The Freedom of Wireless

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Since the late 1990s, wireless networks have become integral to healthcare providers' IT strategies. And why not? Reduced medical errors, enhanced efficiency, improved quality of patient care and diminished costs are some of the clear benefits. And as more applications become mobile, giving clinicians and nurses real-time access to patient records and history, mobile technology will bring hospitals closer to our nationwide goal of electronic medical records.

 "Wireless is something where until you set it up, you don't really know all the benefits that you can get from it," says Kevin Torres, executive director of information services (IS) for Long Beach Memorial Medical Center and Miller Children's Hospital, part of MemorialCare Medical Centers in Southern California.

Mobile technology was first deployed in IS, expanded to a wireless PDA (personal digital assistant) project and then used to create an ER tracker. "A button is placed on incoming patients as they enter the ER and this helps us track the location of patients," says Torres.

The medical team also uses Vocera Communication Inc.'s hands-free voice activated badges that run on a wireless infrastructure. More than 600 hospital personnel can now communicate wirelessly throughout the enterprise.

St. Agnes HealthCare in Baltimore is on their second-generation wireless local area network (WLAN). Nurses use it for point-of-care documentation. "During the past few years, we have gone through several different variations of mobile carts, from touch-screen tablets to finally what we think works best - the everyday laptop," says Larry Lawson, director of IS.

Communication and workflow improved at St. Agnes with the deployment of Vocera and its integration with the hospital's Rauland-Borg nurse call system. "Initially the concept seemed very well suited for the nursing staff, but it has evolved to ancillary services and support groups such as patient escort, housekeeping and security," says Lawson. "For the nurses, it allows hands-free communication to their nursing counterparts, physicians and support services. It allows them to be mobile and communicate at the same time versus having to go back to the nursing station."

THE NECESSITIES

Facilities such as Long Beach Memorial, Miller Children's and St. Agnes that are maximizing wireless networks and technologies often make it look easy. But what's the first step to wireless success? A meticulous site survey, insists St. Agnes' Lawson. "There are so many variations of building structure that you just can't place access points every 50 feet away," he says.

Site surveys determine how architectural structures and various pieces of medical equipment within the hospital will interact with radio waves. Metal, for example, causes signal attenuation and is a WLAN's worst enemy.

Hospitals typically contract with a telecommunications vendor to perform the site survey. However, Kurt Induni, network services manager at Ochsner Clinic Foundation of New Orleans, suggests IT departments use a company's site survey as a guideline and the internal logic and knowledge of the facility to fill in the blanks.

"We paid for a site survey, but found that their recommendations did not work very effectively in the facility," explains Induni. "The placement is touchy business."

WLANs in hospitals also require robust access points. They are the bridge between the wireless world and the wired infrastructure. The cost of enterprise access points are declining steadily, according to Jim Geier, principal consultant and founder of Wireless-Nets Ltd. in Dayton, Ohio. "Access points cost about $300 today, down from $800 a year and a
half ago."

Each mobile computing device used by physicians and nurses require wireless interface adapters. A radio card that plugs into a laptop typically costs about $50 to $70, says Geier. "For a desktop, you can buy a PCI card," he continues. "Other types of mobile devices have wireless LAN cards built in, such as PDAs and tablet PCs."

Wireless middleware is an add-on. "It helps maintain connection," explains Geier. "Someone may be in a condition where they have lost connectivity and the middleware helps save the connection."

Children's Memorial Hospital in Chicago utilizes a wireless LAN for its pharmacy point-of-care tracking system. In addition to the 802.11b Cisco Systems Inc. network, the hospital installed InnerMobile, InnerWireless Inc.'s in-building wireless distribution system, to eliminate "dead zones" and extend