St Vincent - Network Redesign and Clinical PC Deployment 051713

Catholic Healthcare Partners

Mercy St. Vincent Medical Center

Network Infrastructure Redesign & Clinical PC Deployment

BY

Randy Matthews, Dell Services Lead Consultant & Project Manager

May 2013

Mercy St. Vincent Medical Center2213 Cherry StreetToledo, OH 43608

Network Infrastructure Redesign & Clinical PC Deployment Site Information

Mercy St. Vincent Medical Center is a critical care regional referral and teaching center within the Mercy system. •Level 1 Trauma Center with a five Life Flight air ambulance fleet•Medical center is also home to the Mercy Heart & Vascular Center, the area’s first and only freestanding facility for the treatment of heart and vascular diseases•The Mercy Children’s Hospital is also located on site and provides care to the highest risk infants in the area•

65,471 Emergency Center Visits in 2011

19,254 Inpatient Admissions in 2011

1,446 Births in 2011

3,533 Employees

925 Physicians on Staff

550 Licensed Beds

Network Infrastructure Redesign & Clinical PC Deployment Site Information

Project

Network Infrastructure Redesign & Clinical PC Deployment Project Background

Multiple projects being driven by government mandated EMR requirement:1. CarePATH (EPIC) Electronic Medical Records Installation/Go-Live2. Clinical PC Deployment (New & Refresh of Existing hardware)3. New Parallel Network, Wiring Closet (IDF), Cable, and Fiber4. New Wireless Network

7/2012 to 8/2012 - Dell “Toledo Network Assessment”• The 30 Day Assessment was a collaborative effort with the St Vincent’s Facilities

team led by Dell Services PM Randy Matthews with support from 3 additional Dell Network Engineers.

• Applied Nov 2011 CarePATH (EPIC) Assessment to determine initial network and hw requirements for St Vincent, St Charles, & St Anne Hospitals

9/2012 – Start “Dell Network Infrastructure Redesign & PC Hardware Deployment”• Dell Project Manager and St V Facilities Management begin planning sessions.

Total project costs estimated at $14 Million for St Vincent Medical Center

Planning• Using the CarePATH team’s clinical assessment, identify PC, Network, and

Biomed hardware to be installed and the supporting facilities structure. Construct total budget for St Vincent, St Charles, and St Anne Hospitals. Identify work spaces, training areas, and command center locations.

Staging Centers• Construct space to store and configure PC/Network hardware.Training Centers• Build and equip space to train 2000+ clinical employees for CarePATHNetwork Infrastructure Redesign• Redesign of the wired and wireless networks to meet in-patient CHP

Standards and provide capacity to support the CarePATH project.Clinical PC Deployment• Equip in-patient rooms & clinical areas with new or refreshed PC’s along with

printers, laptops, portable devices, and Capsul where required.Command Centers• Design and construct Main Command Center and Physicians CC for two week

CarePATH Go-Live.

Network Infrastructure Redesign & Clinical PC Deployment Project Scope

• Project planning completed on 11/1/2012• Project’s Desktop team used for Reed Vision install in Dec 2012 (110 PC’s)• Clinical scope adds listed below resulted in an additional 300+ pieces of hardware from

December 2012 to March 2013

St Vincent ResearchSt Vincent Cath Lab (old Peds area) St Vincent Cath Lab in MOB1 St Vincent Anesthesia DepartmentSt Vincent Satellite Echo/Vascular labSt Vincent Diabetes Education Dept.St Vincent NICU construction/remodelSt Vincent Additional Training RoomsSt Vincent Various Department adds

St Charles Cancer CenterSt Charles ResearchSt Charles PharmacySt Anne Cancer CenterSt Anne ResearchSt Anne Pharmacy

Network Infrastructure Redesign & Clinical PC Deployment Project Scope

Kelley Recker, CHP CarePATH Clinical PMWilliam Sutton, St V VP of Operations Brian Sterns, Region CHP-IT Relationship MgrDiane Stanfa, St V Clinical PMDave Milhouse, St V Facilities MgrTodd Kwapich, St V Facilities LeadCathy McNutt, St V Biomed LeadDave Bell, Turner Electric PMJoe Barco, Turner Electric LeadCorey Pahl, Lake Erie Electric PMMike Laney, Lake Erie Electric LeadJasen Wagner, CHP Desktop LeadRob Squier, Dell Network ArchitectTom Irick, Dell Wireless ArchitectSandy Sandleben, Dell Network EngineerChris Hamilton, Dell Network Engineer

Dell Desktop Deployment (10 Contractors)Dell Network Deployment (2 Contractors)Radiant Wireless Networks (2 Contractors)Turner Electric (55 Electricians)Lake Erie Electric (20 Electricians)Bryson/Tucker ElectricDunbar Mechanical/HVACJDRM EngineeringVarious St V’s Facilities PersonnelVarious CHP-IT PersonnelCHP CarePATH Training TeamCHP CarePATH OTX Team

Network Infrastructure Redesign & Clinical PC Deployment Project Team (100+)

Dell Services Project Management – Randy Matthews• Weekly on site presence from 9/2012 to 5/2013• Conducted 8:30am Daily Planning & Status Meetings Monday - Friday with St V

Facilities Management, Turner Electric, Lake Erie Electric, Bryson Tucker Electric, Network Contractors, CHP Desktop Lead, CarePATH Implementation PM, St V Clinical PM, St V Biomed Lead, CHP-IT Relationship Manager.

• Tracked progress of all Dell and Facilities related activities and report in weekly status reports. Host weekly project status meeting for senior management every Thursday at 10am.

• Defined high level schedules for task completion of construction, electrical, cabling, and fiber. Define detailed schedules for wired/wireless networks and PC Deployment. Coordinate and adjust facilities and deployment schedules when necessary.

• Inventory accounting and control. Provided justification for additional purchases.

• Managed on site Dell contractors and vendors. Tracked contractor hours associated with Dell Task Order for Network and Desktop resources.

Network Infrastructure Redesign & Clinical PC Deployment Project Management

Staging and Training

Staging Center I• Requirement to store and configure 5,000+ pieces of hardware (pc, printers,

wall mounts, portable devices, network, cabling, & fiber)• 5,500 sq ft of warehouse space was identified and converted for staging &

storage. Space finished out with configuration tables, network switches, Fiber, AC Power, and data cabling to accommodate 96 workstations.

Staging Center I

Network Infrastructure Redesign & Clinical PC Deployment Staging Centers

Staging Center II• Once the majority of hardware was deployed in March, operations were

moved to main hospital’s 3rd floor vacant 3C unit for closer proximity to patient areas to facilitate OTX testing and Go-live support.

Main Training Center at Mercy College• An abandoned surgical unit with 12 Operating

Rooms was converted to accommodate 14 students per room

• Space clean up, lighting, network switch, UPS, fiber, data cabling, podiums, tables, and chairs were installed

• Site will also serve as the Metro Training Center for St Charles & St Anne Go-Lives in 2014

• Main Training Center can accommodate 200 students

Converted OR at Mercy College

Network Infrastructure Redesign & Clinical PC Deployment Training Centers

Physicians Training at St Vincent Medical Center• 4 rooms required were created on the 7th Floor and in MOB1 Cath Lab• Network switch, UPS, fiber, data cabling, tables, chairs were installed• Physician training center can accommodate 60 students

Network Infrastructure Redesign

Network Background• St Vincent IDF (wiring closets) layout origins date back to the early 1990’s and was

based upon space availability with a small switch architecture resulting in scattered small closets throughout.

• 80% of the existing data cable was out of spec Cat5.• Cisco 4506 chassis based switches were at or nearing “End Of Life”.• Legacy Wireless network was not capable of servicing clinical and patient wireless

devices such as laptops, smart phones, and tablets.

Design Goals• Bring Facility to compliance with the CHP Network Team’s “In-Patient Network”

specification and provide CarePATH Capacity.• Reduce wiring closets per floor by consolidating/centralizing in order to fully utilize

network, fiber, cabling, HVAC, and closet space investment. • Position sites to move off of 100mbps (Cat5) to 1gbps (Cat6) for improved

desktop/device connectivity.• Design wireless capacity to support clinical, patient, and voice usage.

Network Infrastructure Redesign & Clinical PC Deployment Network Infrastructure Redesign

Implementation of New Network/IDF Architecture – Transitional State until 2014• A new parallel network was constructed with the creation of either new closets or

the expansion of existing ones. In the main hospital, network core switch locations on the 5th floor (TD-5) and in the Basement (TD-G-PBX) remained static. Access to an abandoned dumbwaiter shaft in the Basement location was utilized for electrical risers, cabling and fiber runs routing to new and existing stacked closets on each of the main buildings 8 floors. These wiring closets are centrally positioned from a cable length perspective to serve the majority of the hospital’s in-patient areas where CarePATH clinical pc concentration is the greatest.


New TD-3 Today services new CarePATH & Wireless ports, In 2014 3J & C3 will be decommissioned and cabled to TD-3

Existing C3With Cat5/4506

Existing 3JWith Cat5/4506


Existing TD-6Existing Cat5/4506

Expanded TD-6 Today services CarePATH and Wireless Ports, In 2014 the existing Cat5/4506 pictured on the left will be migrated/removed

IDF Configurations• Edge IDF: Cisco 4510 network switches, APC 6000 UPS, 50 micron fiber

connectivity to the cores, Cat6 cable plants in both new and expanded closets for new CarePATH Clinical PC’s, Printers, Capsuls, and wireless network.

• Core IDF: Cisco 6509 Core network switches, APC 6000 UPS, 50micron fiber patch panels. There are two sets of cores, the existing set and the new set in TD5 and TD-G-PBX. They redundantly service the entire St Vincent Medical Center Campus switch infrastructure.


Description Counts

IDF Wiring Closet – Expanded 8

IDF Wiring Closet – New 10St Vincent Facilities Team

• Today a total of 30 IDF’s exist• 7 IDF’s will be eliminated in 2014 post Cat5 to

Cat6 cable migration• IDF Locations

St Vincent BuildingsMainRegional Heart & VascularSchool of NursingLife Flight HangarSecurityMob1Mob2

Remote BuildingsSunforestArrowhead SurgeryPerrysburg YMCASt CharlesSt Anne

IDF Construction


Description Counts

110v Circuits 18

208v Circuits 98

50 Micron Fiber Runs 70

Cat6 Cable Runs 2300

St Vincent Facilities Team

Existing TD-M-EExisting Cat5/4506

Expanded TD-M-E Today services CarePATH and Wireless Ports, In 2014 the existing Cat5/4506 pictured on the left will be migrated/removed

Electrical, Fiber, & Cable Installations


Description Counts

Cisco 4510 Network Switch 30



APC 6000 UPS 27

Cisco Wireless Controllers 4

Cisco Wireless Access Points 740

CHP Network Team

Expanded TD-G-PBX 1 of 2 Core Network Switch Locations New TD-G-ACC Ambulatory Care Center

Network Installations

Clinical PC Deployment

Description Counts

PC Wall Mounts 272

Capsul Brackets 170

Electrical Outlets 500

Description Counts

Capsul 170

St Vincent Facilities Team

St Vincent Biomed Team

Network Infrastructure Redesign & Clinical PC Deployment Clinical PC Deployment

Wall Mounted PC

Capsul

Networked Capsul Installations

General Construction & Electrical

Description Counts

Desktop PC 1046

Laptops 56

Track boards 4

WOW Carts 80

Barcode Scanner 950

Card Readers 1650

LaserJet Printers 33

Intermec Printers 20

Zebra Printer 41

Clinical PC Deployment Team


New PC Hardware Installations

Description Counts

Desktop PC 240

Laptops 7

LCD Monitors 1275

LaserJet Printers 9

MFD Printers 38

Clinical PC Deployment Team


Refresh PC Hardware Installations

Command Centers

Main Command Center• Auditorium and Conference Room 2 opened up to create one large space.• Equipped with 54 workstations. The additional ac power and data cables were

installed in temporary overhead raceways. New tables, chairs and projectors also installed.

• Installed 47 VOIP phones utilizing the Cincinnati Call Manager with predefined extensions for the CarePATH Go-Live departments.

Main Command Center

Network Infrastructure Redesign & Clinical PC Deployment Command Centers

Main Command Center Layout (3000 sq ft)



Physicians Command Center Layout (600 sq ft)• Conference Room 1 converted for the Physicians• Equipped with 37 workstations, network switch, additional ac power and

data cabling . New tables, chairs and projectors installed

Project Wrap Up

• Declared a successful Go-Live by the CarePATH, CHP-IT, and St Vincent Senior Leadership Teams.

• 200 technical tickets for desk side support during the two week period that the 24x7 CarePATH Command Center was in operation.

Network Infrastructure Redesign & Clinical PC Deployment CarePATH (Epic) Go-Live

Resolved before Go-Live• Accelerated timeline to complete physical network infrastructure• Scope creep with additional sites and departments• “Fast User Switching” Desktop Configuration not ready by established date.• Citrix performance/Capacity

Unresolved• Domain not migrated – domain project for St Vincent was postponed• Previous GPO’s inconsistently applied to OU’s• End user OBIX configuration not optimal, Nursing and physicians on different

domains

Network Infrastructure Redesign & Clinical PC Deployment Major Challenges

St Vincent Medical Center1. Ascom to Cisco Wireless Phone Migration2. Existing Cat5 to Cat6 Migration/Demo

St Charles Hospital1. New Parallel Network, IDF, Cable, & Fiber2. Wireless Network Refresh3. Ascom to Cisco Wireless Phone Migration4. Clinical PC Deployment (New/Refresh)5. CarePATH (EPIC) EMR Install/Go-Live6. Cat5 to Cat6 cable Migration/Demo

St Anne Hospital1. Network Switch Install/Net New Cable2. Clinical PC Deployment3. CarePATH (EPIC) EMR Install/Go-Live

Toledo Metro Hospitals1. WAN Sonet Ring Replacement2. AD Domain Migration3. Wireless SSID Standardization

Network Infrastructure Redesign & Clinical PC Deployment Next Steps

Projects to be scheduled are listed by site in their logical order:

St Vincent - Network Redesign and Clinical PC Deployment 051713

Documents

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