Cisco health care solutions showcased and deployed at HIMSS, in India and in Austria

Atlanta, New Delhi, Vienna 23 March 2010At the Healthcare Information and Management Systems Society (HIMSS) Conference in Atlanta, Cisco has made available the Cisco HealthPresence platform. Cisco HealthPresence is an advanced, care-at-a-distance technology platform that allows patients to connect with doctors and clinicians for health care consultations in ways never before possible. Cisco has also signed a memorandum of understanding (MoU) with CSC e-Governance Services India Ltd. CSC e-Governance Services India Ltd. is a private company established to catalyze and accelerate the delivery of various eGovernance services through the CSC framework. The purpose of the MoU is to make education and health care solutions available and to promote social inclusion through Common Service Centres (CSCs) across India. And the Klinikum Wels-Grieskirchen, a health care provider in upper Austria, has deployed the Cisco Unified Computing System solution in its data centre.


Traditional telemedicine or telehealth approaches have focused mostly on the problem of physical access to medical care. Cisco HealthPresence addresses four additional key health care delivery challenges:

  • Capacity: the scarcity and productivity of clinical expertise
  • Collaboration: one patient with many clinicians, many providers with many providers, and many patients with many patients
  • Information exchange: the ability of participants to share and view vital health information
  • Personalization: engaging patients in ways that make them more active participants in consults

Cisco HealthPresence extends and expands access to health services and quality care. HealthPresence creates new, streamlined clinical encounters by integrating two technology innovations: Cisco TelePresence and Cisco Unified Communications. With high-definition video, clear audio and connected medical devices, Cisco HealthPresence supports collaboration and personalization rarely accomplished in traditional face-to-face consultations. Patients in HealthPresence encounters can see images and listen to sounds from a variety of diagnostic devices, such as digital stethoscopes, actively participating with what clinicians see and hear.

Beginning with HealthPresence trials in 2008, patients have described how the immersive video experience, along with the real-time transmission of physiologic information, draws them into the medical encounter. At the same time, clinicians report more effective patient management with HealthPresence.

Equally important, HealthPresence allows multiple members of a patient's care team to simultaneously participate in consultations, creating new ways to deliver and co-ordinate care. This is a significant innovation from typical point-to-point telemedicine solutions and even traditional in-person medical examinations. With HealthPresence, primary care physicians and specialists, care managers and rehabilitation therapists, family members, and caregivers can all participate in treatment and care planning. These new capabilities are essential for information and communications technologies to play a vital role improving access to, and the affordability and quality of, health care.

Cisco HealthPresence is planned to be available beginning March 2010 in markets across the United States, Canada and Europe. It is classified as a Class I medical device by the United States Food and Drug Administration.

To evaluate patients in an interactive and highly participatory way, Cisco HealthPresence arms clinicians with the essential tools, including:

  • Cisco Vitals Software, which captures physiological data and streaming high-definition video feeds, sending them to the clinical team with a high degree of security.
  • Cisco TelePresence units in clinical and patient locations.
  • Integrated voice, video and data capabilities that collect patient medical information for transmission among multiple health care providers or between a single doctor and patient before, during and after telemedicine consultation. Cisco's custom software offers highly secure encryption technology to protect the privacy and security of patient data exchanged in distance communications between patients and caregiver staff.
  • Medical devices located at the patient's end unit: a general camera for external observation, ear-nose-throat camera, digital stethoscope, and a vital signs device to capture blood pressure, temperature, pulse rate, and blood oxygen levels.

Cisco HealthPresence can be deployed in permanent facilities or mobile units. The solution was piloted by the Cisco Internet Business Solutions Group (IBSG). Cisco HealthPresence has already been successfully adopted through pilot programmes in the United States and other countries, including:

  • A groundbreaking HealthPresence pilot with Molina Healthcare, two community health centres in San Diego, and the state of California to provide health and wellness services to underserved communities throughout the state.
  • HealthPresence pilots in Aberdeen, Scotland, with a division of the Scottish National Health Service, and in San Jose, California, with employees at Cisco's corporate headquarters. Both 2009 pilots achieved equally favourable feedback: More than 90 percent of participants said they would recommend the service to others.
  • Helping connect patients in need with critical medical resources in international locations including France, the United Kingdom, South Africa and China.

Dr. Kaveh Safavi, vice president and global lead, Cisco Internet Business Solutions Group Healthcare Practice, stated: "Health systems globally are challenged to meet increasing demand for quality services. Patients often have limited access to health care, particularly when they require specialty services or need care for chronic illness, in both urban and rural settings. Cisco HealthPresence is poised to transform how doctors practise medicine and how patients experience care, by allowing individuals to easily and safely connect with the most appropriate clinician or specialist for their particular needs, and to receive some of the best care possible regardless of location."

Dr. Michael M. Siegel, vice president and medical director, Molina Healthcare Inc., stated: "Citizens expect more options for health care services, and new models of care delivery need to be introduced in order to make care-at-a-distance a reality. For Molina's medical offices, Cisco HealthPresence eliminates the need for clinicians and patients to be located in the same physical location. Our facilities are now able to reach a much wider and highly dispersed patient base, in order to provide the appropriate care."

The Cisco-CSC memorandum of understanding was signed by Shankar Aggarwal, CEO, CSC e‑Governance Services India Ltd. and Naresh Wadhwa, president and country manager, Cisco India in the presence of John Chambers, chairman and CEO, Cisco; Wim Elfrink, chief globalisation officer and executive vice president, Cisco Services; R. Chandrashekhar, secretary, Department of Information Technology, government of India; and S. R. Rao, additional secretary, Department of Information Technology.

The Common Service Centres programme is a strategic cornerstone of the government of India's National e-Governance Plan (NeGP) with 250.000 CSCs planned across 600.000 villages. The CSCs have the potential to offer Web-enabled e-governance services in rural areas as well as to provide high-quality and cost-effective video, voice and data content and services in areas such as education, health and entertainment.

By working collaboratively toward a common vision of Smart+Connected Communities, Cisco and CSC e-Governance Services India Ltd. intend to make the technology platform available to CSCs to deliver transformational education and health care solutions to citizens across India. Cisco has worked with governments and communities around the world on delivering its vision for Smart+Connected Communities and believes that the delivery of high-quality services to rural areas can help India produce more inclusive and balanced growth.

The education services will use the Cisco Remote Education Centre, an education platform hosted in the Cloud with the ability to support 30.000 simultaneous classes. Powered by the market-leading Cisco WebEx on-demand collaboration solution, the Remote Education Centre platform brings the teacher, along with e-content, virtually to remote classrooms. It has been successfully piloted in Chhindwara, Madhya Pradesh and other geographies.

The health care services will be offered through the Cisco HealthPresence extended reach solution, a desktop-based telemedicine solution that has immense potential in providing access to high-quality health care across India.

The HealthPresence extended reach solution can also be hosted in a Cloud and support several thousand high-quality video-based telemedicine sessions simultaneously and has been successfully piloted in India, Africa, and Latin America. New delivery models for health care through the CSCs will help expand access to health care and manage access to information in a highly secure and reliable manner.

Cisco believes that a holistic transformation of the educational system can be enabled by collaborative technologies that allow individuals to create, adapt and share content and best practices. By providing extraordinary access to high-quality educational services through the CSCs, Cisco intends to help create a knowledge economy by imparting vocational training to rural youth and preparing students in India to become members of the global workforce.

The Cisco Smart+Connected Communities initiative is designed to provide cities and communities with smart and connected solutions for utilities, safety and security, connected real estate, transportation, health care, learning, sports venues, and government services. By providing a network-enabled blueprint for successful "smart" communities of the future, Smart+Connected Communities solutions help transform physical communities into connected communities that can help realize sustainable economic growth and GDP, enable environmental sustainability through resource management and operational efficiencies, and enhance quality of life for residents.

Transformational health care services have the potential to break the boundaries of geography and ease pressure from the increasing demand for expert services in health care systems regionally and nationally. The network as the platform allows for innovative delivery models with strong communication and collaboration capabilities bringing 21st-century education and health care services to the citizens of India.

Cisco intends to make available education and health care services with the goal of building sustainable replicable models for the future. Cisco has worked with governments around the world to further the cause of inclusive education and health care through the use of technology.

John Chambers, chairman and CEO, Cisco, stated: "Collaborative technologies, powered by ubiquitous broadband access, will not only enable access to high-quality education and health care services but also help drive the next phase of economic growth for our future. Education and health care are fundamentally collaborative, interactive endeavours, critical to the success of future generations. It's an honour to collaborate with the Department of Information Technology and help deliver transformational education and health care services to the citizens of India. We believe communities, cities, countries and individual lives can be transformed by providing access to socially, economically and environmentally sustainable solutions."

Mr. R. Chandrashekhar, secretary, Department of IT and Chairman, CSC e-Governance Services India Ltd., stated: "I am very pleased that this innovative technology platform will bring high-quality health care and education services to villagers across India. It's very encouraging to see how two private sector companies are collaboratively building on the government's substantial investment in IT infrastructure and bringing services to the common man through the Common Service Centres."

CSC eGovernance Services India Limited has been incorporated to provide a range of services to support the Common Services Centre (CSC) network across the country such as back-end support for service delivery, create manage and promote a common "CSC" brand identity and assured quality of service, computer training centres, data processing centres, call centres and other ICT enabled delivery points for offering various e-services, etc. The company is to catalyze and accelerate the delivery of various eGovernance services through the CSC framework by developing appropriate end-to-end technology, business and service delivery models.

Serving two hospitals, 240 general practitioners and 600,000 patients in Austria, the Cisco Unified Computing System solution will serve as a hosting aggregation point for the region's existing Cisco Medical Data Exchange Solution (MDES), a platform for sharing medical records on-line, and will host all of the region's other applications and data. The decision to migrate to the Cisco Unified Computing System platform was made together with x-tention Informationstechnologie, to whom the Klinikum has outsourced its information technology operations since 2001 in order to simplify data centre management while reducing operational costs and improving the Klinikum's IT scalability.

Klinikum Wels-Grieskirchen is one of Austria's largest medical regions, supported by a staff of more than 400 doctors and 1200 nurses. The Klinikum's IT infrastructure has been outsourced to x-tention, a company that specializes in supporting the health care sector, for more than eight years. This latest implementation of the Cisco Unified Computing System is part of an ongoing relationship between Cisco and x-tention, which also installed the Cisco MDES at Klinikum Wels-Grieskirchen in 2008. The deployment builds on the previous innovations of the MDES platform whereby all of the Klinikum's data, such as medical records, X-rays and the like were made accessible to everyone who needs them across the region's hospitals, nursing homes, home care facilities and general practitioners' surgeries, significantly improving the quality and speed of decision making, diagnosis and patient care.

All of the Klinikum's existing applications and data, including the Cisco MDES and Citrix platform, have been migrated to the Cisco Unified Computing System in order to deploy the MDES platform to new more sites quickly, meet the Klinikum's rapidly increasing storage needs, reduce operational costs and improve overall system performance. This deployment represents the first time x-tention has used the Cisco Unified Computing System in one of its data centres.

At Klinikum Wels-Grieskirchen, the Cisco Unified Computing System is configured with two chassis, eight server blades and four Cisco 6120 fabric interconnects. The standards-based Cisco Unified Computing System, which unites network, computational, storage access and virtualization into a single cohesive system, has integrated with the existing environment of Cisco routers and switches, third-party equipment and software, and VMware virtualization technology.

The decision to move to Cisco Unified Computing System was driven largely by the Klinikum's growing data-storage requirements, which are increasing by 60 percent every year - data requirements in 2009 were 800 terabytes. The Klinikum needed a platform that could scale quickly and easily as its requirements changed. The project saw x-tention migrate the largest of its three existing data centres, which currently runs over 150 VMware virtualized servers for a number of health care regions in Austria, including Klinikum Wels-Grieskirchen, to the Cisco Unified Computing System platform. Following the success of the current deployment, x-tention plans to migrate its other data centres to the Cisco platform.

Cost savings include increased server utilization: The Klinikum's primary application for cross-regional health-data exchange, the Cisco MDES, now accounts for only 10 percent of the data center's system resources. The existing Cisco Unified Computing System platform can support up to 72 blade servers within its current configuration. The Klinikum requires just eight servers to operate today. To add resources to the environment, the IT engineers just have to put in another blade into the chassis. Prior to the installation of the Cisco Unified Computing System, any additional servers could take up to one month to be deployed because additional power had to be installed by the local electricity provider.

The deployment of the Cisco Unified Computing System has led to a 30 percent reduction in data centre cooling costs. With a unified fabric design and integrated network and storage access, the new Cisco Unified Computing System deployment uses 66 percent less cabling.

By using the Cisco UCS Manager service profiles, x-tention can provision new VMware virtual servers in half the time, from a whole day to just a few hours. Network, application and server layers are all managed within a single management console, reducing the number of consoles from six - three local area networks and three servers - to just one. Simplifying the ongoing management of servers and remote users, as well as streamlining the deployment of new services, has significantly reduced day-to-day operational costs. The new Cisco Unified Computing System platform is twice as fast as the previous rack-mount server configuration.

Harald Waibel, x-tention, stated: "Having worked with Cisco for a number of years on different projects, including the MDES deployment for Klinikum Wels-Grieskirchen in 2008, we were curious about the claims made by the Unified Computing System. Now that the system is fully deployed in our data centre, we are thoroughly impressed. Every single benefit that Cisco promised has been achieved, from drastically improving server utilization and scalability, to simplifying server management and reducing operational costs. We have been so impressed with the Cisco Unified Computing System platform that we recommend it for all our customers' data centres."

Elmar Flamme, CIO, Klinikum Wels-Grieskirchen, stated: "Combining the Cisco Unified Computing System with our existing Cisco MDES platform has directly improved the care we are able to deliver to our patients. While MDES first revolutionized our service by making all medical information readily available across all sites, the Cisco Unified Computing System has taken the service to the next level by allowing all these services to be deployed and managed in new sites quickly and easily, while significantly improving the performance of all applications. Additionally, it significantly reduces the maintenance and life cycle refresh costs of our data centre, as well as making service provision much more efficient."

More Cisco news is available in the VMW February 2010 article Cisco and Molina Healthcare announce transformative telemedicine pilot programme for underserved and underinsured communities.

Source: Cisco Systems Inc.

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