Under-funding and fragmented strategies have left healthcare IT systems severely wanting. Many hospital systems depend on networks put in when the building was constructed. In this article Mark Pearce explains how wireless networks can overcome these
drawbacks and get information quickly to clinical staff.

It is about IT and getting (often mission-critical) information to clinical staff as quickly and as flexibly as possible. In today’s high tech world mobility inevitably means wireless networks.

Today most hospitals have hard-wired networks which were typically put in place when the building was constructed. These networks terminate at various points such as beds in the wards, operating theatres or the nurses’ control point and can be used to connect to various medical apparatus. However, technology improvements mean that it is now possible to do many more things than were feasible when the hospitals were originally built.

Come April 2013 the NHS is (once again) undergoing a re-structure. NHS Trusts will now be competing for ‘business’ with other NHS Trusts, and the battle for hospitals to be commissioned to undertake future medical work will centre around service delivery. Constantly on the look-out to reduce costs, NHS Trusts will have to give new focus to efficiency and effectiveness to be able to compete. One obvious way of achieving these is through better mobility.

In this article’s context mobility is not referring to getting patients walking. It is about IT and getting (often mission-critical) information to clinical staff as quickly and as flexibly as possible. In today’s high tech world mobility inevitably means wireless networks.

A day in the life

In a typical shift, clinical staff often have problems accessing the required information in a timely fashion. Staff have to constantly return from a patient’s bedside to a centrally-sited ward PC. They may have to access numerous legacy applications such as imaging or patient records which can often reside on separate PCs/systems. Specialists may even have to provide an emergency diagnosis remotely. While the move toward Bring Your Own Device (BYOD) has further complicated things, tablet devices such as iPADS and smartphones have added another dimension to the connectivity puzzle.

In these scenarios, access, aggregation (and integration) of information on one portable device would be a huge step forward, traditional network access is limited and inhibits mobility. As well as efficiency issues, this lack of mobility is far from ideal particularly as healthcare information delays could literally mean life or death.

Not moving with the times

Decades of under-funding coupled with fragmented government strategies has left healthcare IT systems severely wanting. Today most hospitals have hard-wired networks which were typically put in place when the building was constructed. These networks terminate at various points such as beds in the wards, operating theatres or the nurses’ control point and can be used to connect to various medical apparatus. However, technology improvements mean that it is now possible to do many more things than were feasible when the hospitals were originally built. But undergoing infrastructure modernisation while keeping disruption to a minimum is difficult. To expand the physical network to enable greater mobility at this stage would be impractical due to structural and cost implications. In this scenario a wireless network becomes logical.

Ubiquitous networks needed

A few hospitals do have WiFi installed and although some use it for clinical use, it is rarely used for ‘mission-critical’ purposes. The reason for that is most do not have ubiquitous coverage. This can be for building structure or technology suitability reasons, but to maximise the benefits that could be derived from increased mobility, ubiquitous WiFi is exactly what is needed.

Reliability, security and management – a must have for risk mitigation

A wireless network that includes mission-critical medical devices demands the same level of availability that is expected from the wired network. The hospital Wi-Fi must be a resilient and fully redundant resource that is designed for use by essential clinical applications. The wireless infrastructure must enhance the patient and health practitioner experience and provide superior operational and organisational value by lowering Total Cost of Ownership (TCO). This gives IT staff granular visibility, security and control over critical applications and devices from the core to the very edge of the network – using as few resources as possible.

The need to recognise the increasing complexity of maintaining patient safety in the ubiquitous healthcare network is reflected in a plethora of regulation and compliance standards. These have been created to address appropriate risk management in IT-related infrastructure. It is therefore critical, that the WIFi infrastructure can provide a secure environment. It must be capable of handling the needs of the medical devices, the influx of end-user devices, together with hospital provisioned devices, as well as providing a standard of interoperability for securing all data on the clinical wireless LAN.

This infrastructure plays a leading role in enhancing the hospital’s ability to deliver modern, innovative healthcare so the institution remains competitive. It’s about connecting medical devices, associated software, healthcare practitioners and patients together to provide better care with hopefully better outcomes for the entire clinical ecosystem. But most of all, healthcare IT must remain a leader in patient safety and the mitigation of hospital risk.

Technologies such as mobile Electronic Patient Records (EPR) applications supported on iPad’s and iPhone’s, mobile telemetry that is continuously available (no disconnection), and BYOD support for patient devices on the hospital network are just a few of the initiatives that need to be supported. The capability to differentiate between services and guarantee performance, and availability for potentially life-critical applications becomes a key requirement.

As well as clinical benefits there are also other benefits. To be successful in the future Trusts will have to deliver a better ‘customer’ experience as part of its commitment to better service. Both patients and visitors find access to the Internet useful and providing Internet access will become the norm. In cases where large amounts of time in hospital (until recently un-productive time) can be utilised for working or entertainment, it would lessen the blow of time spent in hospital. This ‘customer’ benefit will become a significant USP in the fight to secure future commissions. However, if access to a network with mission-critical functions is to be opened up to non-clinical staff, network bandwidth use must have the capability to be managed and prioritised.

Built-in is best

Some modern WiFi networks can deliver dynamic and automatic control but not many can do this ‘out of the box’. Others can be upgraded by purchasing expensive ‘add-on’ devices which can increase costs by thousands, although a select few such as Enterasys deliver this capability as part of the functionality.

A few NHS Trusts including the likes of Barts and the London and University College London are well on the way to solving this issue by installing a high density WiFi network. This addresses the ubiquitous coverage question and they also benefit from the increased security and management capabilities these modern solutions deliver.

To conclude, to their credit hospitals are beginning to realise that they need mobility, and mobility needs robust wireless. The re-structuring of the Trusts will drive change and that change will include both clinical and non-clinical requirements. Trusts should consider carefully and prioritise their IT infrastructures to accommodate WiFi networks because of the benefits they deliver as the reliance on mobility and mobile IT will only grow in acceptance and usage. Networks must be one of the first considerations when moving forward with mobility and as we know, the consequences of getting it wrong in the health sector are too damaging to contemplate.

Mark Pearce is strategic alliance director at Enterasys Networks