Client Story: Region Nordjylland Hospital, Regional Healthcare System

"IT is a vital part of the operation of a modern health system so that patients can be treated in a timely and proper manner and have their health data safely stored. We are therefore immensely proud that we have become part of the exclusive club of only 41 companies in the world to achieve the Uptime Institute Tier IV Certification."

Klaus Larsen

CIO, Region Nordjylland

Image: Klaus Larsen, CIO, Region Nordjylland
Photo Credit: Lars Horn, Baghuset

The Challenge

In May 2016, capacity limitations led Region Nordjylland Denmark (North Denmark) to upgrade the data center at the Aalborg University Hospital. This 90-kilowatt (kW) facility, located in the basement of a 4800 square meter (m2) building about 4 kilometers from the hospital, was the region's primary data center. Because of the critical nature of the data center, government officials decided to upgrade its facility capacity to 225-kW of IT load and build new infrastructure to meet Uptime Institute Tier IV requirements.  In addition to capacity limitations, Region Nordjylland's legacy data center shared critical infrastructure with other functions in the building, including office spaces which was of concern.

Upgrading the existing data center created risk that could potentially affect the safety and well-being of the region's almost 600,000 residents. In Denmark, the regional government has three main responsibilities: health care, regional development, and social services, and it relies on just two data centers to provide the necessary IT support. The doctors, nurses, and administrators who work in the hospital rely on IT to provide clinical and administrative support. The region’s citizens also depend on these data centers, not only for clinical support, but also because Region Nordjylland is responsible for several national systems, including 911 (emergency) ambulance calls. In total, the Regional Nordjylland Denmark data center houses more than 500 systems including 911 ambulance services, patient health-care records, decision support systems, and other critical systems supporting over 15,000 employees.

The Solution

A Collaborative Effort to Meet The Tier IV Requirements
In order to reach their goals of Tier IV certification, Region Nordjylland started by referencing and applying Uptime Institute’s Tier Standard: Topology standards document.  This provided a baseline for the team to identify and understand the requirements of achieving Tier IV certification.

Second, Region Nordjylland leveraged the expertise of its existing personnel. Employees of the Regional Nordjylland IT department and technical department at Aalborg University Hospital collaborated on the planning, design, and development of the data center, so that the data center was fully designed by Regional Nordjylland’s own employees, with experience operating and designing hospital facilities. Guided by their extensive mission critical operations expertise the team used simple, but effective, solutions designed for operability and maintainability. 

Steffen Jacobsen, Technical Chief of the hospital, was very involved in the design and construction process. Jacobsen spent many years designing hospitals and offered his expertise to the IT department.

In pursuit of the Tier IV certification, Jacobsen and Sørensen took Uptime Institute’s Accredited Tier Designer (ATD) course.  During the three day training course, Jacobsen observed that hospitals and data centers have a lot of similarities, "Running a data center is not that different from running a hospital.  Hospitals must have reliable clean water, clean air, air conditioning, medical equipment, and scanners for the care of patients, but they also have generators, UPS, and cooling systems.”

The combination of Sørensen's data center management expertise and Jacobsen's technology background in hospital technical operations paid off, Sørensen credits Jacobsen with identifying 30 errors in the initial design.

Jacobsen has also been taking knowledge from the ATD course to the hospital. Sørensen noted, “Jacobsen is known for going through the hospital with the Uptime Institute ATD book in his hand.” As a result, Region Nordjylland is trying to use the Tier Standard on ‘patients near supplies’ such as oxygen and clean and sterile water.” In this way, the entire facility is adapting lessons learned from its data centers to the operation and design of its health-care facility and delivery.

The requirements to build to Tier IV concerned Region Nordjylland officials far more than the challenge of continuously serving the existing live loads. Despite the fact that all the data center infrastructure was replaced or upgraded during construction, except the servers and the racks, transitioning the live load was relatively easy because they had planned meticulously for the change. According to Michael Lundsgaard Sørensen, Region Nordjylland's Data Center Manager and Head of IT Operations, "We already had an A and a B side, and we had a 2N solution. Basically we borrowed an external generator and an external cooling system, so we built up the new A side and just made the switch and powered up the new one."

The design team's mantra: "Keep It Simple"

“We found that the most difficult thing about designing a Tier IV data center is to make something that’s very complicated, simple. The design team’s mantra was ‘Keep It Simple,’ which is why we don’t have computer controls such as a building management system (BMS) and programmable logic controllers (PLC).” Initially, the design team struggled to achieve this goal, as the first designs had several weaknesses that needed to be rectified.

Region Nordjylland’s use of industrial-type controls rather than a BMS and PLCs is one example of the simple, but effective approach. Maddison noted that the hospital’s control scheme relies primarily on electric signals and controls rather than computerized systems to achieve the autonomous response to incidents required for Tier IV Certification.

The Outcome

With extensive preparation around transferring the live load and leveraging the expertise of Region Nordylland's extended IT team both in the data center and in hospital operations, upgrading the data center to acheive Tier IV certification went incredibly smoothly.

“In the over thirty Uptime Institute Tier Certification of Constructed Facility assessments I have completed, this has been the best prepared and best executed,” said Eric Maddison, Uptime Institute Consultant. “It is an incredible achievement to upgrade an existing data center to the demanding standards of an Uptime Institute Tier IV Certified data center, and the Region Nordjylland team did an exemplary job.”
"Today, decisions about life and death are made using data, so we need to take the best possible care of it. When upgrading our data center, we needed to be sure that our design would meet our high demands for availability regarding hospital systems. In the future, we plan to eliminate one of our other data centers, and so we wanted to go to Tier IV."

Michael Lundsgaard Sørensen
Data Center Manager and Head of IT Operations
Region Nordjylland
"Region Nordjylland has shown foresight by designing and building the first Uptime Institute Tier IV Certified data center in the region. The focus on achieving the Tier IV certification for both the design and constructed facility means that the data center is ready and able to support the health service for future generations."

Phil Collerton
Chief Revenue Officer
Uptime Institute

Region Nordjylland Aalborg University Hospital Data Center Photos

Innovation Spotlight: Lowering Tier IV Costs by Using Mechanical Systems To Automate Outage Responses

Region Nordjylland innovated in several ways to meet Tier IV requirements - specifically by using mechanical systems to meet autonomous response requirements. 

Eric Maddison, Uptime Institute Consultant commented "Region Nordjylland’s has succeeded in developing a concept for autonomous response and control which is cheaper than a traditional CTS management system.”

The hospital’s Controls and Logging Sub-Systems (CTS) relies on electrical and mechanical response to: 
  • Detect critical and non-critical alarms
  • Alert the alarm central and key personnel
  • Register and log alarms in Tier IV facility
  • Register and log operational data in Tier IV facility
The CTS does not control critical parameters in the Tier IV system. Sørensen said, “The industrial nature of the control does not limit its operation in any way." He notes that the system monitors the full range of conditions as more traditional computerized controls, including:
  • Engine-generator voltage and amperes.
  • UPS output voltage and amperes.
  • Free cooling status.
  • Free cooling error.
  • Exterior and ambient (hot aisle and cold aisle) temperatures
  • Chiller and free cooling water temperatures (entering and leaving)
  • In Row cooling water temperatures (entering and leaving)
  • Temperatures in generator room A, UPS room A, and chiller room A
  • Water and brine pressures in chillers, in-row cooler, and dry and free cooling circuits
“The facility is a 2N design and all the automatic response is performed by the laws of physics. It’s the only Tier IV data center in the world that uses mechanical systems and variables such as weight, temperatures, and pressure to automate outage responses when issues are detected," said Sørensen.

“For instance,” Sørensen said, “The loads in the data center are monitored by a current alarm. If the sum of the currents on one of the phases from the A supply and the B supply exceeds the maximum of either of the supplies, an audible alarm sounds and a critical alarm generated in both the A and the B alarm system. The alarm will continue until the load is within the allowed maximum.”

“Region Nordjylland has shown foresight by designing and building the first Uptime Institute Tier IV Certified data center in the region. The focus on achieving the Tier IV certification for both the design and constructed facility means that the data center is ready and able to support the health service for future generations,” said Phil Collerton, Chief Revenue Officer, Uptime Institute.

Just as important and impressive, Region Nordjylland completed its upgrade without affecting the live load. The clinical nurses, doctors and patients never knew that all the cables, pipes, pumps, cooling, and electrical systems serving the data centers had been replaced. In fact, Region Nordjylland replaced everything in its data center except the servers and the racks.

Learn More about Region Nordjylland

Region Nordjylland Site Characteristics
Region Nordjylland’s Tier IV data is located in Aalborg, Denmark, where it serves the health care needs of almost 600,000 local residents and supports the emergency ambulance service of the entire nation.

The new data center has an IT capacity of 225 kilowatts.  Access to the 211 m2 computer room is strictly limited as it is located in a 1225 square meter (m2) basement of a 35-year old, four -story government building. The basement itself is 8-meters below ground. The building includes 43-centimeter thick concrete walls automatic steel reinforced doors built to withstand possible threats facing the nation at that time. Denmark’s northern location also means that the data center can make extensive use of free cooling, which reduces the facility’s energy use.
Region Nordjylland Electrical Systems
Region Nordjylland Cooling Systems

Region Nordjylland Data Centers with Certification