There are few more challenging demands of an IT professional than designing and implementing an efficient and effective network between several sites in a healthcare system, yet that expectation has become the norm in this era of multi-institution healthcare organizations. To develop a superhighway of efficiency, careful planning and meticulous attention to network configuration must become the order of the day.
One of the most critical steps to networking off-site facilities occurs before the first wire is laid.
Advice from the 30,000-foot view
Ward Keever, executive director for executive services of CTG Healthcare Solutions in Cincinnati, established his expertise with years of experience as CIO of a couple of large health systems, including the Medical Center of Delaware (now Christiana Health) and the University of Pennsylvania. Evaluating the needs of the end-users and assessing the current and projected technology is a vital up-front activity to offer the best chance that a multi-site network will function seamlessly and avoid immediate obsolescence.
Keever largely credits the young network engineer he hired with developing a very robust backbone that featured FDDI (Fiber Distributed Data Interface) that supports data rates of up to 100 Mbps installed through the walls of the hospital, even though the technology which would capitalize on the speed of that wire was not fully developed at the time. Because labor costs for laying the wire was far in excess of the cost of the fiber itself, and they didn't want to have to upgrade their backbone within a couple of years, using high-speed, fiber-optic cable proved to be a good decision.
Assessment also includes testing the sites that will reside on the network to determine if wireless solutions will work well. Keever said that an open Emergency Department might be a great place for a wireless system, while an older building with thick walls filled with asbestos might require hard-wiring.
Another bit of advice that Keever offers is to make sure that the "politics" of networking is addressed up-front. Each department will want to have the network configured to enhance their activities, but where conflicts could arise, the CEO needs to gather department heads together and make decisions for the one set of standards and single infrastructure that will be adopted.
Finally, Keever suggests that besides an expert network engineer (whom he asserts must be compensated well to prevent losing to another industry), a good security person is essential to establishing a valid network. Someone who is very familiar with all of the regulations and legal aspects from HIPAA (Health Insurance Portability and Accountability Act) regulations to JCAHO (Joint Commission on Accreditation of Health Organizations) requirements will prove invaluable in establishing policies and incorporating necessary precautions to insure patient privacy.
John Quinn, principal and CTO of healthcare practice for Capgemini Health, adds that if an institution plans to employ an internet service provider for a portion of the functional network, they must negotiate up-front how much bandwidth the end-users will require. For example, if radiologists will be sending large image data files over the network, and thereby utilize significant bandwidth, the internet service provider must be apprised when the contract is drawn up. While most internet providers will charge a premium price for putting radiology services on their backbone, ethical business practice demands that they be informed.
Pat Pothier, marketing director for SBC Communications, stresses the importance of a networking company performing a thorough assessment of the health customers' needs prior to developing the network solution. The SBC process includes asking the prospective client about their strategic business plan goals and objectives, so that they can determine priorities in
network configuration based on their size, location and applications that will flow over the wires. They want to understand the case mix, any new services the healthcare facility plans to develop, outcomes they are attempting to effect, the number of critical care departments and other factors that will impact network utilization.
Basic network design demands a security focus for perimeter and core segments, including intrusion detection. Wireless services require security as well, that could include encryption and the use of a VPN (virtual private network). Depending on the