Victoria's whole-of-health ICT strategy, HealthSMART, has grown from eight to 1000 servers in four years as it gears up to provide application services to some 140,000 end-users across the state, including the occasional iPad-wielding clinician.\nHealthSMART program director, Bruce Ryan, said from an ICT perspective, Victoria's health sector consists of more than 40 discrete departments, each with its own IT infrastructure.\n"About 10 years ago a number of issues were identified, including application end-of-life, a lack of standardised processes, and some important business processes were not IT-enabled," Ryan said.\n"We now have an emerging focus on technology services. HealthSMART had a number of business drivers like establish DR and business continuity facilities that didn't exist, increasing IT efficiency across the sector and we are now looking at enhanced integration and middleware."\nHealthSMART started in 2003 as the central ICT provider to health clients. The network, HealthNet, connects 40 WANs and remote service providers.\nAfter procuring its key applications and agreeing on service levels with suppliers and clients, HealthSMART has grown at a rapid pace going from no clients to 40 in five years and from eight to 1000 servers during the same period.\n"This demonstrates the environment scaling up with services going live," Ryan said.\nIn March 2008, HealthSMART "discovered" virtual servers and about 60 per cent of its servers are now virtual.\nThe data storage requirements have equally expanded, with its 400TB SAN heading to petabyte scale as national e-health programs kick in.\nHealthSMART hosts 50 application services to 40 clients and Ryan's team worked extensively with Citrix to deploy the application presentation layer.\n"We are focused on XenApp and XenServer and this combination is the most positive model for ratio of production users per physical host," Ryan said, adding XenApp is a "trouble light" environment.\n"The Clinical System is our flagship application. It is complex software and delivered by Citrix. It runs at the bedside and we expect to have 50,000 users in two years. Now we have two clients with 50 concurent users."\nHealthSMART has also implemented load balancing and has agreed on sector-wide licensing for its softwre infrastructure which Ryan says is "effective".\nSpeaking at the annual Citrix iForum in Sydney, Ryan said the state is also working to achieve a single sign-on service for clinicians, who are often forced to use multiple user accounts between different hospitals.\nWanting to remain as flexible as it can with client devices, Ryan said there is "considerable interest" in the iPad in health and that will become another access device for its applications.