Case Study: ACMC Hospital Network Upgrade

This case study analyzes the network infrastructure of Acme County Medical
Center (ACMC) Hospital, a fictitious small county hospital in the United States.
This same case study is used throughout the remainder of the book so that you can
continue to evaluate your understanding of the concepts presented.

Case Study General Instructions

Use the scenarios, information, and parameters provided at each task of the
ongoing case study. If you encounter ambiguities, make reasonable assumptions
and proceed. For all tasks, use the initial customer scenario and build on the
solutions provided thus far. You can use any and all documentation, books, white
papers, and so on.
In each step, you act as a network design consultant. Make creative proposals to
accomplish the customer’s business needs. Justify your ideas when they differ
from the provided solutions.
Use any design strategies you feel are appropriate. The final goal of each case
study is a paper solution.

***There is no claim that the provided solution is the best or only solution. Your
solution might be more appropriate for the assumptions you made. The provided
solution helps you understand the author’s reasoning and allows you to compare
and contrast your solution.***

Case Study Scenario

This case study analyzes the network infrastructure of ACMC Hospital, a fictitious
small county hospital. The hospital has provided you with a short description of the
current situation and its plans. As a network designer, it is your job to identify all
the organization’s requirements and data that will allow you to provide an effective
solution
Organizational Facts

 ACMC Hospital is a medium-sized regional hospital located in Acme

County, with approximately 500 staff members supporting up to 1000
patients. The hospital is interested in updating its main facility (which uses
equipment from various vendors) in its Layer 2 campus.
 You are meeting to define the client’s requirements.
 ACMC has 15 buildings in total on the campus, plus 5 small remote clinics.
There are two main hospital buildings and an auxiliary building. The two
main buildings have seven floors each, with four wiring closets per floor.
 The auxiliary building—the Children’s Place—is connected to the two main
buildings; the switches from these three buildings are connected with fiber
connections in a ring.
 The Children’s Place has three floors, with three wiring closets per floor.
The other 12 campus buildings are smaller office and support facilities, with
10 to 40 people per building, located on one or two floors.
 The network architect is new to the hospital. The hospital is aggressively
expanding its clinic and alternative emergency room presence within Acme
County. Due to population growth in general, plans to enlarge the main
campus are also under way. The hospital is doing fairly well financially.
 It wants to selectively deploy cutting-edge technology for better patient care
and high productivity.
 Management is tired of network downtime and slowness affecting patient
care. Network manageability is important because ACMC has a tradition of
basing operations on small support staffs with high productivity. ACMC’s
upgrade timeframe is 6 to 12 months.

Current Situation
 The current network uses inexpensive switches from several vendors,
purchased over time.
 They comply with various standards, depending on when they were
purchased.
 The switches are not SNMP-manageable, although a small amount of
information is available from each switch via the web or command-line
interface.
 Within each of the three main buildings is a main switch. One floor switch
from each floor connects to the main switch.
 The other switches connect either directly to the floor switch or via a daisy
chain of switches, depending on which was most convenient at the time.
 The small outlying buildings have one or two 24-port switches. One of these
connects back to one of the main building switches via fiber. If there is a
second switch, it connects via the first switch.
 Currently, the staff VLAN spans the entire campus. No Layer 3 switching is
present. The address space is 172.16.0.0 /16. Addresses are coded
sequentially into PCs as they are deployed.
 Staff members have been meaning to deploy DHCP but have not had the
time.
 The applications that the organization is currently running include standard
office applications, plus some specialized medical tools running over IP.
Radiology, Oncology, and other departments do medical imaging. As these
departments acquire new tools, they are adding real-time motion to the
highly detailed medical images, requiring large amounts of bandwidth. All
the new servers are capable of using Gigabit or Gigabit EtherChannel
connectivity.
 Many servers are currently located in various closets. Many lack
uninterrupted power supplies or proper environmental controls. A staff
member has to roll a tape backup cart to each server closet to back up each
server.
 There are about 40 centrally located servers in one raised floor
“serverroom,” and 30 other servers distributed around the campus near their
users.
 The server room takesup part of the first floor of Main Building 1, along
with the cafeteria and other non-networked areas.
 Hospital Support Services has been experimenting with workstations on
wheels (WoW). Moving these and plugging them into an Ethernet jack is
just not working very well.
 The WAN uses 56-kbps links to three of the remote clinics and dialup
connectivity to the other two. The one router uses static routing that was
configured by a previous network designer.
 The staff members have frequently complained about slow response times.
There appears to be severe congestion of the LAN, especially at peak hours.
 The staff provided you with a copy of its recent network diagram, which is
shown below
You believe that the current situation does not provide for future growth, high
reliability, and ease
of management.
Plans and Requirements
 The introduction of new applications will result in an additional load on the
links to the remote clinics.
 The expected tighter integration and growth of remote offices will even
further increase the traffic load on the WAN links. The hospital would like
to upgrade the WAN infrastructure to provide sufficient bandwidth between
the remote clinics and headquarters and, at the same time, find a solution for
better convergence during network failures.
 The company is aware of the drawbacks of its current IP addressing scheme
and is seeking a better solution.
 The hospital must comply with the U.S. Health Insurance Portability and
Accountability Act (HIPAA).

Case Study Questions

Complete the following steps:

Step 1 Document ACMC’s requirements.

Step 2 Document any information that you think is missing from the case study
scenario and that you consider necessary for the design.
Before beginning the design, you will need this information.
Assume that you have talked to the customer about the missing information, and
document any assumptions you make.
You don’t need to assume that all the missing information is provided by the
customer; some might never be available.
However, you do need to assume answers for your critical questions

Step 3 Outline the major design areas that you feel need to be addressed when
designing the solution for this scenario.
List the tasks, and provide a brief comment for each.
Solution:
The following are the major design areas to be addressed:

Step 1 Identify the relevant network applications, their logical connectivity

requirements, and the services required as part of the initial design.

Step 2 Divide the network into modules.

Step 3 Identify the scope of the design to decide which modules are to be
redesigned.

Step 4 Identify design alternatives for each module, including the following:
a. Redesign the campus LAN: The current campus LAN is shared and
interconnects three buildings. Because there is no redundancy, the
designer needs to entirely redesign the campus, including the placement
of servers.

b. Redesign the IP addressing scheme: The flat addressing scheme and

static routes are not desirable features in a scalable growing network. New
hierarchical addressing is required.

c. Introduce a new routing protocol: The hospital is aware of the drawbacks

of static routes. The designer should implement a dynamic routing
protocol that is more scalable and that better fits the planned hierarchical
addressing scheme.

d. Upgrade the WAN links: The upgrade of the WAN links is essential
because, according to the company, the current bandwidth seems insufficient.
The introduction of new applications along with the existing applications
will result in a higher load on the WAN links.
After the design is complete, the implementation will be planned, and the
design will be implemented.