Case Study

“The progressive integration of hospital systemsand voice communications using a convergednetwork provides us with precisely those gainsin efficiency that we need to continue to besuccessful in the face of competition”

Oliver BredelManaging DirectorKreiskliniken Reutlingen GmbH.

While rebuilding its Albklinik hospital in Münsingen, operating company

Kreiskliniken Reutlingen decided to invest in advanced technologies in

order to improve patient care and services. It chose an integrated, high-

performance infrastructure based on the Cisco Systems Medical-Grade

Network concept, featuring IP telephony and wireless solutions. Efficiency

gains, cost savings and enhanced patient care have all followed, contributing

to a more effective and competitive organisation.

Business ChallengesThe Albklinik in Münsingen belongs to a group of hospitals serving the second largest

conurbation in the German federal state of Baden-Württemberg. The three hospitals

operate as a collective unit and, with over 1,000 beds in total and a combined staff of

2,000, they provide a broad range of medical services.

Recently rebuilt, the new Albklinik hospital came into operation early in 2005. The

reconstruction gave the operating company, Kreiskliniken Reutlingen, a unique

opportunity to implement state-of-the-art communications in the new building. The

primary objective was to use innovative technologies to improve patient care and

services which would, in turn, enhance the hospital's competitive advantage in the

fiercely contested German healthcare market.

At the same time, Kreiskliniken Reutlingen expected to achieve cost savings and staff

efficiency improvements, thereby further enhancing patient care. The process of

reviewing all aspects of networking and systems integration would also serve as a

model for the other hospitals in the group.

Solution In order to achieve these goals, Kreiskliniken Reutlingen decided to implement a

converged IP network using switching, IP Communications and wireless technologies

from Cisco Systems. The infrastructure was designed around the Cisco concept of a

Medical-Grade Network, which seeks to provide the high levels of interaction,

integration and accessibility that are essential in a modern healthcare environment.

German Hospital Enhances Patient Services

Executive Summary

Customer Name

• Albklinik Münsingen, Germany

Industry

• Public sector - Healthcare

Business Challenges

• To implement future-proof communicationstechnology that would improve workflowand patient care, thereby enhancing thehospital's competitive position

Solution

• A high-performance, convergedinfrastructure based on the Cisco Systemsconcept of a Medical-Grade Network

• Cisco Systems IP Communications,including IP telephony, and wirelesstechnologies to integrate clinical andadministrative systems and patient services

Business Results

• Better integrated information, applicationsand systems are reducing costs, saving timeand increasing the efficiency of clinical andadministrative staff

• Improved access to medical data is raisingthe standard of patient care

• More effective communication betweenstaff and patients is further improving thequality of care

• Patient services have been dramaticallyimproved, placing Kreiskliniken Reutlingenin a stronger position in the fiercelycompetitive German healthcare market

“Overall, the service costs foroperating the network areconsiderably lower than those forthe previous system. It was a wisemove to go for standards-basednetwork technology, which can beintegrated easily. We will alsobenefit from this when we connectup the other sites as planned.”

Rainer HirtHead of PlanningKreiskliniken Reutlingen GmbH

In addition to all the hospital's data applications, the secure,

high-performance network also carries all its telephone services.

Cisco CallManager software provides the call processing

functionality, and hospital staff use both wired and wireless

Cisco IP phones to access a range of telephony and data services.

A Cisco wireless local area network (WLAN) is integrated into

the wireline infrastructure. This allows medical staff, who are

frequently on the move, to remain in contact with patients or

colleagues not only via wireless IP phones, but also via other

mobile devices such as PDAs or laptops.

Healthcare specialist, xevIT networks GmbH, and building

automation system provider, Novar, collaborated with Cisco to

deliver its Nurse Call solution which is part of the Cisco

Clinical Connection Suite of clinical applications. This allowed

the partners to integrate the hospital's existing nurse call and

alarm systems into the IP infrastructure. As a result, staff no

longer need to carry multiple devices, including pagers, because

they can use their Cisco wireless IP phones to return calls,

forward alerts to colleagues, and even view patients' records

and other data to help them make better-informed decisions.

Business ResultsSince the new network was introduced early in 2005, it has

enabled the Albklinik to progressively integrate its clinical and

administrative systems. Recent innovations include Computed

Tomography ('CT' or 'CAT' scanning) via teleradiology

(the electronic transmission of radiographic patient images

and consultative text). Rainer Hirt, Head of Planning at

Kreiskliniken Reutlingen, explains: “In addition to the existing

Hospital Information System, we have now networked patients'

electronic records, radiology systems and Computed

Tomography at all three hospitals. This enables us to deliver the

same level of high-quality diagnostics service at all sites.”

Münsingen is the first hospital within the group to use IP

telephony and WLAN technologies which have generated

benefits ranging from efficiency gains to cost reductions.

Enhanced communications, enabled by the new network,

are at the heart of these improvements.

“IP telephony and wireless LAN help to reduce costs and save

considerable amounts of time. We can use these gains to

improve patient care,” says Oliver Bredel, Managing Director

of Kreiskliniken Reutlingen.

For example, the integration of the hospital's Clinicom 21 light

paging system into the telephony infrastructure enables patients

to communicate their needs more directly and discretely to their

carers. At the same time, it saves nurses unnecessary journeys

and enables them to care for patients more efficiently while

moving around the ward or unit.

IP telephony has also greatly simplified the invoicing of

patients' telephone calls. This is because the Cisco CallManager

solution is directly linked to the invoicing software, thereby

eliminating the need for manual entry of billing data by the

hospital's administration staff.

Another advantage of Cisco IP telephony is that patients can

take their IP phone and phone number with them if they are

transferred between wards, without the intervention of a

telephone engineer.

Being able to get hold of staff more easily, particularly in an

emergency, is an important benefit for the hospital management.

Emergency calls can be forwarded to every member of staff's

wireless IP phone and text messages can be added. The

technology is also able to handle group calls or search for a

specific member of staff, helping to locate colleagues without

unnecessary, and potentially life-threatening, delays.

Early results suggest that hospital processes have become leaner,

resulting in noticeable improvements in the quality of both

clinical and nursing care. “The merging of different hospital

systems via the Cisco network has improved working

procedures on all wards. We are avoiding duplication of effort

and, by using our staff more efficiently, we are enhancing

patient care,” says Rainer Hirt.

Such service improvements also have a sound business basis, as

Oliver Bredel explains: “We are using innovative technologies

specifically to enhance our competitive position in relation to

other hospitals.”

At the same time, service costs have fallen and the switch to

treatment invoicing according to Diagnostic Related Groups

(the government's DRG financing requirements) has also

brought with it some added financial benefit. IP telephony

enables the hospital managers to save on internal calls (which

are effectively free of charge) and improve workflow in their

institutions, thanks to the integration offered by the technology.

In the long term, the Albklinik in Münsingen will continue to

benefit from using one infrastructure to meet all its

communications requirements: for example, administration and

maintenance costs will be significantly lower than for separate

networks. As well as providing flexible and secure links for

mobile employees, wireless technology also provides a cost-

effective alternative to the infrastructure that would otherwise

be required for digital enhanced cordless telecommunications

(DECT) equipment.

“IP Telephony and Wireless LANhelp to reduce costs and saveconsiderable amounts of time. We can use these gains to improvepatient care.”

Oliver BredelManaging DirectorKreiskliniken Reutlingen GmbH

Rainer Hirt comments: “At the same time, we have

comfortably circumvented the risks posed by DECT interfaces.

Overall, the service costs for operating the network are

considerably lower than those for the previous system.

“It was a wise move to go for standards-based network

technology, which can be integrated easily. We will also benefit

from this when we connect up the other sites as planned,” he

adds, referring to the Reutlinger Klinikum at Steinenberg (the

academic teaching hospital of Tübingen University) and the

Ermstalklinik at Bad Urach.

As it is highly scalable and flexible, the new infrastructure will

also safeguard the investments made so far. Oliver Bredel

concludes: “The progressive integration of hospital systems and

voice communications using a converged network provides us

with precisely those gains in efficiency that we need to continue

to be successful in the face of competition.”

“In addition to the existing hospitalinformation system, we have nownetworked patient’s electronicrecords, radiology systems andcomputed tomography at all threehospitals. This enables us to deliverthe same level of high-qualitydiagnostics service at all sites.”

Rainer HirtHead of PlanningKreiskliniken Reutlingen GmbH

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Technology BlueprintAlbklink Münsingen has deployed a converged IP

infrastructure capable of carrying voice, data and video

traffic. It is based upon the Cisco concept of a Medical-Grade

Network designed to:

• Be more responsive - maximising the effectiveness of

application and device performance to distribute

information intelligently to improve quality of care

• Optimise responsiveness at the point of care to reduce the

number of medical errors and improve clinical productivity

• Use intelligence within the network to make the most vital

information available when, where and for whom it is

needed most

• Enhance integration of applications and services to

improve diagnostic capabilities, reduce time to treatment

for patients, shorten billing cycles and create new

revenue sources

• Provide seamless communication regardless of device

or location

• Be interactive, able to connect various communication

technologies to provide greater collaboration and

knowledge sharing.

The high-performance network backbone consists of Cisco

switching solutions, while Cisco CallManager software

provides call processing functionality. A Cisco Voice Gateway

connects the Albklinik's private network to the public

switched telephone network (PSTN). A range of Cisco IP

Phones, including the Cisco Wireless IP Phone 7920, deliver

voice and data services to clinical and administrative staff.

Cisco IP Phones are highly configurable, thanks to their

ability to act as XML (Extensible mMrkup Language)

terminals. They are flexible enough to run a range of

applications - for example, providing two-way

communications and information facilities to patients and

nursing staff.

The Albklinik's integrated wireless LAN is based on Cisco

Aironet Access Points. This enables staff to connect to the

network anywhere on the hospital campus using devices such

as wireless IP phones, PDAs and laptops.

Online diagnostics and remote management make it easier for

the IT department to identify and fix any problems. In

addition, both the wireline and wireless elements of the

infrastructure are fully redundant in design, to ensure high

levels of availability.

The xevIT Healthcare system combines with the Nurse Call

application from Cisco Clinical Connection Suite to integrate

existing nurse call and alarm systems into the IP network

through xevIT Communication Servers (XCS). Cisco Clinical

Connection Suite is an advanced set of clinical applications

that directs, locates and prioritises information for clinical

staff and their patients. Its four applications include: Nurse

Call, Patient Monitoring, Location-Based Services and

Collaborative Care.