Many institutions are preparing for a proliferation of devices on their hospital wireless network, from radio frequency identification (RFID) tags that track patients and inventory, to additional tablet and laptop computers that support the expanded use of electronic health record (EHR) applications. Whether upgrading existing equipment, or ripping and replacing with all new gear, health IT owners need a solid plan of attack for picking a vendor, then rolling out a hospital wireless network implementation.
SearchHealthIT.com spoke to three health care leaders who recently oversaw hospital wireless network expansions at their facilities:
- Scott Vachon, manager of network services for LRGHealthcare, a two-hospital system in central New Hampshire
- John Cameron, computer technical specialist and wireless technician at the 121-bed Milford Regional Medical Center in Massachusetts
- Robert Mann, manager of information technology for Westminster Canterbury Richmond in Richmond, Va., a continuing-care retirement community with 900 residents and long-term care patients
Here are 10 general tips that evolved from those conversations that should help anyone planning a wireless network implementation in a health care environment. Advice for addressing compliance with the privacy regulations in the Health Insurance Portability and Accountability Act (HIPAA), and the use of medical RFID devices on a hospital wireless network also came from those conversations.
1. Understand your users' habits as well as their physical environment. Lead-walled radiology departments are probably the toughest wireless puzzle to solve, followed by bathrooms and elevators. In Mann's case, he also had to contend with retirees living in 1970s-vintage concrete and steel buildings, some of whom enjoy broadcasting on amateur radio bands. Build these thorny wireless-killers into your site survey -- and don't be afraid to press vendors to explain how they will overcome them. A solid site survey, Cameron said, helped Milford Regional implement a new hospital wireless network that is almost completely without dead spots, compared to a rip-and-replace network replete with dead spots.
2. Build future plans into the rollout. Plan extra bandwidth for emerging technologies that will be coming to many hospital wireless networks in the next few years. These include Voice over Internet Protocol, or VoIP; phones as part of unified communications systems; RFID tags; a general proliferation of laptops, tablets and smartphones; and more wireless patient monitoring devices. These might not be a part of your present wireless infrastructure needs, but if you want to avoid a rip-and-replace in a few years, anticipate them now.
3. Hire a consultant. LRGHealthcare hired an independent wireless systems expert to help conduct a site survey and develop its request for proposals (RFP). This outsider gave them such sound advice, helped them develop such a detailed game plan, and gave them so many ways to grill the vendors that they don't consider his fees an up-front cost but a "long-term investment," Vachon said.
4. Make the RFP as detailed as possible regarding future plans. In its RFP, Milford Regional specified that its new hospital wireless network would have to support additional devices, as well as voice and video, but not interfere with clinical engineering apps, Cameron said. Not all of that is up and running, but the network infrastructure is there for expansions that probably will happen in the next two to three years, he added.
5. Consult with other departments. The infection control and safety officers may have input on placement or protection of wireless gear. As you write your wireless network implementation plan, consult them and other stakeholders, such as facilities management. In Cameron's case, the company maintaining Milford Regional's elevators forbade access points -- or even antennae -- in the shafts. This required workarounds on the part of the wireless vendor to maintain signal coverage in the elevators.
6. Check references. Vachon asked for customer references from his RFP finalists, asking them questions about their own RFP process, about how a particular wireless integrator responded to support calls and meeting deadlines, and about how happy they were with the security setup, as well as about physicians' general satisfaction with their wireless networks. Mann, meanwhile, called customers using different hardware vendors, such as 3Com Corp. and Cisco Systems Inc., and asked specific questions about application performance.
7. Consider guest use carefully. What information will you collect from guests who log on to the network? Email addresses only? How will you limit their use of the network, as well as secure protected patient data from the clinical side? Firewalls; network partitions; strong authentication; wired equivalent privacy, or WEP; key management; and expiration can all be part of the plan.
Plan for future wireless technologies that aren't yet on your network.
John Cameron, computer technical specialist and wireless technician, Milford (Mass.) Regional Medical Center
8. Plan to monitor for rogue access points. Vendors should demonstrate how their wireless controller systems can identify and shut down rogue access points quickly. Sometimes rogue access points are "friendly fire" -- a physician bringing in a router to boost the signal in his office, for example -- not a hacker trying to steal patient information. Building into your implementation plan a written policy to deal with rogue access points, and distributing it to all staffers, will help get everyone on the same page.
9. Pilot gear from multiple vendors in your environment. Though all three interviewees ended up using equipment from Aruba Networks Inc., that didn't stop them from testing gear from two or more vendors. All equipment works great on paper, but mileage will vary in real life. Moreover, the interviewees recommended that in testing, not only coverage and bandwidth speed should be evaluated, but also clinical application performance. Cameron also suggested calling tech support during the evaluation period, even "with just the simplest question." See how quickly they respond, evaluate how knowledgeable the person on the line seems, and decide if that's acceptable, he said.
10. Keep the patient in mind. Sometimes among the RFPs, the regulatory compliance, the budget concerns and interoperability issues, the patients get lost in the shuffle. With every decision, don't forget to keep "what's best for the patients" in mind as the final arbiter of your decision process, Vachon said.
Read our conversations with Vachon, Cameron and Mann about addressing HIPAA privacy compliance and the use of medical RFID devices on a hospital wireless network. Let us know what you think about the story; email Don Fluckinger, Features Writer.
This was first published in August 2010