Managing the Healthcare Network for an 'Empire'

California's Western Inland Empire, comprising Riverside, San Bernardino and eastern Los Angeles Counties, is one of the fastest growing metropolitan areas in the United States. Since 1907, San Antonio Community Hospital of Upland (SACH) has delivered comprehensive, high-quality medical services to the Inland Empire and evolved into a major healthcare center.

With 330 beds and nearly 2,000 professional, technical and service personnel, SACH is meeting the challenge of serving its burgeoning patient population and adopting new technological advancements by implementing an Extreme Networks® applications infrastructure with advanced network management tools.

Radiology Goes Digital with Extreme Networks
Dramatic advances now enable radiology images to be created digitally, filed on a computer system and shared simultaneously across a network. Fulfilling its commitment to leading edge medical care, SACH upgraded its network to support bandwidth-intensive applications such as digital radiology imaging.

"Our goal was to optimize the rapid and reliable access to radiology images," says Jan Snyder, Senior Telecommunications Consultant for SACH. "Extreme's broadband solution, enabling advanced digital imaging for our radiology department, is helping us stay at the forefront in quality care."

Powered by Extreme Networks Layer 3 Gigabit Ethernet switching solution, the hospital network provides greater efficiency in storage and retrieval of radiology images, allowing the hospital to cut operational costs and make patient information available instantaneously.

Managing a Robust Broadband Solution for Digital Imaging
The hospital's commitment to advanced medicine is probably best illustrated by the digital radiology solution€”Picture Archiving and Communications System (PACS)€”that enables computerized communication of images among hospitals, and also between hospitals and doctor's offices, in-hospital departments, and outpatient imaging centers. PACS replaces the traditional light boxes used by radiologists to view x-rays.

Before the PACS was implemented, x-ray results were stored on physical film, viewed using light boxes on the wall, transported by hand and filed away in metal cabinets. By using PACS, these manual steps are automated and the results are accessible directly from a computer, with no worry of misfiling, difficulty in retrieval or storage considerations.

Using an Extreme Networks infrastructure, the hospital met the high bandwidth demands needed to store and transport these very large files with no delays or degradation of the image. When the radiology department was experiencing a slow response time with PACS, the hospital used EPICenter®, part of Extreme's network management system, to quickly gather an inventory of devices by mapping MAC addresses to switch ports.

In the past, diagnosing the degradation in response time would have required a physical inventory€”a time-consuming process that meant end users had to put up with a sluggish network until the cause was pinpointed and corrected. "The Inventory Tool available through EPICenter gives us fast access to the information we need to troubleshoot network issues and solve problems in the least amount of time," notes Snyder. The benefits don't end there.

The IT department wanted to provide each department with detailed reports of network performance, including switch failure, network availability and bandwidth usage. With EPICenter, the hospital can easily generate web-based reports to show how the network is performing and measure continuing improvement. This proactive reporting demonstrates the IT department's on-going commitment to supporting the hospital, its professional staff and patients.

Professional Services Helps the Hospital Plan, Design and Implement New Network
Extreme Networks' application infrastructure has integrated transparently to support the hospital's radiology processes. To optimize network performance and productivity, the hospital enlisted help from the professional services team at Extreme Networks. An integral part of the ExtremeWorks® service solution, the ExtremeWorks Professional Services team supported and worked alongside the hospital to develop and design the network, and also assisted with implementation of the switch hardware and the OSPF network. The ease of implementation encouraged acceptance and confidence among the hospital staff.

Managing and Maintaining the Health of the Network€”Now and in the Future
Besides the advantages of a high-speed networking solution, the hospital needed a solution that would provide the most efficient means of managing and monitoring the network. "The hospital's departments are our customers,î explains Snyder. ìWe want to identify and correct network issues before our customers experience problems or realize there is an issue."

In addition to the productivity benefits associated with EPICenter's network management capabilities€”the ability to perform automatic back-ups of all Extreme equipment, saving time and resources, and eliminating the risk associated with the manual process€”EPICenter quickly prevented a potentially problematic situation. "Some switch closets were actually warmer than we believed, creating an environment that could wreck havoc on switches and, ultimately, the performance of the network," says Snyder. "With EPICenter, we can create thresholds that set-off alarms and pagers to notify us before switch performance is affected, allowing us to fix issues before they become problems."

Better network management helps the hospital leverage its IT investment. It also helps ensure that the hospital's network services are delivered reliably to end users that depend on the network to deliver improved medical services. The hospital plans to use EPICenter's policy-based management functionality for the future. "We hope to implement video-on-demand for even more advanced medical services, like CINA, which are time and motion video clips running at rates of 30 frames per second for moving ultrasound," explains Snyder. "Policy-based network management is critical to supporting applications such as video-on-demand, and EPICenter allows us to implement policy management from source to destination."

High Reliability Supports Network Uptime
Because medical staff depends on the PACS to make lifesaving decisions, this network must never fail. The goal of the project was to design a PACS network that would be 99.999 percent reliable, and if it did fail, make it self-healing with a recovery time of less than 100 milliseconds.

San Antonio Hospital's fully redundant mesh data network is powered by Extreme Networks broadband switches. Alpine® and Summit®48i switches at the edge of the network have redundant links to the dual core switches. Both links are Equal Cost Multipath (ECMP) using OSPF. If one link fails, the redundant link takes over in less than 2 milliseconds, a remarkable recovery. In comparison, SONET, well known for its fast recovery time, takes 50 milliseconds to recover.

Extreme Networks fully redundant BlackDiamond® 6808 core chassis switch is engineered to maximize network uptime, delivering carrier-class resiliency with no single point of failure. With 96 Gigabit Ethernet ports and 128 Gbps non-blocking switch fabric, the BlackDiamond delivers high port density and unsurpassed performance. "For us, Extreme's applications infrastructure gives us cutting-edge technological advances and a high level of confidence from our medical staff. If a single node on the network has an outage, it doesn't take the rest of the system with it," said Snyder.

A Long Term Partnership
For San Antonio Hospital, filmless digital imaging means the hospital can significantly reduce its use of physical materials and staff resources. The solution from Extreme Networks combines EPICenter and Policy-based Quality of Service for advanced bandwidth management and traffic prioritization. This capability allows the hospital's network manager to allocate just the right amount of bandwidth for an imaging application, saving time and cost for the hospital. Furthermore, because Extreme Networks products, software and the management platform share a consistent architecture, the hospital network is easy to manage and scale€”all while reducing the cost of network ownership. EPICenter, combined with ExtremeWare, the embedded software that runs across Extreme Networks switches, delivers a robust network management solution that not only leverages the hospital's investment in Extreme Networks equipment, it also provides a single platform for managing the entire hospital network, including third party devices. "A tool that doesnĂ­t manage switches, identify failures and monitor network availability for the entire network just results in more work for a network manager," points out Snyder. "After all, who has a homogeneous network these days?"

Managing for the Future
San Antonio Community Hospital continues to work closely with Extreme Networks to identify new opportunities for streamlined network management. In addition to video-on-demand, the hospital is also exploring opportunities for Voice-over-IP services.

As the hospital's network grows in size and scope, Extreme Networks is helping San Antonio Hospital build a vastly more efficient and overall progressive health care system. "Our medical staff depends on our network to make lifesaving treatment decisions. Extreme's applications infrastructure is helping us to deliver superior patient care by enabling us to deploy cutting-edge technological advances," said Snyder.