Healthcare ICT Trends & Innovation: Passive Optical LAN (GPON) for the New Era Michael Wilson, RCDD Solutions Engineering Manager, Tellabs Access Darren Vican, RCDD, OSP Vice President, RTKL 3/17/2015
Hospitals of Yesterday Physician Patient Clinical Systems Medical Technology Disparate Infrastructure & Networks for Each Community DAS & LMR Smart Building Operations 3/17/2015
Digital Hospital Redefined Truly Converged IT Systems Physician Patient Clinical Systems Medical Technology DIGITAL HOSPITAL DAS & LMR Smart Building Community Operations 3
Current Trends in Healthcare ICT Patient & Physician Centric Systems: Interactive Entertainment & Education Systems, Wireless, & Video Conferencing, Real Time Collab. Intelligent Facilities: Integrated Location Services (RTLS), Integrated Security, Integrated BMS, Staff Location Tracking Green IT Systems: Reductions in HVAC, Power and Backup systems while increasing system reliability and capacity Potenial Financial Losses: Wait, what? 4
Current Risks in Healthcare ICT Network Downtime Outages = Lost Health Records (EHR) & images $385 = Per Lost EHR* 59% = % of Fortune 500 companies with AT LEAST 1.6 HOURS of downtime per week** $56 = D&B avg. employee per hour rate $140,000 = per hour cost of downtime for a 2,500 employee hospital + EHR losses Human Error (in IT, not the OR) 80% of mission critical outages will be caused by people & process** 50% of the 80% will be caused by change management & mis-configuration** Data Breaches 42% of breaches are caused by malicious or criminal attacks*** 30% of breaches are caused by human error and mis-configurations*** *Healthcare News, February 2014 - http://www.healthcareitnews.com/news/healthcares-slack-security-costs-16b **http://www.businesscomputingworld.co.uk/assessing-the-financial-impact-of-downtime/ ***http://www.evolven.com/blog/downtime-outages-and-failures-understanding-their-true-costs.html **** 2014 Cost of Data Breach Study: Global Analysis, Ponemon Institute, May 2014 http://public.dhe.ibm.com/common/ssi/ecm/en/sel03027usen/sel03027usen.pdf 3/17/2015 5
Current Reliability in Healthcare ICT Reliability 99.938% = 325 downtime Minutes/Year ~ 5.5 hours EXPECTED 2,500 User Network Downtime Cost per Year Reliability 99.9961% = 52 downtime Minutes/Year ~ 1 hours Not practical or cost effective Reliability 99.999% = 5.26 downtime Minutes/Year ~.1 hours This architecture requires the use of two network interface cards in each end-user workstation * Source: Cisco Enterprise Campus 3.0 Architecture: Overview and Framework http://www.cisco.com/en/us/docs/solutions/enterprise/campus/campover.html#wp709323
Ugly Reality in Healthcare ICT Sample 2,500 User/Patient Hospital ALREADY experiences losses due to acceptable networks and infrastructure with poor reliability 99.9961% Legacy Network Downtime/Year 2,500 Users @ $56/Hour for 52.56 Mins:
Current ICT Answers in Healthcare More Technology Rooms More (and larger) Switches Larger Technology Rooms Larger Pathways More Power and More Cooling More Communications Cabling More Wireless Networks More Antennas More IT Staff to React to Downtime
Healthcare Infrastructure of Yesterday 12 24 Cat6 Cables per Critical Care Room 12 24 Cat6 Cables per Operating Room 12 24 Cat6 Cables per Specialty Suite Layer after Layer of Core, Distribution & Access Switches and their Backups 12 24 Cat6 Cables per Patient Room
Re-Thinking Traditional Infrastructure Passive Optical LAN (POL) GPON Technology Globally standardized transport solution for POL technology Enhanced data security (AES encryption) Highly flexible & scalable (from 100 to 100,000 users) Higher bandwidth capabilities than copper solution Less complexity by removing layers of distribution and access switching Converges voice, data, and video on to a single fiber Improved reliability (6 9s or sub 30s of yearly downtime & <3s failover) Downtime losses dramatically mitigated Reduced installation time and costs (~35% ~50%) Reduced overall lifecycle operating costs (~45% ~80%) Increased network performance for demanding applications Eliminates HVAC and UPS requirements and allows for smaller closets Replace workgroup switches with passive SMF splitters and panels
Healthcare Infrastructure of Yesterday (again) 12 24 Cat6 Cables per Critical Care Room 12 24 Cat6 Cables per Operating Room 12 24 Cat6 Cables per Specialty Suite Layer after Layer of Core, Distribution & Access Switches and their Backups 12 24 Cat6 Cables per Patient Room 1 1
Healthcare Infrastructure of Today 2-4 Strands of Fiber per Critical Care Room 2-4 Strands of Fiber per Operating Room 2-4 Strands of Fiber per Specialty Suite Passive Splitters = Simplicity, no HVAC, & Smaller Closets 1 2 Strands of Fiber per Patient Room 1 2
Why Passive Optical LAN for Healthcare Reliability 99.9961% = 52.56 downtime Minutes/Year ~ 1 hours EXPECTED Network Downtime Cost per Year Reliability 99.9999% = 31.5 downtime Seconds/Year ~.0084 hours Passive Optical LAN Saves the Hospital $121k/year in downtime losses alone; doesn t include additional CapEx and OpEx equipment, power and cooling savings
Passive Optical LAN Schematic Core Network Each OLT can support over 8,000 Gbe PoE+ Interfaces from a single managed IP OLAN OLTs (Primary & Redundant) Passive Splitter 1270nm: 10GPON Upstream (10Gbps TDM) 1310nm: GPON Upstream (1.24Gbps TDM) 1490nm: GPON Downstream (2.48Gbps TDMA) 1550nm: RF Video Downstream 1577nm: 10GPON Downstream (10Gbps TDMA) Optical Network Terminals 2x32 Each Gbe Interface can provides: 8 VLAN queues 256 MACs L2 L4 ACLs PoE/PoE+ 802.1x/NAC QAM or Broadcast Video RF Video Fiber Amplifier Concurrent 1Gbps & 10Gbps Operations 1 4
True Healthcare ICT Convergence Nurse Call Patient Monitor Analog Voice VoIP & Analog Phone Medical Imaging WiFi Access Point VoIP Building Automation Systems IP / Ethernet Data 2:32 Video Conferencing & Telemedicine Surveillance Camera IP Video RF and IP Patient Entertainment & Education RTLS Systems RF Video 15
Legacy Copper Networks of Yesterday 16
Become Simple Fiber Networks of Today Passive Splitter Device Ceiling, Floor or Closet Zero power required Zero HVAC required
Eliminate HEPA Tenting Single Mode Fiber (SMF) exceeds 103Tbps, cabling infrastructure never needs to be replaced Zoned architectures greatly reduce any cabling additions/changes and minimizes distances Plug-and-play pre-terminated fiber assemblies reduce any installation times and tenting 1 SMF replaces 4 Category rated cables 18
OLAN Healthcare Redundancy Layer 1 Redundancy in various options & configurations Sub second optical failover of all ONTs Provides N+1 Power Capabilities to the ONTs OLTs can be provisioned to share primary and failover loads for maximum upstream connectivity (80G max) Provides <5 second total system failover, or greater than 6 9s of availability Floor 3: Zone enclosures w/ 2:32 splitters and ONT powering panels. Fed with redundant SMF links and redundant N+1 Bulk DC power sources Floor 2: Closet based splitters, redundant SMF trunk between IDF stacks for 2:32 splitter dual homing & ONT N+1 powering Floor 1: Closet based splitters, redundant SMF trunk between IDF stacks for 2:32 splitter dual homing 19
OLAN Standards Compliance Improved Security and HIPAA (Health Insurance Portability and Accountability Act, 1996) Compliance Optical LAN system wide security includes: Advanced Encryption Standard (e.g. AES) Service Segmentation (e.g. service level VLANs with hard QoS and security) Authentication & Authorization (e.g. IEEE 802.1x, NAC, PAC, DHCP option 82, RADIUS) Access Control Lists (e.g. at Layer 2 Ethernet, Layer 3 IP and Layer 4 TCP/UDP) Rate Limiting (e.g. based on wide range of parameters) Exhaustive list of IP/Ethernet protocols matching legacy active Ethernet vendor functions 20
OLAN Standards Compliance TIA 1179 Compliance TIA 1179 calls for maximum reliability will be priority & highest performing cable media Network Availability Forget about cost of network down time, this is highest priority for healthcare critical care Need to force cost analysis on equal 99.9999 versus 99.999 annual availability Optical Distribution Network (ODN) redundancy With Type B PON redundancy and fiber route diversity Push redundancy to Telecom Enclosures (TE) and beyond Main data center equipment (OLT) redundancy With Type B PON redundancy with OLTs located in different physical locations The Human Factor 3.6% annual revenue loss, 50 80% outages human error 21
Relevant Healthcare Deployments Camp Pendleton Naval Hospital, CA Full Services Hospital: ER/ICU/Inpatient/Outpatient Deployment 2013 VoIP & Data over POL 24 port 1RU ONT deployment with legacy copper 8,100 Data Ports Moose Jaw Moose Jaw Union Hospital, SK, Canada Full Services Hospital: ER/ICU/Inpatient/Outpatient Deployment 2014 15 All healthcare services over POL Mixture of ONTs, all remotely powered with full redundancy 2,700 Data Ports ArchCare Terrence Cardinal Cooke, New York, NY Extended Care Hospital: Inpatient/Outpatient Deployment 2011 All healthcare services over POL 4 port ONT deployment 2,300 Data Ports Western State Hospital, Staunton, VA Mental Health Services Hospital Deployment 2013 VoIP, Data, WiFi (Aruba) backhaul over GPON 24 port 1RU ONT deployment 1900 Data Ports Guthrie Hospital, Corning, NY Full Services Hospital: ER/ICU/Inpatient/Outpatient Deployment 2014 All healthcare services over POL Mix 24 port 1RU ONT deployment & 4 port ONT deployment 3,000 Data Ports
Healthcare ICT Trends & Innovation: Passive Optical LAN (GPON) for the New Era Michael Wilson, RCDD Solutions Engineering Manager, Tellabs Access Darren Vican, RCDD, OSP Vice President, RTKL 3/17/2015