Connected Healthcare: How to Prepare for Future Bandwidth Demand

The healthcare sector is experiencing explosive growth in bandwidth demand, forcing networks
to work at higher-than-ever speeds to deliver services that ensure patient safety. Is your
network designed with advanced technology that will hold up to future demands? Read More...

Apr 28th, 2017

The healthcare sector is experiencing explosive growth in bandwidth demand. From

transmitting MRI images to wearable devices to video consultations, networks must work at
higher-than-ever speeds to deliver services that ensure patient safety. It’s clear that this demand
will continue to grow exponentially, putting more and more strain on your network
infrastructure. Is your network designed with advanced technology that will hold up to future
demands?

The internet is running out of room

Before we explore the healthcare-specific trends and requirements that are driving bandwidth
demand, let’s first look at what’s happening to global IP networks as a whole.

By 2019, global IP traffic will surpass two Zettabytes annually. That means that in one year, the
amount of IP traffic that travels over IP networks will be double the amount that has traversed
the internet since its creation.
It is also anticipated that by 2019, there will be more than three IP devices for every person on
earth. That equates to approximately 24 billion IP devices, most of which will require a unique
IP address so that they can be located and identified on an IP network.

On the internet, IP traffic is transmitted via network packets, which are like envelopes that
contain the voice, data, or video traffic traveling over the IP network. When a network packet is
sent from one IP device to another, the device is assigned a unique IP address to define its exact
identity and location. This is where the address protocols, IPv4 and IPv6 (Internet Protocol
Version 4 and Version 6) come in.

IPv4 was deployed in 1981 by the Internet Engineering Task Force (IETF). IPv4 addresses are
based on 32-bit identifiers, which can be used in 232 unique combinations, to create
4,294,967,296 unique IP addresses. 4.3 billion is a very limiting number, considering the fact
that there will be more than 24 billion IP devices connected by 2019.

It is easy to see why a new address protocol (IPv6) was needed. (IPv5 was mostly experimental,
which is why the protocol skips from v4 to v6.) In terms of the number of possible addresses,
IPv6 is a game changer. It employs a 128-bit address system, which means that the number of
unique IP addresses that can be created is now 340 trillion-trillion-trillion, also known as 340
undecillion.

The world of converged healthcare

It is clear that IP convergence is no longer something we talk about happening “someday.” It is

upon us. We are now connecting not just computers and phones, but also security cameras,
access control, lighting and TVs, as well as diagnostic equipment, nurse call stations, and
parking meters. And because so much is starting to be connected, controlled, and powered
through IP networks, technology has to quickly advance so that the growth of IP convergence
continues.

While hospitals will normally segregate applications, particularly the medical and nonmedical,
the fact remains that the prevalence of converged applications means there are more bits and
bytes being transmitted and increasing the need for greater data speeds.

The data that must be created, transmitted, managed, and stored grows exponentially. In
addition, regulations requiring high levels of data security to protect patient privacy add an
additional layer of complexity to information management. In short, the healthcare sector is
experiencing explosive growth in bandwidth demand and must work at higher-than-ever speeds.

What’s driving all this bandwidth growth?

Digital Connectivity: Medical equipment is becoming more and more digital. A clear example is
the X-ray, now both filmless and digital. One benefit of this digitalization is the ability of
equipment to be interconnected and IP-networked so information can be moved and shared. An
X-ray film is discrete; a digital X-ray can be transmitted to any number of other pieces of
equipment, from the radiology department computer to locations anywhere in the world. Almost
everything that happens in a hospital now requires a network connection.

Virtual Medical Care: Adding to this complexity is the emergence of virtual medical care,
sometimes referred to as telemedicine or mobile health. Virtual medical care gives people online
access to physicians via mobile phone, tablet or computer 24 hours a day. It is estimated that
75% of employers offer telemedicine services in an effort to control rising health care costs. This
remote medical care is adding to the already intense bandwidth requirements placed on
networks by the healthcare industry.

Electronic Medical Records (EMRs): While the vast majority of medical recordkeeping is

already computerized, the push for universal and uniform records is viewed as an important
step to cost control and better patient care. The Health Information Technology for Economic
and Clinical Health (HITECH) initiative has a goal of creating a single digital structure for all
medical records to ensure compatibility in creating and accessing patient records. As EMRs
contain a single repository for a patient’s complete medical history, storage requirements grow.

Exploding Storage Requirements: The amount of stored data continues to grow exponentially.

A typical MRI study generates 200 images, requiring about 40 megabytes (MB) uncompressed.
A multislice CT study can generate more than 2 gigabytes (GB) of data. Table 1 shows typical
storage requirements for different radiological studies, based on 100,000 studies per year. The
network must be able to move large files around quickly, while also handling routine
transactions like email.
Wearable Devices: Wearable medical devices have grown in popularity due to their versatility
and portability. These devices can take many forms, such as smart wristbands, patches worn on
the skin and contact lenses, to name a few. They help both patients and doctors cut down on in-
person visits by gathering data from the patient and feeding it to a database or software
application for analysis, which in turn triggers a response back to the patient. The devices can
perform tests, deliver treatment recommendations, or even congratulate a patient on achieving a
fitness goal. All of these activities contribute to the vast amount of data being transmitted over
IP networks.

Wireless: Wi-Fi is now a need-to-have in healthcare facilities, both for patient care and for
overall patient and visitor satisfaction. The expectation is that it is always on, always fast, and
always easy to connect to. Due to the rapidly increasing number of devices connecting and the
bandwidth required for each device, wireless networks can now be quickly overloaded and
frustratingly slow as a result. Ten years ago, a single wireless access point (WAP) connected by a
single 1 Gbps cable could support all the wireless devices within range with no problem. Today,
not only are more advanced WAPs needed (802.11ac), but more WAPs are required to cover the
same square footage than what was needed ten years ago.

Cabling best practices

There are many factors to consider when planning a new or upgraded network installation.
Cabling is only one piece of the network, one that is sometimes considered only as an
afterthought. However, it is a very costly piece to replace. To avoid future mitigation – or worse,
having to uninstall and reinstall your cabling plant – it is wise to install cable based on what
your bandwidth requirements will be several years from now, rather than what they are today.
This is especially important in areas dealing with patient care, from diagnostics to surgery.
These areas are the ones where sufficient bandwidth capacity must be available for tomorrow’s
needs.

Copper in the Horizontal

The choice of Category 6A cable over Category 6 ensures you are ready for heavy data traffic
today, while equipped for migration to 10G to support future networking and bandwidth needs.
With continued advancement in diagnostic imaging technologies and the growth of electronic
patient records, it is safe to say that bandwidth consumption and network speeds will continue
to increase over time.

Category 6A cabling is the most logical choice as it ensures 10 Gbps network performance and
provides enough bandwidth to fully support emerging technologies. Table 2 shows the Category
6 and 6A offerings recommended by Berk-Tek to support various bandwidth requirements.
Fiber in the Backbone

Most backbones were installed with OM3 fiber. They supported many 1 Gbps connections out
into the healthcare facility with a 10 Gbps backbone. Now, more and more network managers
are installing 10 Gbps drops to support all of the emerging bandwidth-hungry applications
discussed above. Those 10 Gbps drops are coming back to that same OM3 10 Gbps backbone.
The problem is that there is no more buffer left in the backbone, which will cause future
problems.

The next logical choice then is to move to a 40 Gbps backbone, providing a 4:1 ratio between
horizontal and backbone. But when moving from a 10 Gbps to a 40 Gbps backbone, the reach of
OM3 fiber decreases to only 100m. This is not nearly enough reach for most healthcare campus
backbones.

Most campus environments require a maximum reach of 500 meters. The only way to achieve
this required reach, without having to install a costly single-mode solution, is to install Berk-
Tek’s GIGAlite-10XB OM4+ fiber along with Berk-Tek’s enhanced transceivers. Doing so
provides 500 meters of reach at 40 Gbps, providing enough bandwidth to support current and
future applications, without having to switch to a much more costly single-mode solution.

Table 3 compares the reach and cost of a 100-meter link, inclusive of the transceivers,
connectivity, and fiber cable. The table examines the reach that each link can achieve at 40
Gbps, and notes the relative cost comparisons. Installing Berk-Tek’s GIGAlite-10XB fiber
with Berk-Tek’s enhanced transceivers, you could achieve a 500-meter reach at 40 Gbps – with
less than a 10% cost increase over the existing OM3 solution. No other solution on the market
can offer this.
Conclusion

In a healthcare facility, an underperforming network has more than just customer service or
financial implications — it could inhibit critical patient care. More than ever, healthcare
infrastructures are burdened by exploding data storage, wireless access challenges, and ever-
increasing bandwidth requirements. These challenges will only grow as technology continues to
advance. Your cabling infrastructure must not only meet today’s needs, but those evolving on
the horizon.