At any time, day or night, we can order nearly any product, our next meal or a ride – right from a smart phone. This “on-demand economy” is revolutionizing virtually every sector, including healthcare.
In healthcare, the on-demand trend has sprung up in the form of fullservice urgent-care centers, which now number more than 7,000 in the United States, with more opening all the time. The rise of these facilities – especially of clinics connected to a broader health system – stems from multiple patient drivers: demand for more value at less cost; the ability to get care quickly, anytime, outside of the emergency room; and the convenience of a clinic visit being logged with one’s broader medical records.
To the delight of its patients, ProMedica, a nonprofit health system that services large parts of Ohio and Michigan, recently opened several urgentcare clinics and plans more in the near future. With that, comes the need for an always-on IT network.
“The response has been huge to our urgent-care centers,” says Ben Vickers, Director of IT at ProMedica. “It’s the biggest trend we’re seeing at ProMedica. Because we’re open 12 hours a day, it requires an extremely stable network. Patients expect to be served quickly and efficiently.”
Multicasting: A New Frontier for Healthcare
At ProMedica, growth in urgent-care centers is just one of the demands on the company’s network. A new Epic electronic health records implementation, and new applications for patient monitoring and a public address system, all rely on the IT network.
Many of these needs also require robust IP multicast capabilities – something of a new frontier for the healthcare industry. ProMedica has had firsthand experiences of the very real challenges of delivering seamless multicast, fortunately with non-clinical applications.
When desktop dashboards in the hospital’s contact center became unreliable, hindering hundreds of agents in scheduling medical appointments, the network team found troubleshooting conventional Protocol Independent Multicast (PIM) inconsistent and unreliable. Given that, the network team knew that PIM wouldn’t cut it for applications directly impacting patient care.
ProMedica found the answer from its longtime networking partner, Extreme Networks. The Extreme Fabric Connect next-generation network virtualization technology provides a simplified and agile infrastructure that dramatically reduces network configuration and deployment time. Moreover, it supports a highly scalable IP multicast implementation without the technical complexity and uncertainty that is part and parcel of a conventional PIM deployment.
“When we first investigated the Fabric Connect story, we thought it sounded too good to be true: there wasn’t any of the traditional complexity, but it promised to deliver all the resiliency we needed,” says Bruce Meyer, Technical Coordinator of Network Engineering at ProMedica. “Crucially, the way that it handles multicast was very exciting because we knew that we needed to do something different; business as usual was not an option for ProMedica.”
“As we were tasked with evaluating the value of our other network provider and Extreme,” Vickers adds, “we found speed to delivery and cost more favorable with Extreme Networks, making the decision clear that Extreme Networks is the right way to go for all our networking needs.”
Additionally, Fabric Connect allowed ProMedica to converge to one network, instead of running one for biomedical needs and another for business needs. With the ability to connect two data centers with Extreme’s Transparent UNI, Fabric Connect saved the medical center from buying eight more links – saving $18,000 to $20,000 monthly.
Changes On the Fly
Not only does Fabric Connect provide a reliable foundation, but ProMedica’s network team can easily change network services, or enable new services, on-the-fly. “With Fabric Connect, you just need an IP interface and there’s even a simple check box to enable multicasting if that’s needed,” Meyer says. “It makes things so much faster and easier to deploy.”
For the contact center, real-time dashboards now run flawlessly over Fabric Connect, preserving productivity and customer service. And ProMedica taps into multicast for its public address system, used to communicate across the hospital campuses.
Next, the hospital looks to multicasting to connect thousands of bedside monitors, which closely track patients’ vital signs. Once only a few basic metrics were monitored, such as heart rate and blood pressure. Today, multiple, real-time indicators go directly into the patient’s electronic health record (EHR).
More Reliability, Less Risk
Beyond connectivity, the network team has found that the agility that Extreme Fabric Connect delivers saves them time and builds in essential reliability. Engineers take care of day-to-day administration and maintenance without the risks normally associated with changes.
“We have to be able to do maintenance while still keeping everything running. Impacting patient care is not an option,” Meyer says.
In particular, the team can now easily configure network services wherever needed. “If you want to configure a VLAN on a particular switch, with Fabric Connect, you only need to configure that device – it’s literally only three commands – and it’s done,” Meyer says. “It’s dramatically different from the traditional way and really helps us manage time crunches.”
New Site Setup – Within a Week
When ProMedica acquires new practices and locations, the team can configure the new sites in less than a week, compared to an industry average of one month – particularly valuable when the company recently acquired more than 30 physician practices.
“Fabric Connect greatly simplifies the acquisition process,” Vickers says. “We drop in new Extreme Networks gear and we’re off to the races – without touching the core.”
Likewise, ProMedica significantly reduces the burden of managing remote networks. The ability to extend network services across physical locations – making devices appear to be co-located – has delivered significant advances in application deployment and troubleshooting. From a central location, an engineer can directly extend back the remote network and therefore simulate the appropriate subnet. “For a whole week, one of our engineers ran his PC virtually, as if he was at a remote site, which added a lot of flexibility and comfort, gave advance indication of any issues, and saved on travel time,” Meyer says.
Extreme Fabric Connect even bridged a gap where the company’s telecom carrier could not. When ProMedica needed to connect two data centers, Fabric Connect’s special Transparent UNI feature enabled the team to link two ports to create a point-to-point connection – effectively enabling a high-speed Ethernet connection over the IP-based metro network.
Along with simplified configuration and day-to-day management, the ProMedica team has also learned the value of the network’s resiliency. When the company experienced a fiber cut – requiring six hours to fix – business continued as usual.
“We got a notice from our carrier saying that some of their customers may be affected,” Meyer says. “But in our case, traffic instantly routed from one location to another and none of our users knew there was an issue. Before Fabric Connect, it would have taken us a good hour to troubleshoot and the network would have to converge around new routes. Now it’s instantaneous and no applications are impacted so our users stay connected.”
With confidence in the network, ProMedica can make its vision for smart healthcare a reality, while meeting the demands of today’s consumers. Soon, the hospital plans to use its new-found multicast capabilities for video security surveillance. And it will deploy Extreme Fabric Attach, enabling devices to automatically attach and be configured on Fabric Connect – without requiring engineering intervention. The device or edge switch simply requests the required services, greatly easing the provisioning of new, unmanned services.
With this network infrastructure, the network team has peace of mind that it can easily accommodate the hospital’s future demands. Currently, that means replacing all network gear ahead of the Epic deployment, with support from its Extreme partner, IPC Systems.
“If you really want to make your life easier, take a look at Fabric Connect and avoid the marketing hype about SDN,” Meyer says. “When you look at it, you’ll say, ‘It can’t be that easy,’ but I’m telling you it works.”
How it Works: IP Multicasting with Extreme Fabric Connect
Extreme Fabric Connect handles multicast as a natural extension of its service-based architecture. Flows are deterministic and fully optimized; applications benefit from a robust, scalable and bandwidth-efficient solution.
By design, traffic on Fabric Connect runs via the shortest, most efficient network paths for normal unicast and multicast flows. Gone are the days of complicated PIMbased multicast trees and worrying about which device was the rendezvous point. Network-wide services deliver end-to-end connectivity, and edge-only provisioning automatically adds devices into the appropriate community.
Importantly, Fabric Connect requires no additional configuration for the network core, and IP multicast support is a seamless option. These features make provisioning significantly more agile, and deploying and maintaining multicast-based applications pain-free and dependable.
ProMedica is a mission-based, not-for-profit healthcare organization serving northwest Ohio and southeast Michigan. The 13-hospital system has more than 16,000 employees, 2,300 physicians with privileges, and more than 800 healthcare providers employed by ProMedica Physicians. Additionally it offers a health plan, Paramount, which serves 320,000 members including more than 225,000 members in the statewide Medicaid plan. Driven by its Mission to improve your health and well-being, ProMedica offers a full range of diagnostic, medical and surgical specialties in areas such as emergency medicine and trauma, behavioral health, heart and vascular, oncology, orthopaedics, neurology, and women’s and children’s services. The health system has been nationally recognized for its advocacy programs and efforts to raise awareness about hunger as a health issue. For more information about ProMedica, please visit www.promedica.org/aboutus.