Case studies serve a dual purpose. As a technology showcase, they provide a vehicle for vendors to educate the market on state-of-the art offerings. But they also demonstrate the art-of-the possible, helping would-be adopters envision the ‘how’ and ‘why’ of tech implementation — how they might apply IT solutions in their own circumstance, and what kind of outcomes they should expect. Drawn from the real world, the best examples align technology solution with a business challenge, providing not only instruction and advice, but also a lens that can be trained on the narrative to define key benchmarks or metrics.
The Women’s College Hospital networking implementation study which follows below offers a good model for this. It clearly outlines the business requirement in terms of both short and long term goals, explaining how deployment of an integrated networking solution from HP addressed potential moving day issues, while providing the foundation for ongoing innovation in patient care delivery. It describes process — the ‘how’ considerations in technology rollout, as well as the benefits for key stakeholders, including IT management and staff, patients and healthcare practitioners and the hospital itself. Beyond productivity improvements, the hospital’s IT director, Brendan Kwolek, has attributed savings in the range of $500,000 to $1,500,000 to the selection of HP technology over that contained in other proposals on the procurement table, a metric that should be of interest to virtually all users of data centre infrastructure.
Women’s College Hospital (WCH) in Toronto is under renovation, raising on its current site a 400,000 square foot facility that is scheduled for completion in 2015. To support transition to phase one of the project, a 10 story building which opened in May of 2013, the hospital also committed to installing new networking infrastructure that would ensure the availability of critical hospital systems to physicians, staff and patients from day one of building occupancy, while providing the foundation for future technology requirements.
Defining the foundation for innovation
Historically, Women’s College Hospital operated as a branch of the Sunnybrook Health Sciences Centre, which managed a network composed of Cisco wired and Motorola wireless equipment on behalf of WCH in the old building. Describing the hospital’s technology environment, Brendan Kwolek, “Ždirector, IM/IT, Women’s College Hospital, noted that the facility had implemented IT in a piecemeal fashion, leveraging healthcare applications from various partners, for functions such as registration and scheduling. A few years back, the hospital embarked on creation of a new patient information system that is scheduled to go live next year — the EPIC ambulatory electronic health record solution — which would require a robust infrastructure foundation to support both launch operational requirements for electronic registration/scheduling, clinical documentation, provider order entry and results review, as well as future innovation.
“We like to pride ourselves on innovative models of healthcare delivery,” Kwolek observed, “and you need reliable, solid, forward-thinking technology to do that. If you are running on legacy hardware, when you work with partners like EPIC who are forward thinking — or when we come up with internal solutions for research or for other of our divisions that are very innovative, you need to be sure that you have the technology to support that.” The key driver for a new, independent networking implementation, he explained, was to have the “robust readiness” needed to fuel technology innovation.
Building broad but secure access
The WCH team considered a number of options during the procurement process, rejecting one healthcare solution because the equipment was not up date. “When you are establishing yourself,” Kwolek explained, “you don’t want to be on an old platform.” WCH found its modern platform in HP — an integrated wired/wireless solution composed of HP 7506 core switches, HP 3800 access switches, HP MSM460 wireless access points, HP MSM760 wireless controllers and HP’s Intelligent Management Center (IMC) to provide visibility and single pane-of-glass management across the new infrastructure. The team worked closely on the implementation project with HP Technology Consulting Services, which delivered design, implementation and training support, and with implementation partner OnX Enterprise Solutions who held the original contract with the construction company. Work began in the summer of 2011, and by October 2012, HP was on site at the new building to begin installation and configuration of new equipment.
The WCH network was designed to serve a number of constituents, including hospital staff, medical practitioners, patients and guests. This broad access to the network, combined with requirements for data security and privacy imposed on healthcare institutions by regulators introduces its own set of complications. On the wired side, Kwolek explained that it is relatively easy to detect and track network usage with relatively simple tools, however, this is more difficult in wireless environments. To address this issue, the hospital was keen to invest in intrusion prevention and protection for its integrated network and so deployed RF Manager, control software and sensors in the HP Mobility Security IDS/IPS System, which integrate directly with the wireless platform to offer automated policy-based security and location-tracking capabilities. “Having a system that can alert us — let us know that someone has plugged an access point into the wired network, that it is close to this area, and that someone should take a look at it is very valuable to me,” Kwolek added “because it helps me ensure the safety and the security of our network.”
The new network was also intended to serve a number of locations, including the hospital’s main site and three other smaller sites. According to Kwolek, while Sunnybrook and WCH technical managers provided information on subjects like network segments or the hospital’s preferred practice in carving up IP addresses, HP Technology Consulting Services was able to apply considerable design expertise to architecting a solution that would seamlessly connect all locations. For now, the satellite sites are still using Cisco and Brocade hardware; however, use of competitor gear presented no issues to the smooth functioning of the HP system, a critical requirement since uninterrupted IT service was needed from launch day at the main site but also at the busy family practice and at other clinical unit satellite sites. “Having that network available and reliable on day one to make sure operations were uninterrupted was absolutely paramount for us,” Kwolek observed.
An important component of HP Consulting’s service involved the preparation of design and build documents that Kwolek’s team has been able to make use of to fine tune operations. WCH’s network administrator, who joined the team six months ago and six months after data centre launch, was able to take advantage of detailed documentation, as well as extensive HP product training, for a quick onramp to his administrator role. For Kwolek, the most significant implementation challenge was ensuring the right staff was in place to work with the technology — for example, there was no networking administrator for the first six months of the project, a requirement that was addressed through access to some extra HP consult/support time that was specified in the original HP SOW but unused. In Kwolek’s view, “This [arrangement] speaks to the relationship that HP builds with its customers,” whereby they provide ongoing resources and WCH consults on new initiatives to encourage overall success of the technology implementation.
The ‘why’ of implementation
While WCH’s new network was part and parcel of the move to a new building, a key goal driving the HP implementation was to support increased demand introduced by the EPIC deployment. If installed on the old networking equipment, Kwolek believes the hospital would have “encountered caps, or technology limits” on its new patient information system. As a vendor, EPIC is highly involved in ensuring the specs on supporting infrastructure for its software, and arrived on site last year to assess the hospital’s wireless capabilities — signal strength, noise ratio, coverage, heat mapping, etc. “The great news,” Kwolek explained, “is that we’re fully compliant, so from a readiness perspective we’re in pretty good shape.”
In contrast to the old network, the HP solution delivered gigabit speeds to the desktop with power over Ethernet, providing IT with new flexibility in the choice of endpoint devices. Kwolek noted: “whether it’s a PC, a zero client or an access point, I don’t have to worry about providing power to those ports because it’s already there.” This enables Kwolek to work with new or innovative pieces of hardware without worrying about network support. Over the coming year, the IT team has a number of projects on its ‘to do’ list: in addition to the EPIC roll out, WCH is looking into VDI, an IaaS implementation, and a BYOD mobility solution, and Kwolek is confident that the network foundation is now in place to support these initiatives.
Since the new networking infrastructure was provided by a single vendor, Kwolek has found the interoperability and interaction between various wired and wireless systems to be “very tight”: “we see a lot of advantages to having HP products work with HP products, they talk very nicely to each other” he added. This was an especially important factor given resource constraints at WCH, as interoperability simplifies infrastructure management for the hospital’s small IT team. Currently, IT service for approximately 1,400 staff members and volunteers (as well as public WiFi) is provided at the hospital by fewer than 10 technical personnel, including a network administrator, an infrastructure specialist, service desk analysts, database admins and some project support people who are working on the infrastructure refresh. “To be able to manage a network the size and the scale of the one we have implanted with a very lean team speaks volumes about the quality of the solution, both from a hardware perspective, but also from a design perspective,” Kwolek added.
With IMC management, Kwolek’s team now has “unparalleled insight into traffic levels,” and can use information delivered by the system to pinpoint abnormalities — ex. alarms on a port reaching maximum traffic thresholds — and fine tune management for better load balance. At this point, due to good design architecture, Kwolek claimed that the team is not seeing high utilization rates; however, the IMC can provide trending analysis that may be helpful for planning going forward. “It helps us be less reactionary,” Kwolek noted. “If I can get ahead of the phone call [to IT], this allows us to work more efficiently as a team. Monitoring the servers and the network [at the same time through IMC] has been a blessing for us.” WCH IT is now looking into using some additional capability in the IMC software to expand beyond alerts and into the introduction of proactive security policy at the networking core.
Beyond these productivity savings, the HP solution has also delivered significant financial benefits to the hospital. As compared to proposals and quotes submitted by other vendors, Kwolek calculates that the selection of HP technology provided a saving of $500,000 to $1,500,000. In addition, many of the component products are guaranteed for life. “I’m not aware of many hardware vendors out there, especially in networking, that will put their stamp on a piece of hardware and say ‘we will warranty this product for life. It’s not common.” As the hospital is now in the midst of creating an infrastructure foundation for the future, knowing that products have this warranty for many years to come was very reassuring to Kwolek. So far, the hospital has experienced no equipment failure or system downtime.
While boosting the hospital’s bottom line, these savings enable focus on new initiatives in patient care. For the technology user, the doctor or researcher that now sees a fast and reliable network, there is clear benefit in infrastructure that serves as the basis for work with IT on the creation of innovative solutions in patient care delivery. “The fact that we can now support our clinicians and our researchers who come to us with an innovative idea is a huge benefit to them and to us,” Kwolek noted. Ultimately though, the primary advantage accrues to the recipient of technology innovation — Women’s College Hospital patients.