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Part 1: Health Care Goes Wireless
September 2008 -
Health Care Facilities
Every day, businesses use wireless technologies to connect their employees with clients and the rest of the outside world. Health care has adopted the same technologies, and more. In fact, no other industry uses as many different wireless applications as health care. Health care providers may purchase a number of wireless systems if they have identified a need and available funds. This includes adding wireless systems to improve patient connectivity to the outside world, internal staff communications and the ability to monitor patients and hospital property.
The installation of wireless systems in hospitals has changed rapidly. Only a few years ago, most health care facility executives wouldn’t even consider wireless applications. Today, most hospitals and large clinics are running a host of applications over wireless networks. These applications, in many cases, are familiar to those in other segments of the business world. But there are others that are very specific to health care.
Some standard business applications used in health care include Wi-Fi, distributed antenna systems and VoFi, or voice over Internet protocol over Wi-Fi. Other systems that are more specialized, but still familiar to those in the logistics industry, include applications such as real-time location systems (RLTS) and radio frequency identification (RFID) methods. Finally, applications that are geared to hospitals and clinics include wireless clocks, temperature tracking, and telemetry, in which measuring, recording and transmitting devices are connected to patients in order to monitor their conditions and alert doctors to changes.
Why the recent push in health care for wireless systems? First, past concerns regarding the interference of the new wireless systems with traditional hospital wireless systems, such as telemetry, have been alleviated as the two become more integrated.
A hospital telemetry system is responsible for monitoring patient vital signs, which includes monitoring the heart and issues that may arise from illness or operations. In the past, those in charge of the telemetry systems were convinced that there were potential interference issues that could not be tolerated. These problems have been remedied by moving newer telemetry systems to new frequencies that are not as susceptible to interference.
In addition, public and industry fears about the safety of wireless have been put to rest. A tremendous amount of research has been done on this topic, and it indicates all radio frequencies used in wireless health care applications are safe, as are 98 percent of frequencies. In fact, all frequencies used for consumer applications have been tested extensively by agencies such as the FCC, EPA, FDA, the National Institute for Occupational Safety and Health and OSHA. All the studies show that the frequencies used for things as varied as radar and cell phones are safe.
Health care executives are looking at their patients in a whole new light, seeing them more as clients that have choices. Those choices include going to other hospitals for their care if they don’t like the treatment they are getting. As a result, executives at hospitals and clinics regard convenience to clients and their families as a way to make sure they’re satisfied. This convenience includes accommodating patients and family members who want to use laptop computers and mobile phones both around the hospital and patient rooms. After all, many people don’t want to be out of touch for hours while visiting the hospital, and if they do, they turn off their devices. If this option is available at another hospital three blocks away, patients may go to that facility.
Patient convenience is only a small part of the puzzle. Wireless connectivity is also useful for staff and doctors. Nurses can use systems such as hands-free VoFi to stay in constant contact with the rest of the staff or the main nursing station. With the ability to call or locate another nurse immediately, wireless reduces the need to leave the nursing station and scour the floor for a staff member. A nurse can also enter information on patient charts while moving from room to room with a tablet PC.
Doctors today are becoming more dependent on wireless. Often, they use applications or access files on an office server through their mobile phones. Even more importantly, doctors are using text messaging and e-mail to keep in touch. With the greater sophistication of wireless mobile devices and with more applications available just by pulling a phone from a pocket, it is no wonder that some doctors require the use of these devices from the moment they enter the hospital.
To allow patients, staff and nurses to remain connected to a wireless network, hospitals are increasingly installing distributed antenna systems. These systems boost signals from one or more mobile carriers within a building. Low signals on mobile networks have traditionally been an issue in very large facilities, such as metropolitan hospitals and clinics, but distributed antenna systems alleviate that problem as long as a carrier is on the system. These systems are becoming prevalent in the design stage of any large facility, not only health care, where mobile phone communications are seen as either important or necessary for customer convenience.
Another system that is becoming increasingly important within large health care facilities is a system, such as RLTS or RFID, that allows the hospital to track assets. Clinics or hospitals can now keep track of wheelchairs, infusion pumps, beds and other equipment. Some have even considered using tracking methods on patients, although this has not been adopted yet.
Large facilities lose assets every year. Wheelchairs roll out the door and never come back. Equipment wrongly goes into storage areas. Or it is transferred to the wrong department. What happens then? Well, in many instances purchasing will lease or buy more equipment, even though they have ample supply somewhere in the facility. With an RFID tag on those assets, hospital management will know where they are, when they are wheeled out the front door and when they are sent to the wrong floor.
An RFID or RLTS system works with a smart tag on each asset that sends out a signal wirelessly. This signal is picked up by a network such as Zigbee, Wi-Fi or an infrared system that is connected to a facility network. A tracking application resides on a server that is monitored by the hospital, so with RFID a large hospital can tell when a bed needs cleaning, or they can keep track of the infusion pumps they already have and avoid purchasing duplicates.
There are still some challenges that must be overcome with wireless applications. Most health care organizations want to provide the most they can to their patients, but there are limits to what they can afford. Many times, these systems are sacrificed because of cost as health care entities include wireless in the design phase of a project only to take it out when the cost of the full project is understood.
Another issue that seems to be important is determining who will be in charge of these applications. In many cases, the departments that oversee these types of services — like IT or biometrics — are already overloaded and, if they are not authorized to add staff, don’t want to take on another process. This is especially true when it involves an application that will cover millions of square feet of space.
In the end, producing a state-of-the-art facility is about looking into the future. Driving the installation of these services will be demands from patients, staff and doctors, and what is best for the bottom line. If a hospital sees the applications as necessary to meeting the needs of the people — including those paying the bills — and running the facility, these applications will be added, either now or later.
Thomas Fox is an associate with the special systems design group of RTKL, one of the world’s largest architecture and engineering firms. Based in the firm’s Baltimore office, he has worked in the wireless, networking and telecommunications industries for more than 15 years, specializing in health care and educational projects.