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How to amp up your hospital wireless network for PACS, EHR, video

These days, a hospital wireless network must accommodate PACS, VoIP, EHR access, patient Internet connectivity, even video. Here, three CIOs explain how they got the job done.

Hospital wireless networks are expanding to accommodate increasing traffic from patient laptops and the deployment of electronic health record (EHR) systems. Some IT managers, however, figure that as long as they're going through the trouble of site surveys, requests for proposals, ripping and replacing access points, and upgrading capacity, they might as well build enough infrastructure to do even more over wireless -- such as picture archiving and communications system (PACS) traffic.

Grove Hill Medical Center, a multispecialty clinic headquartered in New Britain, Conn., but spread across four cities in two states, has a "large, pretty substantial orthopedic department" that makes a lot of use of magnetic resonance imaging (MRI) technology, MIS Manager Carl Labbadia said.

"[Physicians] like to be in their room with the patient, on their tablet, looking at the medical record, go[ing] into the PACS system, hit[ting] the image," Labbadia said, noting that an MRI might have 300 images in it, for 300 MB of total memory.

Grove Hill's previous wireless network was good enough to support such functions as e-prescribing -- which the hospital set up five years ago. Not surprisingly, the network frequently "bombed out" when it handled images, Labbadia said, and manually resetting it required several vendor service calls a week, plus site visits.

VoIP also on list of new hospital wireless-network demands

An upgrade Grove Hill completed in the last six months added the capacity and access points to accommodate present demand -- and, Labbadia hopes, future demand, which includes Voice over Internet Protocol (VoIP) communications and an increasing need to serve video over the wireless network. On top of that, clinicians are bringing in smartphones and other devices, such as the iPad from Apple Inc.

Likewise, VoIP communications, better coverage and patient demand for Internet connectivity drove the 210-bed East Orange [N.J.] General Hospital to upgrade its wireless network, said IT director Jean Zahore. Along with those needs, the hospital's pending EHR implementation on numerous wireless devices was a factor in determining how much coverage and saturation the network would need eventually.

"Down the road, [VoIP] will be part of the electronic medical records implementation," Zahore said. "The [EHR] vendor we have chosen includes in its plan laptop PCs and iPads as well, and other devices compatible with the system." Wireless PACS access is part of future plans, too.

At the Waycross, Ga., Satilla Health Services, which comprises a 231-bed hospital and other physician offices, Barry Rudd, director of information and his co-worker, Network Administrator Terry Ammons, had not only to accommodate new devices, but also to expand wireless coverage beyond the hospital's hallways because those new devices were changing the way the facility delivered care.

Mobile phlebotomy tests, for example, now start with a scan of the patient's armband, Ammons said. Clinicians must go into a patient's room to do that. If the network's not there, the device loses connectivity and the test cannot run.

Interestingly, it took a very detailed site survey to get the job done; the survey unearthed such details as that many more access points were needed in the older parts of Satilla's building to support growing hospital wireless network demand. After extensive testing, Ammons figured there must be "kryptonite in the walls," blocking wireless signals.

How to choose the right hospital wireless-network vendor

Having recently gone through hospital wireless network upgrades, all three IT leaders recommend comparing service and technical support from a number of vendors to determine which one is the right fit for a particular facility. It pays to include some smaller vendors -- or those that traditionally haven't served the health care sector -- in the evaluation process. (Ultimately, all three facilities chose Sunnyvale, Calif.-based Ruckus Wireless Inc.)

Make sure your system will meet your immediate needs and your long-term needs. If you don't do that, you are going to be replacing your network every one or two years.

Jean Zahore, IT director, East Orange General Hospital

Gear from every vendor being considered should be tested side by side in the same locations, Rudd and Ammons say. As they put it, "beat them up" -- put the equipment under stress, and test signal performance with diagnostic tools, as well as with such video applications as Skype. Both found they not only had to increase their facility's wireless bandwidth but also had to do that in an environment plagued by radio-frequency interference that was both inherent in the building architecture and produced by devices already in use.

Testing is crucial because most access points must maintain a connection despite such interference. Satilla's Ammons found that some vendors' gear lost more than half its throughput during periods of interference, even though other vendors' gear was not affected nearly as much.

Rolling business needs into the site survey helps make the choice of a vendor more obvious, too, Labbadia said. Grove Hill does not have the immediate, life-or-death need for continuous hospital wireless-network connectivity that some hospitals with busy emergency rooms might have, but its business needs include keeping physicians' devices connected as they move among patients' rooms. Analyzing and prioritizing those needs will help build a list of specifications for an accurate site survey.

In a similar vein, planning for future needs in a present hospital wireless-network expansion -- all the technology mentioned here, plus, perhaps, medical radio frequency identification, or RFID -- is critical, East Orange General Hospital's Zahore said. "Before you go ahead, you have to make sure your system will meet your immediate needs and your long-term needs. If you don't do that, you are going to be replacing your network every one or two years."

Service and general vendor attitude also play a big part in selecting equipment. Without naming names, Labbadia said his previous vendor's equipment was on par with the others' he considered, but it was not "pleasant to try to do business with" that company. That, in part, influenced his switch to Ruckus.

"They wouldn't bend from the corporate mentality," Labbadia said. "You almost have to promise them they'll get a contract before they'll even talk to you."

Labbadia advised fellow health care CIOs to think carefully about choosing a vendor from which it takes "an act of God" or the signing of multiple service contracts to get support, support information or software patches, even if the price is right.

Let us know what you think about the story; email Don Fluckinger, Features Writer.

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