Network technology

Wireless networking for efficiency and enhanced patient care

February 2006

Wireless networks are rapidly gaining popularity. Wireless fidelity (WiFi) has already become a standard business technology, and almost all PDAs and laptops today offer wireless connectivity. But while the technology has been available for some time, the healthcare sector has only recently been taking advantage of it as a way of maximising efficiency and enhancing patient care.

It hardly needs to be said that accuracy and efficiency are essential in the healthcare environment, but with a mobile workforce this can often be difficult to achieve. Wireless networks can assist by providing healthcare staff with increased access to information and services while on the move and by enabling realtime updating of diverse applications.

Any healthcare IT application should aim either to improve patient safety or to enable staff to work more efficiently and make more use of available resources.

The benefits of using a common wireless infrastructure to deliver multiple services and applications include:

• increased flexibility: work is adaptable and information can be made accessible wherever it is needed;
• enhanced productivity: the time staff on the move would otherwise be unable to work for lack of information is minimised by improved access to information; and
• more timely information: an increased capacity to transmit fresh data instantly, when and where it arises or is originated, allows constant updating of records and application databases, so helping to reduce medical errors.

Service delivery improvements

Healthcare wireless networks are designed to improve information access and delivery of applications, leading to a number of enhancements in service delivery and patient management:

Staff efficiency

Use of wireless networks enables healthcare staff to work with a single handheld communications and recording device on which a number of functions that formerly required separate devices are combined. Telephoning, text messaging, emailing, paging, access to records and information, photographing, dictation, note taking and more (see below) can all be done on a single device. It means staff can work from wherever they are — and that’s a big saver of time. Research by Intel has shown a 10–30% increase in efficiency and responsiveness through use of wireless networks, contributing to a saving of between 24 and 72 working days per user per year.

Order communications

Doctors on their rounds can make requests for diagnostic imaging and laboratory tests to be carried out from their handheld devices while still at a patient’s bedside; and the same may be done for prescribing medication or physiotherapy. The patient’s hospital record can instantly be updated and the order transmitted to the required destination. Access to results may also be made via the handheld.

Bed management

A major advantage of installing a hospital-wide wireless network is that messages can be relayed instantly. A decision about a patient’s discharge, therefore, can be transmitted to the bed-management system as soon as it’s made, thereby keeping the hospital’s bed-occupancy/availability status up to date. It also frees the bed manager and ward personnel from spending time on landline phones in order to keep updating the status of bed availability.

Patient safety

The use of radio-frequency identification (RFID) chips on patients’ ID wristbands is not a new concept. RFID tagging has two main advantages. Firstly, the chip can hold much more detail than a written tag and can include, if necessary, a photo. It can also hold other valuable information, such as the patient’s blood group and allergies. All of this helps to enhance patient safety — not least by minimising errors in identification, estimated to underlie 19% of potentially costly medical errors.

Secondly, use of RFID tags allows for the monitoring of patients’ whereabouts, important at both ends of life: to prevent theft of babies and to prevent wandering of the old and mentally ill. Movement of either category outside their permitted range of movement can automatically alert staff.

Recent introduction of RFIDs in one ward for patients with Alzheimer’s reduced the need for ‘lockdowns’, and it increased flexibility of movement for the patients as well. Staff on the ward had increased peace of mind from the knowledge that they could locate any patient at any time if necessary. Consequently reduced staffing needs were estimated to have achieved a return on investment within 10 months of introduction of the system.

Staff safety

The high level of movement of staff, patients and visiting public means it can be hard to manage the security within a hospital’s grounds, and these days protection of staff from assault needs to be considered, especially in pharmacies, remote locations, or almost anywhere late at night.

Staff can be provided with devices — making use of their PDA if they have one — that will signal both the occurrence of an emergency and its location. The nearest security guard can be alerted and directed to the scene or sent a map indicating it if he has a PDA.

If the device is voice-enabled, he or she can speak to security, and even a link can be established to the nearest surveillance camera.

Decision support

Healthcare staff need to conform to local and national guidelines for managing patients and ensuring correct diagnoses. There is often a considerable amount of diagnostic support information, however, that is not immediately to hand. Without access to this information unnecessary tests and investigations may be ordered, particularly by juniors, to ‘cover their backs’, incurring unnecessary expense. Through a PDA, however, diagnostic decision-support information can be obtained, allowing them to ensure that the process of diagnosis is conducted in the most efficient way.

Prescribing support can also be made easily accessible, as can information on how to use complex medical equipment.

Surveillance

Wireless networks can provide flexible surveillance systems not requiring a fixed infrastructure. This means that surveillance cameras can be set up anywhere — eg in car parks — without having to carry out ground excavations or the refurbishing of buildings in order to lay network cabling.

In addition, patients in intensive or high-dependency care can be monitored ad hoc by use of wireless cameras.