Hospitals are large, complex buildings presenting unique connectivity obstacles. Aging infrastructure, unique cabling challenges, the translation of device data from numerous proprietary device formats into something that can be read and understood by EMRs, and radio frequency-blocking masonry and concrete are but a few of those obstacles. Throw in security and regulatory compliance and it’s easy to understand why healthcare is struggling to stay connected.
But, stay connected we must. Hospital CIOs view Wi-Fi not as a luxury, but as an essential tool for doing business. Patient information is no longer being recorded on paper — it is now required to be kept as part of an Electronic Medical Record that needs to be shared throughout the hospital. The need for mobility and the constant struggle with BYOD only compound the problems of how to maximize connectivity, protect patient information, and deliver positive patient outcomes.
Health IT Outcomes recently had to opportunity to discuss these issues and more with Eric Abbott, Director of Product Management and Strategy for ExteNet Systems, Inc., an owner and provider of Distributed Networks which creates a scalable network design utilizing its high-bandwidth fiber network to meet the network densification needs of the wireless service providers.
Health IT Outcomes: What demands is ICD-10 placing on the technology infrastructure and mobile connectivity framework of a typical health system?
Abbott: It’s a given that healthcare infrastructure is becoming more reliant on mobile connectivity, namely in spreading eHealth commerce and Virtual Health methods in conjunction with telemedicine and mobile health initiatives. Indeed, “access” is one of three pivotal tenets of the eHealth initiatives being driven by the ONC. Towards this end, both providers and vendors are wrestling with technology, processes, and practice management considerations as they relate to mobile connectivity infrastructure that is appropriately sized, economical, available, secure, and private. The conversion from ICD-9 to ICD-10 is heightening pressures on infrastructure as the number of descriptive medical codes will jump from 14,000 to 68,000. This pressure is particularly relative to third-party services (i.e., clearinghouses, payers, etc.) given the necessity for accurate, timely, and directed reporting standards.
Health IT Outcomes: Is the typical health system prepared to meet these demands?
Abbott: Larger systems are somewhat prepared to meet these initiatives, having made investments in mobile connectivity infrastructure over a number of years. On the other hand, it is estimated that providers in rural markets, who serve an estimated 51 million Americans, may not be prepared. This is a result of shrinking revenues and budgets allocated to higher priority HIT initiatives and decreased reimbursements from CMS/Medicare/Medicaid. This is particularly severe with new accountable care metrics driving investment to comply with the latter at the opportunity cost of mobile connectivity solutions.
Health IT Outcomes: Wireless is often thought of as a single system allowing devices to work in a medical facility with instant connectivity. What are other different and discrete wireless networks that serve individual applications and devices, and how can a health system leverage these solutions?
Abbott: The reality is there is a rich diversity of wireless networks within a medical facility including cellular, near field (Bluetooth), Wi-Fi, medical wireless telemetry, and other body area network (BAN) technologies. With the explosive growth in wireless wearables, internables, and consumables enabled by the Internet of Things paradigm, the grand vision is to have a single wireless system that can seamlessly and transparently support this plethora of devices and their systems in a consistent and cohesive manner. Unfortunately, the reality today is that many of these wireless technologies are operated and managed separately, often with different service level agreements and/or key performance requirements. What is needed is a common approach to create a classification of wireless connectivity that can be managed with a common dashboard in a secure, private, and highly-available manner.
Health IT Outcomes: What do health systems need to consider with regard to connectivity as they place more emphasis on telehealth?
Abbott: In addition to technology acquisition considerations (economics, management, process, and technology), two key considerations are the changing regulatory and reimbursement landscape (which is moving in a favorable trajectory) and behavioral/change management. The latter is most likely the hardest consideration given resistance to change, reluctance to change, and concerns over the delivery, provision, and treatment of care, particularly given performance requirements under ACO guidelines. As with any new approach to services delivery, there will be a kaleidoscope of different viewpoints. This presents a challenge to the governing body of a health system as it relates to breaking down these potential barriers.
Health IT Outcomes: What are the benefits of fiber optic cabling in healthcare facilities?
Abbott: Fiber optic cabling provides an extremely fast, inexpensive, secure, and highly-performing means to convey large amounts of information (data) without the inherent disadvantages of copper wiring, which is subject to interference, intrusion, and other deleterious effects. Simply put, there are no equivalent substitutes for cabled infrastructure as it pertains to fiber optic cabling. That is why fiber optic cabling has mostly displaced all copper wiring for large data interchange systems.
Health IT Outcomes: What recent healthcare-related implementations has ExteNet participated in?
Abbott: ExteNet has been providing mobile connectivity services and solutions to health systems and the healthcare sector for many years. Besides solving the problem of poor cellular connectivity, ExteNet solutions increase overall availability of mobile connectivity networks where its solutions are deployed, which can mean faster alerts and notifications to caregivers. This is particularly relevant when traditional cabled/wired infrastructure is comprised, which has been reported in the popular media.
Additionally, ExteNet has proprietary technologies such as iDUCT that minimize disruption to hospital services during network installations and speed network builds, providing a shorter implementation and higher ROI. One example of this comes from ExteNet’s work with Banner Health. ExteNet delivered advanced mobile connectivity across more than 6.5 million square feet in nearly a dozen Banner hospitals throughout Arizona.