The network is the service

If the United States ever decides to reform its healthcare system, the reformers should stop by Scott Lokey's office in Atlanta to learn about the best way to incorporate network technologies into their plans. He does them all.

Lokey is the manager of network engineering for RelayHealth, an online service owned by McKesson that processes transactions between patients and their insurance providers with pharmacies, doctors, hospitals and other healthcare operators. Given the number of insurance companies, including Medicaid agencies in each state, with their individual and byzantine payment policies coupled with the myriad of connectivity requirements among RelayHealth's customers, Lokey has had to build a network that's not only fast and resilient, but one that can handle just about any protocol in use.

He says RelayHealth works with each healthcare operator specifically for its connectivity issues. Some mom and pop pharmacies can only handle one connection in one manner. Other multi-billion dollar pharmacy chains have the need for thousands of connections by multiple methods to RelayHealth's service.

As such, working with legacy technology becomes an everyday affair in Lokey's network.

"Yes, we still have bisync," he says, referring to IBM's binary synchronous communications protocol that was introduced in 1967, dominated the market into the 1980s and since has been usurped by TCP/IP.

Working with backend legacy systems is not the only reason Lokey's team continues to use aging protocols. As part of its 24x7 uptime demands, one large pharmacy chain has required RelayHealth to install X.25 connectivity as backup in case the Internet links go down on either end.

Beyond protocol management, the physical network links are equally diverse at RelayHealth. It has scads of T1 lines, a dozen DS3 connections as well as frame relay OC-3 and DS3 links to manage.

Most of the traffic over those links, of course, is IP-based. And RelayHealth settled on Seattle-based F5 Networks Inc., Lokey says, because scaling the network while keeping performance high was central to the business. He says one of the capabilities of F5's BIG-IP technology that sold him was the ability to offload SSL traffic without diminishing overall performance.

"We encrypt everything on the network, even if it's already encrypted," he observes.

He also likes the built-in redundancy features of the BIG-IP systems, which is helpful when linking to a small pharmacy with only one relatively low-speed connection.

Lokey says RelayHealth signs stringent service-level agreements with its customers, who would not be able to do business if the transaction across RelayHealth's network balked. Literally thousands of businesses and millions of medical transactions are utterly dependent on Lokey's network service. In fact, you could argue that at Relay Health, the network is the service.