Unit-2 Progressive Hospital Case Study

Unit-2 Progressive Hospital Case Study

Unit-2 Progressive Hospital Case Study has a failover / fault tolerance system in place to ensure a link between the two sites is maintained in the event of a failure in the dedicated fibre connection.

Unit-2 Progressive Hospital Case StudyAn entirely separate connection between the sites is created using additional routers at each site connected by a 6Mbps microwave link.

Cisco Hot Standby Router Protocol is used to monitor the state of the primary connection (fibre link) between the two sites and if this connection fails for any reason, all traffic is diverted to the standby routers and is thus transmitted via the microwave link.

The 6Mbps capacity of the standby link would not be sufficient to provide full services, but would at least allow essential connectivity between the sites to be maintained.

Description of Protocols

   LAN Protocols

The site uses TCP/IP exclusively, and Ethernet (IEEE802.3) and Gigabit Ethernet (IEEE802.3z) to support this.  Speeds include 10Mbps, 100Mbps and 1Gbps.  Gigabit Ethernet is for the link between the 2 sites.

  Network Management Protocols

SNMP is the network management protocol used on site, largely because the key managed devices and tools used on site are all SNMP based.

   Hot Standby Router Protocol

Hot Standby Router Protocol is used to provide network redundancy, ensuring connectivity between the two main sites in the event of failure of the main fiber connection.


CCHB use L2TP to create a Virtual Private Network connection between users’ home PCs and the CCHB network, over the Internet.


While L2TP ensures the transfer of unsupported data across the Internet, it does so in clear text.  IPSec is used to encrypt the data prior to encapsulation to provide authentication, confidentiality and integrity.

Unit-2 Progressive Hospital Case Study


Wired Equivalent Privacy is an encryption algorithm defined in the IEEE802.11 standard for encrypting data on wireless LANs.  It has several weaknesses that result in wireless LANs being considered as security risks.  The main weakness of WEP is the way in which data is encrypted and the fact that a hacker can use a ‘sniffer’ to crack the encryption key.

   Frame Relay

Frame Relay is the Wide Area Network protocol used by CCHB to implement Permanent Virtual Circuits between the main sites and their Community Clinics.

 Network Management Software 

All servers managed by the Network Operations team are Compaq servers.  A server tool, Compaq Insight Manager, is used to maintain a view of the server states.  This view uses colours to indicate the status of each server and allows the Network Operations staff to drill down to individual servers to view a number of elements including network and disk state information, eg statistics on CPU usage, and disk health.

WhatsUp Gold and CiscoView are used to keep track of the network operations.  CiscoView provides a view of the current state of any given switch, with the ability to drill down and access detailed performance information regarding the traffic active on the switch.  Cisco provides WhatsUp Gold bundled with CiscoView for use as a network mapping and monitoring tool, which has been used at CCHB to map the Core and Building Switches.

Compaq Insight Manager, WhatsUp Gold and CiscoView all run on a management PC in the Network Operations area at CCHB.  3 monitors are connected to the PC to allow concurrent viewing of the 3 main screens: the server states, the switch states, and the core link between the sites.

Performance Management

§  ensuring the network is operating as efficiently as possible

A 3rd party service provider, IPClarity, provide a performance monitoring service.  The company provide a hardware device (called a ‘DataSink’) which is connected to the CCHB network.  This ‘box’ polls devices on the network to gather information about their state.  The DataSink can auto-discover SNMP capable devices on the network and can include these in the monitoring if configured to do so.  The polling results are forwarded to the IPClarity central database where they are compiled and made available in the form of web-based reports and alerts.  The CCHB Network Operations staff can access realtime information to see current and recent statistics on many variables.

The service can provide reporting on: CPU performance, up/down status, latency from the DataSink to the device, availability, free memory, and buffer utilisation.

IPClarity is a fully managed service, provided and managed offsite and accessed via a web interface.

Reporting can be carried out on live data or historical data.  Filter reporting can allow the site to identify any potential bottlenecks or trouble points (eg list the 10 most error-prone ports) and therefore allow opportunity for better optimisation of the network.

CCHB has access to the last week’s worth of data in online, realtime reports to view any recent trends.  The service can provide up to a year’s worth of data for live reporting and data is stored for 3 years.

Unit-2 Progressive Hospital Case Study

The IPClarity service  includes threshold alert functionality, where thresholds can be configured and alerts raised if the threshold is exceeded.  Alerts can be sent using SMS (short messaging service), or email, or simply logged.  Additional configuration options allow the site to specify the period for which the level is sustained before alerting; a period of time or counter in which not to raise the same alert again, or request not to be notified again unless it drops back to a pre-defined level.  However, CCHB do not make use of the alert functionality –  the Network Operations Manager believes that they hear of bottlenecks, issues, etc from users just as quickly as they would from alert reporting.  CCHB has 24 hour network support, so any queries are directed to the on-site or on-call staff.

The Internet is widely used by staff members, with a few key websites particularly popular.  The Network Operations team use Latency Testing provided by the IPClarity service to monitor the latency on some popular websites, to help ascertain whether any speed problems are internal network issues.  This is done using a ping and HTTP request.  The XTRA DNS router (closest point), NZ Herald (reliable NZ site) and Recruitsoft (US site popular with hospital staff) are all monitored.

Compaq Insight Manager

Performance monitoring of CPU, PCI and EISA bus utilization in the Compaq Servers is possible with Compaq Insight Manager.  It allows the setting of thresholds on parameters such as CPU, bus and disk partition usage for performance monitoring.  However, CCHB don’t use the Performance Monitoring functionality of the software.  They do use the drilldown capability of the software to view individual details for a server in a Fault Management capacity.


CiscoView is partly used for performance management, with the ability to drilldown to view current performance statistics on individual routers (Layer 3 switches), however, CCHB generally make use of CiscoView for Fault Management.

Hardware Tools

All cabling is outsourced by CCHB and is warranted by the suppliers, so the CCHB network team don’t make any real use of tools such as cable testers, LAN analysers, reflectometers, etc.

 Other Software Utilities

PerfMon (to capture and analyse performance statistics) and NetMon (to capture and analyse network packets) are used on occasion if required to investigate a specific problem.  Event Viewer is used to monitor Servers, and the site are investigating the use of Microsoft SMS (Systems Management Server) for planning, deploying and managing software applications.

Organisation of the Operation and Maintenance functions

The City Centre Health Board network and data communications are a centralised system with a hierarchical structure, and consistent protocols, equipment, and management across the whole network.  One central team is responsible for managing all network related activities and they are also responsible for integrating any new network requirements appropriately into the existing framework.

For example, in 2003 the Radiology department completed an 18 month long implementation of a new computerised Radiology system (PACS) which manages the production and storage of all radiology images (MRI, CT, X-ray, etc).  The system replaced the hardcopy filing system and is now producing over 20GB worth of images per day which must be created, transported and saved, and be available realtime for retrieval by specialised diagnostic workstations.  Rather than implementing a separate LAN to support this new system, the support for the system was incorporated into the existing infrastructure.  This saved on duplication of hardware (media) and ensured full interoperability with other hospital systems.  A VLAN was created to separate the significant amounts of data from the rest of the hospital network.

MAN and WAN management is outsourced to Telecom New Zealand Ltd, and remains part of the responsibility of the centralised Network Operations team.  Telecom’s LANLink Managed Network Service is used to manage the Mayoral Drive switch and the Frame Relay connections between the Community Clinics and the main sites.

Tasks are spread across the Network Operations team, ensuring a multi-disciplinary team.  Documentation is used to assist in ensuring consistency in actions and tracking of activities.

The site does not have a specific maintenance plan.  Service Packs and non-critical updates are applied whenever a server is having other work done on it.  Critical updates are applied as they are released.  Other network maintenance is done on an ‘as required’ basis.

The site maintains 24 hour support by having Primary and Secondary on-call staff.  They are required to respond within 15 minutes.

User access to servers, applications, etc on the network is by exception – users start with minimal Internet access (a few approved sites) and a few basic applications.  Any additional access is requested and granted if approved.  The integrity of the machines is protected by user awareness and culpability.  With 15000 users and a 20% staff turnover rate, the Network Operations team felt that trying to manage Group Policy and Profiles could prove very time consuming.  Instead, CCHB have a user-pays policy.  CCHB allow a user one incident where a PC needs significant attention due to careless use of the machine/resources (eg as a result of inappropriate Internet access). Any future incidents cost the user personally, at $500 each.

Any software installation on a client PC is attended to by a Network Operations team member (staff do not have permissions to install software). 

Backup Systems

The site uses Veritas Backup Exec to backup server data, using daily incremental backups.  Two copies are made of each backup and are stored separately in different locations (buildings) from the servers.  Data redundancy is also ensured on the servers by using RAID 5 or disk mirroring.

800GB of data is backed up per day on each of the two main sites.

The Requirement 

Due to the increase in the number of customer base it is envisaged that the existing City Centre hospital is to be extended to cater to an additional 2000 patients and 100 staff members. The areas of expertise in the new facility would be spread across all areas of the medical discipline as in the existing set up at the City Centre and the Remuera sites. A network needs to be established for the new extension and integrated with the rest of the existing network at the city centre site. The IT manager is expecting the network traffic to increase in proportion to the additional load. As for the other requirements like performance management and security, these would be at a level no lower than the existing set up. A possibility of change in the existing infrastructure in addition to the media and equipment for the new facility as a consequence of the integration would also need attention.  The new extended network design is anticipated to cater to Vo-IP and other requirements well into the next five years.  The senior nursing and medical staff that would be 50% of the total staff members are expected to be connected on an anytime anyplace basis. The hospital CEO has also recommended that you explore the possibility of video conferencing involving document/radiological/surgical procedure exchange in the new network design.

List any assumptions being made for the requirements analysis, the logical design and the final physical design.  Assumptions being made should be supported by research for both the standard and specialist applications in a modern medical facility.Order Now

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