How CNS helped Elekta's Citrix deployment with Azure


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Case study overview




  • Elekta wanted to embrace Cloud with a business wide SaaS transformation of their product suites for Oncology care.
  • Ensuring a secure, performative and highly available patient treatment platform.


  • Design Citrix centric solution with improved end customer supportability, operational resilience, reduced costs, and optimised profiles and user management to provide the best clinical experience.
  • Design and build a highly available Citrix farm on Azure to support over 35,000 clinical staff treating millions of patients annually across multiple continents. 
  • Provide contuial uptime for clinical treatments 24 hours a day 7 days a week. 




  • Significant cost reduction and enhanced operational efficiencies, while consolidation of Citrix farms reduced administrative efforts and optimised resource allocation.
  • Citrix's environment ensured uninterrupted operations, eliminating downtime and increasing service reliability.
  • Elekta's Citrix environment features safeguards designed to minimise patient and treatment impacts.
  • Performance metrics improved significantly with reduced login durations that increased user experiences and promoted improved satisfaction ratings.
  • Intergration of Citrix products and technologies in line with industry best practices into Elekta solutions.



"CNS are an amazingly talented group of professionals and a trusted, valued business partner to help manage our Azure and Citrix infrastructure. Their commitment to excellence and vibrant, healthy corporate culture foster excellent work relationships, helping us work together as one team to deliver world-class oncology software solutions to clinicians and patients across the globe"


Cory McCormick

Technical Product Manager

Detailed Case study

The Challenge

Elekta serves the Radiation Oncology, Medical Oncology and Neuroscience communities with their solutions and services that adhere to the highest international standards.


Elekta were embarking on a SaaS transformation and wanted to embrace Cloud and automation of their product suites for Oncology care. Ensuring a secure, operational, and highly available patient treatment platform was a high priority to make MOSAIQ cloud ready.


Providing a seamless transition for clinical staff for a historically on premise application was critical to successful adoption across their customer base. Steps must be taken to ensure there were no changes to the interface, method of interaction for clinicians, and minimised changes for frontline staff.


Ensuring a high-performance platform to support clinical workflows was a high priority, as even small delays could cause massive impact on patient care and mortality.


Scalability was also a must, with management of tens of thousands of active users across 7 different countries in multiple time zones and languages needed to be addressed in a seamless manner.


Security was also paramount in dealing with patient medical information, integrity, confidentiality, and availability. Healthcare is one of the most targeted industries worldwide for cyber-attacks so making sure strict regulatory compliance with CIS, SOC2, GDPR, HIPPA, HITECH & ISO 27001 was needed. This, as well as security fortification to lock down systems and to facilitate high availability and rapid disaster recovery.

Elekta recognised the need to address their technical challenges quickly, so they turned to CNS for help. 




The Solution


CNS, as an established technology partner with deep insight into Elekta's organisational dynamics, undertook an initiative with them to design their Citrix environment while providing continuous operational support. This included overseeing critical updates, proactive issue resolution, regulatory compliance e.g. SOC2, HIPPA, HITECH & ISO 27001 and security fortification to strengthen compliance standards as well as setting up robust systems to facilitate high availability and disaster recovery.


Following an investigation conducted by our team of Citrix architects and engineers CNS came up with a robust and highly available multi regional Citrix architecture. 

  • - CNS focused its services in line with Elekta's strategic imperatives, and prioritised aspects critical to the smooth functioning of Elekta's Citrix deployment. Through careful solution and discovery phases, CNS overcame these milestones with Citrix:

    - Elekta's Citrix infrastructure required a revamp to better support end customers, while guaranteeing high availability across various Azure regions.

    - Upgrading of Citrix versions from Citrix Virtual Apps and Desktops 7.15 LTSR (EOL/EOS) versions in various Azure locations, to Citrix 1912 and 2203 LTSR versions; reinstating Citrix environments back into supported, maintainable configurations.

    - Implementing a once redundant environment, using Microsoft SQL always on high availability features and clusters, in disparate Azure regions for maximum operational resilience.

    - Enhancing Citrix ADC infrastructure by simultaneously introducing high availability measures that not only ensured increased system reliability, but also led to cost reductions.

    - Citrix user profile management enabled Elekta to effectively implement customer roaming profiles , mitigating disk and space issues on its Citrix servers and keeping customer roaming profiles at an acceptable level for customer use.

    Elekta's Azure infrastructure provided an ideal platform to implement a comprehensive solution that allowed Elekta to consolidate and reduce their Citrix farms across their Azure platform, streamlining operational management efforts.  



The Results


Elekta has found great benefit from CNS' Citrix solutions, manifesting itself across several key areas of the business. 

In the background:

The restructuring of Elekta's Citrix environment has resulted in significant cost reduction, improving efficiency while optimising expenditure. Citrix farms' consolidation and rationalisation has resulted in reduced administrative efforts, improving operational efficiency and resource allocation. The new Citrix environment design has guaranteed uninterrupted operations, creating an operational framework with zero downtime that mitigates disruptions while strengthening reliability of Elekta's services.

Benefits for the customer: 

Elekta's environment features multiple safeguards to minimise patient or treatment impacts, further demonstrating Citrix's infrastructure resilience and dependability. This also has led Elekta's Citrix environment to significantly enhance performance metrics, such as reduced logon durations and the elimination of large roaming profiles for Elekta customers, leading to improved user satisfaction overall.

CNS works closely with Elekta to continually enhance ongoing operations, including incorporating Citrix products and technologies that comply with industry best practices, increasing user satisfaction levels for Elekta customers, and contributing to better user experiences overall. Our proactive approach reinforces our dedication to offering cutting-edge solutions that keep pace with technological progress.

"CNS Citrix Engineers and Architects have facilitated the seamless deployment of healthcare applications worldwide, making it effortlessly accessible from any location. Leveraging Citrix has simplified large scale operational support and processes. I love using a technology that looks professional and is easy to understand."


Jignesh Parbhu

Operations Manager

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