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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.
Network Infrastructure Redesign & Clinical PC Deployment Network Infrastructure Redesign
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
Network Infrastructure Redesign & Clinical PC Deployment Network Infrastructure Redesign
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.
Network Infrastructure Redesign & Clinical PC Deployment Network Infrastructure Redesign
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
Network Infrastructure Redesign & Clinical PC Deployment Network Infrastructure Redesign
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
Network Infrastructure Redesign & Clinical PC Deployment Network Infrastructure Redesign
Description Counts
Cisco 4510 Network Switch 30
Cisco 6509 Network Switch 2
Cisco 3750 Network Switch 9
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
Network Infrastructure Redesign & Clinical PC Deployment Clinical PC Deployment
New PC Hardware Installations
Description Counts
Desktop PC 240
Laptops 7
LCD Monitors 1275
LaserJet Printers 9
MFD Printers 38
Clinical PC Deployment Team
Network Infrastructure Redesign & Clinical PC Deployment Clinical PC Deployment
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)
Network Infrastructure Redesign & Clinical PC Deployment Command Centers
Network Infrastructure Redesign & Clinical PC Deployment Command Centers
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: