The Perfect Panacea

Many healthcare, education and
patient care applica-tions are constrained by bandwidth availability. Therefore,
healthcare environments increasingly require additional bandwidth to support emerging
applications. Harvard Medical School (HMS) has deployed a high-speed network
infrastructure to support patient care, research and health education.

The network is designed and deployed on a phased schedule, allowing HMS to evolve the
network rapidly to support emerging technologies and standards. The network strategy is
based on long-term partnerships with relatively few vendors. This approach has enabled HMS
to build a network infrastructure based on leading-edge technology that is scalable to
support new applications and flexible enough to leverage new technologies.

HMS selected Bay Networks as its strategic supplier of networking equipment. According to
Daniel D Moriarty, CIO and Associate Dean, “We have ambitious network development
plans and we prefer a `strategic vendor’ approach that includes out-of-the-box
interoperability and device management. This allows us to focus more time on deployment
and network management than on SI and compatibility testing. We made a strategic decision
to build our network infrastructure based on Bay Networks technology and this approach has
allowed us to cost-effectively deliver high-speed connectivity to our users throughout our
campus environment. This strategy lets us continuously evolve the network to support
additional user requirements for multimedia applications, intranet access and
scalability.”

HMS is a world-class scientific institution offering biomedical research, patient care and
education. It is one of the few world-class health education facilities without a
wholly-owned hospital. The students, however, spend nearly half of their time in clinical
rotations at affiliated hospitals and primary health care facilities.
Says Moriarty, “Our intent is to have a limited number of technology partners with
the leading medical technology and IT suppliers in the world. HMS expects these key
vendors to invest in our long-term success and in exchange, we provide them an opportunity
to challenge their products in a demanding, highly visible, world-class production
environment.”

Driving bandwidth expansion
IT has become a central component of the research, teaching and patient-care mission of
the school. HMS has numerous faculty that conducts scientific research in the digital
environment and nearly all research requires advanced computing and communication
resources. For example, molecular modeling, x-ray crystallography, modeling and imaging of
membrane functions and designing new types of molecules and pharmacological agents all
require massive file transfers. Additionally, the transfer of data, image and video
applications, as well as the sharing of research databases throughout the world, requires
highly reliable connectivity at transmission speeds not thought possible just a few years
ago.

The network now connects teaching, research, classroom, library and administrative
facilities on its Longwood campus in downtown Boston, via a single, high-speed backbone,
enabling real-time multimedia communications. It supports interactive research and
training and offers students a ‘virtual classroom’ environment that transmits multimedia
images for simulating surgical procedures. The amount of research conducted is pushing the
edge of current bandwidth limitations. Emerging projects, including an effort to provide
real-time video capability throughout the network promises to create new demands. Local
and remote faculty and students can potentially watch surgical demonstrations or lectures,
since Moriarty foresees video integration between clinical training affiliates and HMS.

Increased access to information
The school is migrating many legacy applications to run over an intranet to improve and
simplify access to information. Many mainframe-based applications have been rewritten to
run in lower-cost, more efficient, distributed web-client computing environments that are
accessed via browser interfaces. The data over the network is secure and standard browsers
serve as front ends for research applications, allowing remote downloading of encrypted
files from server databases.

This intranet strategy provides broader access to common information assets, an
opportunity to effectively organize user information and a means to navigate throughout
the network to access the rich content. “We will clearly add new information
resources online, including interactive applications, research and collaborative
computing,” said Moriarty. “We are experiencing major increase in content, so
our challenge is to deliver an infrastructure for delivering this information efficiently
to provide the tools that allow faculty, students, researchers, healthcare professionals
and administrators to access the vast amount of information being made available.”

Higher connectivity
This aggressive migration to intranet applications has driven demands for bandwidth,
remote access, security, network management and high-speed desktop connectivity. To
provide world-class connectivity to members of HMS community, the school decided to select
a single vendor dominant in the industry to solve the problems inherent in broad
deployment of new networking technologies. Moriarty said, “Bay Networks not only
provides a leading-edge, visionary approach, but is also committed to open,
standards-based solutions and offers a broad product set that addresses our diverse
requirements.”

HMS decided to select a strategic vendor for the network infrastructure equipment.
“We wanted to avoid finger-pointing between multiple vendors and we wanted to
leverage our own staff time by minimizing the number of relationships to manage,”
said Moriarty. “Concurrent implementation of so many leading-edge technologies is
always a challenge, but it can be overwhelming if your suppliers are not fully committed
to your success. We decided to select a single vendor and establish a multi-year agreement
and long-term business relationship. We felt this approach was much more efficient than
playing the field with mix-and-match products and vendors.”

HMS selected Bay Networks because the company offered a solution from the desktop through
the network backbone and had extensive experience in the health, education and research
industries. The two organizations worked closely together to develop a long-term network
strategy with phased implementation steps. “We didn’t want to be viewed as just
another customer,” said Moriarty. “We wanted to have a clear long-term vision of
the evolving product strategies. Bay Networks has kept us abreast of changes in network
standards, market trends and product shifts, providing us early notification of any
changes in product development plans or addition of new products.”

Moriarty continued, “Our relationship has been collaborative and open and I think we
have the ideal client/vendor partnership. Our team at HMS works closely with the Bay
Networks sales, engineering and technical support departments to collectively build,
operate and manage a complex network that best meets the needs of our users. Together,
we’ve implemented a model that demonstrates how vendors and customers can work closely to
develop the optimal network infrastructure that adapts to user requirements.”

Adaptive networking
The Bay Networks Adaptive Networking strategy allows HMS to evolve the network to
incorporate new technologies or launch new services. HMS has been able to cost-effectively
improve management because of its investment in a flexible, high-performance, adaptive
network infrastructure.

Adaptive Networking is the process of building IP-optimized networks that are invisible to
users, worry-free for network managers and strategic for the business. To meet the
opportunities and challenges inherent in building IP-optimized networks, Bay Networks is
focusing on key cornerstone technologies like switching/routing access, IP services and
network management. These transparent, scalable technologies ensure long-term,
non-disruptive network evolution and investment protection, drive operational productivity
at every level of the network, and adapt to continuous changes in network usage and
business requirements.

The hallmark of Adaptive Networking is the immediate flexibility that the products under
its umbrella exhibit to detect and adapt to changes in network traffic types, volumes, and
requirements both today and tomorrow. It offers the greatest flexibility required in all
parts of the network from the campus LAN, to the WAN, to remote access.

Phase I: Focus on collapsed backbone configurations
Since networking technology is extremely dynamic, HMS felt that a multi-year network plan
might be outdated before it was installed. Therefore, HMS and Bay Networks agreed to a
phased implementation strategy over a period of five years, with detailed evaluations upon
the completion of each phase. This approach has allowed HMS to reconsider alternatives as
new technologies become available, standards are finalized, or breakthrough products are
unveiled.

The first phase focused on upgrading network infrastructure at the HMS building and the 10
other buildings on the Longwood campus. Previously, there were disparate LANs serving
different departments and organizations, so this campus backbone network would provide a
common, scalable topology and also provide secure connectivity to desktop in all 11
buildings.

This phase was completed in 1996, and was based on 10Mbps Ethernet and 100Mbps Fast
Ethernet LAN connections to Bay Networks Distributed 5000 hubs, and a backbone network
connecting the facilities. Most LANs were connected over 10Mbps Ethernet, but some
workgroups that required higher-speed connectivity were provided with 100Mbps fast
Ethernet connections.
In each building, on each floor, a distributed 5000 hub was installed in a wiring closet
and connected over 155 Mbps OC-3 fiber running Asynchronous Transfer Mode (ATM) technology
to a single System 5000′ BH hub with a Centillion 100 ATM switching module. This collapsed
backbone topology allows HMS to easily segment workgroups within each building, providing
the option to upgrade LAN connections in the future if needed.

Phase II: ATM core network
HMS recognized that ATM is an ideal long-term, transport-layer switching technology and is
implementing a strategy focused on an ATM backbone with 10 Mbps, 100 Mbps and Gigabit
Ethernet technology deployed to the desktop, as needed. In the next phase, the buildings
were interconnected over an ATM backbone that provided high-speed throughput and
multimedia capabilities to each of the 11 buildings. Since LAN traffic in each building
feeds into a System 5000BH hub, each of these hubs was interconnected over an OC-3 fiber
backbone running ATM. The Bay Networks switching modules can eventually be expanded to
support 622 Mbps ATM speeds, ensuring HMS of a long-term upgrade path for delivering the
bandwidth required for emerging applications.
The switches are based on ATM technology, which provides a high-speed, multimedia
switching fabric. Traffic is routed at the ATM core using a Backbone Concentrator Node
(BCN(r)) router from Bay Networks, which creates logical subnetworks to optimize
performance.

Patrick Nta, Manager, Network Services, said, “We also optimized LAN configurations
to isolate workgroups and increase performance. We have implemented a multimedia
clustering strategy that concentrates servers on high-speed LAN segments. We have even
implemented a few 1,000 Mbps Gigabit Ethernet workgroups for delivering high-speed server
connectivity.” For example, users in the R&D laboratories require extraordinarily
high levels of bandwidth. In one application, users are conducting three-dimensional
modeling of virus structures using Silicon Graphics workstations. These workstations are
connected using Gigabit Ethernet switches. Nta said, “Our overall desktop strategy is
based on thin clients, high bandwidth and fat servers. Our intranet architecture allows us
to provide browser interfaces for simplified access to common applications and
databases.”

Constant uptime
In each phase, HMS has implemented a hedging strategy to ensure continuous network
operations. “We require constant uptime, but we’re constantly introducing new
technologies into our production network,” said Moriarty. “We’ve balanced the
need for network stability and the need for major network evolution, by implementing
strong network management and a hedging strategy that includes spare components and a
redundant Fast Ethernet backbone.”

HMS relies on the Optivity(r) suite of network management tools for controlling all of the
network equipment. Operations staff monitors network activity and they generate periodic
reports on usage to proactively identify any potential performance problems. “We
could switch from the ATM backbone to the redundant Fast Ethernet backbone within a couple
of hours if we needed to and we can resegment LANs instantly if needed from a central
site,” said Moriarty. “The modular architecture and flexibility of the Bay
Networks equipment allows us to create redundancy plans while also allowing us to quickly
respond to any changes in user requirements for bandwidth.”

Supporting remote users
HMS is now focused on remote access to the intranet by planning a Virtual Private Network
(VPN), so that hospitals and affiliates throughout Eastern Massachusetts can access it.
Moriarty explained, "We’d like to provide secure access to all of our affiliates and
to each authorized member of the greater HMS community. We’re not trying to standardize or
centrally dictate internet access requirements, so we’re designing a secure solution that
is compatible with all major internet access methods. Once these users access the
internet, they can be authenticated and provided with intranet access."

Authorized users, whether they are remote hospitals or individuals dialing in from home,
will be granted access to intranet resources using the Security Dynamics SecurID
two-factor token-authentication technology. HMS is currently initiating a collaborative
planning effort with its users and affiliates to define the final VPN requirements and
will then add the appropriate technology and management systems.

Moriarty expects upgrades throughout the network infrastructure to accommodate user
demands. "The explosion of high-quality content and applications continues to drive
additional bandwidth requirements, particularly for the medical school and our affiliates.
We survey our user community so we understand the applications under development and the
evolving needs. Our strategy is to evaluate user requirements and when we foresee user
needs potentially exceeding network infrastructure capabilities, we develop proposed
solutions for review by the HMS community. This way, we are sure that network growth is
driven by real demand and that we are efficiently building capabilities that our users
require."

Future plans
User requirements for new healthcare, research and education applications continue to
drive network growth. HMS faculty at the Harvard-Beth Israel Educational Foundation are
now developing Virtual Patient case studies multimedia applications that allow students to
diagnose clinical problems they are unlikely to come across in their field training.

These case studies recreate clinical conditions in a multimedia environment, complete with
voice interviews, patient videos, lab tests, radiology and pathology images, and apply
other interactive technologies that simulate real-world patient health concerns. Moriarty
said, "The faculty is creating a portfolio of Virtual Patients so our students can
practice their diagnostic and history-taking skills in an interactive environment. This
approach also ensures that students are exposed to classical diagnostic situations,
including diseases and conditions that they may not have had the opportunity to see during
clinical rotations."

"Bay Networks has demonstrated its commitment to the advancement of healthcare
networking technology and has proven to be a valuable partner," said Nta. "We’ve
been extremely pleased with Bay Networks technical abilities and the company’s integration
of networking technologies into a consistent, manageable architecture. The web version of
optivity has been a blessing, since it has allowed us to access the status of each device
on the network from anywhere on campus. The engineering support has been very good and Bay
Networks has a team in its Technical Support Center assigned to our network. This reduces
our upgrade risks and allows us to scale new solutions and introduce them rapidly into the
network."

"Bay Networks has demonstrated its commitment to the advancement of healthcare
networking technology, and has proven to be a valuable partner." concludes Nta.

Technical
Notes


Applications:
Student education; Virtual Patient case studies, molecular modeling,
x-ray crystallography, modeling and imaging of membrane functions, multimedia labs,
multimedia instruction, billing, financials, payroll, personnel, Internet access, library
catalog access, electronic mail, WWW research services, distributed databases, remote
access, file transfer.

Platforms: Intel-based PCs, Windows NT and UNIX Workstations, SGI Workstations, IBM
mainframes

Network Protocols: TCP/IP, NetBIOS, NetWare, SNA, Novell IPX

LAN and WAN: Ethernet, Fast Ethernet, Gigabit Ethernet, ATM

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