Imagine a world where nurses quickly order medications or enter a patient’s status directly into an electronic chart from the patient’s bedside using a Mobile Medical Workstation; or where doctors and hospital staff can log into the core network from any remote location over a secure virtual private network connection and have full access to the information they need to deliver first-rate patient care; or where healthcare workers from one branch location can plug into the hospital’s network while at another site and access all of the same voice and data features.
That is the world emerging at Erlanger Health System, a non-profit, academic teaching center affiliated with the University of Tennessee College of Medicine in Chattanooga, serving southeast Tennessee, north Georgia, north Alabama, and western North Carolina.
With 10 locations and some 900 physicians, delivering health care that makes a difference in patient quality of service is a life or death matter for Erlanger. Such responsibility is one of many reasons Erlanger selected a Nortel Networks converged voice and data network to expand the reliability, manageability, and information access of its communications network.
Network aches and pains
Information technology at Erlanger is essential to efficiently delivering patient care. According to network director John Haltom, “It’s important that necessary information is made available when and where it’s needed to facilitate clinical and business decisions. 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.”
With a communications network playing such a critical role in meeting the needs of patients and staff, it is not difficult to understand why Haltom and Erlanger’s 16-member IT 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.
“What’s more,” said Haltom, “we found ourselves in the very precarious position of having an unsupportable network. Due to churn, including vendor acquisitions and discontinued service support for our existing ATM Local Area Network (LAN), our data network was in serious jeopardy. Our voice network included PBXs that were no longer under warranty and were difficult to maintain. It was absolutely necessary to replace our network end-to-end or be without vendor support.”
“Our goal,” Haltom continued, “for about five years 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.”
The Vendor Search
Erlanger launched a comprehensive, two-year vendor selection process to determine the best means of meeting its long-term network objectives. Haltom and his team clearly delineated the evaluation criteria and approached Nortel Networks, as well as Cisco, Marconi, Alcatel, and Extreme.
The criteria for vendor selection were as tough as it gets. Erlanger looked closely at the scope of functionality and services the new network would support, as well as other important factors, such as network management, cost and time requirements for training the IT team and hospital staff, the extent of vendor support in the form of technical manpower, and Web-based support services, maintenance, investment protection, and especially the total cost of ownership of the network.
“We gave each vendor a set of criteria on which to base a network scenario for the bid,” said Haltom. “This provided a visual reference for us to use in evaluating the strengths and weaknesses of the offerings. Because of our dire situation with our previous vendor, we also verified the financial stability of the bidding companies looked closely at their ability to meet our future needs.”
“In the final analysis, Nortel Networks 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 very simple-to-implement network plan,” Haltom explained.
“Where other vendors had trouble meeting all of our requirements, Nortel Networks excelled in providing an elegant, complete solution.”
Furthermore, even though there were less expensive offerings, in terms of initial capital outlay, the total package solution from Nortel would cost far less and provide more functionality over the course of three years...
Anatomy of a converged VoIP network
The network overhaul for Erlanger Health System involves a three- to five-year phased-in approach to prevent disrupting the delivery of patient care. The data network, once at risk due to product discontinuations and a lack of vendor support, now is supported solely by Nortel.
• Nortel Networks Passport 8600 routing switches and Business Policy Switch (BPS) 2000 create the data backbone for a future-proof end-to-end converged VoIP solution.
• A Synchronous Optical Network (SONET) smart ring provided by BellSouth uses Nortel Networks 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 QoS to support advanced voice communications, Nortel simplified Erlanger’s network with an Ethernet solution versus the previously costly and hard-to-manage ATM configuration.
• Nortel’s Succession Communication Server for Enterprise (CSE) 1000 — a fully distributed IP PBX — supports a wide spectrum of leading applications and telephony features. With its Release 2.0 software, the Succession CSE 1000 will allow 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.
• Six Succession CSE 1000 Branch Office Gateways and two Nortel Networks Business Communications Manager (BCM) systems will be deployed throughout Erlanger’s metropolitan region.
• The Contivity Virtual Private Network (VPN) client software will allow users to securely access the network from remote locations
• The Optivity Telephony Manager 2.0 (OTM) brings converged voice and data network management to Erlanger’s IT department.
• Physicians, nurses, and staff will gain access to full featured desktop solutions with a broad range of features using Nortel Networks i2002 Internet Telephone, i2004 Internet Telephone, i2050 Software Phone, and CallPilot 2.0 Unified Messaging.
Abundant network benefits
During Erlanger’s two-year vendor selection process, many benefits of the Nortel Networks solution emerged — Haltom says Erlanger continues to discover new advantages.
“Our biggest benefit was the immediate feeling and realization that we — our IT staff — are now in control of the network, not the other way around,” said Haltom. “The network was easy to implement and still is. We have so many application tools and troubleshooting techniques that were non-existent in the past. The combination of Nortel Networks’ latest suite of network management solutions makes configuring, installing, managing, administering, and recovering a breeze.”
“The management of a single converged voice and data network is freeing so much of our time. We used to fight fires and do crisis management. Now we’re actually able to be proactive, to take on projects we couldn’t do before, to provide QoS, and guarantee our users that their mission-critical applications will be available.”
Haltom cites other important benefits:
• Integrated infrastructure — The Succession CSE 1000 will let Erlanger operate a converged voice and data network and manage it as one. It will make possible the delivery of integrated services, and positions Erlanger to fully leverage next-generation applications such as unified messaging, mobility, centralized directories, and other emerging services.
• Costs savings — In addition to substantial savings in training time and costs over the original ATM LAN equipment, Haltom estimates an overall cost savings of $40 every time Erlanger deploys an i2002 or i2004 Internet Telephone compared to a traditional digital set — the organization expects to replace some 1,000 existing digital sets.
• Ease of administration — The Optivity network management solutions make monitoring, troubleshooting, managing VLAN configurations, and implementing business-level policies across the network “a true networking lifesaver.” Also, the Internet Telephones will automatically register users with their same services at their new location without administrative involvement, allowing network staff to focus on more mission-critical responsibilities.
• More robust connections — Once limited to a few 100 Mb connections to the hub and servers, Haltom said his department is now using multiple Gigabit Ethernet interfaces to support imaging and application servers throughout the network.
• Secure remote access — The Nortel Networks Contivity VPN solution and the i2050 Software Phone combine to provide traveling staff with a means of staying in touch by logging into Erlanger’s network. With a simple Internet connection via dial-up modem or DSL service, users get secure, high-quality voice with four-digit dialing wherever they live or travel. In addition, users have transparent access to the same advanced telephony features available on-site at the hospital.
• Effective, satisfied users — “I have people lined up and waiting for some of the applications our new network makes possible,” said Haltom. Nurses participating in the pilot of the Mobil Medical Workstations (see “Traveling Nurse’s Station,” page 84) “can’t get enough of the new technology; others are knocking at my door wanting the branch-to-branch VPN and remote access using the i2050 Software Phone.”
Erlanger envisions many opportunities for network expansion and new healthcare applications as it completes its current installation and looks to the future. The healthcare environment necessitates taking the time for a smooth installation, conducting beta tests and network trials for the various components, replacing equipment, and rolling out added functionality carefully to ensure high-quality patient care throughout the network’s implementation.
That said, Erlanger feels confident that its Nortel Networks converged VoIP network offers investment protection for years to come and creates a solid foundation for the future. Erlanger anticipates continued network expansion and support of new applications, such as imaging over Digital Subscriber Line (DSL) technology to a physician’s home or to any number of Personal Digital Assistant (PDA) devices used by roaming or remote personnel.
“We didn’t enter into this agreement without a long-term commitment,” reminded John Haltom. “We fully intend on keeping this partnership going, and we’ll work together through every beta test to continue putting intelligence in our network.” When asked to describe the greatest benefit of his company’s new converged voice and data network, Haltom returns to what’s really important at Erlanger: “Our greatest benefit,” he said, “is having a strategic partnership for advancing patient care. What Nortel Networks has allowed us to do is to put tools in the hands of our staff to improve patient care. That’s our job.” IT
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