Zero Downtime, Zero Touch: Rebuilding Endpoint Operations Across a Health System
Duke Health Technology Solutions legacy endpoint tooling required manual patch gating, physical media for provisioning, and a separate MBAM stack for BitLocker key management — all while supporting a clinical estate with no dependable maintenance window. The team migrated more than 61,000 endpoints to Tanium, retiring the legacy tooling outright rather than running parallel stacks, moved to zero-touch patching, replaced USB imaging with PXE network provisioning, and consolidated eight IT teams onto a single agent and console. The migration surfaced over 15,000 unmanaged devices, moved 30,000+ devices to Windows 11 with zero downtime, and automated the ServiceNow CMDB feed. Support case volume fell 64% as platform usage grew roughly fivefold, and the team is now building toward proactive DEX and automated security response on the same agent footprint.