Two heads are better than one, but when it comes to networks…

The history of connecting ETZ Hospital’s networks and brilliant minds

Elisabeth-TweeSteden Hospital has been one of Extreme’s most loyal Dutch customers for 20 years. After a merger, all existing infrastructure of two hospitals with three branches was merged into one future-proof redundant secure network within five years. All the more reason to have a nice little chat with Franz Steinhauser and Dennis Groen who admit: "With Extreme, we have a partner who inspires us with their vision and who, vice versa, is inspired by us – the customer."

The Elisabeth-TweeSteden Hospital (ETZ) is one of the largest in North Brabant in the Netherlands and serves the people of Tilburg, Waalwijk, and the surrounding areas. With the merger of the Elisabeth Hospital and TweeSteden Hospital in Tilburg plus the branch in Waalwijk a few years back, the new organization had one central goal: migrate the hospitals' individual networks into a single metropolitan-area network for three locations that would be manageable from a single interface and would allow for a fast and easy deployment of services in all locations.

According to Senior Project Manager Dennis Groen and ICT advisor Franz Steinhauser, with the help of Extreme this wish has been more than fulfilled.

In fact, the new Elisabeth-TweeSteden Hospital can now securely add on-site partners, companies and users to the ETZ network and manage them flexibly. After all, what are hospitals, if not a collection of internal and external users like labs, specialist clinics, catering services, other services, and last but not least, the patients? All of them use a wide range of equipment. And no matter if it’s modern or a little bit outdated, it still needs connectivity.

Healthcare is a great, dynamic environment with huge innovation. There are always lots of challenges. For someone in IT, healthcare is a mix of many facets.

Dennis Groen, Senior Project Manager, Elisabeth-TweeSteden Hospital

Thanks to the Extreme solution, everything is now connected. Not physically, but logically separated on the ETZ network and accessible via physical and virtual routers, switches, appliances, access points and firewalls.

But how did all of this come to be?

Elisabeth-TweeSteden Hospital - a truly modern, Dutch healthcare facility.

Hospital networks, then and now

A fully redundant network has been designed and rolled out for the three locations and two data centers, with the help of Dennis Groen and Franz Steinhauser. Dennis’ and Franz's long careers share a lot of similarities. For example, they both began their journey in the tech industry in the late 90s when the entire IT sector was concerned about the Millennium Bug. And both have held many positions and various roles within the hospitals that today form the ETZ.

Franz Steinhauser was originally hired at the Elisabeth Hospital and has worked his way up from Oracle DBA in the Millennium change through head of management, working foreman (with one foot in the mud), team leader, consultant and project leader to ICT advisor with a focus on the bottom layers of the network. “The work is just as challenging as it was when I was starting out as a temp worker in 1997. The combination of healthcare and IT raises so many problems that I can hardly imagine a more challenging environment. Especially with the trend towards even more wireless networks and the ever-growing need for capacity. If someone told me five years ago that today we would be working with AI and petabytes of storage, I would have simply laughed in his face”, Franz admits.

Dennis Groen has an equally long history with ETZ, though his roots lie in the TweeSteden Hospital. He too entered the healthcare sector at the time of the Y2K craziness. And he too has climbed the ladder from technical and executive roles to project management, senior management and consultancy. “One day I just decided I want to enjoy my work. No reward can beat that. Luckily, I found that here. Healthcare is a great, dynamic environment with huge innovation. There are always lots of challenges. For someone in IT, healthcare is a mix of many facets”, says Dennis.

The ETZ's IT team, from left to right: Franz Steinhauser, Patrick van Oosterwij, Hans Beerens, Dennis Groen, Dwight Peijen, Michel Pluijm.

Two heads are better than one, but when it comes to networks…

Since the merger, Dennis and Franz have formed a great duo. But despite all the similarities, there was one big difference between them. In TweeSteden, Dennis always worked with Cisco and at Elisabeth Franz worked with Avaya.

In the tender process after the merger, the offers of several suppliers were reviewed in a market survey. It was then that Dennis’ and Franz's backgrounds collided. Franz: “We carefully assessed the vendors with special regard to their vision. Avaya's offering was clear: infrastructure with services based on SDE with Fabric Connect. We both agreed that as far as the functionality and pricing was concerned, they scored very well. With Fabric, Avaya was already way ahead of the competition. At Elisabeth we have been very satisfied with the speed and flexibility of Avaya for almost 20 years and never had a single downtime. That said, others vendors were also more expensive for the same installation and complexity.”

However, during the tender, Avaya got into Chapter 11 (a form of bankruptcy that involves a reorganization of a debtor’s business affairs, debts, and assets). As time would tell, it turned out to be a blessing in disguise for the ETZ. With the acquisition of Avaya’s network division by Extreme, the new hospital found the ideal partner. “Extreme's resources, roadmap and vision on networking were a perfect match with our collective networking DNA,” Franz admits.

At Elisabeth we have been very satisfied with the speed and flexibility of Avaya for almost 20 years and never had a single downtime.

Franz Steinhauser, ICT advisor, Elisabeth-TweeSteden Hospital

During the merger into one organization, there was a need to properly merge all the IT services, infrastructure, networks, mail, telephony, etc. Another factor was that the infrastructure needed to be partly replaced. “We envisioned one network for the entire organization, one supplier for all wired and wireless infrastructure that would translate into reduced management work. We wanted the same number of engineers to be able to service the organization and a future-proof network that facilitated in-house partners in a secure manner. We were looking at a multi-year project that can’t be done overnight”, says Dennis.

Franz Steinhauser: "The combination of healthcare and IT raises so many problems that I can hardly imagine a more challenging environment."

Why Extreme Fabric Connect?

When choosing Extreme, Dennis and Franz quickly realized that Fabric Connect is the future. Hospitals increasingly need to facilitate in-house companies and organizations in a separate, safe and easily manageable way on their network.

Dennis admits that it all became possible with the adoption of Extreme Fabric Connect. “As a Cisco expert, I know that migrations can have hick-ups. Using Fabric, migrations are now much easier and cause little to no downtime. Moving core switches can be done without downtime. Expanding new ports and switches to Satellite Equipment Rooms is much easier and doesn’t require configuring all the uplinks. The network does that all by itself, is much faster and more reliable with these tasks. We don’t require a high level of expertise and can expand standard parts of the network with less qualified, and therefore less costly, engineers.”

We wanted the same number of engineers to be able to service the organization and a future-proof network that facilitated in-house partners in a secure manner.

Dennis Groen, Senior Project Manager, Elisabeth-TweeSteden Hospital

Fabric offered an ideal solution for connecting them. The network must be available to the staff, medical specialists and guests at all locations. That also includes employee walkie-talkies, building management systems and camera surveillance. Extreme Fabric Connect speeds up the configuration, reduces the risk of human errors and, according to Franz, basically saves a lot of time. “Fabric ensures that connectivity can be created quickly and where it’s needed. The hospital can now design virtually endless single and double connections, with stars and rings between network equipment without them interfering with each other. In our data centers we can now simply add a switch if necessary and Fabric saves us so much configuration time and thinking during the migrations.”

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Connecting outdated equipment

Fabric will lead to huge operational and cost benefits for connecting specialized medical systems like cardiac monitoring devices, radiological equipment, X-ray systems and scanners. This type of equipment requires complex certification processes and usually depreciates over more than ten years, after which it remains in use for many years. From the IT perspective these devices are perceived as outdated and can cause interoperability issues with modern networks, Wi-Fi or chips.

Franz admits that Fabric and Extreme support would help to find the answer for that issue, too. “For example, Extreme Defender for IoT enables protection of outdated medical endpoints and can be implemented between the network and medical devices that normally couldn’t be replaced or modified due to certification reasons. Since we take security issues very seriously, this solution can offer us enormous savings. If it weren’t for Extreme, we would be forced to either spend hundreds of thousands of euros on new equipment or build a separate network for this medical equipment alone. Not only would that be expensive, it would also go against our one network philosophy”.

Franz Steinhauser: "If someone told me five years ago that today we would be working with AI and petabytes of storage, I would have simply laughed in his face."

Future developments

With Extreme’s help, ETZ is now ready for whatever the future may bring. And that’ll prove useful sooner rather than later, as the hospital is planning to open a new building in 2025, housing an emergency department and operating capacity. It is set to be packed with innovation, using more Wi-Fi, even more flexible networks and a new data center.

With new technology in mind, ETZ wants to migrate to the EXOS switches and expand the use of Extreme management tools. Dennis: “Using ExtremeControl gives us flexibility and scalability when upgrading to new hardware. The solution is able to support both our current infrastructure and new systems that we are planning to acquire, such as Extreme EXOS. It means that our migration path not only doesn’t force us to unnecessarily replace the existing infrastructure, it also helps us prevent divestments.”

Extreme's resources, roadmap and vision on networking were a perfect match with our collective networking DNA.

Franz Steinhauser, ICT advisor, Elisabeth-TweeSteden Hospital

Groen and Steinhauser are an old hand at the IT game and are certainly the right people to theorize on the future of networking in the healthcare sector. Of course, both predict an important role for Fabric Connect and ExtremeControl Management Suite which will become more and more intelligent through AI. Collecting and analyzing data based on pattern recognition and (deviant) behavior ensures that engineers can work better, faster and easier. Modern intelligent switches on the edge of the network, combined with cloud applications such as ExtremeCloud IQ and ExtremeAnalytics, guarantee greater security and access control.

Dennis Groen: "Using Fabric, migrations are now much easier and cause little to no downtime."

From core to edge and back

And for the more distant future? “Certain network services will move from the core in the cloud to the edge of the infrastructure. Closer to the clients”, says Dennis Groen. “Local intelligence prevents unnecessary strain on lines between the edge and the core. Sometimes it is desirable to deploy edge network intelligence in a targeted manner. Based on behavioral signals in the network, we can decide to scale or close ports, access points or bandwidth. This way we can keep an eye on the network. We can also meet the needs of the organization with the same number of engineers.

“The next step for technology is to warn us about things before we see them and then take action by itself if necessary. The hospital's strategy is in line with those technology trends”, Franz Steinhauser thinks. “With Extreme, we have a partner who inspires us with their vision and who, vice versa, is inspired by us – the customer”, he concludes.

ETZ network in a nutshell

• Extreme VSP switches in the core network and in the two own data centers, the latter recently replaced by models with more capacity
• 380 ERS edge switches, possibly to be replaced with EXOS switches
• More than 700 access points (type 3935) managed locally, potentially managed in the cloud in the future
• Extreme Management Center for network management and administration
• ExtremeAnalytics for network traffic monitoring
• ExtremeControl for the Wi-Fi network and client authentication
• Soon, ExtremeControl will also be used for the wired network