A Decade of Innovation for Atlantic Health System

An innovative and future-focused organization

AHS first turned to Citrix to operate its electronic medical record system (EMR), creating an enterprise-wide solution that ensures consistency and scalability across AHS’ more than 500 locations. “When AHS decided to move forward with the Epic EMR over a decade ago, the most mature solution for its delivery was Citrix,” says Meraz Nasir, Chief Technology Officer at AHS. “At Atlantic Health System, we view patient care as a sacred trust—a commitment that demands unwavering dedication to excellence, security, privacy, and human dignity.

Our strategic partnership with Citrix represents more than a technological solution; it is a profound promise to our patients and healthcare professionals. By implementing a robust, scalable platform that ensures secure and seamless access to critical medical information, we empower our caregivers to focus on what matters most: delivering compassionate, high-quality patient care. This is not merely an infrastructure investment, but a fundamental commitment to protecting the most sensitive personal information while enabling our medical teams to provide world-class healthcare with confidence and precision.”

The relationship grew into a long-term partnership that allowed AHS to replace legacy technologies with Citrix solutions such as NetScaler and expand to non-clinical systems that make life easier for staff and patients.

Supporting staff and increasing efficiency for wider organizational goals

Each day, AHS supports 15,000 unique Citrix users – up to 11,000 EMR and other application users at any one time. Approximately 1,000 of those users are mobile nursing stations, where AHS has implemented Citrix to improve user satisfaction and operational efficiency. Thin clients provide nurses with secure access to virtual apps and desktops via Citrix. The thin clients minimize attack surfaces and reduce vulnerabilities, while Citrix provides faster logins and rapid access to patient data.

Safeguarding sensitive patient data and maintaining unwavering adherence to stringent security regulations are paramount responsibilities for any healthcare organization. "Implementing zero trust segmentation across an enterprise of our scale is a significant undertaking," notes Nasir. "A critical element of our strategy involved minimizing the attack surface presented by nursing stations, specifically by reducing the necessary ports and protocols. This approach allowed us to effectively narrow the scope of our cybersecurity efforts. Leveraging Citrix solutions, we have successfully isolated these vital access points within a highly secure, segmented network."

This implementation reduces the organization’s risk of data breaches. It also supports secure access to healthcare applications and patient data from any location while maintaining security and privacy standards. So far, it’s been rolled out to support hundreds of nurses, with plans to replace most of the stations as the rollout continues.

The entire project has been challenging in scale but successful and worth the effort. “Fundamentally, the reason I feel comfortable with this, and any other such project, is that without a rock-solid Citrix ecosystem, it would present an unmanageable operational risk, jeopardizing our success,” comments Nasir. The positive implementation has helped him clearly prove the value of Citrix to AHS’s leadership team in streamlining operations and improving user experience.

Organizational security and system confidence

From a business continuity perspective, one of the key advantages of leveraging Citrix to deploy critical applications and a standardized clinical desktop environment is the ability to rapidly revert to a 'golden image' and swiftly restore access for our users. This rapid recovery capability is particularly invaluable in mitigating the impact of cyberattacks. A recent example that underscores this benefit was AHS’ ability to recover the Citrix-based virtual desktops following a CrowdStrike blue screen incident. The technology enabled AHS to quickly restore critical access to the EMR, ensuring minimal disruption to patient care.

“We have a much greater capability to restore rapidly from any type of cyber event and re-stream everything down to the end points,” says Kyle Hedden, Lead Engineer at AHS. “We don't have to worry about touching thousands of endpoints to perform any type of recovery action. When the CrowdStrike event happened in July 2024, it simulated that same type of net effect on the endpoints and we felt that pain, but the very first thing to recover and get back up and running were the thin clients.”

AHS enjoys an added layer of security thanks to NetScaler, which hosts and drives its entire patient portal, as well as managing global server load-balancing for seamless distributions across data centers in case of interruptions. Some of the NetScaler features were also used to protect the patient portal during the COVID-19 pandemic. When vaccine appointments would get booked up within five minutes, the team used NetScaler to develop rate limiting policies and surge protection. “With the Web App Firewall, we were able to get users into a queue more effectively, enabling them to actually get in and book the vaccines,” says Nasir.

What’s adding even more confidence in the system is the fact that, with rapid updates powered by Citrix Provisioning, EMR maintenance times have been reduced. In fact, a recent triple maintenance upgrade of multiple packs for back- and front-end, only took 39 minutes instead of hours or days. “Consistency and the granularity of control coupled with agility is what drives our success,” comments Hedden.

Supporting acquisitions and mergers

Amidst mounting financial pressure in the healthcare industry, AHS, like many hospitals and health systems in the US, is continually growing and diversifying through mergers and acquisitions. To keep pace with this growth, AHS needs a reliable way of onboarding new acquisitions. “Citrix is one of the reasons we are able to do this well,” says Nasir. “It helps from the technology-stack perspective; it gives us flexibility in how we deploy the EMR to all our sites; it is our standardized delivery method for the enterprise, but it also enables us to address additional challenges such as external access to the EMR.”

Despite the complexity and security challenges of combining separate businesses, for AHS, onboarding new ambulatory acquisitions is seamless thanks to Citrix, leading to better time to value and providing care to patients. “All we have to do is make sure the new acquisition has a compatible Workspace app. After that, the Citrix environment is all engineered so that it’s hands off for us,” explains Hedden. This centralized approach will also allow for more effective and efficient deployment of best practices and streamlined operations across all of AHS’ facilities. And all this is possible without causing any disturbance to patient care. Which is, arguably, the most valuable result of the Citrix implementation for AHS. “That’s the North Star,” comments Nasir. “Providing care to our patients with minimum disruptions.”

Unique approach to new trends

Apart from increasing operational efficiency and security, the AHS team enjoys being able to do more with Citrix. Hedden comments: “The biggest thing that takes the stress off us is that we can do everything with our full test stack before, and then get things deployed to Prod. With a mature Citrix program and buy-in from our app owners to do all the regression testing, we have far fewer outages, far less frequently than we did seven years ago. All while maintaining a consistent experience and operational excellence and agility.”

The team is continually looking to deliver further improvements. They are already moving to XenServer, which will produce significant cost savings when it replaces the existing platform. There are also plans to move the organization’s EMR to an Epic-hosted solution while retaining Citrix for remote access and non-EMR workloads. This means that, while keeping the Citrix tier, AHS will leverage Epic-hosted Hyperspace Web Servers, making it one of the few healthcare organizations to run this hybrid Epic solution. AHS is leading the charge for innovating technology solutions in the healthcare space.

This innovation speaks to the partnership between AHS and Citrix. Over a decade of collaboration allows the organization to deliver cutting-edge solutions with the knowledge that it will have Citrix support in delivering consistent patient care.