Mobile technology

Mobilising healthcare with wireless technology

Without a doubt, healthcare leads in wireless mobility implementations where other industries follow. From the consultant on the ward moving between patients’ beds, to roadside accident triage, wireless networks can make an immense difference to patient care and efficiency of professionals, and is a major contributor to the development of clinical excellence.

The ready availability of key patient information at the point of need, and the ability to quickly access information to optimise clinical care, are key drivers behind the deployment of mobility solutions both inside and outside hospitals. From accessing electronic patient records at the bedside without having to return to the nursing station or office, through updating records directly reducing the risk of errors, to tracking the location of drugs and reconciling dosage information, wireless networks now lie at the core of many hospitals’ plans for the next stage of IT infrastructure deployment.

Wireless networks based on the 802.11 WiFi standard — so familiar to home users — are now widely used in business and are becoming all-pervasive in healthcare. They allow healthcare organisations greater flexibility in accessing data, while at the same time providing a more secure infrastructure than traditional wired Ethernet solutions. What’s more, they act as a single network to support wireless voice (Voice over Wi-Fi or ‘VoFi’), location tracking, video surveillance, and of course, clinical data applications. So what real applications are deployed over wireless networks — and why?

Data entry and access at the point of diagnosis

The pursuit of clinical excellence has given rise to widespread adoption of wireless solutions in healthcare. Litigation — or the threat of litigation — following clinical errors is a considerable burden for hospitals. Reducing the number of steps in which data is handled and allowing healthcare professionals secure access to mobile clinical applications reduces the risk of transcription errors, improves overall efficiency and affords traceability in decision making.

Traditional ‘high tech’ hospitals wired up wards with Ethernet cables, allowing laptops or computers on wheels to be plugged into a socket near the patient and access to electronic patient records (EPR) to be provided. However, relatively high costs (compared to wireless implementations) limited the roll out of wired wards and a lack of security remained a concern as — unlike a wireless network — authentication was rarely based on 802.1x/RADIUS, and data is never encrypted. Finally, the enabling and disabling of computer communication ports for security meant that connectivity was rarely ‘instant’.

Instead, properly implemented wireless networks, with their pervasive nature and inherent authentication and encryption, allow healthcare professionals to access electronic patient records from wherever they may be in the hospital. Increasingly, patient-monitoring equipment is ‘wireless’, allowing patient data to be recorded wherever the patient is located or being moved to. ‘Wireless clipboards’, based on platforms such as a tablet computer or mobile clinical assistant, allow instant updates and access to patient data for the healthcare professional.

Closing the pharmacological delivery loop

The barcode scanner used in supermarkets — wirelessly connected back to a data server that tracks each purchase made either as the shopper moves through a store, or at a checkout, will no doubt be familiar to many. However, the same technology can be usefully and easily deployed in a hospital to reconcile drug usage to patient. Simply scanning barcodes on a patient’s wrist and on the drug bottle prior to administering the drug provides a comprehensive record of usage, location, date and time — but more importantly it can provide instant warning of drug usage inconsistent with the patients needs, while documenting the drug’s administration in the clinical record (EPR).

Location tracking

In a building or campus as large as a hospital, knowledge of the location of expensive or critical equipment (eg IV pumps, computers on wheels, laptops) is essential to protect the investment in technology, but also to protect the patient.

For equipment, if a mandatory upgrade is required to the firmware and the equipment cannot be found by the bio-medical engineer, then it may remain in use while faulty. Knowledge of the location of equipment leads to productivity gains, but can also result in less equipment being needed because it can always be found.

Location awareness can be used to track and protect vulnerable patients, alerting staff to patients moving to areas that may present a danger to the patient, including leaving the hospital.

Simply fitting a battery-powered transmitter to the asset or patient to be tracked allows location to be determined within minutes, and exit alarms to be sounded immediately should a tag pass a pre-determined ‘pinch-point’.

Video surveillance

From the car park to A&E, from the corridor to the maternity unit, video surveillance has become part of the hospital environment. But when combined with wireless networks, the cost of deploying video solutions falls dramatically, and the usefulness increases.

The concept of a bank of TV screens watched by a security officer in a room is rapidly becoming outdated. With image processing and motion sensors, video cameras can be used for remote sensing or monitoring of rooms — automatically recording images or creating an alert if a baby is moved from a cot, or if a door is opened. Using wireless as a transport, video images may even be streamed to a remote laptop or PDA allowing a security officer to ‘see around corners’ and receive live video from areas prior to entering them.

Typically, only 20–30% of the cost of a surveillance solution comprises of hardware (cameras, servers to store images, etc), the remainder of the cost comes from the installation and associated professional services. However, co-locating cameras and wireless access points and using the wireless network as a transport for video can cut the cost of an implementation in half, and improve coverage.

Emergency response

Deployment of wireless mesh networks at the scene of an accident can allow healthcare emergency responders secure access to electronic healthcare records through 3G or satellite uplink within a hundred or more metres of the ambulance — and to share access to key data sources with other emergency workers. Creation and updating of a patient's EPR in the ambulance while transporting the patient to hospital is also possible, so that the A&E staff are fully prepared upon the patient’s arrival.

Without wires, the same patient monitoring equipment used to monitor critical life signs in the ambulance can be transported with the patient into A&E, and remain with the patient as long as necessary, no matter where the patient is moved to. Once in the main building the life-signs monitoring equipment switches to the hospital wireless network, automatically updating servers and patient records.

Voice

In addition to supporting video streams, wireless also easily supports voice (VoFI) — allowing hospitals to operate a single infrastructure for voice, video or data. Voice solutions come in many shapes and sizes — from traditional telephones with integral location sensing or emergency buttons, through to voice-operated ‘badges’ that attach to the lapel and recognise voice commands while operated ‘hands-free’.

What is common to the needs of voice, video and patient monitoring data in a hospital is that these data types must be prioritised over all other traffic types, and secured against intrusion — something that is inherent in ‘best practice’ wireless networks.

Summary

No two hospitals or clinicians are the same. There are multiple reasons for a wireless implementation in hospital, but the benefits remain the same once deployed — mobile access to key patient data, a measurable increase in productivity from the enablement of healthcare professionals and faster, better, more accurate care for patients.

Roger Hockaday, Director of Marketing, Aruba Networks EMEA