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Configuration Guide
Intended use
This network configuration guide is intended for hospital IT departments and network
administrators/designers and GE network design consultants. Its purpose is to aid
the hospital or hospital assigned entity in the designing, configuring and testing of a
Patient Monitoring Network implemented as VLAN to the hospital enterprise network
or implemented as its own network separate from the hospital enterprise network.
Ordering manuals
A paper copy of this manual will be provided upon request. Contact your local GE
representative and request the part number on the first page of the manual.
Revision history
The part number and revision letter for this manual are at the bottom of each page.
The revision letter changes whenever the manual is revised. The first letter shown in
this revision history table is the first customer-released version of this document.
Revision Description
A Initial release of this manual.
B Updated to remove checkout and checkout
form.
C Updated recommendation and equipment.
Revision Description
D Updated the following sections:
● Cautions
● Symbols
● Design Control
● Performance
● Acronym definitions
● back cover
E Updated the following sections:
● Warnings
● IP Addressing
● Speed and Duplex
● Renamed ATS to CTS
● Checkout form
Related documents
● Patient Monitoring Network Approved Equipment List
● CARESCAPE Network Router Supported Service Supplement
Responsibility
Customer/network installer responsibility
● Management of the network traffic, bandwidth, security and performance to
support the patient monitor(s).
● Management of network that ensures bandwidth and performance required for
patient monitoring is met.
● Maintenance and troubleshooting of the network.
● Process management to coordinate planned network maintenance and outages
and provision for unplanned outages.
● Design and configure network connectivity for the patient monitoring network
addressing network related issues.
● In additional to the above responsibilities, GE recommends following the
responsibilities outlined in IEC 80001-1:2010 Application of risk management for IT
Networks incorporating medical devices.
Manufacturer responsibility
● Provide installation and troubleshooting of the patient monitoring equipment under
warranty or extended service contract.
● Provide guidelines in designing and integrating the patient monitoring VLAN on a
hospital enterprise network, or designing a segregated patient monitoring network,
addressing issues related to patient monitoring products.
Safety information
Safety statements
The safety statements presented in this chapter refer to the system in general and, in
most cases, apply to all aspects of the network. There are additional safety statements
in other chapters which are specific to that chapter content.
The terms danger, warning, and caution are used throughout this manual to point out
hazards and to designate a degree or level of seriousness.
The order in which safety statements are presented in no way implies the order
of importance.
Dangers
Danger statements identify an imminent hazard which, if not avoided, will result in
death or serious injury. No danger statements apply to this system.
Warnings
Warning statements identify a potential hazard or unsafe practice which, if not
avoided, could result in death or serious injury.
The following warning statements apply to this system.
WARNING LOSS OF MONITORING — The network design should provide
resources for the Patient Monitoring Network clients;
bandwidth, equipment CPU and memory should be available,
not only during normal network activity, but also during
periods of traffic bursts, compromised states of network and
presence of unplanned traffic.
Cautions
Caution statements identify a potential hazard or unsafe practice which, if not
avoided, could result in minor personal injury or product/property damage.
The following caution statements apply to this system.
CAUTION NETWORK INSTALLATION REQUIREMENTS— Failure to comply
with the installation requirements as defined in this document
can impact the performance and reliability of the network.
Notes
Note statements provide application tips or other useful information.
Equipment symbols
Manufacturer name and address.
Overview
Patient Monitoring Network description
The Patient Monitoring Network designed by the customer to host GE monitoring
devices should deliver the same performance and function as the CARESCAPE
Network (a segregated network infrastructure designed and commissioned by GE
to host GE patient monitoring devices). The CARESCAPE Network has its dedicated
equipment separate from the hospital network infrastructure.
The monitoring devices, that include bedside monitors, central stations, gateways and
servers, are referred to as client devices to differentiate them from network equipment.
The Unity Network has been renamed to the CARESCAPE Network. Not all references to
the Unity Network will be changed immediately. Unity may appear in some places and
CARESCAPE in others. It is important to understand that while the CARESCAPE Network
replaces the Unity Network name, they refer to the same GE monitoring network.
There are three types of data coming from GE monitoring devices:
● MC: Mission Critical, consists of real-time clinical traffic that includes:
■ Service discovery (RWhat)
■ Alarm broadcast
■ Alarm configuration
■ Waveform request/update
■ Parameter request/update
■ Time request/response/update
■ Admit/discharge
■ Trends
■ Graphs
● IX: Information Exchange, consists of non-real-time clinical traffic that includes:
■ Full disclosure
■ Print data
■ Citrix data
■ HL7 outbound data
■ Patient data, including waveform and numeric data via the CARESCAPE Gateway
High Speed Data Interface (HSDI)
■ Non-clinical data (such as InSite)
■ ADT inbound
● RX: Real-time unprocessed telemetry data, that includes communication between
Access Points (APs) and the ApexPro hosts that process data and determine alarm
condition. The RX network is not allowed to share its network equipment with the
hospital network.
Traditionally, monitoring devices that communicated to both the MC and IX networks
required two network connections. Devices that only interface to the MC network, but
have the ability to communicate to the IX network and hospital network are referred
to as Inter-VLAN devices. Routing among the Patient Monitoring Network VLANs
enable a network client to use a single interface to reach devices in other networks.
The single interface has to be connected to MC so monitoring devices can listen
to MC Network broadcasts that are not routed. The network may have controlled
connectivity to the hospital network using the router function of the core/distribution
layer equipment or using an existing IX router.
The CARESCAPE Network MC network, IX network and RX network provide the
connectivity for the exchange of MC data, IX data and RX data generated by MC
clients, IX clients and RX clients, respectively.
The Patient Monitoring Network provides connectivity for the exchange of MC and IX
data as discussed in VLAN (14).
VLAN
A VLAN is a logical network of client devices that runs on a physical network
infrastructure of switches that could potentially be shared with other VLANs.
VLANs in the same physical network behave as separate networks. Client devices in
different VLANs cannot send unicast or broadcast to each other without using routers.
The network that provides connectivity to MC client devices and the network that
provides connectivity to IX client devices can be implemented as VLANs in the hospital
network, together with hospital VLANs that carry data, voice or video traffic. Or they
could be implemented as VLANs in their own network that is not shared with hospital
VLANs that do not carry patient monitoring data.
The network that provides connectivity to RX devices cannot share the hospital
enterprise network infrastructure.
The Patient Monitoring Network hosting MC client devices will be referred to as the MC
network and the VLAN implementation of the MC network will be referred to as the MC
VLAN throughout this document. The network hosting IX devices will be referred to as
the IX network and the VLAN implementation of the IX network will be referred to as
the IX VLAN throughout this document.
Requirements
If a product is not listed in this section, consult the product manual for more
information on settings.
The Patient Monitoring Network (as an enterprise VLAN or as a segregated network)
must meet the requirements of GE monitoring products that are clients on the
network. Basic requirements of the MC Network clients and the IX Network clients
most affected by sharing network infrastructure are:
● Performance: Latency less than or equal to 250 ms.
● Reliability: Packet loss less than or equal to 5 per million packets
Factors affecting performance and reliability are discussed in Recommendations (22) .
monitoring device services needing router connectivity to the hospital network, refer
to the appropriate documentation (e.g., CARESCAPE Network Router Supported
Service Supplement or the appropriate product documentation).
The RX network is not allowed to share its network equipment with the hospital
network. Also, the RX network is not connected to the hospital network.
Performance requirements
The MC application requires MC packet latency of less than 250 ms. Packet latency
from the ApexPro Telemetry Server (ATS)/CARESCAPE Telemetry Server (CTS) or bedside
to the CIC Pro Clinical Information Center (CIC Pro center)/CARESCAPE central station
must be less than or equal to 250 ms in order for the system to meet AAMI EC13
- 2002 Sections 4.2.8.4, 4.2.8.5, 4.2.8.6 Time to Alarm.
Reliability
The MC application requires MC packet loss of less than or equal to 5 packets per
million.
Packet loss referred to in the requirements is measured in one direction between two
specific endpoints. It is not the aggregate packet loss of the network as a whole.
Packet loss count is measured on a fully operational, properly configured network; it
does not include packets that did not reach the destination because of downtime on
the network.
IP addressing configuration requirements
The MC network requires to have its own network address that is different from the
IX network. This prevents confusion on devices(which have a dedicated MC and an
IX interfaces) regarding which interface to use. Some older devices do not support
classless subnets. If minimum of one device which operates on classful address is
present in the network, then classful IP addressing should be used. The IX network may
use subnets depending on whether all the IX clients support classless subnets. Solar
9500 has a dedicated MC & an IX interface, and it does not support classless subnets.
The following products do not recognize subnet masks or do not support classless
subnetting on both MC and IX:
● DASH
● Solar
● Unity ID
● ATS or CTS
● CIC
Addition to above mentioned reference list of devices, it is recommended to refer the
documentations shipped with the respective device to confirm if the device supports
classful or classless IP addressing.
In addition, it is required that all MC client devices that need to communicate with
each other are placed in one broadcast domain (single MC VLAN). This is because IP
broadcasting is used by MC client devices to discover services, announce alarms and
synchronize time.
Customers use their own IP addressing scheme. Devices are shipped with 126 or 172
MC IP addresses. However, it is recommended that public IP addresses, such as 126,
should not be used without proper authorization, and that all addresses should be
verified to be unique before installation.
The maximum size of the MC Network is typically 1023 RWhats, but may be larger
or smaller as determined by the most limiting device. Refer to the documentation
provided with the device that will be connected to the network for more information.
Some older devices have more limitations on network size, as shown in the following
table.
Device Configuration1 Number of patient Number of RWhats
views supported supported
CDT LAN Wired 10 per patient, but 1023
no more than 50 per
tower total
Eagle Wired 10 800
Wireless 5 500
The qualified switches are able to negotiate correctly with client devices configured
to auto negotiate.
Qualified switches are also able to default to correct settings with client devices fixed
at 10 Mbps/Half duplex.
However, the switch is unable to negotiate or default to correct duplex setting with
client devices fixed at 100 Mbps/Full Duplex.
Refer to the following table for speed/duplex settings on CARESCAPE Network client
devices.
If a product is not listed in the table, consult the product manual for speed/duplex
settings.
Device Port name Default Maximum speed Recommended
speed/duplex and duplex switch port
setting on the supported by setting
device NIC the client device
Central station platforms
Bedrock MC Auto-negotiate 100 Mbps/Full Auto-negotiate
Nightshade IX Auto-negotiate 100 Mbps/Full Auto-negotiate
BCM
MP100 MC Auto-negotiate 100 Mbps/Full Auto-negotiate
IX Auto-negotiate 1000 Mbps/Full Auto-negotiate
MP200 MC Auto-negotiate 1000 Mbps/Full Auto-negotiate
IX Auto-negotiate 1000 Mbps/Full Auto-negotiate
Telemetry Server platforms
NOTE Speed and duplex settings may vary depending on the Device
version. Refer to product documentation shipped with the
device to confirm the speed and duplex settings supported
by the device.
The following table shows the CARESCAPE Network client devices that apply DSCP
markings on the packets. Products not listed do not mark traffic.
2. If client device is fixed at full duplex, the switch port must be set to the same speed and duplex setting as the client device. If client device
is fixed at half duplex, the switch port is kept in the default configuration of auto-negotiate so the switch port can default to half duplex
but will detect and match client speed.
High-quality network devices selected by the hospital for its infrastructure and
selected to host the Patient Monitoring Network should pass functional and system
testing under design control. The hospital may select network devices that have been
qualified by GE or they may choose to check alternate devices, or appoint another
entity to manage the verification.
Qualified network equipment testing requirements
Requirements to be met during testing come from different sources, including the
following:
● Network client requirements, in terms of function, performance and reliability.
See Requirements (17) .
● User requirements, in terms of ability to configure and manage the network and
availability of documentation.
■ Quality of service
■ Redundancy
■ Network monitoring
■ Labels in English
■ OS download
■ SNMP, NTP
■ Password protection
■ Banner
■ Stacking
■ Link aggregation
■ Routing
■ Throughput
These numbers are generalized and will vary widely depending on use model of the
devices. Refer to the following sections for detailed calculations.
CARESCAPE Network RWhat broadcast
The frequency of RWhat packets depends on the number of bedside monitors
connected in the CARESCAPE Network.
The bandwidth of RWhat broadcast for 1023 devices: 1023 devices* 38.29 bps per
device = 39170 bps, 39 Kbps RWhat.
CARESCAPE Network alarm broadcast
The frequency of alarm broadcast packets is one packet every two seconds while the
device is in an alarm state. The size of an alarm broadcast is 130 bytes.
Even if there are two alarms active in a bedside monitor, only one Alarm Broadcast
packet is sent.
The bandwidth of alarm broadcast for 1023 devices: 1023 devices * 130 bytes/2 sec
per device = 66495 bytes per sec = 531960 bps = 532 Kbps.
Bandwidth of GE bedside patient monitors
A typical patient monitor has one waveform stream (referred to as patient view in this
document) required for display on the CARESCAPE Central Station and one waveform
stream required for Full Disclosure. For each patient view, 40 Kbps is required. This
amounts to 80 Kbps waveform traffic per patient monitor.
To account for the rest of CARESCAPE Network traffic (alarms, RWhats, graphing,
histories, trends, etc.), assume that the waveform traffic is 80% of the total.
The remaining traffic will amount to approximately 20 Kbps, totaling 100 Kbps per bed.
This number can vary significantly depending on the use model. For example,
configuring a bedside patient monitor to Auto View on Alarm (AVOA) can cause a
sudden increase in bandwidth generated by the alarming bedside because each view
requires approximately 50 Kbps.
Bandwidth of CTS
The CARESCAPE Telemetry server (CTS) outgoing traffic to the MC VLAN is calculated
as follows (assuming each of the 16 patients is viewed once and full disclosed):
16 patients * 100 Kbps = 1600 Kbps
The CTS incoming traffic from the network to the MC VLAN is calculated as follows:
((16 patients * 108 bytes parameter requests/10 sec) + (16 patients * 108 bytes
waveform request/10 sec)) * 125% for rest of traffic = 3.4 Kbps.
The CTS can source up to 40 views per patient, meaning the maximum outgoing
bandwidth for an CST be up to 16 patients * 40 views * 50 Kbps = 32 Mbps.
Bandwidth of Central station
The bandwidth of central station incoming MC traffic is 1.65 Mbps; outgoing on MC
traffic is 5.4 Kbps; outgoing/incoming on IX during transmission: depending on usage,
when not limited by bandwidth, full disclosure retrievals can result in short bursts of
2 to 12 Mbps.
The switch trunk port with 100 Mbps bandwidth, full duplex, could easily handle an
additional full disclosure traffic (Depending on usage, when not limited by bandwidth,
full disclosure retrievals can result in short bursts of 2 to 12 Mbps) on IX network.
Recommendation
Mixing patient monitors with central stations in the same switch is a good way to
utilize available uplink bandwidth; central stations use incoming link; patient monitors
use outgoing link.
Also, having a central station view patient monitors on the same switch allows for
monitoring of 16 patients simultaneously in case of distribution switch failure.
Switch use case 2
Another possible use of a 24-port access switch is to host central stations in a
monitoring center. Assuming there are eight central stations getting data from across
the network, eight central stations occupy eight MC ports and eight IX ports in a
24-port switch; eight ports are Admin and spares. The following is the estimated
bandwidth usage on the switch uplink trunk port.
Uplink port traffic Broadcast Eight central Total (average
stations traffic)
Incoming 566 Kbps 1.65 x 8 = 13.8 Mbps
13.2 Mbps
Outgoing 5 Kbps 5x8= 45 Kbps
40 Kbps
Access switches are connected to the distribution switch using at least 100 Mbps,
full duplex link.
Switch use case 3
Use a 24-port access switch to host ApexPro hosts in a closet.
The ApexPro host uses approximately 1.6 Mbps to send two views for each of 16
patients (one for viewing on a central station, and one for full disclosure). ApexPro v4.1
and later are updated to handle up to 40 waveform requests per patient. A single
ApexPro host could potentially send 64 Mbps of waveform data.
Recommendation
Use the calculated bandwidth usage to determine if adding an ApexPro host to a
switch will exceed uplink bandwidth. Do not concentrate the ApexPro hosts to one
switch unless there is a mitigation plan for loss of monitoring for the telemetry patients
affected when the switch becomes disconnected or non-operational.
There is no backup monitoring available for telemetry patients if the ApexPro host is
disconnected.
Qualified network equipment limit on number of clients in access switch
The hospital may use the DSCP marking on packets from monitoring devices as a
basis for remarking packets. See QoS priority marking (21) .
MC and IX access ports for clients that implement DSCP markings should be
configured to trust DSCP markings of incoming packets. Ports for clients that do not
implement DSCP markings should be configured to apply markings to all incoming
packets according to hospital priority scheme.
Mappings between CoS and DSCP should be maintained consistently throughout
the network.
Installation
Cabling
Cabling must use the following:
● Category 5e at the minimum for speeds of 10, 100, 1000 Mbps and at least
category 6 or 6A for speed of 10 Gbps
● Fiber uplinks whenever there is possible electromagnetic interference (EMI) and
other environmental interference; the fiber may be multi mode (62.5/125 or 50/125
micron) or single mode depending on distance and optical transceiver used
The fiber runs must be tested and certified in accordance to ANSI/TIA/EIA-526-14A
standards.
The cabling must meet standards defined in ANSI/TIA/EIA-568-B.1-2001, -B.2-2001,
-B.3-2001 or later issue of the standards.
Network equipment protection
Network equipment protection is necessary in achieving the close to zero downtime
goal for the CARESCAPE Network. The following security measures are required:
● Network equipment must be in an area with restricted access such as a locked
closet or enclosed rack.
● Configurable network equipment must be protected with a password.
In addition, measures must be taken to protect network equipment from loss of power.
Network equipment must be connected to UPS (Uninterruptible Power Supply). It is
recommended that UPSs have SNMP v3 or v2 and have an RJ-45 Ethernet connection
for remote management.
It is strongly recommended that a backup power system (e.g., emergency power
supply) is available for network devices so communication is uninterrupted when
power is lost for a longer duration.
It is recommended that configurable network equipment display a warning message
before the login prompt to indicate it is used for patient monitoring; this is to prevent
unintentional changes to the configuration.
Labeling recommendations
Labeling prevents mishandling and misuse of equipment. The following labeling is
recommended for the applicable equipment:
● Network equipment should have a warning label to indicate it is used for patient
monitoring.
● Power cords for networking equipment should have warning labels to indicate that
they are used to power devices that carry patient data. It is recommended to place
the label near the plug to the power source.
● Network cables attached to the network equipment should have warning labels
at both ends of the cable to indicate that they carry patient data; segregated
networks may use color-coding to identify cables used exclusively for the Patient
Monitoring Network.
● Wall jacks used to connect patient monitoring devices should be clearly labeled or
marked to differentiate them from wall jacks of different networks.
Environment requirements
Equipment must be in an environment that meets equipment operating requirements
in terms of temperature, absence of interference (EMI) and other environmental
factors.
Operating ambient temperature range is between +0 °C to +35 °C (32 °F to 95 °F)
Storage ambient temperature range is between -25 ºC to +70 ºC (-13 ºF to +158 ºF)
Atmosphere up to 85% relative humidity
Normal office environment meets equipment operating requirements.
Maintenance
Process to coordinate planned downtime
The hospital should have a documented process to coordinate planned network
downtime and maintenance with the biomedical and clinical representatives.
Network design documentation and record
The network should have documentation of its design, installation, configuration
and commissioning. Documentation of the network includes but is not limited to
the following:
● Equipment list
● Interconnection matrix
● Topology drawing
● Closets and equipment in closet
● Cable run diagram
● Cable certification record
● Equipment configuration
● IP addresses (used and available)
● Commissioning record
Network monitoring
A good network management policy is one that is proactive. It monitors traffic
regularly, looking for changes in network usage. It uses network management tools
that notify administrators of change in link and network device status.
SNMP monitoring of the status of the switch, its modules and trunk ports is strongly
recommended, especially in chassis-based network equipment. It enables correction
of a non-catastrophic failure like fan failure before it causes a switch shutdown.
Network equipment should be time synchronized so a sequence of events could be
created using logs from the different equipment. NTP is the recommended protocol.
will require 5 Mbps of MC bandwidth, the QoS policy for that link should ensure the MC
VLAN receives at least 5 Mbps even in the presence of higher priority traffic. Higher
priority traffic, like voice and video, may have preferential queuing, to minimize jitter,
but they should not starve the MC VLAN of bandwidth.
Limited access to Patient Monitoring Network
The hospital enterprise network should not route data in and out of the Patient
Monitoring Network, except for the limited specific data that is necessary for the
operation of the Patient Monitoring Network client devices.
If there is a route between the hospital VLAN and the Patient Monitoring Network, that
route should be controlled and access should be limited.
Cases when routing is enabled include the following:
● If there are Patient Monitoring Network client devices that communicate to devices
in the hospital network, then controlled routing should be implemented. See
Connectivity (17) .
● If there is a resource shared with the hospital, such as an NTP and SNMP server,
then routing is implemented to enable these services.
● Inter-VLAN routing between MC and IX networks is enabled to allow Inter-VLAN
devices on MC networks to communicate to devices in the IX networks.
● Limited one-way routing may be permitted from the MC network to third-party
devices.
Protection from virus, intrusion, denial of service attack recommendations
A hospital enterprise network that is open to many users and is connected to other
networks such as the Internet has increased chances of being brought down by
viruses and denial of service attacks.
The hospital enterprise network should have protection from virus, denial of service
attack and intrusion.
Due to varying protection levels of client devices, the overall network protection relies
on being in an isolated or protected network to avoid virus and denial of service
attacks.
The hospital network management is responsible for the selection, maintenance and
assessment of effectiveness of its network protection system.
Additional documentation recommendations
The Patient Monitoring Network documentation is in addition to hospital enterprise
network documentation. See Shared equipment and link data sheet example (63).
Documentation should include:
● List of shared network equipment and links and configurations
● List of additional network equipment and links and configurations
● Documentation of interconnections: spreadsheet and diagrams
● VLAN spanning tree root and backup root (if redundant)
● QoS scheme showing the Patient Monitoring Network with respect to hospital
VLANs
● Documentation of IP addresses used for Patient Monitoring Network
● Data path for each Patient Monitoring Network and VLANs sharing path with
Patient Monitoring Network
● Current loading at trunk ports of shared network equipment for baseline purposes
Patient Monitoring Network management
The Patient Monitoring Network management should be part of the hospital network
management.
Management responsibility includes ensuring the network delivers the connectivity
and performance required by the applications running on the network.
GE recommends that the Patient Monitoring Network be commissioned by GE prior to
being used to ensure it meets monitoring product requirements.
Close to zero downtime
The equipment used for the Patient Monitoring Network has to be maintained with
a goal of zero downtime. Scheduled downtime due to changes or relocation of
equipment, etc., should be close to zero once monitoring is started.
As much as possible, hospital network expansion and maintenance should not cause
disruption of traffic on the Patient Monitoring Network.
Network changes policy
Additions and changes to the network equipment shared with the Patient Monitoring
Network should meet the applicable requirements specified in this guide.
Changes in Patient Monitoring Network and hospital traffic that goes through shared
equipment and changes in topology should meet applicable requirements specified
in this guide.
GE recommends following the responsibilities outlined in IEC 80001-1:2010 Application
of risk management for IT Networks incorporating medical devices. As part of a fully
risk-managed medical IT-Network, formal configuration and change management
policies are in effect, and include documentation of network changes as well as
verification of network functionality before go-live.
Changes to the network should initiate Risk management activities according to
hospital Risk policies.
Additionally, re-commissioning is recommended for areas of the network which carry
the Patient Monitoring Network VLANs for the following changes:
● Adding GE monitoring devices to existing edge/access switches
● Adding non-GE, bandwidth deterministic clients to existing edge/access switches
● Adding of an edge switch to an existing care area
● Network re-architecture to add capacity or modification of data flows
● New care area expansion
● Hardware upgrades to core switches
● Adding of new high priority VLANs (e.g., VoIP, video)
● Adding of new high priority devices
1. Check that the network devices are qualified by GE or the hospital. Refer to the
Patient Monitoring Network Approved Equipment List for a list of equipments.
2. Check that the switches used as access switches, distribution and aggregator
switches for Patient Monitoring Network are qualified for those roles. Refer to the
Patient Monitoring Network Approved Equipment List.
3. Check redundancy on switches that are approved for use in redundant
configuration only. Refer to the Patient Monitoring Network Approved Equipment
List for redundancy requirements on GE qualified equipment.
4. Check that the roles & limitations of the network equipment are implementation
appropriately. For details of the defined roles & limitations, refer to the Patient
Monitoring Network Approved Equipment List.
5. Check if there is a loop prevention mechanism in the network design.
6. Check if no two access ports are directly connected.
7. If spanning tree protocol (STP) is used to prevent loops, check the shared
distribution switches are the root and backup root (for redundant configuration) of
the STP for the Patient Monitoring Network.
The shared distribution switch designated as the root should be assigned the
lowest numeric STP priority for the Patient Monitoring VLAN. The backup root is
assigned the second lowest numeric priority.
8. Check that a redundant topology is implemented.
9. Check that the Patient Monitoring Network extend only to the sections of hospital
network servicing areas with patient monitoring devices.
10. Check that no more than 48 access ports per switch are assigned to the MC VLAN.
Access switches design recommendations checkout
1. Check that hospital devices sharing access switches with GE patient monitoring
devices have known average port bandwidth utilization:
The bandwidth referred to here is the theoretical bandwidth calculated or
historically known for a device, versus the actual bandwidth reading on the
access switch.
2. Check that, the sum of uplink bandwidth usage in the Patient Monitoring Network
is less than or equal to 80% of uplink bandwidth of 1 Gigabit per second, 40% of
uplink bandwidth of 100 Mbps or lower. The limit applies separately for input
and output in a full duplex link.
Estimate input and output bandwidth for shared uplink on each shared access
switch.
3. Check that shared access switches shall receive user traffic on its uplink only
on VLANs of its client devices.
Refer to Bandwidth calculations for GE monitoring devices (26) .
Data flow design recommendations checkout
1. Check that the data flow of the MC and IX VLANs are established in the design
phase and traffic bottlenecks are identified and resolved even before topology is
implemented.
QoS design recommendations checkout
1. Check that the hospital enterprise network’s priority scheme for QoS gives
preferential treatment to MC data according to the guidelines in this document.
2. Check that the hospital network assigns COS or DSCP priority to MC network and
IX network packets according to the priority order.
Installation recommendations
Cable installation recommendations checkout
1. Check that cables used are:
● Category 5e or higher for speeds of 10, 100, or 1000 Mbps and at least 6 or 6A
for a speed of 10 Gbps.
● 62.5/125 micron or 50/125 micron multi-mode fiber, or single mode fiber for
uplinks, whenever there is possible EMI or other environmental interference.
This can be based on data furnished by the installer or site IT department.
2. Check cabling meets applicable standards based on cable type defined in
ANSI/EIA/TIA -568-B1-2001, 568-B2-2001 and 568-B3-2001. This can be checked
based on data provided by the installer or site IT department.
3. Check that fiber runs are tested and certified in accordance to
ANSI/TIA/EIA-526-14A. This can be checked based on testing performed by the
installer or other qualified individuals. A copy of the certification record is kept as
part of the network documentation.
4. Check that the network cables are identified as Patient Monitoring Network. The
segregated CARESCAPE Network may use color coding instead of warning labels
to identify cables used exclusively for the Patient Monitoring Network.
5. Check that wall jacks are clearly labeled or marked to differentiate them from
wall jacks of other networks.
Network equipment installation recommendations checkout
1. Check that the network equipment is in an area with restricted access.
2. Check that the network equipment is connected to UPS.
3. Check that there is a backup power supply (e.g., emergency power system)
available in case of power outage. If not, check that the use of backup power
was recommended to the customer.
4. Check that N+1 network equipment is installed per closet.
5. Check that the network equipment environment meets the equipment operating
requirements. The following are the requirements for GE qualified equipment:
● Operating ambient temperature range is between +0 °C to +35 °C (32 °F to
95 °F)
● Storage ambient temperature range is between -25 ºC to +70 ºC (-13 ºF to
+158 ºF)
● Atmosphere up to 85% relative humidity
Normal office environment meets network equipment operating requirements.
6. Check that the network equipment has the appropriate Warning label.
7. Check that the network equipment power cord has the appropriate Warning label.
IP connectivity requirements
IP connectivity requirements checkout description
The testing requires two computers used as client devices.
A computer can be a laptop, central station, server or network client device that is
configurable with an IP address and gateway and is able to ping.
IP connectivity requirements checkout procedure
1. Check IP connectivity on the administration network.
a. Configure a computer with an Administration VLAN IP address.
b. Connect to an Administration port.
c. Ping the IP addresses of all the switches from the computer.
d. If the pings are successful, pass the test.
2. Check the IP connectivity on the MC network.
a. Configure two computers with MC IP addresses.
b. Connect the computers to MC ports of different access switches.
c. Check the computers are able to ping each other.
d. Test other access switches by moving the computers to different access
switches and repeat ping.
e. If the pings are successful, pass the test.
SNMP checkout
Check SNMP monitoring of the network, in particular the status of a chassis-based
switch, its component modules and its trunk ports.
Protection checkout
Check that the hospital network has some form of protection from viruses, as well as
denial of service for attacks and intrusions.
Process checkout
Check that the hospital has a documented process to coordinate implementation of
changes to the Patient Monitoring Network among the parties affected, including
biomedical and clinical staff.
Commissioning checkout
Check that it was recommended that GE perform commissioning of the Patient
Monitoring Network prior to using the network after installation or upgrade.
Term definitions
Term Definition
Access switches Switches with ports that connect to edge
devices.
CARESCAPE Network The network infrastructure designed and
commissioned by GE to host GE patient
monitoring devices.
CARESCAPE Network protocol The application layer protocol that defines
the rules of communication among
CARESCAPE Network patient monitors,
central stations, data servers and other
supporting devices.
Central Station CIC Pro Clinical Information Center and/or
CARESCAPE Central Station
Data link Layer two of the seven layer OSI network
model.
Distribution switches (DS) Switches with mostly trunk ports that
connect to access switches.
Term Definition
Edge devices PCs, medical devices, servers, etc., connected
to the network.
Information exchange (IX) Non-real-time clinical data.
IX Network The network for non-real-time, information
exchange data.
Jitter Variation in latency.
Latency Time it takes for a packet to travel from
source to destination.
MC Network The network for real-time mission critical
data.
Mission critical (MC) Real-time patient data.
Quality of Service (QoS) The preferential delivery of data based
on priority markings.
Shared links Hospital network links that carry Patient
Monitoring Network traffic.
Shared switches Hospital switches that allow Patient
Monitoring Network in their trunk ports to
have ports belonging to Patient Monitoring
Network.
Inter-VLAN devices Monitoring devices that only need an
interface to the MC network to send
messages to MC, IX and hospital networks.
Unity Network The Unity Network has been renamed to
the CARESCAPE Network. Not all references
to the Unity Network will be changed
immediately; Unity may appear in some
places and CARESCAPE in others. It is
important to understand that while the
CARESCAPE Network replaces the Unity
Network name, they refer to the same GE
monitoring network.
General information
Site: ________________________________________________________________
Date: _______________________________________________________________
GE Representative: _____________________________________________________
Site Representative: _____________________________________________________
Documentation recommendations
Category Test description Numerical Recommended/
results (if Implemented
applicable)
Documentation Equipment list
Interconnection and topology
documented
Closet with racks and equipment
documented
Equipment configuration
Cable run and cable certification
IP addressing
Installation commissioning
Category Test description Numerical Pass/
results (if Fail
applicable)
Installation commissioning Installed configuration is the same as
documentation
Configurable network equipment is
password protected
IP connectivity requirements
Category Test description Numerical Pass/
Results (if Fail
applicable)
IP connectivity IP connectivity on Administrator
network
IP connectivity on MC network
IP connectivity on IX network
IP controlled connectivity between IX
VLAN and hospital VLAN
IP connectivity for no No IP connectivity between MC VLAN
Inter-VLAN design and other networks
IP connectivity for IP connectivity between MC VLAN and
Inter-VLAN design IX VLAN
IP connectivity between MC VLAN and
hospital VLAN
All testing and results are subject to the terms and conditions set forth in the
agreement between the parties with respect to these services.
● Completion of the above tests with passing results confirms that Patient Monitoring
Network, as currently configured, is suitable for carrying Patient Monitoring
Network traffic.
● The testing performed, as specified in this document, does not constitute a
guarantee of Patient Monitoring Network, the equipment on the network, the
network itself, or the performance of the network. The hospital understands
and agrees that many factors can affect both the equipment, as well as the
performance of the network.
● The hospital understands and agrees that the confirmation is for the Patient
Monitoring Network configuration and usage at the time of the test, and does not
guarantee future performance of Patient Monitoring Network. Among other things,
changes to the configuration of Patient Monitoring Network or additional traffic
volume could negatively impact the performance of Patient Monitoring Network,
possibly resulting in lost data.
● The hospital understands and agrees that it is responsible for the risk and function
of the Patient Monitoring Network and is responsible for the maintenance of the
Patient Monitoring Network configuration, the equipment on the network and
the network itself.
● The hospital understands the risk in exceeding the 48 port limit for MC in a single
network device and agrees to have a mitigation plan in case it exceeds the limit
and there is a loss of the network device.
Signatures
GE representative:_____________________________________________________
Site representative:_____________________________________________________
Closet
The following information should be provided for each closet that has network
equipment used for Patient Monitoring Network data traffic.
Hospital: ____________________________________________________________
Address: ____________________________________________________________
Location (building/floor/closet): ___________________________________________
Admin VLAN: ________________________________________________________
Admin Subnet: _______________________________________________________
Equipment Model Number of ports Shared with Admin
type/name Patient Monitoring
Network?
Switch205 Cisco 2960 24 10/100 BaseTx Yes
2 1000Base Sx
Switch209 Cisco 2950 24 10/100 BaseTx No
2 1000Base Fx
... ... ... ...
Access switch
The following information should be provided for each shared access switch or
additional switches for Patient Monitoring Network.
Hospital: ____________________________________________________________
Address: ____________________________________________________________
Location (building/floor/closet): _________________________________________
Switch:
● Model: __________________________________________________________
● Name: ___________________________________________________________
● Admin VLAN: ____________________________________________________
● Admin IP: ________________________________________________________
Access ports
Switch port Hospital VLAN(s) QoS,DSCP/CoS1Bandwidth Bandwidth Bandwidth
device avg/max avg/max (broadcast/
(current or (ingress) (egress) multicast)
planned)
Hospital
device
Hospital
device
...
Trunk ports
Switch port VLAN(s) Device to QoS setting Bandwidth Bandwidth Bandwidth
which trunk (trust or avg/max avg/max (broadcast/
is connected assign CoS)3 (ingress) (egress) multicast)
24 AP1
24 Switch 205
... ...
VLANs
VLAN Subnet STP Root STP Root Port5 Bandwidth Bandwidth
Switch4 (broadcast)6 (multicast)7
Distribution switch
The following information should be provided for each shared distribution switch.
Switch model: ________________________________________________________
Name: ______________________________________________________________
Admin IP: ___________________________________________________________
CPU Utilization: ______________________________________________________
Memory Utilization: ___________________________________________________
Trunks
Switch port VLAN(s) Device QoS setting8 Bandwidth Bandwidth Bandwidth
connected avg/max avg/max (broadcast/
(ingress) (egress) multicast)
1 Switch 101
2 Switch 205
... ...
VLANs
VLAN Subnet STP Root STP Root Port10 Bandwidth Bandwidth
Switch9 (broadcast)11 (multicast)12
GE Medical Systems Information Technologies, Inc., a General Electric Company, doing business as GE
Healthcare.
www.gehealthcare.com