Roisin Woolnough finds out how one hospital in the East Midlands
overcame its lack of bandwidth
Like all NHS hospitals, Nottingham City Hospital is trying hard to
reduce patient waiting lists and the cardiac surgery unit is under
particular scrutiny. In order to improve the facilities available
and cut waiting times to meet government targets, the hospital
decided the cardiac unit needed a network upgrade.
Mike Ross, network manager at Nottingham City Hospital, says he
realised back in 2000 that the existing network was not up to
scratch when it started getting very congested and was crashing
several times a day. "The old network was falling apart at the
seams - it was severely overloaded and used obsolete equipment,
which meant no new kit and no support was available," he
says.
Not only was there insufficient bandwidth on the network to cope
with demand as it was, but the unit needed to add new services,
boost capacity and cater for any future increase in demand. "We had
a requirement to send big medical imaging transmissions across the
network," Ross explains. "Consultants needed to have a moving X-ray
picture."
This meant deploying technology to enable them to transmit X-ray,
scan and ultrasound images across the local area network so that
medical staff could easily access data from anywhere on the
hospital premises; they would no longer have to wait for film or
printouts to be delivered.
To achieve this, the hospital decided to install a new 3,500-node
Gigabit Ethernet network. It chose Hewlett-Packard as its supplier
and in September 2000, a pilot scheme was set up. "We have one unit
of the hospital that is more or less separate to everyone else, so
we used it as a guinea pig," Ross says.
The idea was to implement the new equipment and monitor its
performance for six months before rolling it out to other
departments. "But the situation got very urgent and it was so easy
to configure and very reliable that we went ahead with full
implementation after three months," he says.
Basing the network on switches from HP Procurve, the hospital
installed a single routing switch and more than 100 Layer 2
switches. HP's Openview and Toptools are used to manage the
network, with Specialist Computer Centres and Xpert Systems
supplying the networking and additional hardware and software
respectively. "HP Openview monitors the devices on the network - we
have in excess of 150 devices now," says Ross. "It gives us advance
warning of any malfunctions and a remote control facility."
Whereas the old system had a fibre distributed data interface,
running at 100 megabits per second in the backbone, the new network
has a multiple gigabit backbone, with eight gigabit trunks in it.
"This runs on a gigabit a second, four duplex, so that we can
transmit at the same time as receiving," says Ross. "This ability
to transmit and receive at the same time doubles the speed
again."
As Nottingham City Hospital is one of the largest acute teaching
hospitals in the East Midlands, with more than 5,000 staff, speed
of access and delivery is of crucial importance. Using the new
network and its capacity to transport images and video, doctors can
monitor operations and performance remotely. "The head consultant
can view what is going on in the operating theatre, without
actually being there," says Ross. This has a big impact on how
training is delivered and has opened up new training
possibilities.
When it came to implementing and tweaking the new system, Ross and
his team found they could learn the skills as they went along so it
was all managed in-house. The harder part was training up other
hospital staff to use the new system, but Ross says they soon
adapted too. The unit is now buying another scanner because they
are getting through their workload much faster with the new
set-up.
The primary reason why Ross chose HP as the network supplier was
the price. The initial cost of buying in the network was pretty
low, but he says the real money-saver is the minimal maintenance
costs. "The company offered us a replacement guarantee for the life
of the equipment, which saves us a lot of money and time on
maintenance. Other suppliers quoted us for maintenance and the
prices were phenomenal. We are saving so much money because we were
spending £20,000-£25,000 a year on the old network, but are
spending less than a fifth of that on the new one," he says.
Faulty parts are simply returned to HP to be replaced or fixed. As
a result of this arrangement, Ross says the hospital has fairly
loose service level agreements in place, simply because HP has
already shouldered the burden of maintenance. He says the hospital
is saving £10,000 a year by not having to pay for
maintenance.
But, it is not only the financial savings that Ross is pleased
about. "Over the past two years we have had no downtime and no
major faults. Bearing in mind that we are growing the network all
the time, this is a very notable achievement. Personally, I am very
impressed with the HP switches."
The implementation process was so smooth that the hospital finished
the roll-out five months ahead of schedule.
The symptoms and the cureProblems:
- The old network had insufficient bandwidth and was
underperforming
- Hospital staff needed to be able to send X-rays, scan and
ultrasound images over the network from any place and at any
time
- Maintenance costs with the old network were high
Benefits of the new set-up:
- The new network has a tenfold improvement in bandwidth
- The hospital now has the ability to transmit moving images over
the network
- Supplier took on maintenance responsibility and costs
- The cardiac surgery unit is processing its workload faster,
helping it to reduce patient waiting times.
Nottingham City Hospital's system architecture- 3,500-node Gigabit Ethernet network
- One HP Procurve routing switch 9304M
- Two HP Procurve switches 4108GL
- Twenty HP Procurve switches 4000M
- Fifty-five HP Procurve switches 2524
- Thirteen HP Procurve switches 2424
- Eleven HP Procurve switches 224
- HP Openview
- HP Toptools
- Fourteen Unix servers (Siemens, Sun and IBM) and 56 Windows NT
and Windows 2000 servers
- Two Linux servers
- Oracle8 database
- Specialist medical applications
- PC clients
- Megastream link with University Hospital Nottingham for
data-sharing.