Consolus|Wireless Systems|News

IT Wireless - February 17, 2003

FEATURE STORY:
A Hospital Goes Thoroughly Wireless

Health care is one of those industries that is perfectly suited to the use of wireless technology: Its staff is very mobile, patient data is needed fast and on demand, and there's already a ton of wires for electrical power, monitor hookups, and other equipment that leave little convenient space to plug in computer equipment. That's why an increasing number of hospitals are going wireless, integrating wireless access to their wired networks. The Veterans Administration was a pioneer in such deployments two years ago, but now even smaller hospitals are finding they can implement wireless effectively.

Consider Memorial Medical Center in Springfield, Ill. A teaching hospital associated with the Southern Illinois University School of Medicine, it is one of two medical centers in the city of 112,000 people, and has about 2,000 staff members and physicians who access medical records. Last year, the hospital decided to introduce electronic records access to physicians, nurses, and other medical staff. The goal was to improve patient care by having standardized information and fast access to it. The hospital wanted doctors and nurses to be able to access patient information as they needed it wherever they happened to be, as well as eliminate error-prone paper documents, prevent unintended drug interactions, and eliminate illegible handwriting with electronic forms, called order sets, that ensured procedures were documented and followed hospital, insurance, and government regulations. Even though the hospital expects the system won't lower its per-patient care costs, providing such access should improve care and patient safety, preventing potentially costly mistakes.

Part of a three-year, $30 million effort, Memorial Memorial originally planned on having 802.11b wireless access in just a few locations that were hard to wire or where staff was very mobile, such as in patient wards. But CIO O.J. Wolanyk argued that it made more sense to make the entire hospital wireless -- including the parking structures and cafeterias -- so doctors and nurses can access information anywhere. He also wanted the full coverage so he could later implement voice-over-wireless-IP (VoWIP) phones, whch he's now evaluating. In November, the hospital adminsitartin OK'd his wireless-everywhere approach, which will cost $900,000.

Wolanyk first thought he'd need about 300 access points, based on the square footage of the hospital. But his system integrator, Daow, hired a spectrum-analysis firm, CONSOLUS, INC., that did a three-week-long spectrum analysis of the hospital to determine optimal access point placement. The result: The hospital will need fewer than 150 access points. "They paid for themselves," Wolanyk says.

The wireless network will have three levels of security to protect patient data and ensure only authorized users can log in: Windows NT Active Directory authentication, policy-based firewall access (to ensure that users get only access to the information they are allowed to see), and 128-bit Dynamic IPSec 3-DES data encryption. Although federal regulations don't dictate the technology used, they are very strict in their patient-records protection standards. Wolanyk is also using redundant servers and edge controllers from ReefEdge, whose systems allow seamless roaming and session-keeping handoff between access points, to eliminate downtime.

The system does require the use of Windows 2000 or XP, so initially only notebooks, tablets, and PCs can be used. ReefEdge is working on a Pocket PC version for handhelds, which Wolanyk expects to be available this summer. Other devices won't be supported.

Wolanyk is enthusiastic about the project, even though it means no cost savings. Having better, safer operations is payback enough, he says. "I want to experience this myself," he says, so Wolanyk uses a notebook as his primary computer and works throughout the hospital -- he has no office -- connecting wirelessly in the administration section that already had some wireless access and via Ethernet jacks elsewhere. He recognizes that doctors are not technology adopters, so it's critical that they find the system easy to use and that it make their patient care easier to deliver -- a reason he's asked doctors to help design the applications and work methods, as well as why he has tried to live a mobile worklife himself.

Still to be decided is how the hospital will connect to the outpatient services wing across the street, connected via a walkway. Although the staff that work in the main hospital don't go into the outpatient building, and vice versa, Wolanyk would like to have both on the same network. But first he has to work with other tenants in the outpatient building, since several have wireless networks that overlap the outpatient unit's space. Wolanyk is also working with the other major hospital in town (St. John's, which is three blocks away) to try to standardize the medical information systems, including the wireless access, so physicians can work at both without changing procedures or technologies. (Physicians are typically private businesses that affiliate with one or more hospitals so they have the right to practice there, such as for surgery.)

Three other technology issues await:

* One is the use of thin-client devices that don't store data locally, so patient information doesn't leave the building even if the devices do. (Wolanyk says he does not expect theft to be a problem based on his experience at other hospitals, and recognizes that doctors will likely want to use their own notebooks so they have the data at their offices. But for hospital staff, it would reduce the chance of data being compromised because someone accidentally lost a notebook or handheld.) He's heard that Dell Computer will be reselling such thin-client systems from Fujitsu this year.

* Second is choosing a VoWIP system that can run over his wireless network, so staff can communicate anywhere without incurring phone-call expenses. Wolanyk had used Avaya phones on two floors but said the devices didn't work well and that Avaya later discontinued support for them. He's looking at several vendors, including Avaya, for VoWIP phones.

* Third, he wants to build power racks and deploy them throughout the hospital. He notes that no company makes recharging racks so multiple devices can be recharged from one power outlet; instead, every recharger takes its own power jack. He wants both visiting doctors and hospital staff to be able to recharge their devices easily without having to find an open power jack.