1. OVERVIEW
Scope of the Project
RapidCare will house 250 physicians that practice over 25 specialties. The clinic will
specifically house departments such as a central lab, a pharmacy, billing and
administrative offices, a surgical center, a radiology department, and various specialty
clinics. The clinic will be in the heart of the State of Alabama’s largest city,
Birmingham. Birmingham has over 1 million people living in its metro area, with roughly
242,000 people living within its city limits. Due to the facilities size, a large span of
specialty practices and location the facility can expect to serve a large number of patients
per year. In addition, due to cost inefficiencies throughout the health care system, many
health care organizations have shifted the reliance on traditional hospitals for the delivery
of care to either affiliated or non-affiliated outpatient or ambulatory care centers, such as
RapidCare. Not only will the reliance on health care information technologies and robust
networks be vital to connect an affiliated or non-affiliated network of care providers be
critical, the linkage of these networks within a health care organization and beyond will
likely be key. As a result, patient data is growing more voluminous as each year passes
and issues of fiscal and clinical efficiencies and patient safety are only growing in
concern. Also, as the traditional delivery method of health care is shifting to a more
fragmented and disparate model, the management of patient and clinical information will
more than likely be critical going forward. As a result of these fiscal and clinical
inefficiencies, health care costs have reached an apex. In response, the health care
industry is heavily relying on HIT to implement electronic medical records, computerized
physician order entry systems, clinical decision support systems and other technologies to
help practitioners and care providers achieve greater efficiencies by more effectively
managing and responding to critical patient data. A great example of the reliance of these
systems is through the passage of the HITECH Act through ARRA legislation. As a
result, the federal government predicts these systems will save the health care industry
billions of dollars each year by the effective management of data and will ultimately
improve patient safety. Due to the shift in focus in the health care industry on process
efficiency and patient safety, our team recognizes that RapidCare must employ the use of
EHR, CPOE, and CDSS systems. Therefore, this proposal hopes to achieve a
comprehensive solution to address the robust communication needs that RapidCare
expects and the industry demands.
Objective of the Network
The sheer development of a robust IT network only will not, in itself, be the only factor
to achieve the clinical and informational efficiencies that RapidCare demands. Therefore,
our team has outlined 6 specific goals that, if achieved, will make this implementation an
overall success. The following are the specific goals in detail:
1. Security: Of all the industries that place a premium on secure IT networks, the health
care industry likely ranks at the very top of the list. Health care organizations have a
voluminous amount of patient specific clinical data such as charts, diagnosis, and
medications. In addition to clinical data, these organizations also keep patient specific
administrative data such as names, addresses, social security numbers, and financial
information. Network security threats are evolving rapidly from the relatively
simplistic hackers to a very sophisticated network of organized IT criminals. Due to
the shift of housing this information from the traditional paper and filing systems to
electronic filing systems coupled with the alarming growth of sophistication of the
network hackers, keeping this highly sensitive information safe and secure is at a
premium. Just like the IT criminals, the nature of their network attacks varies in
nature. Some attacks have no motive other than to create malicious activity on the
network. These attacks often cause harmful problems not only in the business and
process efficiencies of the network, but more critically, can interfere with the delivery
of critical patient care. Other attacks are more specific in nature and are created to
steal the personal information of patients. These attacks are lucrative for the
criminals, but they are as equally devastating to the victims and the health
organization that was compromised. Government regulations such as the Health
Insurance Portability and Accountability Act (HIPAA) require that health
organizations keep sensitive patient information safe and secure. In order to protect
patients against these network threats and to protect itself against heavy government
penalties, our solution will address the security needs of RapidCare by developing
comprehensive and integrated safeguards throughout the network.
2. Integration: Due to the large number of different specialty areas housed throughout
the clinic, each area will require and rely upon many different disparate systems to
achieve the overall efficiencies and reliability they expect. Therefore, the RapidCare’s
network will be robust enough to allow compatibility and integration among these
systems.
3. Versatility: RapidCare will employ the use of many types of data files such as text,
graphics, audio, and video. Due to the needs and demands from each department, the
network will allow each department and its end-users to retrieve, process, share and
store all data such as a simple patient demographics file to as large and complex as a
3D radiological image.
4. Collaboration: RapidCare will not only have the need to share and transfer data and
information within the walls of the clinic, it must also have the ability to share data
beyond the walls of the clinic in order to achieve the comprehensive care that the
industry and patients alike demand. Therefore, the network will be robust enough to
allow the clinic to easily and efficiently share various types of data.
5. Scalability: The demand for highly effective and highly efficient patient care has
served as the catalyst for the rapid change of health care information technology over
the past several years. Therefore, the network will not only have to be robust and
comprehensive enough to meet their IT needs today, but must be scalable enough to
meet future demands without overhauling the entire network. The proposed network
will be solid enough to achieve these demands.
6. Training: The power and efficiency of the network will be for naught if RapidCare
does not understand the network, its capabilities, and threats. Our team will ensure
that this need is met by scheduling comprehensive training sessions with appropriate
staff who will be concerned with the day to day operations of the network.
Intended Users
The primary users of the network will be physicians, physician-assistants, nurse
practitioners, nurses, pharmacists, lab technicians, clinical technologists, departmental
administrators, departmental financial staff, and other personnel.
Assumptions
(group input??)
2. NETWORK ANALYSIS
Data Types: The data types at RapidCare will both be similar and varying among the
number of departments within the clinic. The following are the specific data types within
the network:
 Text: Patient demographics, patient charts, billing information, and various
reports
 Graphic: X ray images, CT images, MRI images, pictures, and various other
clinical images.
 Voice and Video: VOIP, teleconferencing, and various clinical video images.
Data Sources: Data will be created and used at all of the various workstations throughout
the RapidCare clinic. There are 231 data/voice jack locationsindicated on the plan
throughout the clinic. Each location will have two data drops and two voice drops of
CAT6 ethernet. Therefore, the network could support 924 wired devices. The types of
equipment will vary among each department. These equipment types might include:
o PCs, Printers, and Scanners
o IP Phones
o Lab equipment
o Radiological equipment such as X ray machines, CT scanners, and MRI
machines.
o Biomed Equip such as infusion pumps, medicine dispensers.
o Bedside equipment
o Surgical Equipment
o Software
Number of Users: RapidCare contains a central lab, radiology, surgical suites, other
medical offices, and a retail pharmacy. RapidCare houses more than 250 physicians in
the specialty areas of ENT, Internal Medicine, GI-Endoscopy, Cardiology, General
Surgery, Dermatology, Neurology, Hematology/oncology, OB/GYN, and Orthopedics. It
has been assumed that each area of the clinic has at least 7-10 support staff. Therefore, it
can assumed that there are at least 200 additional staff working at RapidCare resulting in
a total of around 450-500 end-users.
Transmission Speed Requirements: The network at RapidCare must be powerful, fast,
secure, and efficient enough to meet all of its current and future IT demands. To support
these demand, our team will deploy a Gigabit Ethernet capable infrastructure througout
the clinic.
Load Variation Estimates: Unlike traditional industries, health care peak business hours
can vary. However, our team as estimated that due to the fact that RapidCare is an
outpatient center, the clinics peak load will likely be during the hours of 7AM-7PM
Monday-Saturday. (Tom input needed)
Network Storage Requirements: The implemented network must have sufficient
storage, archival and retrieval capabilities to handle the enormous amount of data and
data types, as well as support the numerous complex data sources which were listed
previously in this document. In addition, there could be 450-500 end-users that stressing
the network infrastructure with demands of their own at a given time.
Reliability Requirements: Industry standards require that any given network achieve at
least 99.99% uptime annually. Therefore, assuming that RapidCare will be have network
needs 24 hrs per day, 6 days per week for 52 weeks per year results in roughly 7,500
network hours per year. Therefore, the maximum amount of unplanned downtime the
network will have is a total of 7.5 hours per year. Redundant systems will be used to
achieve this reliability level.
Security Requirements: As detailed previously as one of our primary network goals, the
following are the network security requirements for RapidCare:
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Firewalls: A network firewall is a highly effective security tool that surrounds the
network and serves as a secure buffer between a private network and an outside
network such as the internet. Firewalls specifically will help RapidCare to ensure
that only authorized personnel access to its network and the sensitive information
its patients, block potentially dangerous transmissions from both internal and
external users, and provide internet and email filtering capabilities.
Intrusion Prevention Systems: IPS supports the network firewall and serves as an
added protection against outside attacks to the network. If an attack makes it
through the firewall, the IPS will detect this attack before any damage can be
done. Once the attack is detected, the IPS will alert administration, stop the
hackers, and can assist in reconfiguring the system to prevent future attacks.
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Wireless Intrusion Prevention System: The wireless IPS is very similar to the
traditional network IPS, except that the wireless IPS is specifically designed to
monitor and prevent attacks on the wireless network and devices.
3. NETWORK DESIGN
(Bill’s diagrams and description inserted here.)
4. EQUIPMENT DETAILS
The following is a detailed least of equipment that has been identified to support
RapidCare’s network needs:
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Category 6 Ethernet cable: is the standard cable to support 1 gigabyte Ethernet
speeds and is designed at frequencies up to 250 MHz. In addition, Cat 6 helps to
reduce cross-talk and electron magnetic interference.
Single-mode Fiber Cable: Fiber cable is ideal for supporting networks that
require high speeds, a large carrying capacity, over a long distance, and with
increased resistance to electromagnetic interference. Fiber will serve as the
horizontal backbone of the clinic and will be the closet-to-closet connection on
each floor.
RJ45 jacks: RJ45 is an industry standard, 8 conductor, modular jack that is
specifically designed to terminate UTP data cable and support various types of
Category 5 and 6 cable.Racks: APC NetShelter SX 48U racks, Feature-rich
enclosures optimized for easy installation, managing cables, integrating power
distribution, and maximizing airflow. Racks will include ceiling fan trays with
thermostats to aid in cooling.
Cisco 3800 ISR router: This router delivers the performance, availability, and
reliability required for all mission critical business applications in very demanding
environments. The features include built in security, service device manager,
modular platform with a broad range of interface options, up to two built in
10/100/1000 Mps built-in routed ports, up to 112 10/100 Mps switch ports with
optional power over the Ethernet, up to 2500 VPN tunnels, Call Manager Express,
Survivable Remote Site Telephony, Support for WLAN, Support for Small Form
Factor pluggable port gigabyte Ethernet, and built in redundant power supply.
Cisco ASA 5510 Firewall: An Adaptive Security Appliance that has a robust
suite of highly integrated security services. It also offers the most proven
firewall; a comprehensive, highly effective intrusion prevention system (IPS) with
Cisco Global Correlation and guaranteed coverage; high-performance VPN and
always-on remote access, the Cisco ASA 5500 Series helps organizations provide
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secure, high performance connectivity and protects critical assets for maximum
productivity
Cisco 1200 wireless access point: The Cisco Aironet 1200 Series Access Point is
a single band lightweight or autonomous access point with dual diversity antenna
connectors for challenging RF environments. It offers the same versatility, high
capacity, security, and enterprise-class features demanded by industrial wireless
LAN customers in a single-band 802.11g solution.
Cisco Wireless Control System: Software program that allows the user to plan,
deploy, monitor, troubleshoot, and report on WLAN. The program improves
efficiency through easy to use GUI and scales to support a WLAN of any size.
Cisco Security Agent v5.2: Cisco Security Agent security software provides
threat protection for server, desktop, and Point-of-Service (POS) computing
systems. Cisco Security Agent goes beyond conventional endpoint security
solutions by identifying and preventing malicious behavior before it can occur,
thereby removing potential known and unknown security risks that threaten
enterprise networks and applications. Cisco Security Agent mitigates new and
evolving threats without requiring reconfigurations or updates on endpoints,
providing robust protection with reduced operational costs
IronPort C160 email security: The Cisco IronPort Email Security Appliance
X1070 delivers high-performance protection for the most demanding networks in
the world: the ISPs and large enterprises that are the primary targets of spam and
viruses. The X1070 provides high email security on a platform that can meet
today's demands for innovation and tomorrow's demands for scalability. IronPort
preventive filters and signature-based reactive filters, combined with content
filtering and Cisco partner technology, provide high levels of email security with
innovative visibility and management tools.
Cisco Catalyst 3750 Switches (stacking): The Cisco Catalyst 3750 v2 Series are
next-generation energy-efficient Layer 3 Fast Ethernet stackable switches. These
new switches support Cisco Energy Wise technology, which helps you manage
the power consumption of your network, thereby reducing energy costs and
carbon footprint. The Cisco Catalyst 3750 v2 Series consumes less power than its
predecessors and is an ideal access layer for enterprise, retail, and branch
environments. It helps increase productivity and protects your network investment
by providing a unified network for data, voice, and video.
Cisco Unified Communications Series 500: Communicate effectively by
reaching the right resource the first time. Now your small business can deploy an
affordable, easy-to-manage communications system with Cisco Unified
Communications 500 Series for Small Business. The series supports from 8 to
104 users in flexible deployment models based on your needs, a wide array of IP
phone models, public switched telephone network (PSTN) interfaces, and internet
connectivity with security services. The series eliminates the need for multiple
servers and combines voice, data, video, security, and wireless capabilities. It
integrates with existing desktop applications such as calendar, email, and
customer relationship management (CRM) programs.
Cisco 4400 WLAN controller: Cisco Wireless LAN Controllers are responsible
for system wide wireless LAN functions, such as security policies, intrusion
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prevention, RF management, quality of service (QoS), and mobility. They work in
conjunction with Cisco Access Points and the Cisco Wireless Control System
(WCS) to support business-critical wireless applications. From voice and data
services to location tracking, Cisco Wireless LAN Controllers provide the control,
scalability, security, and reliability that network managers need to build secure,
enterprise-scale wireless networks-from branch offices to main campuses. Cisco
Wireless LAN Controllers smoothly integrate into existing enterprise networks.
They communicate with Controller-based Access Points over any Layer 2
(Ethernet) or Layer 3 (IP) infrastructure using the Lightweight Access Point
Protocol (LWAPP). These devices support automation of numerous WLAN
configuration and management functions across all enterprise locations.
APC Symmetra Battery Backups: The APC Symmetra PX is a world class,
redundant, scalable, power protection system designed to cost effectively provide
high levels of availability. Seamlessly integrating into today's state-of-the-art data
center designs, the Symmetra PX is a true modular system. Made up of dedicated
and redundant modules--power, intelligence, battery and bypass, all engineered
into a design that is easily and efficiently serviceable, this architecture can scale
power and runtime as demand grows or as higher levels of availability are
required. Symmetra PX serves as the core power train that drives APC
InfraStruXure® systems for small and medium data centers but can also power
individual "zones" of larger data centers. Highly manageable, the Symmetra PX
features self-diagnostic capabilities and standardized modules which mitigate the
risk of human error resulting in increased overall data center reliability.
Cooling Systems: (need Bill input)
List I put on Wiki
o Cost, Description, Warranty, Licenses, etc
o (Bill’s input needed, # of, etc)
5. COST ANALYSIS
Product
Category 6 Ethernet cable (price per ft)
Single-mode Fiber Cable
RJ45 jacks
Racks, shelves, etc
Battery Backups
Cooling Systems
Cisco 3800 ISR router
Cisco ASA 5510 Firewall
Cisco 1200 wireless access point
Cisco Wireless Control System
Cisco Security Agent v5.2
IronPort C160 email security
Cisco Catalyst 3750 Switches (stacking)
Cisco Unified Communications Series 500
Cisco 4400 WLAN controller
TOTAL
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Ben makes spread sheet
o Product
o Price
o Quantity
o Total
6. BENEFIT ANALYSIS (optional)
Price
Quantity
Total
0.17
394
57000
1
$1,050.99
8
$8,978.77
$2,667.81
$39.99
$0.00
$304,500.00
$8,904.99
$18,229.78
$2,661.68
$9,205.61
$465,069.39
$9,690.00
$394.00
$0.00
$8,407.92
1
$8,978.77
1
$2,667.81
7
$279.93
0
$0.00
1 $304,500.00
1
$8,904.99
6 $109,378.68
1
$2,661.68
1
$9,205.61