Riding the Wireless Wave

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Thinking about installing a wireless network? Join the club. It is an affordable, practical and smart solution. Adding to the allure is a growing list of benefits. Radiology departments report that wireless is a tremendous boon to productivity in intake areas because information can travel with a technologist instead of remaining at a fixed computer.

A wireless network provides physicians with immediate access to information, and it can eliminate the grueling hours nurses spend on chart-entry by allowing them to enter information as they work. In short, wireless can increase productivity and improve patient care across the enterprise - when it is deployed effectively.

This ultra-productive wireless utopia is not for the faint-hearted though. The most successful wireless installations are well-planned initiatives that address genuine problems. Clyde Hewitt, principal with Phoenix Health Systems (Montgomery Village, Md.), explains, "Hospitals need to identify their requirements. It's not ready, fire, aim. It's ready, aim, fire."

A wireless installation lacking leadership, vision and planning could leave the hospital open to security breaches or become a financial black hole that fails to demonstrate a return on investment (ROI).

Paul Chang, M.D., director of the Division of Radiology Informatics at University of Pittsburgh Medical Center (Pittsburgh, Pa.), recommends wireless wannabes start the process by asking a series of questions:

  • Is there a need for mobile decision-makers? What can the hospital do to improve their productivity?
  • What problems can wireless solve?
  • Where does wireless make sense?

Radiologists might yearn for wireless solutions, but they fail the screening test because they hold a primarily sedentary position and have little need for mobility. Other healthcare professionals, however, are a different story.

A cross-functional team that includes the chief information officer or IT director, HIPAA officer, chief nursing officer and chief operating officer can assess wireless needs and devise a solution. Defining objectives upfront leads to better implementations and makes it easier to calculate ROI. Once initial questions have been answered, a hospital can move onto the next step-finding the best wireless solution, which typically includes a wireless LAN (aka "WiFi" or 802.11b), but can also include cell phones, PDAs and Blackberrys.


As the planning team researches wireless, it needs to consider the downsides - performance and security, or lack thereof.

Technophiles may overlook the reality of wireless performance. Wireless forces users to take a giant step backwards in performance. Chang warns, "Users are going from switched to shared network resources. Even the newer flavors with increased bandwidth [802.11a and 802.11g] are still shared bandwidth." Wireless applications should work well in a shared bandwidth environment. Bandwidth hogs, like traditional PACS, should be avoided.

The second, more disturbing downside is security. Wireless networks are inherently insecure. Without adequate security measures, wireless networks provide unauthorized users an open door into the hospital network. The least benign scenario is the script kiddie [aka network hacker] who just wants free wireless access. Hospitals have not been exempt to war chalking, where aficionados label free wireless access points on a sidewalk. The really bad guys hack into the network and create a HIPAA nightmare.

Hewitt recommends that hospitals develop a security plan before purchasing the first piece of hardware, which allows the hospital to buy the right components to improve security.

Hospitals can choose from an assortment of encryption and security mechanisms on the market. Wired Equivalent Privacy (WEP), typical of current "Wi-Fi" implementations, is insufficient.

Rick Hampton, wireless communications manager for Partners HealthCare Systems (Boston), says, "Until security standards are ratified, the next best option is a proprietary system. These, however, are usually password-based mechanisms and can be subject to dictionary attacks [hackers use common words to gain improper access]. Long passwords consisting of random numerals and letters changed on a frequent basis can hamper dictionary attacks, but they present other problems if made too complicated. People can't remember them and leave the password on a Post-it attached to the computer."

Some third-party encryption programs provide coverage on an application-by-application