Heart of the matter

Roisin Woolnough finds out how one hospital in the East Midlands overcame its lack of bandwidth

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 cure
Problems:
  • 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.

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