Client-Specific Web Applications Enabled
Qualys Rating for SSL
U.S. States — Sole Provider to EMS and Fire Departments
In the category of electronic Patient Care Reporting (ePCR), ImageTrend, Inc. delivers software applications, data analytics and IT services. It enables fully integrated, patient-centric healthcare to customers such as fire departments, emergency medical services (EMS), hospitals and critical care facilities. In more than two-thirds of American states, ImageTrend is the sole provider to EMS and fire departments. ImageTrend’s main product, Elite, is used by paramedics and firefighters in the field for collecting on-scene data about patients, incidents, drugs administered and patients’ medical conditions.
One of the highest priorities at ImageTrend is compliance. Its Elite product delivers the data needed from initial contact all the way through treatment and rehabilitation, as well as for billing and insurance claims. Handling patient records means ImageTrend must be compliant with protocols for Service and Organization Controls (SOC) 2 and Health Insurance Portability and Accountability Act (HIPAA). The domains it manages for its health care customers must attain high grades on SSL configuration, including cipher suites and protocol support.
"We have three hosting facilities here in the Minneapolis-Saint Paul area of Minnesota," says Pete Larsen, an IT Services Engineer at ImageTrend, “plus a geographically separated hosting facility in Dallas, Texas. We believe in running almost entirely in house with on-premises hosting because many of our customers don’t trust the cloud for their data and operations. Most of our applications run on virtual machines, and our stack is built on Microsoft products like Hyper-V, Virtual Machine Manager (VMM) and Storage for Windows Server.”
ImageTrend was using Microsoft Application Request Routing (ARR), which acts as an extension to Internet Information Server, enabling an IIS server to function as a load balancer.
"The clincher for us, was that LoadMaster was a solid virtual offering."Christoph Riesterer, IT Systems Engineer, ImageTrend
The company sought a more secure solution for load balancing and web termination. But it also wanted flexibility in moving workloads around, which few physical appliances offer. ImageTrend IT Services Engineer, Pete Larsen downloaded a free Virtual LoadMaster appliance to evaluate.
ImageTrend subscribed with Kemp Metered Licensing, a monthly, in-arrears capacity license for Virtual LoadMaster load balancer, where the peak throughput of the LoadMaster instances are used for billing. The next step was starting their implementation.
"We had gotten by with Microsoft ARR for several years, but there were a lot of unknowns with ARR and it wasn’t very well maintained. We had open support tickets with Microsoft for years and when we explained how we were using ARR, they told us we should switch to Kemp. It wasn't physical and it wasn't ARR. It supported PowerShell and VMM, and it looked like a good fit for our environment."Christoph Riesterer, IT Systems Engineer, ImageTrend
ImageTrend separates all of its clients into tenants, which are logical groupings. There is no overlap among tenants, such that customers are never co-located on a particular app server. Running hundreds of separate tenants across the company’s half-dozen main applications means that ImageTrend continually runs 500 to 600 client-specific web applications.
ImageTrend spent a couple of months on testing and troubleshooting with Kemp, then another month deploying to production. “In our environment, that’s quite fast,” says Christoph Riesterer. “Kemp was easy to learn and deploy in our environment and the level of support we’ve received is outstanding, certainly better than what we had with ARR.”
"We run between 30 and 50 pairs of Kemp load balancers, some with multiple virtual services. We use load balancing for about 80 percent of our applications, which are built in .NET, ColdFusion Markup Language (CFML) and Node.js. We're constantly getting new clients, so we're constantly spinning up new tenants. That means new Kemp Virtual LoadMasters."Pete Larsen, IT Services Engineer, ImageTrend
Since implementing Virtual LoadMaster, the company spins up one pair of load balancers per tenant in a high-availability configuration. Then, depending on the number of domains in each tenant, it splits up the Virtual LoadMaster so that each domain has its own virtual service.
ImageTrend has been able to roll out deployments of Virtual LoadMasters much more smoothly than it could roll out the ARR pairs before. Taking advantage of Kemp templates and the integration with PowerShell, it can spin up Virtual LoadMasters and deploy them to production within an hour.
“We love the stats on Kemp 360 Central,” says Christoph Riesterer. “They make it easy to see which Virtual LoadMasters bear the greatest load. Better yet, Kemp lets me email those statistics to the product teams regularly so they can see how many connections their Virtual LoadMasters have handled and how they’re split up. Also, we've started deploying Kemp into our dev environments. Getting our developers to understand what they can do with the Virtual LoadMasters will make a big difference.”
As for compliance, some ImageTrend customers demand A-grades for SSL web server configuration from Qualys. That’s a high bar for any service provider to reach, but Kemp’s dedication to updating cipher suites and protocols has enabled ImageTrend’s applications to achieve A-grades and even A-pluses.
Reliability has been so much better since we’ve switched to Kemp. Maintaining those ARR servers would introduce some strange effects we could never figure out. We haven’t had to spend time digging around in the Kemp Virtual LoadMaster. The quick and accurate deployments have made our lives so much easier.Christoph Riesterer