Cherry Health Removes Microsoft Office 365 Performance Roadblock with FSLogix

Non-profit health services Cherry Health provides essential care to people living 200-percent below the poverty line. Information technology (IT) services are a pivotal enabler in health services and are particularly critical for a non-profit provider such as Cherry Health. The health services organization understood the value of optimizing its IT infrastructure over 20 years ago and was an early adopter of Citrix technologies.

When Cherry Health ran into performance problems when migrating to Microsoft Office 365, it removed the roadblock with FSLogix Office 365 Container for Citrix. Without the FSLogix solution, Cherry Health either needed to revert to an on-premises Microsoft Exchange deployment or experience a measurable productivity loss across its 1,000 staff and providers.


“It provided centralized management, data control and access, as well as remote access,” says Ken Brower, Cherry Health’s Chief Information Officer. “We have much greater agility and scalability, coupled with a lower total cost of ownership. We simply need to add more hardware to our datacenter and order additional thin clients. There isn’t any need to purchase workstations
and laptops and spend valuable time configuring them.”

A little more than eight years ago, Cherry Health opted to move to a virtual desktop infrastructure (VDI) by adding Citrix XenApp. The XenApp infrastructure supports approximately 40 different applications proprietary as well as commercial software-as-a-service (SaaS)-based services. “In addition to XenApp, we have [Citrix]
XenDesktop in some niche cases,” says Tim Riegler, systems engineering manager at Cherry Health. “Our thin-client architecture allows us to ensure that our patient information is always in the data center and not stored on any local devices.”

When we started testing Office 2013 with Office 365, we saw a substantial degradation in performance. Office 365 automatically connects to Exchange in online mode and thus does not store anything locally on the client.

– Tim Riegler, Systems Engineering Manager

Early this year, Brower and Riegler initiated a project to upgrade from Microsoft Office 2010 to 2013, including a move to Microsoft Office 365. “We were quite excited about some of the new capabilities in Office 365,” Riegler says. “But when we started testing Office 2013 with Office 365, we saw a substantial degradation in performance. Office 365 automatically connects to Exchange in online mode and thus does not store anything locally on the client. It took three minutes or more for Outlook to launch, not to mention the ongoing performance issues we saw when using Outlook.”

“This was a true showstopper,” observes Brower. “We needed to find a way to store Exchange cache locally without going to the Office 365 cloud, or we would have needed to regress back to our earlier Office state.” He and Riegler found the solution when attending Citrix Synergy in May. “I sat beside another Citrix customer during one of the sessions who told me about FSLogix,” Riegler recalls. “I booked a demo and in-depth discussion and there’s so many people out there who need our services because we’re a Federally Qualified Health Center servicing those 200 percent below the poverty line and we simply don’t have the resources and staff to see all of them. So for us, performance is very important because it has a direct impact on our ability to see patients.”


Cherry Health is quite pleased with the results FSLogix has given the organization. “We are impressed with the product as well as the outstanding support that we’ve received from the team,” Riegler says. “It was a collaborative relationship from the very start, and they have been very supportive every time a question or issue came up.”

We elected to integrate it into our Office 2013 test environment to determine if it would work in a real-world setting. The reality is that there really isn’t anything else out there when it comes to Citrix XenApp

– Ken Brower, CEO


The findings of the test deployment proved convincing. “FSLogix gives us true cached Exchange mode through its Office 365 Container,” Riegler explains. “Our Outlook launch times went from several minutes to seconds. We also saw a dramatic improvement in the ongoing performance issues when navigating within Outlook such as opening a new email and composing an email, replying to an email, and switching to the calendar.”

FSLogix removed the roadblock that Cherry Health had reached with its Office 365 migration. “We had reached a point where we were looking at what would need to be done to regress to hosting our Exchange environment in house again,” Brower says. “The performance was abysmal, and it would have impacted care givers and their ability to see patients.” As nearly all 1,000 staff at Cherry Health launch their Outlook at the start of each day, the productivity repercussions were huge—over 11,400 hours annually or $687,000 (assuming a $60/hour salary).

“Time is a critical commodity for us,” Brower adds. “The performance degradation would have prevented our approximately 300 providers from seeing at least one patient daily.” This adds up to potentially over 70,000 patient visits. The upgrade to Office 365 also extends SharePoint collaboration to all of Cherry Health’s staff and providers, something Riegler believes will improve productivity and the quality of patient care. Disaster recovery (DR) and availability are areas of benefit as well.

The ability to use shared mailboxes with Office 365 Riegler anticipates is another area that will benefit Cherry Health. “While we don’t have a huge number of shared mailbox instances, we have some use cases where these will improve staff and provider productivity,” Riegler says.

FSLogix gives us true cached Exchange mode through its Office 365 Container. Our Outlook launch times went from several minutes to seconds.

– Time Riegler, Systems Engineer Manager


Organizations like Cherry Health are special. Founded in 1988, the independent, non-profit Federally Qualified Health Center (FQHC) provides high-quality health services to people with incomes 200 percent below the national poverty level in 20 locations scattered across five counties in the state of Michigan. Cherry Health offers an integrated care model that includes primacy care and family medicine, pediatrics, internal medicine, obstetrics and gynecology, optometry, and psychiatry.


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