I’ve seen many digital transformation efforts, but one recent example was unique: At the recent Cisco Systems Inc. Partner Summit event, I sat down with Grady Nichols, senior director of information technology operations at Mercy Ships, and Rob Kim, chief technology officer at Presidio Inc., and discussed how the two organizations are partnering with each other and Cisco to transform the way healthcare is delivered in underserved areas.

Modernizing IT on a ship presents unique challenges

Mercy Ships has embarked on a journey to modernize healthcare with most of it happening on the water. The humanitarian organization operates two large hospital ships serving low-income communities in Africa: Global Mercy in Sierra Leone and Africa Mercy in Madagascar. These ships are like floating cities with more than 800 people on board, including medical staff, families and volunteers.

Given the scale of these vessels, the technology must be able to support the complex environment of a hospital, cruise liner, food service provider and logistical hub. The ships dock in areas where internet access is limited, latency is high and outages are common. On top of that, the metal walls make wireless coverage even more problematic. None of this resembles a typical hospital campus.

Partnering on delivering technology to meet business challenges

Cisco and its partner Presidio, a global IT solutions provider, were brought in to help upgrade the infrastructure, so the ships can provide uninterrupted medical services in remote locations. The team designed two onboard data centers for redundancy and spent time physically walking the ship to see how Wi-Fi signals behaved from room to room. There’s no standard layout or predictable floor plan, so most of the network design had to be done by observation and testing.

“We need to modernize around our unique situation,” Nichols told me. “We’re not in an environment where bandwidth is plentiful. Because of this, we must bring new technology onto the ships and make it fit our needs as best we can — for our hospital staff, our surgeons and everyone else. Also, we need the ability to operate autonomously because of the latency and other limitations we have in these countries.”

Before and after

The network runs almost entirely on Cisco equipment. Each vessel location has a separate on-premises Cisco call-management voice over internet protocol system and multiple Cisco-powered intermediate distribution frames or IDFs. The ships use many Cisco switches and switch stacks, in addition to roughly 1,600 Cisco phones. Nearly everything ties back into this Cisco infrastructure, including Wi-Fi, cameras, operating room equipment and telepresence systems.

Speed of innovation remains a challenge for Mercy Ships

An ongoing challenge for Mercy Ships is keeping up with technology while building new ships. Global Mercy took nearly seven years to complete, partly because of the pandemic. The next ship, Africa Mercy II, isn’t expected to enter service until 2028. With such long timelines, hardware may already be outdated by the time the ship launches. Therefore, it requires a different level of planning to deal with all the complexity.

“If you think about the places that they’re docking these ships, the quality of power that you have, and the environment around that when you’re building out data centers,” Kim said. “Where you’re building it out is less of a factor in terms of constraint than you have with this essentially floating Faraday cage. So, a lot of consideration must go into not only how we architect but also potentially provide resiliency.”

Artificial intelligence is starting to gradually make its way into operations. At the moment, it’s mostly used for day-to-day clinical work. Some of the surgical tools and imaging systems include deterministic AI features, such as image classification, which helps doctors review patient scans faster. Mercy Ships is also looking at newer AI capabilities, such as generative models, but these are still in the early planning stage and will depend on the infrastructure that’s being built now.

Resilient and performant connectivity is critical to deliver healthcare

Connectivity is one of the biggest limitations. Cloud-based AI isn’t reliable enough to use for patient care in remote locations. To get around that, the teams are working toward localizing more of the compute on the ship by adding graphics processing units. But they must be powered and cooled properly inside a steel vessel. Presidio and Cisco have already factored these requirements into the modernization plan, since running workloads locally reduces the amount of data that must move over slow satellite links.

Telemedicine plays a big role as well. The ships use Webex and other telepresence tools for remote consultations, sometimes with multiple doctors reviewing a case together. These sessions require stability, particularly in ports where outside connectivity is unpredictable. The same goes for training. Mercy Ships uses simulation and other digital tools to train local medical teams so they can continue providing care after the ship leaves.

Going forward, implementing new tools such as Cisco IQ would allow Mercy Ships to optimize limited bandwidth from shore. Cisco announced the digital platform at its recent Partner Summit. Cisco IQ provides visibility into an organization’s entire asset inventory, including device health, software versions, and lifecycle timelines. It’s enabled by agentic AI or a collection of specialized AI agents that analyze, diagnose and resolve problems.

“In the future, we think Cisco IQ is going to have a big play in what we provide, not only in terms of managing some of the entitlements from a cost efficiency perspective, but then also being able to pull in telemetry data and seeing if there’s even more ways, we can optimize the limited bandwidth, given the remote nature of the boats,” said Kim.

The goal right now is getting the infrastructure ready, especially with a new ship under construction. Most of the work being done today — building out local compute, strengthening the network, and reducing reliance on external connectivity — will eventually make those AI capabilities possible. Mercy Ships is focused on running the hospital and giving volunteers the support they need to do their work. Everything else will follow.

Final thoughts: Purpose and technology meet

Cisco is one of the most active companies, not just in technology but all organizations in giving back through purpose-led initiatives. The Cisco powered Medibus and floating classrooms in the Amazon are a couple of examples. This is not something Cisco does alone, as it collaborates extensively with like-minded partners.

Mercy Ships is a great example of a technology vendor and partner coming together to solve a problem that is considered a difficult to solve challenge. The work Mercy does is of critical importance in Africa as it brings world class healthcare to areas that would not have it otherwise but the small IT team at Mercy certainly would not have the know-how to deploy the technology and keep it up to date. Cisco and Presido have laid out a blueprint that I hope others follow to bring the benefits of modern technology to underserved areas.

Zeus Kerravala is a principal analyst at ZK Research, a division of Kerravala Consulting. He wrote this article for SiliconANGLE.

Photos: Mercy Ships