Cisco ONS 15400 Series

Located in Brevard County, Florida, Health First is one of the fastest growing healthcare organizations in Central Florida. The organization's three main hospitals - Holmes Regional Medical Center (HRMC) in Melbourne, Cape Canaveral Hospital in Cocoa Beach, and Palm Bay Community Hospital in Palm Bay - encompass 724 beds and 906 physicians, and serve more than 63,000 patients throughout the Cape Canaveral region.

Health First has a longstanding reputation as a technology innovator, using the latest clinical tools to enhance patient care and safety. Clinicians use wireless personal digital assistants (PDAs) to access digital patient records, order entry systems, and a variety of clinical applications. Hospitals are equipped with state-of-the-art digital radiology imaging and wireless nurse/physician call systems. Health First even operates a network-based "e-ICU" video system that allows an intensive care specialist to monitor all ICU beds at the three hospitals from a single remote location.

All of these services - as well as connectivity for each hospital's Siemens PBX phone system - were centrally provisioned from Health First's Rockledge, Florida, Business Center via an OC-12 ATM network over dark fiber. But by 2004, as use of the clinical applications - especially the Picture Archiving and Communications System (PACS) - expanded, the organization was outgrowing its WAN.

At the same time, the Health First IT team was reviewing their disaster recovery strategy. While the current system - a backup facility in upstate New York connected via a T1 line - met basic requirements, it was costly, cumbersome, and could not scale with changing needs.

"When we first deployed the solution, we had only five or six applications we considered critical to our operations," says Marvin Reece, manager, Network and Telecommunications Services for Health First. "Today, we have more than 20. In a disaster, we would be trying to push all those services back to Florida over a T1 line - basically pushing them through a straw. We would have to deliver just a subset of our applications, and the performance would be marginal."

Reece wanted to bring the disaster recovery system to HRMC, 25 miles from the Business Center, and deploy a state-of-the-art storage area network (SAN) solution to provide synchronous mirroring of all network activity. But the solution was not feasible with the existing ATM infrastructure.

Health First needed a more robust, flexible WAN to support the full range of Fibre Channel, Ethernet, and traditional voice services, while providing the same - or better - reliability as the existing network.

"If you look at the technology our physicians are using today, they're relying on these systems for order entry, electronic signature, dictation - everything," says Reece. "For these hospitals to operate safely and effectively, we need these systems operational."

With the dark fiber ring already in place, Health First had the foundation for a state-of-the-art, high-speed network. The IT team believed a DWDM optical solution could provide much more flexibility and scalability, and take full advantage of this resource. After an exhaustive review of several potential solutions, Health First chose a Cisco ONS 15454 Multiservice Transport Platform (MSTP) DWDM solution.

"We look at several vendors for any planned deployment, and we run them through the same set of criteria: affordability, flexibility, manageability, support, ease of integration with our infrastructure, and product development roadmap for the future," says Reece. "Based on all those criteria, we chose Cisco."

The fact that Health First's wired and wireless LANs were already built exclusively with Cisco network infrastructure also played a role in the decision.

"When we upgraded our LANs to Cisco Catalyst® switches, we gained a huge amount of stability," says Mark Davidson, senior networking engineer, Health First. "We believed that the Cisco DWDM offering would be that same level of quality. We also saw that Cisco was aggressively developing new features for the platform, and we couldn't honestly say that about the other vendors."

Reece and Davidson also believed that, unlike many optical platforms, the Cisco DWDM solution could be managed just as easily by an enterprise IT staff as by a service provider.

"My team is highly educated and highly capable, so I wanted something we could understand and work with ourselves," says Reece. "With some of these solutions, the vendors basically said, `No, we're the experts and we'll do it for you, and charge you to do it.' That wasn't the approach we wanted."

After visiting the Cisco Proof of Concept lab in Richardson, Florida, and seeing the straightforward Cisco DWDM provisioning tools firsthand, Reece was convinced that the Cisco solution was right for Health First.

To provide expert implementation and configuration assistance, Health First turned to BellSouth. With their assistance, Reece's team deployed dual Cisco ONS 15454 MSTPs at the Business Center, HRMC, and Cape Canaveral Hospital. (Palm Bay Community Hospital links with the optical ring through HRMC.) The Cisco ONS platforms combine carrier-class optical network performance and reliability with the functionality and manageability of traditional IP networking solutions. The dual-chassis implementation helps ensure high reliability for all network services, as well as ample room for future growth, with built-in capacity to support up to 32 channels.

Because the Cisco ONS 15454 MSTP provides true multiservice aggregation, Health First was able to connect the Siemens PBX switches at each hospital directly to the DWDM platforms via Cisco ONS 15454 high-density OC-3 Intermediate Reach/STM cards.

"The way our ATM network functioned before, we had to prioritize voice over data in the environment," says Reece. "Basically, we had one pipe that had to fit everything. Now, we can isolate our voice from our data, and our applications don't have to compete for bandwidth."

To design the network, Reece's team used the Cisco optical network planning tool, Metro Planner, to configure three distinct channels: Gigabit Ethernet for the data and video services, Fibre Channel for the disaster recovery solution, and a separate channel for voice. Offering an intuitive GUI and extensive online help, this Windows-based application helps enable quick and accurate design of Cisco optical networks. The extensive Metro Planner database of product capabilities and features helps ensure that the design is cost-optimized to fully support the required traffic demands. The deployment itself went very smoothly, and Reece's team was able to fully convert to the new network core in a single cutover.

"The Cisco Metro Planner software made the implementation a breeze," says Reece. "It took all the complexities out of the configuration, and it just worked from that point on."

"We had heard from a number of vendors that DWDM was difficult to manage and provision," adds Davidson. "But with our technical experience and the Cisco DWDM design and provisioning tools, we were able to pull it all together very cleanly, with no impact to our users."

BellSouth also played a critical role in ensuring a smooth transition.

"The expertise of BellSouth in assisting us with the testing, documentation, and configuration of this equipment was invaluable," says Reece. "We would definitely use them again for architecture engineering and implementation of any of our large-scale projects."

Today, Health First is better positioned than ever before to support its patients and staff. The hospital can continue deploying cutting-edge applications that enhance the safety and quality of clinical care, confident that the network will accommodate any new services that are required.

"The ability to slice this fiber into 32 channels really sets us up for the future, both in terms of capabilities and costs," says Reece. "If we need to deliver two more Gigabit services a year or two from now, we don't have to go through an ISP. We can just bring up another channel ourselves."

Health First is also much better protected against potential disasters - critical for the Palm Bay and Cape Canaveral facilities, which reside in Florida's hurricane zone. The Fibre Channel SAN solution helps ensure that if the connection with the main Business Center goes down, critical clinical and business applications can be restored to full use within hours. And, by moving the entire disaster recovery implementation onto the optical ring, Health First eliminated the recurring costs of maintaining the New York site and its T1 connection.

For the Health First IT team, the ability to provision all network services with a single, comprehensive optical platform greatly reduces networking complexity. Having just one network to manage and monitor means less network downtime, fewer unexpected problems, and much lower operational costs to maintain service. In addition, Health First no longer needs to convert Ethernet traffic to ATM as it traverses the network core.

"Previously, we had to use a lot of extra services and processors in our core, which caused some significant bottlenecks," says Davidson. "With the ability to deliver Ethernet end to end, we've reduced the complexity of transporting data across the WAN, reduced our latency, and realized a 10 percent performance increase. We would also spend significant staff resources every month monitoring and maintaining those conversion processes. All that administration is gone."

Most importantly, Health First now has a network foundation robust and scalable enough to meet whatever challenges lie ahead.

"By going to the Cisco DWDM solution, we've given ourselves an infinitely flexible foundation for meeting our future business requirements," says Reece. "Brevard County is one of the fastest growing areas in America, and Health First is expanding by leaps and bounds. As we push more and more data over our WAN, we're going to see more and more return on this investment."

In the coming months, Health First plans to roll out the Cisco CallManager IP Communications solution to support wireless IP phones for clinicians, and provide full 5-digit dialing over the WAN to new sites. To prioritize IP voice and video traffic, the IT team is deploying quality of service (QoS) over the Gigabit Ethernet channel. Since the Cisco ONS 15454 platforms can carry traffic with QoS tags - which the previous network could not do - Health First will have true end-to-end QoS across the WAN.

Looking farther down the road, Reece expects to continue adding modules to the Cisco ONS platforms and bringing new channels online as application requirements change.

"Right now, our PACS traffic is carried with the rest of our data," he says. "If the need arises, we can add a separate channel for that. We can begin delivering Gigabit speeds to the desktop if we need to. We can deal with whatever comes our way."

Cisco optical solutions have already helped enterprises and service providers around the world reduce costs, simplify service provisioning, and support a wide range of new applications. To find out how Cisco Systems® can help your organization, contact your local account representative, or visit www.cisco.com/go/optical.