Today, after years of hardening and enhancement in some of the world's most challenging network environments, WDM-enabled optical networking is poised for wide-scale adoption across the healthcare industry.
By Todd Bundy and Bernard J. McElroy
ADVA Optical Networking
Healthcare organizations are falling under increased pressure from governments and insurers to implement business improvements, enhance patient care, and reduce costs. Customer-operated WDM networks provide virtually unlimited bandwidth and resilient, flexible network support for promising, new life-saving applications and critical process improvements in healthcare. Fixed operational expenditures (opex) drive a typical payback of within four years, positioning a healthcare organization for dramatic cost savings over the long term.
A convergence of trends
Governments and insurers are encouraging healthcare organizations to adopt more sophisticated strategies for protecting and storing data; replacing outdated processes, such as scribbling prescriptions and patient records on paper; and storing and exchanging X-rays on film. Today's healthcare organizations must ensure business continuity and disaster recovery, eliminate the possibilities of human error, expedite and enhance care, and enable closer collaboration among caregivers--all while reducing costs.
At the same time, the healthcare industry is in a tremendous state of flux. Hospitals are expanding from standalone locations to campus environments and--through mergers and acquisitions--regional healthcare organizations that stretch across large geographic areas.
These trends have created new challenges for healthcare Information Technology (IT) departments. Historically, as bandwidth demands increased, healthcare organizations have provisioned additional telecom services, such as T1/T3 connections, from carriers. In some cases, though, these traditional services failed to deliver the necessary capabilities. And with the accelerating rate of change in healthcare, the job of predicting IT costs has morphed from science to art; it is not uncommon for healthcare organizations to record 10% to 20% annual average increases in telecommunications costs. Healthcare IT departments have sought a more powerful, flexible, cost-effective way to meet their bandwidth needs.
Technology evolution
WDM-enhanced optical networking--originally developed in the mid 1990s for financial institutions--provides the benefits sought by healthcare IT departments. Over the last decade, as deployment has spread to a wide range of enterprise and service provider networks, the technology has undergone critical improvements that have rendered WDM the ideal underlying foundation for data, voice, and video communications in healthcare.
In WDM, wavelengths of different applications are multiplexed and transferred over the same fiber without jeopardizing the data stream. Applications of any recognized protocol--Ethernet 10/100/1000/10G, ESCON, FICON, Fibre Channel, Coupling Link, Sysplex Timer, ATM, and SONET/SDH--can be transported cost-effectively and at native speed using WDM. Adding a new application does not require deployment of additional fiber; the existing fiber infrastructure is efficiently shared.
The introduction of Coarse WDM (CWDM) and hybrid CWDM/DWDM systems has led to additional improvements. CWDM uses 20-nm channel spacing between wavelengths across an optical fiber, while DWDM employs 1.6-nm channel spacing. Consequently, more "virtual channels" can be created across a given fiber with CWDM, typically eight compared with DWDM's 64. Relying on lower-cost components (uncooled distributed-feedback lasers, passive filters, and small-form-factor transceivers, for example), CWDM systems tend to be 30% to 50% less expensive than DWDM systems of the same channel count and system functionality. However, DWDM is generally needed for higher-bandwidth applications and longer transmission distances.
Hybrid CWDM/DWDM networking, meanwhile, provides a compelling alternative for healthcare IT departments seeking both affordability and scalability. Two or four channels can be deployed initially via CWDM, and more channels can be added incrementally and cost-effectively via DWDM as new needs arise. Users also save on costs for staff training and equipment spares because both CWDM and DWDM are deployed from the same platform.
Among the most important applications supported by WDM is business continuity and disaster recovery across geographically dispersed data centers. Sophisticated storage solutions enable a healthcare organization to ensure that its data and applications are always available, even in the event of simultaneous failure at multiple sites.
Recently, the security of traffic carried by these storage solutions has come under greater scrutiny. Physical-layer intrusion detection, in which the optical networking platform is programmed to shut down service or take some other immediate, automated actions per level of signal degradation, has emerged as an important capability. In-flight data encryption also has emerged as an important last line of defense. WDM platforms can be deployed in tandem with recently released appliances that perform native storage area network (SAN) encryption without adding latency delay for sophisticated, real-time applications such as 1-, 2-, 4-, and 10-Gbit/sec Fibre Channel or FICON. Healthcare organizations, challenged by the high data-privacy standards set forth in the Healthcare Insurance Portability and Accountability Act of 1996 (HIPAA), find great value in these multi-layered defense strategies.
These and other enhancements have led healthcare organizations to deploy WDM-enabled optical networks. More and more hospitals, urgent-care facilities, diagnostic centers, research universities, and other healthcare institutions are turning to WDM to reduce network costs and enable virtually "flat-lined" telecom expenses over a period of sometimes longer than five years. Using WDM, healthcare IT departments can deploy and manage state-of-the-art data, voice, video, and storage services more easily and cost-effectively from the same optical networking platform.
Application revolution
The flexibility and cost-effectiveness of WDM has enabled a revolution in available applications for healthcare organizations to improve patient care, including:
Picture Archiving and Communication System (PACS) -- This advanced clinical service allows caregivers to digitally store, manipulate, and share cardiology and radiology images.
Grid computing -- The processing load is split among multiple desktop and laptop computers across geographically dispersed facilities, enabling academic researchers to more affordably and seamlessly collaborate.
Computerized Physician Order Entry (CPOE) -- Old, manual processes delay diagnosis and treatment and increase the potential for human error, hampering patient care and increasing costs. In CPOE, a caregiver accesses a patient's medical history and orders procedures from a handheld device.
Electronic record-keeping systems -- Nurses input patients' vital signs, symptoms, and medications directly into a healthcare organization's network via wireless laptop computers. Doctors can sign in, monitor their patients' progress, and order procedures more efficiently.
Physiological monitoring -- Telemetry data is relayed in real time from intensive-care units to enable constant monitoring and analysis of a patient's condition.
Robotic arm surgery -- A doctor views a magnified image of the patient and remotely guides a robotic arm. The capabilities of a precious resource--specialized, skilled surgeons--are extended remotely to areas where they were previously unavailable. Bleeding and post-operation recovery time are reduced because the robotic arm, unsusceptible to the tremors of a human hand, makes smaller, more precise incisions. This type of surgery is becoming more prevalent for an expanding range of operations, including removal of cancerous prostate glands, heart repairs, and gastric bypass.
Disk mirroring -- Via the Fibre Channel protocol, data is synchronously written to multiple data centers, ensuring continuity of care in the event of failure at any one of the sites.
In addition, many healthcare organizations seek to join collaborative research efforts, such as the National Lambda Rail (NLR) and Internet2 initiatives. The common requirement across all of these applications is the availability of reliable, secure bandwidth, which WDM cost-effectively delivers.
One hospital's experience
Healthcare organizations can follow a "make" or "buy" model in developing their geographically dispersed networking capabilities via WDM. In some cases (when in-house IT resources are insufficient, for example), a hospital might partner with a managed service provider. However, most healthcare organizations tend to favor the "make" route for one or more reasons. In building and managing its own optical infrastructure, a healthcare organization avoids dependency on the economic viability of a managed service provider and establishes a more predictable, more easily budgeted model for telecommunications costs. The organization's bandwidth budget will consist only of lease payments for dark fiber; operational expenses remain largely fixed over time, regardless of growth in bandwidth demand.
This was precisely the conclusion that New York-Presbyterian Hospital drew as it analyzed its options for meeting increased bandwidth demands. The benefits of long-term fixed opex fueled the capital expenditure (capex) cost justification for building and managing a WDM-enabled optical network. After a five-year run of 20% annual growth in bandwidth costs, NewYork-Presbyterian Hospital effectively leveled future bandwidth costs while accommodating bandwidth growth for at least the next 10 years by implementing a high-capacity DWDM solution.
Optical platforms are deployed at six of the hospital's major Manhattan campus locations, including data centers and patient-care facilities, in a ring/logical mesh architecture that measures 50 km in circumference. The network provides simultaneous support for 64 channels of data, voice, and video services of up to 10 Gbits/sec.
NewYork-Presbyterian Hospital now has the bandwidth necessary for PACS and other life-saving services. The network offers inherent support for Fibre Channel SAN applications so an updated copy of all data is always readily available. Its resilient network architecture has no single points of failure (SPOF). Even if the hospital loses power to a given location, pass-through traffic does not terminate on the impacted DWDM platform. And the network is flexible, allowing NewYork-Presbyterian Hospital to consider applications such as CPOE without increasing bandwidth costs.
Todd Bundy is director of business development and alliances and Bernard J. McElroy is vice president, business development, with ADVA Optical Networking (Mahwah, NJ, and Martinsried, Germany). They may be reached via the company's Web site at www.advaoptical.com.