As many leading healthcare providers have learned, improving productivity sometimes can have unintended consequences. Consider the case of Scott & White Memorial Hospital, one of the nation’s largest multi-specialty healthcare systems. Founded in 1897, the venerable institution, with its 29 regional clinics, meets the needs of 2 million patients in central Texas by delivering services effectively, rapidly and economically. Newsweek and U.S. News & World Report have recognized the hospital for its excellence in research and treatment of cancer, strokes, orthopedic problems and cardiovascular disease, and the facility has made the Thomson “100 Top Hospitals” list five years in a row.

Always seeking to improve efficiencies and patient care, Temple, Texas-based Scott & White deployed over the last 10 years an array of advanced applications, such as medical imaging systems and an internally-developed electronic medical records (EMR) system. To ensure its 700-plus physicians and 7,000 staff members could rapidly access information, Scott & White implemented a dual-fabric storage area network (SAN) to support the servers that deliver and store patient records, medical images, billing and business files, e-mail, and data from many clinical systems.

These measures improved the hospital’s productivity and services, but the enterprise soon had well over 400 servers and other devices in its data center and across its campus, which incurred substantial power and cooling costs. Additionally, by dedicating a server to each application, Scott & White was under utilizing the servers’ capacities, causing inefficiencies particularly among platforms that did not generate much network traffic.

The hospital’s issues were further complicated by its burgeoning storage needs. To meet HIPAA regulations, its data center currently stores 300 terabytes of patient and business data on the SAN, which the hospital projects will grow annually by 15 percent. The costs of procuring and maintaining large numbers of servers and storage systems started to spiral.

Moreover, Scott & White’s data center, built 12 years ago, was not designed to support so many devices. “We started to run short of physical space for additional servers and switches,” says Paul Anslie, Scott & White’s SAN administrator. “This, coupled with the complexity of our growing IT infrastructure, financially burdened the hospital and jeopardized our future ability to deliver networked applications and data.”

Seeking a Solution

In 2006, Scott & White’s IT managers asked their staff to identify the most effective strategy for conserving space at the data center while reducing capital and operational IT costs. Administrators concluded that a proven approach would be to consolidate servers, thereby enhancing data-center efficiencies. They would deploy virtualization technology, installing “virtual machines” that enable a single server to run multiple applications. One device can then do the work of several. By better utilizing its servers, the hospital could render many unnecessary and retire them.

“We reasoned that to overcome our physical constraints, we required a solution that got us out of the physical world,” explained Bill Roe, Scott & White’s manager of server services. “Through virtualization, we would free up space in the data center, simplify our IT infrastructure, lower procurement expenses, and slash energy and cooling costs.”

After evaluating virtualization solutions from several vendors, administrators selected VMware’s VMotion technology for its performance and high availability. It enables a running virtual machine to move instantaneously from one server to another should a device fail for any reason. Additionally, many of the hospital’s applications are unable to take advantage of clustering technologies, which VMware’s ESX solution remedies. Scott & White could run these applications on ESX servers, enabling them to take advantage of pooled resources for increased performance and uptime. Moreover, administrators would be able to easily migrate the systems for hardware maintenance.

The hospital’s enhanced SAN also accelerates the delivery of even large radiology and cardiology images, ensuring that its staff always accesses and shares medical and business information quickly.

“The solution ensures that applications are available even if a server malfunctions,” says Ainslie. “This also permits us to perform maintenance or proactively move virtual machines away from under-performing servers without disrupting business operations.”

The consolidation strategy, however, demanded improvements to the networking infrastructure. Many of the hospital’s medical applications, such as its EMR, generated large amounts of files and data. The SAN’s 2 Gbit/sec links supplied enough bandwidth for every server to support one application without congestion or latency; however, administrators feared that this performance would be inadequate if each device ran multiple applications. As a result, the hospital needed to enhance its SAN to support the consolidation.

Administrators determined that because the hospital’s existing SAN switches from Brocade performed well and were scalable, upgrading these platforms was more cost-effective than replacing them. Moreover, they would avoid any learning curves required for another vendor’s systems.

Administrators also sought to extend the SAN throughout the hospital’s data center because many servers are up to several hundred feet from the SAN’s core. They realized that they could reduce cabling costs by connecting the servers to the core via a few edge switches rather than directly link each individual device to the SAN. Consequently, they included in their solution additional edge switches. By enhancing and expanding the SAN infrastructure, they would obtain the performance, ports and efficiencies needed to support virtualized servers.

Consolidating the Infrastructure

Scott & White implemented “virtual machines” on its servers and bolstered its SAN, starting with the two redundant Brocade 6140 directors comprising the system’s core. Thanks to the scalability of these systems, administrators simply installed ASIC cards, which doubled their speed to 4 Gbit/sec and added ports. Scott & White then deployed eight 4 Gbit/sec Brocade edge switches, placing some near servers. It linked the servers to these local switches and connected the switches to the SAN, containing deployment costs by reducing the number of cable runs.

Thanks to the straightforward deployment of the switches and their familiarity with the systems, Scott & White’s administrators performed all the installations themselves. They upgraded the SAN without additional training or professional support from the vendor, further economizing on the consolidation. Moreover, they enhanced the SAN with no down time, ensuring continuously available medical and business data. They also hardly disrupted users when migrating applications to VMware-enhanced servers by conducting the relocations during slow periods of network use or after hours.

As part of the overall project, Scott & White deployed an EMC Clariion CX3 Model 80 disk array to ensure data storage could keep pace with the SAN’s new 4 Gbit/sec capabilities.

Scott & White is now implementing a second phase to bolster its SAN’s performance and scalability. The hospital deployed a pair of Brocade 48000 directors for improved performance, scalability and power efficiencies. These systems presently deliver 4 Gbit/sec speed, but administrators will soon double their throughput merely by installing 8 Gbit/sec line cards within the devices. They also are deploying an EMC Symmetrix DMX storage platform that will be upgradeable to 8 Gbit/sec, ensuring a high-performance infrastructure.

Cost-Efficient, High-Speed Healthcare Services

By bolstering its SAN and running some 200 “virtual machine” servers, Scott & White consolidated 200 physical servers down to 20. It eliminated the increasing maintenance expenses of 180 servers as well as the energy costs to power and cool the devices.

Scott & White now more fully utilizes the computing power of its remaining servers for optimal efficiencies. It also freed space in the data center. Moreover, the IT staff trimmed the costs of the consolidation by modifying the architecture of its SAN.

The hospital’s enhanced SAN also accelerates the delivery of even large radiology and cardiology images, ensuring that its staff always accesses and shares medical and business information quickly. “When the applications were performing slowly, I’d get a lot of phone calls,” notes Anslie. “I don’t get many calls now.”

Scott & White’s robust infrastructure can easily deliver additional applications for more productive healthcare services. Additionally, by migrating to 8 Gbit/sec speeds the hospital can easily keep pace with the burgeoning volumes of data that its applications will generate