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Rx for better health care.

Bassett Healthcare uses frame relay to future-proof its network and enable telemedicine.

To stay in the running in the competitive health care industry, a company has to reach more patients or become more efficient. Bassett Healthcare was able to do both through a frame relay solution using enterprise networking and access products.

Bassett's multimedia network takes its modern technology and health care services to more patients in the upstate New York region. It also provides greater network efficiencies and positions the company for future applications such as the transfer of X-rays over a computer network.

Bassett Healthcare wanted to link its three hospitals, a main referral clinic, and 18 community outpatient clinics with more advanced network technology capable of consolidating voice, video, and data traffic.

The company deployed frame relay and asynchronous transfer mode (ATM) technology, resulting in reduced networking costs at the same time that traffic has increased fifteen-fold. In fact, total line costs have been reduced by more than $250,000 per year.

Bassett also implemented a number of advanced telemedicine applications made possible by the increased, affordable bandwidth, improving the scope and quality of patient care.


The network transformation process began after it had become apparent that Bassett Healthcare had significant bandwidth and cost inefficiencies in its network. At that time, three separate but overlapping networks served Bassett's voice, data, and video needs.

For data, the existing wide area network (WAN) was a combination of leased, point-to-point, 56 kb/s private lines and switched 56 kb/s and T1 circuits. This not only was expensive, but also provided limited bandwidth to the outlying clinics, where dumb terminals were used to access and exchange medical information.

Bassett Healthcare's voice traffic was routed over a virtual private network (VPN) provided by a long distance carrier. Toll charges were high, especially since many rural locations couldn't justify the use of expensive dedicated access lines to the VPN. Calls to and from these off-net sites were billed at a premium rate.

In addition to the data and voice networks, Bassett also operated a separate videoconferencing network employing video codecs using multiple switched 56 kb/s circuits to create fractional T1 circuits.

This multiplicity of networks is typical. A study commissioned by Nortel found that, on average, each Fortune 1000 corporation maintains 6.7 separate and distinct networks. Managing and maintaining multiple networks increases costs and adds to network complexity. And bandwidth allocated to one application's traffic stream is usually unavailable for other applications.

Bassett Healthcare decided its best course lay in network consolidation and transformation.

"When we looked at expanding into more advanced telemedicine applications, we decided that we needed a true multimedia enterprise network that would integrate voice, data, and video, and allow us to serve a greater number of patients at a lower cost," says Dr. Michael Levenstein of Bassett Healthcare.

The search for a multimedia solution in turn led to consideration of frame relay and ATM.


Bassett installed 21 Nortel Magellan Passport enterprise network switches on its Cooperstown campus and in remote clinics. Connected by T1 circuits, the Passport switches provide a frame relay network carrying voice, data, and video between all of Bassett Healthcare's sites. Passport switches would handle local area network connections.

In the outlying clinics, 11 Magellan Access Integrators (MAIs) were installed to consolidate voice and fax traffic over frame relay.

At the main campus in Cooperstown, an OC-3 SONET ATM backbone connects 16 buildings, including an acute care hospital, main referral clinic, financial center, data center, medical office building, education center, a dialysis center, and support facilities.

Two Passport switches reside on the ATM backbone, functioning as the hub of Bassett's star-configured WAN to the remote sites.

As more telemedicine applications are developed and deployed, Bassett's long-range plans include a migration to enterprise-wide ATM over DS-3 circuits for even greater bandwidth for all network locations.

"This solution provides the breadth of interfaces we need today," says Charles Taylor, network manager, Bassett Healthcare. "It also provides that seamless migration path to ATM."


Bassett's enterprise network now has the increased bandwidth to support even the most advanced telemedicine applications. For example, a family physician in a rural clinic can transmit X-ray, magnetic resonance imaging, or CAT scan results to one of the acute care hospitals, where a radiologist can view the images and provide a diagnosis. Because the switches interleave broadcast-quality video with voice and data, this on-line consultation can also include a real-time video link.

The capability to transmit video images over the network adds a personal element to the consultation, and is essential for bringing the advantages of telemedicine to specialties such as dermatology, in which a high-resolution visual examination of the patient is critical.

Through LAN-to-LAN routing, hospital and health clinic staff now have immediate access to the Cooperstown campus network, regardless of their location.

The former mainframe/terminal configuration has been replaced by client/ server topology, streamlining such everyday tasks as patient scheduling, laboratory results reporting, medication orders for the pharmacies, inventory management, and billing.

Bassett Healthcare is consolidating thousands of patient records in a central repository, where the information will soon be accessible from clinic locations throughout the network.

Bassett facilities in Cooperstown comprise one of upstate New York's primary teaching hospitals. The network's video capabilities are also used to support interactive distance learning (IDL) applications.


Toll charges for voice calls represented a significant expense for Bassett Healthcare. The new enterprise network has reduced that expense, carrying 120,000 minutes of voice traffic per month at a 12% savings compared to the lowest VPN-rate bid Bassett received from a long distance carrier. Using the spare capacity on the frame relay circuits, Bassett has realized a 40% reduction in long distance expenses.

RELATED ARTICLE: A regional intranet for advanced telemedicine

With its enterprise-wide multimedia network in place, Bassett Healthcare is considering ways to expand its telemedicine offerings. The vision is an ATM-backbone intranet serving the medical needs of upstate New York and rural New England.

In this scenario, Nortel Rapport Dialup Switches would be deployed in tandem with the Magellan Passport nodes in Bassett Healthcare's remote clinics. These nodes would serve as points of presence (POPs) for the regional intranet.

Physicians and hospitals could gain access to Bassett Healthcare's resources through these POPs via dialup modems, ISDN, or switched 56 kb/s service.

Through the intranet, health care providers not affiliated with Bassett could provide their rural patients with the consulting specialists of the region's top teaching and research hospital. Bassett Healthcare also would have a new revenue stream generated over an expanded geographic area.
COPYRIGHT 1997 Nelson Publishing
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1997 Gale, Cengage Learning. All rights reserved.

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Title Annotation:Company Operations; includes related article on Bassett Healthcare's ATM intranet; Bassett Healthcare's frame-relay, ATM network
Author:Middleton, Joe
Publication:Communications News
Date:Mar 1, 1997
Previous Article:What we need to know to use the Internet.
Next Article:No excuses.

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