Brad's new network: CIO Brad Brown of Erlanger Health System decided on a converged solution to tie together staff at locations in four states.

Imagine a world where doctors and hospital staff can log into the core network from any remote location over a secure socket layer (SSL) or virtual private network (VPN) connection and have full access to the information they need to deliver first-rate patient care--where healthcare workers in multiple locations can collaborate online by using electronic devices in real time. That is the world emerging at Erlanger Health System.

Information technology at Erlanger is essential to efficiently deliver patient care for both routine and critical situations. "It's important that necessary information is made available when and where it's needed to facilitate clinical and business decisions," explains Brad Brown, chief information officer at Erlanger. "This means providing a variety of communications services among our several campuses, departments, disciplines and care teams, as well as to our patients and their families."

Erlanger is a public non-profit, academic teaching center affiliated with the University of Tennessee College of Medicine in Chattanooga, providing care for patients in southeast Tennessee, north Georgia, north Alabama and western North Carolina. With six medical-based locations and some 900 affiliated physicians, delivering healthcare that makes a difference in patient quality of life is a critical matter for Erlanger.

With a communications network playing such a critical role in meeting the needs of patients and staff, Brown and Erlanger's 17-member network services team found themselves concerned and frustrated with their existing network infrastructure. Erlanger's separate voice and data networks covered a 125-mile radius and some 30 sites, making the infrastructure costly and cumbersome to manage. The network also included an ATM local area network no longer vendor-supported and PBXs for voice that were no longer under warranty or maintenance contracts.

"Our goal," says Brown, "has been to put in place a common infrastructure for all voice, data and video services provided, and then take advantage of converging technologies as industry standards became established and adopted."

Erlanger launched a comprehensive, two-year vendor selection process for an end-to-end network solution. Brown looked closely at the scope of functionality and services the new network would support, network management, cost and time requirements for training the network services team and hospital staff, the extent of vendor support, and Web-based support services, maintenance, investment protection, and especially the total cost of ownership (TCO) of the network. The final choice was a Nortel converged voice and data network solution.

"In the final analysis, Nortel not only delivered more options than we had asked for, but the company did so with a single-switch configuration, full end-to-end manageability and a simple-to-implement network plan," Brown explains.

LONG-TERM SAVINGS

Brown and his team ran final configurations through a TOC model. Even though there were less-expensive offerings in terms of initial capital outlay, the total package solution from Nortel would cost less and provide more functionality over the course of three years.

The network overhaul for Erlanger involves a three-to-five-year, phased-in approach to best prevent disrupting the delivery of patient care. The data network, once at risk due to product discontinuations and a lack of vendor support, is now built on Nortel's Ethernet Routing Switches 8600, 8300 and 5500, Business Policy Sw itch (BPS) 2000 and Ethernet Switches 470-POE and 460-POE to create the data backbone. A SONET smart ring provided by BellSouth uses Nortel high-speed OC-3 links to interconnect the core at Erlanger's downtown campus with the company's three main remote campuses.

To provide the infrastructure and quality of service (QoS) to support advanced voice communications, Erlanger opted for a network with an Erhernet solution vs. the previously costly and hard-to-manage ATM configuration. The Ethernet Routing Switch 8600, combined with the Business Policy Switch and Ethernet Switch 460, supply the infrastructure designed to handle bandwidth-stringent applications.

QoS, pro-active voice quality management, and power-over-Ethernet ports and configuration tools make implementing IP telephony easier. QoS and extensive traffic filtering ensure that bandwidth is allocated to the applications that need it the most. Wire-speed routing and non-blocking switch fabrics provide the performance required for unified communication applications. The resulting benefits for applications such as IP telephony are resilient voice quality and call routing over the most cost-effective method at any given time.

Erlanger chose Nortel Communication Server 1000e--a fully distributed IP PBX-- to support a wide spectrum of applications and telephony features. This allows Erlanger to have seamless network integration, simplified network management, greater flexibility in network deployment, and reduced costs for supporting its users across multiple sites and those needing remote access.

In addition, six 1000B (media gateway) systems and an "emergency phone switch" in the form of a 1000S, five Nortel Business Communication Manager (BCM) systems and a MCS 5100 Multimedia System have been deployed throughout Erlanger's metropolitan region. The VPN Router client software is allowing users to securely access the network from remote locations, and the Communication Server 1000 Telephony Manager portfolio--OTM 2.2 and TM 3.0, as well as Enterprise Subscriber Manager 1.1-are bringing converged voice and data network management together for Erlanger's network services department.

With more than 8,450 telephone nodes on its network and assignment of the entire 778- exchange in Tennessee's 423 area code, Erlanger also migrated its desktop and voice mail functionality to the latest converged voice and data technology available. Physicians, nurses and staff are gaining access to full-featured desktop solutions with a broad range of features using Nortel IP phones. With power-over-Ethernet capability, the Nortel Ethernet 460, 470 and 5520 switches are providing power to these IP phones--enabling data and power to be transmitted over a single cable without using power outlets.

NEW FEATURES AVAILABLE

The next dimension in Erlanger's network evolution is emerging with deployment of the Nortel Multimedia Communication Server (MCS) 5100, a network-based application-delivery solution that seamlessly integrates voice, data and video services. It offers a variety of features and tools that will transform the way Erlanger's professionals work, share information, and serve patients and their families, including:

* collaboration tools such as virtual whiteboards for sharing visual information in real time, exchanging files seamlessly while on the phone and communicating "what if" scenarios;

* personalization features that allow managing incoming calls based on various criteria set by the user to indicate whether each call is to be answered or sent to voice mail or e-mail;

* multimedia applications such as video calling, instant messaging and Microsoft Outlook integration; and

* mobility services that let users connect to the network with a telephone, PC, mobile phone or wireless device whether in the office or working from a remote location.

"Convergence is taking us leaps and bounds above what other hospitals are doing," explains Brown. "Our strategy has been to test these exciting new technologies with technology-literate users to help us determine the best applications and usage among all our users. We can now provide new productivity tools for clinical and non-clinical staff that really fits their environment."

For example, Erlanger staff members now have the ability to create a virtual "in" and "out" box, as well as call routing and screening capabilities. With Personal Agent, users can tailor their communications to their needs. When calls arrive, they can have multiple devices ring simultaneously or one at a time to make sure they are not missing important calls.

"Being able to find someone in a hurry without the need to print a hard copy corporate directory is priceless to us," says Brown. Erlanger also has deployed the Nortel Application Gateway 1000 product, which provides an enhanced corporate directory and visual voice mail, as well as a host of other applications and features over IP telephones.

The MCS 5100 dynamic-presence capability is letting users in 20- to 40- person work groups or departments visually check the availability of others before calling or sending an instant message. As its network continues to evolve, Erlanger plans to deploy MCS 5100 multipoint video-calling capabilities for use among hospital staff in various locations in conjunction with its existing Polycom videoconferencing solutions.

With more than 25,000 surgeries and in excess of 250,000 patient admissions a year, Erlanger must maintain the availability, security and performance of its network. Degradation in service level or loss of service can impact the care given to many patients and could delay or hamper a critical surgery. Erlanger recognized the need to implement a policy-based system for managing network QoS and access security.

SECURITY PROBLEM ADDRESSED

The Welchia and Blaster viruses threatened Erlanger in mid-2003. With its newly deployed Enterprise Policy Manager, Erlanger was able to quickly create and deploy filters that blocked the spread of these viruses, enabling Erlanger to upgrade security on unaffected systems and scrub those systems infected before the filters were deployed.

By doing this, Erlanger was able to avert the major outages and performance problems that were experienced by many other enterprises. It experienced some small impact to a few services over the course of one day but it was minimal compared to the four-day outages experienced by their peers at other companies in the area. New processes and procedures have now been adopted to ensure an even quicker proactive response.

Erlanger has discovered numerous benefits from its converged network. "Foremost was the immediate feeling and realization that our staff is now in control of the network, not the other way around," says Brown. "The network is easy to implement and manage. We have so many application tools and troubleshooting techniques that were non-existent in the past. We used to fight fires and do crisis management-now we're able to be proactive, take on projects we couldn't do before, provide QoS, and guarantee our users that their mission-critical applications are available."

Brown cites other important benefits:

Integrated infrastructure. The converged voice and data network is scalable, allowing Erlanger to add new technologies and applications at its own pace.

Improved user productivity. Brown anticipates significant productivity gains from converged desktop and multimedia solutions, particularly among healthcare executives and the nursing staff. "The MCS 5100 system and converged desktop will allow me to help our healthcare professionals get more out of their down time and manage their up time better."

Costs savings. Erlanger is realizing cost savings from simplified network management and training. SIP protocol-based service enhancements have become invaluable, says Brown. He also applauds network flexibility that lets his team pick and choose the best way to serve individual users' needs, which ultimately improves TCO. "We can conduct a TCO and functionality overview on every construction or deployment project," explains Brown, "and choose the most cost-effective solution for meeting user requirements."

Ease of administration. Erlanger can monitor, troubleshoot, manage VLAN configurations and implement business-level policies across the network. Brown's team can now add, restrict or change any point on the network from one location and have immediate verification that the change worked. "And by loading the IP Softphone 2050 or MCS 5100 client on their laptops," Brown says, "our network and other staff members are realizing the time savings of just plugging in--wired or wireless--wherever they are to perform vital business requirements."

More robust connections. Once limited to a few 100-Mbps connections to the hub and servers, Brown says his department is now using multiple Gigabit Ethernet interfaces, with plans for 10-gigabit interfaces in the near future to support imaging and application servers throughout the network.

Secure remote access. The Nortel Contivity VPN and SSL VPN solutions, and the IP Softphone 2050, combine to provide traveling staff with a means of staying in touch by logging into Erlanger's network. With an Internet connection via cable modem or DSL service, users get secure, high-quality voice with four-digit dialing wherever they live or travel.

Erlanger has noticed a $65,000 savings over previous deployment strategies during the first 14 months of its deployment, and expects to continue to realize at least the same return year after year. Brown estimates an overall cost savings of $40 every time Erlanger deploys an Internet telephone compared to a traditional digital handset.

He also envisions many opportunities for network expansion and new healthcare applications as Erlanger completes its network installation, such as secure imaging over DSL technology to a physician's home, or to any number of PDA and other wireless devices used by roaming or remote personnel.

"What this network has allowed us to do is to put tools in the hands of our staff to improve patient care," Brown says. "The sky's the limit, and we can't get there fast enough."

ABOUT NORTEL

Nortel delivers innovative technology solutions encompassing end-to-end broadband, voice over IP, multimedia services and applications, and wireless broadband. Nortel provides solutions to public network carriers, wireless operators and multi-service operators, as well as enterprises of all kinds, from small and medium-sized businesses to Fortune 500 companies.

Mike S. Zafirovski has served as president and chief executive officer of Nortel since November 2005. Prior to joining Nortel, Zafirovski was president and chief operating of. ricer of Motorola. He joined Motorola in June 2000 to lead the company's mobile devices business, which included cellular phones, related software and consumer two-way radios. Before joining Motorola, he spent 25 years at General Electric (GE), including 13 years as president and CEO of five businesses in the industrial (GE Lighting) and GE Capital areas. He also held numerous senior positions in finance, marketing and strategy/business development at several GE Capital businesses.

John Haltom is network director at Erlanger Health System.

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Brad Brown's task as CIO of Erlanger Health System was to replace the organization's separate voice and data networks, spread out over a 125-mile radius and some 30 sites, an infrastructure that was costly and cumbersome to manage.