Healthcare ICT Trends & Innovation: Passive Optical LAN (GPON) for the New Era

Michael Wilson, RCDDSolutions Engineering Manager, Tellabs Access

Darren Vican, RCDD, OSPVice President, RTKL

3/17/2015

3/17/2015

Clinical SystemsClinical Systems

PatientPatient

OperationsOperationsSmart BuildingSmart Building

Medical Technology

PhysicianPhysician

Hospitals of Yesterday

Disparate Infrastructure & Networks for Each

Community

DAS & LMRDAS & LMR

Clinical SystemsClinical Systems

PatientPatient

CommunityCommunity

OperationsOperationsSmart BuildingSmart Building

Medical Technology

PhysicianPhysician

Digital Hospital Redefined

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Truly Converged IT Systems

DIGITAL HOSPITAL

DAS & LMRDAS & LMR

Current Trends in Healthcare ICT• Patient & Physician Centric Systems: Interactive Entertainment

& Education Systems, Wireless, & Video Conferencing, Real Time Collab.

• Potenial Financial Losses: Wait, what?

• 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

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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**

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*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

• Data Breaches• 42% of breaches are caused by malicious or criminal attacks***• 30% of breaches are caused by human error and mis-configurations***

Current Reliability in Healthcare ICT

* Source: Cisco Enterprise Campus 3.0 Architecture: Overview and Framework http://www.cisco.com/en/US/docs/solutions/Enterprise/Campus/campover.html#wp709323

This architecture requires the use of two network interface cards in each end-user workstation

Reliability  99.938% = 325 downtime Minutes/Year  

Reliability  99.9961% = 52 downtime Minutes/Year  

Reliability  99.999% = 5.26 downtime Minutes/Year  

~ 5.5 hours

~ 1 hours

~ .1 hours

“EXPECTED” 2,500 User Network Downtime Cost per 

Year

Not practical or cost effective

Ugly Reality in Healthcare ICT

99.9961% Legacy Network Downtime/Year

Sample 2,500 User/Patient Hospital ALREADY experiences losses due to ‘acceptable’ networks and infrastructure with poor reliability

2,500 Users @ $56/Hour for 52.56 Mins:

• More Technology Rooms

• More (and larger) Switches

• Larger Technology Rooms

• Larger Pathways

• More Power and More Cooling

• More Communications Cabling

• MoreWireless Networks

• More Antennas

• More IT Staff to React to Downtime

Current ICT Answers in Healthcare

Healthcare Infrastructure of Yesterday12 – 24 Cat6 Cables

per Critical Care Room

12 – 24 Cat6 Cables per

Specialty Suite

12 – 24 Cat6 Cables per Patient Room

12 – 24 Cat6 Cables per Operating

Room

Layer after Layer of Core, Distribution &

Access Switches and their Backups

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)

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12 – 24 Cat6 Cables per Critical Care

Room

12 – 24 Cat6 Cables per

Specialty Suite

12 – 24 Cat6 Cables per Patient Room

12 – 24 Cat6 Cables per Operating

Room

Layer after Layer of Core, Distribution &

Access Switches and their Backups

Healthcare Infrastructure of Today2 - 4 Strands of

Fiber per Critical Care Room

2 - 4 Strands of Fiber per

Specialty Suite

1 – 2 Strands of Fiber per Patient Room

2 - 4 Strands of Fiber per Operating

Room

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Passive Splitters = Simplicity, no HVAC,

& Smaller Closets

Why Passive Optical LAN for Healthcare“EXPECTED” Network 

Downtime Cost per YearReliability  99.9961% = 52.56 downtime Minutes/Year   ~ 1 hours

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

2x32

1310nm: GPON Upstream (1.24Gbps TDM)1490nm: GPON Downstream (2.48Gbps TDMA)1550nm: RF Video Downstream

Core Network

OLAN OLTs(Primary & Redundant)

Passive Splitter Optical Network

Terminals

RF Video Fiber Amplifier

QAM or Broadcast

Video

Passive Optical LAN Schematic

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Each OLT can support over 8,000

Gbe PoE+ Interfaces from a single managed IP

Each Gbe Interface can provides:• 8 VLAN queues• 256 MACs• L2 – L4 ACLs• PoE/PoE+• 802.1x/NAC

1270nm: 10GPON Upstream (10Gbps TDM)

1577nm: 10GPON Downstream (10Gbps TDMA)

Concurrent 1Gbps & 10Gbps

Operations

Patient Monitor

VoIP & AnalogPhone

WiFiAccess Point

SurveillanceCamera

Video Conferencing & Telemedicine

Building Automation Systems

Medical Imaging

RF Video

IP Video

IP / EthernetData

VoIP

Analog Voice

RF and IPPatient Entertainment & Education

Nurse Call

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True Healthcare ICT Convergence

RTLS Systems

2:32

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Legacy Copper Networks of Yesterday…

…Become Simple Fiber Networks of Today

• Passive Splitter Device• Ceiling, Floor or Closet• Zero power required• Zero HVAC required

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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

• Layer‐1 Redundancy in variousoptions & configurations

• Sub‐second optical failover of allONTs

• Provides N+1 Power Capabilities tothe ONTs

• OLTs can be provisioned to shareprimary and failover loads formaximum upstream connectivity(80G max)

• Provides <5‐second total systemfailover, or greater than 6‐9s ofavailability

Floor 1: Closet based splitters, redundant SMF trunk between IDF stacks for 2:32 splitter dual homing

Floor 2: Closet based splitters, redundant SMF trunk between IDF stacks for 2:32 splitter dual homing & 

ONT N+1 powering

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

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OLAN Healthcare Redundancy

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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)

OLAN Standards Compliance

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

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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

OLAN Standards Compliance

– 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

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

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

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

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

Moose Jaw

Relevant Healthcare Deployments

Healthcare ICT Trends & Innovation: Passive Optical LAN (GPON) for the New Era

Michael Wilson, RCDDSolutions Engineering Manager, Tellabs Access

Darren Vican, RCDD, OSPVice President, RTKL

3/17/2015