Introduction

PAMS’ four clinics are remote.  Telephony services are provided by the Telstra microwave network.  The microwave links are inadequate to provide responsive connections to the internet. Approaches to Telstra, including to the office of the CEO David Thoday in March 2010, to install 3 or 4G communications to the communities were unsuccessful.  This meant that a costly satellite based system was the only option to enable PAMS’ four remote clinics to acquire responsive internet access to enable information management and eHealth.

Domestic grade satellite based systems had been installed at each of the PAMS’ remote clinics in 2006 but the 56k/56k Telstra system was unreliable and the speeds unusable.  A system upgrade with Orion Communications in 2008 enabled 256k/128k connections but this was also inadequate to support a Private Virtual Local Area Network (VLAN) with coordinated clinical information management between all the clinics and with the administration office in Newman.

The Board decision in September 2010 was to install an industrial strength network with the capacity for expansion in terms of bandwidth and connection speeds that would be capable of supporting 2 VLANs, one for clinical information and one for VOIP telephony, administration and non-clinical internet access.  The architecture of the network is summarised in the following diagram showing the PAMS Private VLANs to Newman and the link to a remote monitoring centre in Sydney.

PAMS satellite based communications overview

Components.

PAMS has three systems one satellite-based internet for the clinics, the second local-radio based to provide internet access via the satellite connection to staff houses and Dr’s quarters and the third being a Voice over the Internet (VOIP) telephony system.

A further consideration was the continued monitoring, operation and maintenance of a state-of-the-art system in a region where there are no technical support services in any of the communities and only limited support in the regional centre of Newman.  Therefore each of the clinics has identical infrastructure components.

Satellite-based system.

Parnngurr communications in place

The common components are:

1) an outdoor 1.8m KU band VSAT ground mounted antenna (satellite dish) with 4 Watt transmitter units
2) an indoor rack containing a satellite modem, multi-function router (SkyWire), wireless access point and 24 Port 10/100 managed Ethernet switch and a
3) stand-alone 2 KVA UPS with Ethernet connection to the switch.

Ground mounts were chosen for the satellite dishes because quotations to install pole-mounts in this cyclone prone region in such remote locations were prohibitively expensive.

The Newman office is the connection point to a high bandwidth SDSL

The indoor components are mounted in travel cases so that if there is a failure of any of the components a spare fully configured travel case is held in Newman that can be sent on the mail plane and swapped out on site, without any technical knowledge.

Travel case with communications components

Local Radio System

Local radio components

The local radios are based on 900MHz radio bridges.  One bridge at each of the clinics acts as a gateway connecting the network, or individual PC in each house, back to the PAMS network.  The common components are:

1) an external omni-directional base-station antenna
2) an external directional antenna with lightning arrester on each building
3) internal Trio bridge radio with router and
4) wireless access point

VOIP Phone System.

When the administration office was to be moved to a new location in Newman there was the opportunity to either move the existing PABX system at considerable expense or to install a new system with outreach to the clinics.  A newly released Hosted PBX system was selected which would allow all clinic phones to be extensions from Newman.  The purpose being to provide multiple lines for the PAMS main telephone number and the ability for calls to be transferred or tele-conferenced between any one or more locations.  This facility will enhance communication options for clinical and administrative functions with the initial focus on acute client care and case conferences.

The components are:

1) remotely hosted PBX
2) main switch phone in Newman
3) extension phones in each of the clinics, with multiple extensions in the main clinic in Jigalong.

Satellite services and Network Security

PAMS is teamed with URSYS which currently operates 3 separate iDirect technology based satellite networks, from the Mawson Lakes in SA, Bayswater in Perth and at Kalgoorlie satellite teleports. PAMS uses the Kalgoorlie hub which uplinks to the Thaicom 4 satellite. This is the hub URSYS uses to provide Telstra with its Iterra satellite services.

The general purpose IP Data network currently operated by URSYS provides contended customer services operating at business grade contention ratios of 10:1 and 16:1, with speeds up to 2Mbps. In addition this service Ursys provides private customer networks and the ability for customer self-contention amongst sites.  PAMS current budget allows for a 512/256kbps 10:1 service to provide a reasonable quality connection that can be upgraded as performance is monitored, user requirements change and funds become available.

Network Security, Encryption and Service Profiles Capability.

The iDirect platform implements AES and 3-DES encryption of the link layer as well as public/private key management and authentication using a protocol based on X.509 certificates designed to prevent man-in-the-middle attacks. This security protects data traversing the satellite and terrestrial links.
Service Profiles may be applied to the VLAN to give different profiles to different traffic types. For example Communicare database updates may be prioritised over other web traffic; operational priorities will be tuned with load balancing between the 2 VLANs with more being added if required.

Remote Monitoring

Remote monitoring, in Sydney, covers 3 situations monitored by the individual Skywire routers at each loaction:

1) WAN/LAN/VOIP Internet Failure alert.  When the SkyWire detects a failure of single link, traffic will automatically fail over to a redundant link if one is present and an event will be forwarded to the central Network Monitoring System (NMS) which will trigger notification to be sent to the PAMS Operations Manager.  At present there is a single satellite link but in the future a fail-over link is to be installed.
2) Power.  When the SkyWire detects a power failure or recovery from the UPS an event will be forwarded to the NMS which will result in an email being generated and sent to the nominated helpdesk contact for the site and to the PAMS Operations Manager. The NMS monitors power quality, outages and the condition of batteries.
3) Temperature.  The SkyWire will be configured to monitor equipment temperature and to send an event to the central NMS if temperature exceeds operating levels. Equipment will be automatically shutdown if a specified temperature is reached. The temperature will also be plotted for historical averages which will help pinpoint an extraordinary event.

The NMS also allows for remote detection of the operational state of the network and the VOIP phones to assist in network balancing and performance management.

Help desk facilities are provided from Sydney with a ticketing system in place to monitor response times for the resolution of issues according to a Service Level Agreement.

Reports

The purpose of the network management service is to ensure the stability of connections, quality of service and maintainability of systems.

A proactive management regime based on the URSYS NMS (Network Management System) has three main functions:

1) Service Polling – determining service availability.
2) Data Collection – collecting, storing and reporting on network information.
3) Event and Notification Management – receiving events, both internal and external

In particular, the NMS will enable URSYS to minimise the time taken to identify and rectify faults. In this instance URSYS uses the SkyWire router and an NMS agent to collect and identify the information of interest. The central NMS server receives and analyses information from remote site NMS appliances and provides:
1) A support desk view of the network
2) Automatic generation of alarms and alerts with subsequent email or SMS notification
3) Recording of historical performance data

Monthly reports are provided from the NMS and help desk.  Reports will cover:

1) satellite connection performance
2) internet access performance
3) VLAN performance
4) power conditions
5) the temperature regimes of the equipment (very important in the desert regions where temperatures in the shade exceed 50 degrees Celsius on occasion and there are lengthy period with temperatures in the mid-high 40s and
6) help desk ticket actions and outcomes.

Status:

After the decision of the Board of Directors to proceed with the project in September 2010, system configurations and componentry were refined in September and orders placed.  Equipment arrived in Newman in October and early November.

The Newman communications cabinet was commissioned in early October.

Logistics of getting items to Newman and then to the remote communities was a challenge complicated by needing to get 600kgs of cement to each site to weigh down the ground mounts for the satellite dishes.

The satellite and comms systems were installed and commissioned at each of the remote clinics in November and December 2010 and are to be fully tested and tuned in January 2011.  It is anticipated that periodic adjustments will need to be made to the directionality of the satellite dishes to ensure that the best quality signals available are being maintained, the first systematic re-alignment of satellite dishes was undertaken in February 2011.

Network performance monitoring  is underway with the Patient Information Recall System, Communicare.  For more details click here.

(to be continued)