The Road To Wi-Fi Wellness

By Ken Congdon

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A recent Ponemon Institute study showed that hospitals are absorbing an estimated $8.3 billion annually as a result of using old technology. When you peel back the layers, you find that much of these costs are attributed to insufficient productivity. For example, old technology forces clinicians to waste an average of 46 minutes a day waiting for patient data. The main culprits impeding the flow of this information are inefficient and outdated pagers, deficient email, BYOD bans, and most notably, unreliable or nonexistent Wi-Fi communications.

In today’s healthcare environment, a reliable and powerful wireless communications network is no longer a “nice-to-have” commodity — it’s an essential piece of your health IT infrastructure. Today’s clinicians demand to be mobile. They wish to access and record more data at the patient bedside to improve care and accuracy. These mobile communications demands go far beyond simple voice, text, and email capabilities. Physicians and nurses want to access information rich systems and applications (such as EHRs) wirelessly on their mobile devices.

“When we implemented our new EMR and therapy applications, we knew we wanted to enable real-time documentation at the patient bedside,” says Chris Fadrowski, senior director of IT at Brookdale Senior Living. “Historically, our clinicians would have to walk to a designated nurses’ station to record patient information into the EHR. This required them to walk back and forth between the patient room and the nurses’ station. It also forced them to remember their conversations with patients for documentation. This wasn’t always so easy because clinicians could get interrupted several times en route to the nurses’ station. We needed to ensure our patient documentation was timelier and more accurate, so wireless access to these systems was a must.”

THREE STEPS TO OPTIMIZING YOUR WI-FI HEALTH

Like Brookdale, many healthcare facilities are striving to mobilize their clinicians and patient data. Doing so effectively and securely starts with the Wi-Fi network. Many healthcare organizations already have Wi-Fi in place, but oftentimes these networks were designed with a different purpose in mind. They may not be adequate enough to support EHR access or other data-rich applications.

“Many hospitals initially deployed Wi-Fi as guest networks for visitor Internet access,” says Sreekanth Kannan, senior marketing manager at Aerohive (a Wi-Fi solutions vendor). “Guest networks are secondary networks and not designed to handle mission critical communications. If you try to leverage these networks for mission critical data traffic, it will quickly expose holes in your Wi-Fi capabilities.”

Kannan states there are three primary Wi-Fi characteristics healthcare facilities should focus on when designing a network for clinical data traffic — coverage, density, and performance.

1. Coverage — Many healthcare facilities are older buildings with architecture that is not conducive to wireless signal flow. For example, some walls may interfere with the signal, creating “black spots” where wireless coverage is poor. Furthermore, hospitals often restrict the installation of wireless access points in certain areas (e.g. ICU, NICU, etc.) to protect the sensitive medical equipment in use in these areas from wireless interference. To create an effective clinical Wi-Fi network, a healthcare provider must strategically deploy technology to provide universal and optimal wireless coverage throughout the facility in spite of these known obstacles.
2. Density — Many Wi-Fi guest networks were designed assuming a 1:1 ratio of people to mobile devices. However, many clinicians today carry two or more mobile devices (e.g. smartphone, tablet, laptop, pager, etc.) with them on the job. Furthermore, there are several wireless medical devices and asset tracking solutions in play today that also need to access a Wi-Fi network. Healthcare providers need to use this new math to design a Wi-Fi infrastructure that is dense enough to meet all of the facility’s current and future wireless demands.
3. Performance — Performance is essentially a function of bandwidth, and today’s EHR applications need a lot of it — approximately three megabits per second — to ensure quality service. If the bandwidth drops below this level in any area, at any time, then the clinical experience can suffer and frustration can set in. For example, the EHR application may be slow to respond or may even time out, forcing the doctor to log back into the system. Healthcare providers need to ensure their Wi-Fi networks provide the bandwidth necessary to fulfill desired application obligations.

“Certain variables can sometimes have an unexpected impact on the coverage, density, and performance of your Wi-Fi network,” says Joel Vincent, director of product marketing for Aerohive. “For example, there is currently an influx of consumer-grade mobile devices in healthcare. These devices have varying Wi-Fi capabilities. Most are designed to optimize battery life, so they transmit at a lower-than-optimal Wi-Fi setting. Furthermore, emergency medical situations (e.g. Code Reds, etc.) can cause a crowd of people and mobile devices to congregate in the same area and compete for bandwidth. Your Wi-Fi network should include some load-balancing technology to handle these types of situations.”

DON’T SKIMP ON SECURITY

There’s one additional characteristic that I would argue is every bit as important as coverage, density, and performance when it comes to designing a Wi-Fi network in healthcare — security. Securing a Wi-Fi network starts with proper authentication of both the individual and the device. You need to be able to confirm that a clinician is not only who they say they are, but that they’re using the device they’re supposed to be using for a specific function. For example, you don’t want a clinician to bring an unauthorized laptop from home and try to access the EHR with it. Wi-Fi solutions that provide full integration with active directory, open directory, and RADIUS servers can help facilitate wireless authentication. Furthermore, security certificates can be issued to each mobile device approved for use on the healthcare network. These certificates can be compared against database records to verify that the device being used is authorized to access the systems it is attempting to penetrate.

Encryption of both the mobile devices and the data that is transmitted over the air is the next layer of Wi-Fi security. Proper wireless encryption protocols are clearly outlined in HIPAA. HIPAA also enforces administrative safeguards that require healthcare providers to be able to access and review access of wireless system activity (via audit logs, access reports, security incident reports, etc.) at any time.

DETAILED DOCUMENTATION ENSURES LONG-TERM WI-FI SUCCESS

Once you have your Wi-Fi network deployed, you need to do your due diligence to ensure the network continues to deliver optimal service. Storing detailed documentation (e.g. CAD drawings, etc.) and heatmaps of your network for reference and maintenance is critical. For example, Brookdale Senior Living deployed more than 6,500 wireless access points throughout its 647 facilities in the United States. There are no IT people out in the field, so the IT staff in Brentwood, TN headquarters office often needs to reference Wi-Fi network documentation to walk maintenance personnel at the field offices through Wi-Fi troubleshooting.

“Nowadays, you can’t just deploy a Wi-Fi network and walk away,” says Fadrowski. “Clinical operations and patient care are becoming more and more dependent upon these networks to work properly, so you need a solid maintenance plan to ensure uptime. I wouldn’t be surprised if healthcare facilities were 100% wireless in five to ten years. Wireless has become so commonplace in our facility, we really look at it as being the new wire.”