating model, but it's really when you get down from a healthcare perspective, it's all about experiences and there's a lot of experiences that are provided by these softer vendors, by these, these companies that are out there.

But what really starts to differentiate different. in the healthcare spaces is what is the kind of experience you can provide them. So if you want to start to create a customized experience, which we heard some about that earlier today, creating customized experiences in a cloud world should not be something that's done over on the side.

It's something that, that that you should be leveraging as part of a, if you wanna build a development environment, great develop, but also make sure that you can maintain that and you can sustain that as you move.

again, I'm, I'm gonna throw a curve ball at you here. So, Epic comes out with their hyper drive, hyper space space to drive, right? Hyper space, hyper drive. It's interesting because a majority of organizations actually operate their, epic environment on one of your competitors. as you sort of look at that, what are you seeing? I mean, it's, first of all, it surprises me that they would develop that, and it already exists in the industry.

It surprises me that, to develop that. But the second thing is you have, you have a competitor that really hasn't expanded out of that space. So that's a real significant blow to that competitor as well. I mean, what do you, what do you see as you see that?

So you. I was actually just up in Verona last week, and I will tell you this, they, they definitely care about the healthcare customers. Oh, ab absolutely, absolutely. Care about them. Yeah, that's, I would never question that. And I would even comment, even for our competitors that are on the market, they, they care about the healthcare customer as well. Yep. Right. So, so I think from that perspective, at the end of the day, like our CEO says, right?

We have to keep the main thing the. We absolutely want to compete on, on value, and we want to compete on why we firmly believe our technology is better. At the end of the day, we have to do what's right for we have to do what's right for our, our joint customers. Yeah, and I think from that perspective, I can't really comment on why they go down this route.

I think that there's push around around leveraging security. I think there's, there's other components. There's performance that comes into this. I think from our perspective, we're going to continue to work very closely with. Our customers, right? Our healthcare partners that are, that are going through this transition work with our partners up in Wisconsin and beyond that are, that are developing these and really jointly come together to find that outcome that provides the best value.

I love your partnership mindset. Man, it's because I've run into so many organizations that are now building on your native environment. We talk to a mam. Company that was doing AI built essentially on top of Yep. On top of the VMware stack. And they're doing amazing things there. I mean, identifying things in the mammograms not in replace of the doctor, but in saying, Hey, here's some things you might wanna look at.

Right. And the and the accuracy level of that is really, really amazing. I really appreciate your partnership and. In partnering with just a ton of different organizations that are out there. So hey, I want to thank you. I wanna thank you for your time. Thank you for being at this event. Great conversations.

Absolutely. Bill and I wanna thank you. I appreciate what you're doing for the industry. I appreciate you bringing everybody together. I think that ultimately there's that saying that if you want to go fast, go by yourself, you wanna go far, go together. And I really appreciate you bringing everybody together and ensuring that every has the perspective and as a context to be able to to improve wellness across the healthcare space.

Raj, thank 📍 you. Pleasure.

What a great conversation. I love sitting down with Raj so insightful. A lot of things you can take and apply to your health system. Just fantastic conversation. And of course I want to thanks. VMware. We would not be able to fulfill our mission to develop the next generation of health leaders without them. And their support over the years and really appreciate all that they do. I just wanna thank you again for listening to this content and referring it to friends and whatnot. We continue to grow and it's really in part to our great guests and to our great listeners 📍 who are sharing the good word with others. So thanks for listening. That's all for now.


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