Maimonides Medical Center

Maimonides Medical Center, the third-largest independent teaching hospital in the U.S., has to store electronic records on hundreds of thousands of patient visits each year. In this case, ensuring maximum uptime and accuracy of the storage can save someone's neck -- literally.

"In the IT profession, you always have people yelling at you," says Mark Moroses, senior director of technical services at the hospital. "Here, at least you know why. It's not like at Merrill Lynch, where you need to fix the system because they need to make another $2 million. This is different, because they're saying, 'I need that X-ray up because this guy's going into surgery in an hour.' "

The Brooklyn, N.Y., hospital last year decided to migrate all of its storage to a SAN, a multiyear project that is about halfway completed at this point. Moroses says moving to Fibre Channel-based storage has given the hospital well above 99.5 percent uptime, and very close to the magical "five 9s" -- 99.999 percent.

"The most important thing we do is keep accurate records," he says. "We didn't deploy a SAN because it's neat technology -- we did it because it drives down errors... It's infinitely better than direct-attached storage."

Couple that with the fact that Maimonides's storage needs are progressing just as steadily as patients come in through the front door, and the need to move away from DAS was evident. By law, Maimonides is required to hold medical records for seven years for adults; for children, the hospital must keep records until patients are 18 and then for another seven years after that. The 705-bed hospital handles 77,000 ER visits, more than 250,000 ambulatory visits, and 36,000 discharges every year -- each one of those events produces data that must be stored.As of next month, Maimonides will have about 1.5 Tbytes of primary SAN-attached storage. All of that is served by IBM Corp. (NYSE: IBM) Serial Storage Architecture (SSA) drives, which are connected to two 18-port Gadzoox Networks Inc. (OTC: ZOOX) 2-Gbit/s Fibre Channel switches.

Maimonides mirrors the SAN to an offsite data center 10 blocks away on a different power grid. That has close to 1 Tbyte running on less-expensive IBM storage. "It's been a bear to get the disaster recovery up because our priorities are always on the primary applications," Moroses says. "Disaster stuff always takes a back seat."

The first application to move to the SAN, in July 2001, was its NextGen Healthcare Information Systems Inc.'s Ambulatory Medical Records system, followed by its OB/GYN patient-tracking system. In October, the hospital will move its PeopleSoft Inc. HR and financial system to the SAN.

The remaining applications slated to move to the SAN in the next year are the hospital's picture archiving and communications system (PACS), which stores X-ray images, and its voice technology transcription system.

To manage the SAN, Maimonides picked DataCore Software Corp.'s SANsymphony. A consultant installed the software, so the hospital's IT group avoided the headache of integrating it themselves. Moroses says the decision to go with DataCore was strategic: Since the DataCore software isn't tied to any single vendor's hardware, it offers the flexibility to introduce a wide variety of hardware. One full-time IT staffer takes care of the SAN on a daily basis, with two other administrators who can step in.There's only been one 15-minute outage with the SAN since it was installed more than a year ago. A port on one of the Gadzoox switches failed and didn't switch over automatically. Maimonides's IT personnel quickly figured out the problem and switched it over manually.

"The SAN has been absolutely rock solid," says Moroses, noting that about five or six of the IBM SSA drives have failed, but the DataCore software handled those outages seamlessly.

Moroses says the hospital leaned toward IBM hardware because it receives extremely prompt service from IBM Global Services, which supports Maimonides's storage infrastructure.

"We're going to stay with the IBM family, primarily because they have the ability to get parts here in four hours. They've proven it time and time again. That's well above what we've seen from the people who service the HP stuff."

When it evaluated storage suppliers, the hospital did consider a bid from EMC Corp. (NYSE: EMC). "It was top-of-the-line stuff, based around the Symmetrix. I'm not going to knock the EMC solution, because it had a lot of nice features. But in some places you have a culture where it's hard not to go with the king of the mountain, and we weren't afraid to go with another player."What about the financial straits that Gadzoox has landed in lately? Moroses says the company's bankruptcy doesn't concern him. "We consider the Fibre Channel switch to be pretty much commodity hardware," he says, adding that the hospital is determining which FC vendor it will go with next (see Gadzoox Runs Out of Road).

As it is, Moroses figures the current SAN architecture Maimonides has in place will meet the hospital's needs for at least the next three years. The design point of the SAN from the beginning was to be able to expand easily by adding more SSA drives -- without reengineering applications or bringing systems down. "I don't have the old problem of, 'Oops, my disk is full,' " he says. "All I need to do is make sure that if my utilization is 75 percent or more I need to add more trays." The SAN is presently at around 30 percent utilization.

What's next? Moroses and his group is now trying to project where storage networks will evolve from here on the four- to six-year horizon. "Does the SAN become NAS or something else? We're having discussions in those terms."

But, he notes, "we can't be bleeding edge." No pun intended, we're sure.

Todd Spangler, US Editor, Byte and Switch
http://www.byteandswitch.com