Nuffield Hospitals

Nuffield Hospitals were the first private hospital group to implement a fully managed hosted environment.  With the planned roll out of iSOFT’s i.Independent Patient application to improve its patient and clinical management processes, Nuffield Hospitals wanted to move away from its distributed IT strategy to a more centralised approach to improve the consistency in the levels of services being delivered to users across its 43 hospital sites. Working in partnership with iSOFT, Centrom was selected to deliver a fully managed hosted environment from two data centre sites with the new infrastructure based on HP technology.

Nuffield Hospitals is the largest network of not-for-profit, independent, acute hospitals in the UK and employs over 7,000 staff and serves over a quarter of a million patients each year. In keeping with the Hospitals objective to continuously improve its facilities to promote better healthcare, Nuffield recognised the need to improve the quality and efficiency of its patient and clinical applications and the way in which they were being delivered to users across its 43 hospital sites.

The first stage of the process was to find a solution that would improve its patient and clinical management processes and iSOFT’s i.Independent Patient application was eventually selected. Already an iSOFT user, Nuffield choose i.Independent Patient because it had been specifically designed to assist private hospitals in understanding and improving resource allocation and cost structure and could provide a complete solution addressing the information needs of clinical, administrative and financial users. Exploiting the latest Windows™ and SQL Server™ technology, Nuffield decided to re-think the architecture on which this new application could be delivered and took an ambitious decision to move to a hosted environment primarily to improve the manageability and speed of deployment of the application.

Nuffield had been operating a distributed IT strategy which meant that each hospital site was self sufficient in terms of delivery of applications. The result was inconsistency in the levels of service being delivered to users at each site and overall control was proving difficult. By moving to a hosted infrastructure this meant that deployment of i.Independent Patient could be controlled and monitored centrally with increased reliability and security as well as a reduction in the management burden of supporting multiple sites.

“Next we needed to select a technology partner to work with iSOFT to design and build the architecture,” stated Chris Cook, IT Director Nuffield Hospitals. “It came down to a choice between three suppliers BT, Synstar and Centrom and after an intensive evaluation process Centrom’s proposal based on HP technology was a clear winner. With an existing five year relationship, having already installed the Hospitals server infrastructure and a confidence in their technical ability, we believed Centrom could deliver what we required.” Steve Graham, CEO iSOFT Plc further added: “With an ongoing relationship we were keen to partner with Centrom on this project plus the fact that iSOFT and Centrom were already technology partners working on major implementation programmes for Nuffield Hospitals. As Centrom has come to understand our applications we were confident that the technology environment they recommended would be configured to ensure optimum performance of the iSOFT i.Independent Patient system.”

The result was a contract between Nuffield and Centrom worth £3.5 million over five years, to roll out a fully managed hosted environment for the deployment of iSOFT’s i.Independent Patient application. Working in partnership with iSOFT, Centrom were tasked with designing and configuring the architecture to host iSOFT’s application for delivery to 2,500 users across Nuffield’s 43 hospital sites and were given a six month timeframe to complete.

To help design and configure the hosting infrastructure, Centrom ran a feasibility study through a series of workshops working with both the Nuffield and iSOFT project teams over a four month period. Nuffield were aiming to migrate and improve its network by centralising the distribution of the iSOFT application and so it was recommended that the architecture for the hosting and deployment of i.Independent Patient should be set up across two data centre sites based in south west London. It was also vital that the solution delivered was highly resilient with high availability features.

The infrastructure was therefore configured around HP technology including at each datacentre site:

• one HP StorageWorks Enterprise Virtual Array (EVA5000) Server running continuous access
• three database clusters running on HP ProLiant DL580 G2 Servers
• two integration engine clusters running on HP ProLiant DL380 G3 Servers
• one file and print server cluster running on a HP ProLiant DL380 G3 Server
• 10 application servers running on HP ProLiant DL380 G3 Servers
• two domain controllers running on HP ProLiant DL380 G3 Servers
• one Backup server running on a HP ProLiant DL380 G3 Server

 “The major challenge was to make sure that we designed, implemented and configured the technology platform within a timescale to enable iSOFT to install its solution. We achieved this by working in very close collaboration with iSOFT so they could conduct thorough testing before delivering the final solution,” commented Chris Ellis, Operations Director Centrom. “In fact we completed one data centre site before the set deadlines to enable the iSOFT application to be deployed to certain hospital sites.”

Every cluster has been split across 2 racks for power resilience, as well as the network cards being “teamed” for fault tolerance. Each data centre has two management servers, which monitor the hardware and software events generated by the operating systems and applications and the infrastructure has also been built to cope with data centre failures. If one site were to go down all of the real time data from the affected data centre would become available locally at the opposite data centre with the minimum amount of degradation of services.

Within the datacentre infrastructure Nuffield also required a thin client application and Citrix was the preferred solution. Centrom not only configured and implemented 29 Citirx server farms running on HP ProLiant DL360 G3 Servers, but also supported the Citirx rollout across all the hospital sites.

“The HP technology was chosen because of its superior management features, scalability and reliability. The EVA model was selected because of its superior performance and flexibility and we believed it provided one the most extensible, resilient, controllable storage solutions available. The new infrastructure also provided Nuffield with a future proof platform that could cope with our planned growth and changing IT requirements,” commented Chris Cook.

As well as implementation Nuffield agreed a five year contract with Centrom to provide the day-to-day support of the hosted environment housed within the data centres. This includes daily monitoring and management of the server infrastructure, network, operating systems, databases and functioning of the applications as well as handling of the administrative tasks. All support calls are channelled through Centrom and monthly service delivery meetings are held with Nuffield personnel to ensure service levels are being maintained and to address any other issues.

By hosting a portion of its network, Nuffield has benefited from: increased control of operational costs; increased reliability and security; reduced management burden; a high quality consistency in the delivery of service to users across the hospital sites; improved availability with up to 24x7 support; quick recovery from critical failures minimising costly downtime and a full disaster recovery strategy to protect user and application data. Also the support of the system has taken into account the mission criticality of the data being stored and the HP management tools continuously monitor the server hardware, minimise the need for manual intervention and speed the delivery of routine services.

It has also given iSOFT the re-assurance that its i.Independent application is being run from a stable platform, giving them greater control over the delivery of its solution.

Chris Cook commenting on the project stated: “We set very aggressive timescales when the implementation plan began in January 2004. We set a target date of August for the two datacentres to go live and that target has been met. Centrom has certainly been prepared to go that extra mile to meet our deadlines and to ensure that all our solution requirements have been achieved. Its team has been professional and responsive throughout the project and their technical expertise and knowledge has been second to none. We are already looking at plans on how we can continue to work together into the future.”

Chris Ellis Operations Director, Centrom commented: “To be involved in the first hosted project for a private hospital is further proof of Centrom’s ability to deliver innovative technology. It also demonstrates our commitment to HP’s Adaptive Infrastructure Strategy which aims to deliver new levels of flexibility and operational benefits. Working with a collaborative approach with Nuffield and iSOFT the project has been extremely successful, so much so that it has given Nuffield the confidence to start developing a long term strategy to look at hosting all its other applications. Centrom looks forward to extending its already long term partnership with Nuffield.”