Terry Slattery
Terry Slattery, is a senior network engineer with decades of experience in the internetworking industry. Prior to joining Chesapeake NetCraftsmen as...
Read Full Bio >>

Terry Slattery | December 23, 2015 |


Healthcare & SDN: A Good Match?

Healthcare & SDN: A Good Match? Compelling use cases exist for SDN in healthcare.

Compelling use cases exist for SDN in healthcare.

Healthcare is potentially a great environment for Software-defined networking (SDN): Staff and patients are moving all the time, there are many different customer communities with differing data requirements, and security of patient data is crucial. Let's take a brief look at how SDN can help solve problems in each of these areas in a healthcare environment:

Patient Monitoring

Let's start with patient monitoring systems (sometimes called "bedside monitoring"), which require mobility, reliability, and security. Patient data must be reliably delivered to the monitoring control system, even while the patient is moving within the hospital. At NetCraftsmen, we refer to patient monitoring data as "Clinical Life Critical." Reliable connectivity is important while guaranteeing that patient data is kept secure. If patient monitoring data is to be handled on a converged network, QoS guarantees must be provided to protect from congestion loss.

Patient monitoring systems typically specify that a separate network infrastructure be constructed, because the network is considered part of a medical device. However, that creates another network to design, build, and manage, which creates additional costs and adds complexity that frequently compromises the reliability and security of that network. Modern patient monitoring endpoints support both wired and wireless connectivity, and maintain connectivity with the monitoring system controller when switching from a wired connection to wireless, then back to a wired connection. It is also useful if the connections can be reliably and securely handled from any network interface, not just a few pre-specified interfaces located in selected locations in patient rooms, waiting areas, and hallways. In other words, we would like the network to dynamically adapt to the requirements of patient monitoring.

Voice, Video, and Unified Communications

Voice and video communications (and ultimately, all unified communications) is critical in healthcare. UC needs good connectivity and proper QoS to function properly, requirements that are nearly identical to those of patient monitoring. Static configurations work well for dedicated phones, both wired and wireless. However, static identification of voice calls from soft phones running on a computer or a mobile device are difficult to identify. This is the scenario in which the UC controller can tell the network of the voice (or video) call to configure itself to handle the call.

Other Data Sources

Hospitals tend to be complex organizations, especially research and teaching hospitals. In addition to clinical life critical data (patient monitoring), there are clinical data requirements such as health care records and imaging files that must be handled securely and in a timely manner. Research data must be kept private from internal and external access. Researchers often have their own network connectivity requirements. Patients and their family and visitors desire Internet access. All of these data sources are competing for the same set of network resources. Reliability, security, and high performance are common requirements. Meeting these requirements with a static network configuration is doable, but at the cost of increasing complexity.

Characteristics of a Software-Defined Network

One of the key characteristics of an SDN is that the applications and the network can communicate with each other using APIs. The network can ask the application server what it needs or tell the application server that an endpoint has joined the network. Conversely, the application server can tell the network what type of service it needs and what types of packets to allow. By default, most SDN implementations do not allow packets to flow. The SDN controller configures the network switches to perform packet processing and forwarding.

Another characteristic of an SDN is that multiple virtual networks can be created, and the configuration of each virtual network can be delegated to the organization that it serves. A separate virtual network instance (VNI), which may also be called a Virtual Tenant Network (or VTN), can be configured to handle each of several individual networks:

  • Patient monitoring (clinical life critical data)
  • Unified communications (voice and video)
  • Clinical data (medical records, medical imaging)
  • Research networks
  • Patient, family, and guest Internet access
SDN Implementation

In a patient monitoring system, we want reliability, mobility, and security. The SDN controller detects when a patient monitoring endpoint connects to the network, perhaps by identifying the MAC address or with a more advanced authentication mechanism. Forwarding entries are loaded into the network switches that allow the endpoint to connect only with the patient monitoring controller. QoS markings are applied at the ingress switch port, and high priority treatment is given to the forwarding of patient monitoring data. Bandwidth limits are established at the ingress interface to limit the impact of a denial-of-service attack. The monitoring endpoint can be connected anywhere in the SDN switch network since the SDN controller will automatically identify the endpoint and connect the ingress interface to the corresponding virtual network (VNI). Mobility and security are provided by this functionality. Dynamic application of QoS provides reliable handling of data. Backup forwarding entries in the network switches allow for immediate re-routing if a failure is detected.

Similar functionality exists for UC communications. In addition to fixed phones, the UC controller will inform the SDN controller of calls that involve a computer or mobile device (i.e. soft phones). In both the fixed phone and soft phone case, the SDN controller will then configure the proper QoS markings and handling between the endpoints involved in the call. Bandwidth limits protect the other network traffic from excessive UC traffic and vice versa. Details may be found in the International Multimedia Telecommunications Consortium whitepaper, "UC SDN Automated Quality of Experience Service" (registration required to download the 45-page document).

To address the other virtual network instance cases (clinical data, research networks, and patient/family Internet access), the SDN implementation creates separate forwarding domains that naturally prevent packets from going between virtual networks. And in the case of research networks, the research staff can be given control of the allocation of network resources within the VNI that is allocated to that group. This capability removes the need for a research group to coordinate with a central networking group to put changes within their virtual network into effect.

Security is also improved. The forwarding entries that are loaded into the network switches only allow connectivity from the endpoint to the monitoring system and not the reverse. Endpoints cannot talk with any other system. Only the type of traffic that is expected will be allowed.


SDN offers more flexibility and dynamic functionality than static network configurations. Most, but not all, functions described above can be implemented in a traditional statically configured network. The virtual networks could be implemented using VRF-Lite (Virtual Routing and Forwarding -- Lite) or with MPLS Layer 3 VPNs, but at the cost of considerable complexity and increased fragility (i.e. the easier it is to fail in some way).

Are we there yet? Can we buy SDN products that fulfill the requirements stated above? Check out the Case Study of Kanazawa University Hospital by NEC. It is a very brief document that describes problems similar to those presented above and how they were solved with a new installation of an SDN network. What we need now are more case studies with details of implementations. We need the early adopters to tell their stories and identify what things worked well and how to mitigate problems during the implementation.

Learn more about management and security trends and technologies at Enterprise Connect 2016, March 7 to 10, in Orlando, Fla. View the Management and Security track sessions; register now using the code NJPOST to receive $200 off the current conference price.


April 25, 2018

Yesterdays simple phone call to a contact center or business location is rapidly becoming todays interactive session, spanning multiple channels and devices. If you need to know how Omnichannel can

March 7, 2018

Video collaboration is experiencing significant change and innovation-how can your enterprise take advantage? In this webinar, leading industry analyst Ira Weinstein will present detailed analysis

February 21, 2018

Business agility has become the strongest driver for enterprises to begin migrating their communications to the cloud-and its a benefit that enterprises are already realizing. To gain this benefit

March 12, 2018
An effective E-911 implementation doesn't just happen; it takes a solid strategy. Tune in for tips from IT expert Irwin Lazar, of Nemertes Research.
March 9, 2018
IT consultant Steve Leaden lays out the whys and how-tos of getting the green light for your convergence strategy.
March 7, 2018
In advance of his speech tech tutorial at EC18, communications analyst Jon Arnold explores what voice means in a post-PBX world.
February 28, 2018
Voice engagement isn't about a simple phone call any longer, but rather a conversational experience that crosses from one channel to the next, as Daniel Hong, a VP and research director with Forrester....
February 16, 2018
What trends and technologies should you be up on for your contact center? Sheila McGee-Smith, Contact Center & Customer Experience track chair for Enterprise Connect 2018, gives us the lowdown.
February 9, 2018
Melanie Turek, VP of connected work research at Frost & Sullivan, walks us through key components -- and sticking points -- of customer-oriented digital transformation projects.
February 2, 2018
UC consultant Marty Parker has crunched lots of numbers evaluating UC options; tune in for what he's learned and tips for your own analysis.
January 26, 2018
Don't miss out on the fun! Organizer Alan Quayle shares details of his pre-Enterprise Connect hackathon, TADHack-mini '18, showcasing programmable communications.
December 20, 2017
Kevin Kieller, partner with enableUC, provides advice on how to move forward with your Skype for Business and Teams deployments.
December 20, 2017
Zeus Kerravala, principal analyst with ZK Research, shares his perspective on artificial intelligence and the future of team collaboration.
December 20, 2017
Delanda Coleman, Microsoft senior marketing manager, explains the Teams vision and shares use case examples.
November 30, 2017
With a ruling on the FCC's proposed order to dismantle the Open Internet Order expected this month, communications technology attorney Martha Buyer walks us through what's at stake.
October 23, 2017
Wondering which Office 365 collaboration tool to use when? Get quick pointers from CBT Nuggets instructor Simona Millham.
September 22, 2017
In this podcast, we explore the future of work with Robert Brown, AVP of the Cognizant Center for the Future of Work, who helps us answer the question, "What do we do when machines do everything?"
September 8, 2017
Greg Collins, a technology analyst and strategist with Exact Ventures, delivers a status report on 5G implementation plans and tells enterprises why they shouldn't wait to move ahead on potential use ....
August 25, 2017
Find out what business considerations are driving the SIP trunking market today, and learn a bit about how satisfied enterprises are with their providers. We talk with John Malone, president of The Ea....
August 16, 2017
World Vision U.S. is finding lots of goodness in RingCentral's cloud communications service, but as Randy Boyd, infrastructure architect at the global humanitarian nonprofit, tells us, he and his team....
August 11, 2017
Alicia Gee, director of unified communications at Sutter Physician Services, oversees the technical team supporting a 1,000-agent contact center running on Genesys PureConnect. She catches us up on th....
August 4, 2017
Andrew Prokop, communications evangelist with Arrow Systems Integration, has lately been working on integrating enterprise communications into Internet of Things ecosystems. He shares examples and off....
July 27, 2017
Industry watcher Elka Popova, a Frost & Sullivan program director, shares her perspective on this acquisition, discussing Mitel's market positioning, why the move makes sense, and more.
July 14, 2017
Lantre Barr, founder and CEO of Blacc Spot Media, urges any enterprise that's been on the fence about integrating real-time communications into business workflows to jump off and get started. Tune and....
June 28, 2017
Communications expert Tsahi Levent-Levi, author of the popular blog, keeps a running tally and comprehensive overview of communications platform-as-a-service offerings in his "Choosing a W....
June 9, 2017
If you think telecom expense management applies to nothing more than business phone lines, think again. Hyoun Park, founder and principal investigator with technology advisory Amalgam Insights, tells ....
June 2, 2017
Enterprises strategizing on mobility today, including for internal collaboration, don't have the luxury of learning as they go. Tony Rizzo, enterprise mobility specialist with Blue Hill Research, expl....
May 24, 2017
Mark Winther, head of IDC's global telecom consulting practice, gives us his take on how CPaaS providers evolve beyond the basic building blocks and address maturing enterprise needs.
May 18, 2017
Diane Myers, senior research director at IHS Markit, walks us through her 2017 UC-as-a-service report... and shares what might be to come in 2018.
April 28, 2017
Change isn't easy, but it is necessary. Tune in for advice and perspective from Zeus Kerravala, co-author of a "Digital Transformation for Dummies" special edition.
April 20, 2017
Robin Gareiss, president of Nemertes Research, shares insight gleaned from the firm's 12th annual UCC Total Cost of Operations study.
March 23, 2017
Tim Banting, of Current Analysis, gives us a peek into what the next three years will bring in advance of his Enterprise Connect session exploring the question: Will there be a new model for enterpris....
March 15, 2017
Andrew Prokop, communications evangelist with Arrow Systems Integration, discusses the evolving role of the all-important session border controller.
March 9, 2017
Organizer Alan Quayle gives us the lowdown on programmable communications and all you need to know about participating in this pre-Enterprise Connect hackathon.
March 3, 2017
From protecting against new vulnerabilities to keeping security assessments up to date, security consultant Mark Collier shares tips on how best to protect your UC systems.
February 24, 2017
UC analyst Blair Pleasant sorts through the myriad cloud architectural models underlying UCaaS and CCaaS offerings, and explains why knowing the differences matter.
February 17, 2017
From the most basics of basics to the hidden gotchas, UC consultant Melissa Swartz helps demystify the complex world of SIP trunking.
February 7, 2017
UC&C consultant Kevin Kieller, a partner at enableUC, shares pointers for making the right architectural choices for your Skype for Business deployment.
February 1, 2017
Elka Popova, a Frost & Sullivan program director, shares a status report on the UCaaS market today and offers her perspective on what large enterprises need before committing to UC in the cloud.
January 26, 2017
Andrew Davis, co-founder of Wainhouse Research and chair of the Video track at Enterprise Connect 2017, sorts through the myriad cloud video service options and shares how to tell if your choice is en....
January 23, 2017
Sheila McGee-Smith, Contact Center/Customer Experience track chair for Enterprise Connect 2017, tells us what we need to know about the role cloud software is playing in contact centers today.