Life or death depends on the 'golden hour'

RACAL-DATACOM EQUIPMENT PRESCRIBED FOR TRAUMA CENTER'S FIBER NETWORK

January 19, 1994 -- SUNRISE, FL. -- When Jackson Memorial Hospital of
Miami, Florida, planned the most comprehensive trauma center in the world,
it selected Racal-Datacom equipment for the fiber optic backbone network
handling digitized distributed X-rays, laboratory reports and computer
data.

Trauma is the third largest killer of Americans and the primary cause of
death for persons under age 45. In South Florida trauma strikes four times
the national average and the chances are I in 2 that a resident of Dade
County will face trauma in his or her lifetime, the hospital reports.

"Our new Ryder Trauma Center is geared toward lowering the preventable
death rate by speeding up the delivery of trauma care during the 'golden
hour,' the critical 60 minutes after a traumatic injury," said Mark B.
Cohen, Jackson Memorial Hospital's (JMH) director of Public Affairs and
Communications. "Almost 4,000 patients a year are brought to JMH's trauma
center, where the trauma team has to assume each patient is dying when
they arrive and that the team's work-time to save that person's life is
measured by seconds."

JMH is part of the University of Miami/Jackson Memorial Medical Center, the
largest and busiest medical complex in the Southeastern United States.
This center is consistently ranked as one of the best medical facilities
in America. The hospital is a 1,567-bed facility, the primary teaching
hospital for the University of Miami School of Medicine and schools of
nursing at both the university and the hospital. In a recent year
(1991-92), the hospital had 62,261 patients (452,435 patient days) plus
411,949 outpatients. Employees and house staff total 9,400 plus 3,642
volunteers.

The trauma center provides resuscitation, diagnostic and medical treatment,
emergency surgical intervention, and intensive care to Dade County's
trauma victims. Team members include surgeons specializing in trauma,
neurosurgery, orthopedics, pediatrics and cardiovascular/thoracic
injuries; highly trained trauma nurses; radiologists, pathologists, social
workers, dietitians, chaplains, patient relations representatives,
security officers and volunteers supporting the trauma patients and their
families 24 hours a day.

The trauma center also features extensive research and education
facilities, administrative and ancillary support space. It is the only
certified Level I trauma center in South Florida with its personnel and
integrated resources available and accessible at all hours.

Jackson expanded from its old 5,000-square-foot trauma center to a new
166,000-square-foot building with a helipad on its roof. The new facility
is adjacent to the hospital's Emergency Care Center. The design of the new
$28 million Ryder Trauma Center incorporates state-of-the-art technology
with the flexibility to expand to meet the future needs of the community.

"The trauma center is a very highly engineered building," said Cathy
Gallagher, Manager of Telecommunications. "Everything in there is the
latest and greatest. Everything has a fail-safe system. A patient can't be
endangered by a machine that doesn't work properly. Network redundancy is
at the highest level, including Racal and telephone equipment. Switches
generally are two switches in one. If one processor goes down, another
kicks in. A full system of alarms is built in. We are notified immediately
of any problem."

JMH wanted to build a network over which it could run any kind of
information that needed to be transmitted -- voice, data or imaging -- in
the most cost-effective manner. But the hospital still wanted to take
advantage of the latest technology on the market. The constant goal is to
deliver a very high-quality product of health care to the patient.

The hospital has been working toward a fiber network for several years.

"We always worry about hurricanes and water damage," Gallagher said. "We
have had water damage to the existing twisted pair and coax cabling. But
by using fiber, that is no longer a concern. Fiber offers cost-savings and
the convenience of all networks running over the same media. Fiber also
allows voice and imaging on one strand, another cost savings."

With fiber installed, JMH doesn't have to deal with hundreds of pairs of
thick copper cable. Cabling is handled by just a few thin optic fibers.
JMH found that components of fiber are no longer expensive and it's more
cost-effective than running copper. Fiber serves JMH's needs to transmit
voice, data and imaging.

THREE WORLDS OF DATA

"When plans focused on the new trauma center, management looked at
developments in the industry and decided to go to an 'open systems'
environment," said Rudy Sainz, the hospital's Computer Operations
Manager.

"We are a typical IBM SNA shop using 3270 terminals locally attached to our
Computer Room; and we support personal computers by emulation cards at the
controller. The laboratories use a DEC VAX system. Radiology uses UNIX for
X-ray imaging.

"So we decided to go to a single FDDI backbone that those three systems
would share, instead of each having its own cable." (FDDI stands for Fiber
Distributed Data Interface, an American standard for fiber optic links
with data rates up to 100 megabits per second.)

"We were able to get three different worlds, these three departments, each
using a different computer system, to share one network," Sainz said.
"Voice uses separate strands of cable within the main cable and is not a
part of the FDDI network.

"We route all data from our Token-Ring network in the Computer Room over
the FDDI ring to Token-Ring 3174s in trauma; we route DEC LAT traffic from
the VAX network to trauma; and we route traffic from TCP/PI Token-Ring
imaging to trauma."

The imaging is high-resolution, used in a radiology-type setting. The
network digitally transmits X-rays on the same network with the LANs and
the Hospital Information System (HIS). Basically, the images and data run
over the same fiber.

Imaging is a growing medical trend, but it requires extensive electronic
storage to handle the X-rays. Now X-rays can be stored for quick access
when response time is a critical consideration. With the new fiber
network, X-rays are immediately available to doctors anywhere in the Ryder
Trauma Center and throughout the hospital.

Current X-rays are stored in the workstation Each of the intensive care
units has a RISC 6000 workstation with optical disk drive for local
storage. After several days X-rays are stored in a jukebox-like device
full of laser disks. This keeps the latest results at the medical staffs
fingertips in the workstation and less recent images quickly and easily
accessible in the jukebox's storage.

"We implemented our network with Racal-Datacom equipment," Sainz said. "We
have four Racal-Datacom RNX 6500 bridge/routers: one each in the Computer
Room, Lab, Central Switch Room, and Ryder Trauma Center. Each has FDDI,
Ethernet and Token-Ring cards."

The RNX units provide multi-media, multi-protocol bridging and routing
capabilities for any application connecting Ethernet, FDDI and Token-Ring
local area networks over a wide area network. RNX utilizes RISC-based
processor technology for high performance backbone applications.

VOICE TRAFFIC

Prior to the opening of the new trauma center, JMH had direct inward dial
lines for departments and nursing stations which handled more than a
million calls per month, more than 30,000 calls daily. In addition, the
hospital's main number handles a half million calls that have to be
redirected within the hospital every month. The paging system also is
served over this network. That is another thing that made this new fiber
network more attractive. The hospital can run communications between
different types of switches.

"Now voice runs on a different strand within the fiber bundle in
point-to-point connections," Gallagher said. "In our hospital setting,
that capability is invaluable. We would have had to put three types of
cabling over a fairly long span from building to building on the medical
campus here. Now all we need is one type of strand utilizing Racal-Datacom
equipment."

Racal supplied its PremNet 5000 and Racal Management System for the voice
network.

The PremNet Network Fiber Optic System provides transport and
interconnectivity for a variety of data and voice interfaces within the
local premise environment. A 100-Mbps fully redundant backbone system,
PremNet typically functions as a multi-interface "fiber superhighway"
providing connections to Ethernet and Token-Ring LANs, IBM 3270 terminals,
T1 multiplexer links and four-wire analog devices.

PremNet is managed by the Communications Management Series (CMS) 400
component of the Racal Management System. At JMH, call accounting data
from a remote PBX (telephone switchboard) being transmitted over data
lines to the central site also is managed by CMS.

Racal-Datacom offers network solutions for the delivery and management of
information between local and remote locations. It is one of the world's
leading independent providers of data communications products, systems and
services, with a direct presence or representation in more than 80
nations.

Racal-Datacomm, 1601 N. Harrison Parkway, Sunrise, FL 33323-2899
Mailing Address: PO Box 40744, Fort Lauderdale, FL 33340-7044
305-846-1601;  Fax: 305-846-3935

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