Healing a tired old hospital network.

An overhaul improves network/server uptime from 63% to 99.99%.

A network infrastructure overhaul at Denver Health and Hospitals Authority (DHHA) has improved network and server uptime from 63% to 99.99%. "We've gone from a situation where the network was dropping six to eight times per day to the point where we haven't had a serious outage in nearly two years," says Frank Barrett, chief financial officer for DHHA (pictured on next page). "The result has been improvements in patient service and productivity that have extended throughout our organization."

The key to these improvements was replacing the existing network with a switch-based infrastructure that provides redundancy for all critical components. The overhaul was designed and implemented by Interlink Group of Denver.

DHHA is an integrated health delivery system that was recently described by Modem Healthcare as "a textbook case of what to do right at a time when many public institutions have lost their way." DHHA's mission is to provide access to acute, chronic and preventive care to Denver's population, regardless of ability to pay.

Based on a 320-bed medical center, DHHA transformed itself from a city owned and operated organization to the new Denver Health and Hospital Authority in 1997.

Besides its core medical center, DHHA operates the nationally known Rocky Mountain Poison Control Center, 11 federally qualified healthcare centers, Denver's ambulance and trauma center, an HMO called the Denver Health Medical Plan, and Denver's ambulance system.

NETWORK PROBLEMS

Four years ago, when Barrett assumed his present position, network infrastructure was a major problem area for the DHHA. "The network would go down and come up and no one would know why," Barrett says. "When this happened, a lot of people were unable to do their jobs and had to wait idly until service was restored. Some of the more critical areas of the hospital, such as the operating room and emergency room, had to rely entirely on paper-based systems because they couldn't depend on the network being up when they needed it.

"The problem, in my opinion, was that the network had never been properly architected," Barrett adds. "As the computerization of core and satellite facilities proceeded, new systems were grafted onto old, resulting in a hodgepodge of technology that was difficult to troubleshoot or even understand. Without a logical structure, it was very difficult to identify problems that were causing outages on a regular basis. This situation was unacceptable, and one of my first priorities when I joined the DHHA was to fix it."

Barrett recognized that the DHHA did not have the internal technical and project management resources needed for the project, and handpicked Interlink for the assignment. "I selected Interlink as the technology partner for this project because they clearly had the competencies and resources needed to handle a large networking infrastructure project," Barrett says. "I felt that their experience implementing network solutions for a variety of companies across multiple industries would help to speed up delivery and minimize risk and downtime. I also liked the fact that they have developed prebuilt architectures and templates, each of which has been proven in previous projects."

PLANNING PHASE 

"Using our architecture analysis and design methodology as our road map, we began planning sessions between DHHA executives and the Interlink project team to clarify DHHA's business objectives," says Jason McGregor, managing director of Interlink's Network Solutions. "This was necessary for the development of a new mission-critical infrastructure that would be done right the first time. Frank and his team explained the importance of providing consistently reliable access with remote facilities and providing 100% assured service to critical departments.

"Our next step was to discover and document the existing infrastructure so that the new architecture could consider incorporating some of the many investments that DHHA had already made, as well as creating a migration plan that would be least disruptive for the end-user community," McGregor continues. "We found that the existing infrastructure was inadequate for supporting current needs, and especially not prepared to address DHHA's future objectives. For example, DHHA was using several shared 10 MB Ethernet networks connected by routers, an antiquated design that caused sluggish and unpredictable performance across the hospital.

"We looked at current usage trends, along with future technology projections, to create the new architecture," McGregor recalls. "Our number one goal was to make swift enhancements to the existing network to greatly improve stability, while implementing the new infrastructure that would deliver reliable and scalable access for the increasing number of mission-critical applications that were being installed on the network. Our design effort concluded with an architecture and migration plan that was to take DHHA into a whole new era of information technology."

A NEW FOUNDATION

Carefully following the recommended architecture and implementation plan, Interlink set out to help DHHA significantly reduce downtime, increase end-user productivity and eliminate the risk of the network being incapable of supporting the organization. The implementation began with replacing the main fiber backbone that interconnected the main campus. This new backbone provided high-bandwidth enterprise-system access for all campus buildings, replacing what was previously unstable, unreliable and unmanageable system access.

Next, the critical remote sites, such as clinics and the poison center, were connected to the DHHA campus network via high-speed wide area network technology. Since these critical remote sites rely on the network for system services, this eliminated any possibility of disruption as a result of a network outage. In addition, other remote locations were redesigned using redundant links to dramatically reduce their risk of losing access to the enterprise systems.

"The installation of leading proven technologies was critical to establish a foundation in which DHHA could scale its business," says Gregg Veltri, Interlink's on-site project manager and senior architect. To further ensure that the previous reliability problems were eliminated, Veltri's team designed several layers of redundancy into the solution. For example, in the main campus, Interlink specified Cisco's HSRP to provide Layer 3 switching in the event of a hardware or line failure.

In parallel to the new infrastructure, Veltri's team also focused its efforts on stabilizing and rebuilding a mission-critical environment for the on-site file, print, application and gateway servers. Standards and consolidation were primary results of this effort that has exponentially increased the level of stability and end-user productivity throughout the organization.

DRAMATIC IMPROVEMENTS

The new networking infrastructure dramatically outperforms the old, according to Barrett. "The proof of the pudding is that we haven't had a network outage in nearly two years," Barrett says. "As a result, we have been able to move ahead with confidence in the installation of major clinical and business applications that have had a significant impact on our business performance. For example, we will soon be rolling out a clinical record relational database to provide a long-term clinical repository that will eventually maintain all of our patient records online. The next major application will be one that will provide instantaneous access to diagnostic images throughout our facilities by authorized personnel.

"But it's limiting to look at the impact of the networking improvements from purely an IT perspective, because from a higher-level viewpoint they have had a significant business impact, as well," Barrett continues.

"We have begun to utilize existing and new systems to a much higher level than in the past," he adds, "to streamline the workflow of the organization, eliminate paper-based processes and provide information in a form that helps make better decisions. This impact is difficult to measure, but there's no doubt in my mind that it has been one of the major factors in the improved clinical and financial performance of this institution."

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Phase 15 reflects next-gen internetwork testing efforts

The Internetwork Interoperability Test Coordination (IITC) Committee, sponsored by the Alliance for Telecommunications Industry Solutions (ATIS), is moving forward with its next-generation internetwork testing efforts, known as Phase 15.

Phase 15 will improve understanding of the performance and reliability issues associated with the introduction of next-generation network, or packet-switched, technologies, to existing interconnected circuit-switched networks. Phase 15 will consist of testing from proposed vendor and carrier architectures. Participating companies include Bell Atlantic, WinStar, Sprint and GTE. Also participating is the Financial Networks Readiness Consortium (FNRC), a group of corporations with business related to the financial community. FNRC conducts compliance-related efforts with major telecommunications service providers and industry groups.

Phase 15 testing will be conducted in three subphases over a four- to six-month period. Several different packet-network technologies and architectures will be integrated into an interconnected laboratory test bed, replicating the public switched telephone network. The three subphases are designed to simulate the evolution from a pure circuit-switched network to a converged network of both circuit and packet technologies.

For more information on the work of the IITC, visit the ATIS Web site at www.atis.org. Companies seeking to participate in the IITC's Phase 15 testing activities should contact ATIS Forum Director Jean-Paul Emard at 202-434-8824. Information on ATIS is available by contacting the ATIS headquarters at 202-628-6380, or by writing to: ATIS, 1200 G St., NW, Suite 500, Washington, D.C. 20005.