Re: COVID-19 vs. our Networks

[Mike Hammett <nanog () ics-il net>]

Join an IX your provider is on? 




----- 
Mike Hammett 
Intelligent Computing Solutions 

Midwest Internet Exchange 

The Brothers WISP 

----- Original Message -----

From: "Mike Bolitho" <mikebolitho () gmail com> 
To: "Tom Beecher" <beecher () beecher cc> 
Cc: "NANOG" <nanog () nanog org> 
Sent: Tuesday, March 17, 2020 12:03:46 PM 
Subject: Re: COVID-19 vs. our Networks 




> The answer is don't shove application traffic that has tight service level requirements onto the public internet at 
> large and expect the same performance as private circuits or other SLA protected services. 


I keep seeing this over and over again in this long thread. What's your suggestion? How does a hospital, with dozens of 
third party applications/devices across multiple cloud platforms do this? 


We have two redundant private lines out of each hospital connecting back to primary and DR DCs and a metro connecting 
everything together in each region. But for things we do not own that are not hosted locally, what are we supposed to 
do? We have to go out DIA to get there. Everything we own is connected via fully SLAed private lines. We have zero 
issues there. I think people vastly underestimate just how much in the healthcare vertical is outside of a medical 
providers control/ownership. 



- Mike Bolitho 



On Tue, Mar 17, 2020 at 9:54 AM Tom Beecher <beecher () beecher cc> wrote: 



The answer is don't shove application traffic that has tight service level requirements onto the public internet at 
large and expect the same performance as private circuits or other SLA protected services. 






On Tue, Mar 17, 2020 at 11:40 AM Mike Bolitho < mikebolitho () gmail com > wrote: 

<blockquote>


<blockquote>
If an x-ray machine won't work because the Internet is down, I'm not sure that is responsible. As inefficient as it may 
be to have a license server on-prem if there is an option to check against one in the public cloud, for a medical 
use-case, that would make more sense to me. 





Totally agree with you. Unfortunately it's not a problem with the medical providers, it's a problem with the medical 
devices. Anybody who works in the healthcare vertical will tell you just how bad medical devices are to work with from 
an IT perspective. And that is part of my original comments. 


<blockquote>
In your case, I am not sure I have an answer for you, unfortunately. The public Internet is what it is, mostly 
best-effort. Your applications and use-cases certainly deserve better than that. I'm not sure how to achieve that as 
your industry shoves more and more activity into the public Internet domain, for one reason or another. 
</blockquote>



I don't know what it's going to take either. A general shift in mentality from the vendors we use I guess. I'm not sure 
how you get a bunch of medical providers to tell these companies they need to fix their stuff. You can't exactly use 
your wallet to force change either. There are only a handful of vendor options out there so there isn't a ton of 
choice. It's not like you can buy one of 50 different models of CT machines or EHR systems. 

Generally speaking it's not an issue. It's just in crazy times like these where, if congestion on the public internet 
gets too crazy, that certain platforms might need to be deemed "unnecessary". Is playing Fortnight a right? Is 
streaming a movie in 4K a right? In cases like San Francisco they have decided that leaving your home for anything 
other than work or medical care is no longer a right because you're now infringing on other's rights by potentially 
getting them sick. Maybe 4K Netflix fits into that category if you're causing problems for first responders and 
hospitals trying to save lives. 




- Mike Bolitho 



On Tue, Mar 17, 2020 at 2:22 AM Mark Tinka < mark.tinka () seacom mu > wrote: 

<blockquote>


On 16/Mar/20 16:54, Carsten Bormann wrote: 

> I recently had to reschedule an X-ray because the license manager for the X-ray machine was acting up. I don’t think 
> people have a grasp for how much of the medical infrastructure no longer works when the Internet is down. 

I get this, to some extent. But also, there is a reason hospitals, 
airports and military installations are either put on special power 
grids or invest plenty of money in backup power. 

If an x-ray machine won't work because the Internet is down, I'm not 
sure that is responsible. As inefficient as it may be to have a license 
server on-prem if there is an option to check against one in the public 
cloud, for a medical use-case, that would make more sense to me. 

Mark. 

</blockquote>

</blockquote>

</blockquote>