Wireless woos doctors

Networked mobile devices help improve = patient care=20 and diagnosis.

By John = Cox
Network World, 12/09/02

Healthcare network executives are = discovering=20 that wireless = access to=20 data can have a dramatic effect in boosting the number of patients = served,=20 improving quality of physician diagnosis, and speeding payments = and=20 billing cycles.

Wireless and mobile technologies are top = spending=20 priorities for healthcare organizations, according to a recent = report from=20 Forrester Research. Although wireless LANs have been used in = hospitals for=20 some time, the rollouts are getting bigger, and the applications = are more=20 sophisticated. Several factors are spurring this trend: =

=95 New applications specifically = designed for=20 handheld deployment. =95 = Devices that are=20 high-quality, powerful and reliable, yet affordable. =95 Faster data rates of up to 54M = bit/sec=20 with 802.11a<= /A>=20 in the 5-GHz band, and the same rate with = soon-to-be-released 802.11g<= /A>=20 wireless LANs in the 2.4-GHz band.=20

Administrators and physicians view these = developments=20 as a foundation for improved efficiencies in billing and quality = of=20 patient care, says Rick Shoup, vice president of healthcare = solutions for=20 management consultancy Infosys.

"One of our [healthcare] customers told me = recently,=20 'We lose millions and millions of dollars each year because we = don't=20 accurately capture data about tests that have been ordered or = other=20 services,' " he says.

Wireless = LANs=20 can let staff with handheld computers instantly record all charges = and=20 update billing databases. But in many cases, return on investment = takes=20 second place behind improved patient care.

Doctors and related professionals = increasingly are=20 pushing for the most current and accurate patient information. To = get it,=20 they have to be able to access hospital databases and records via = wireless=20 LANs coupled with handheld devices.

"Our entire clinical perspective on = wireless has=20 changed," says Michael Minear, CIO for the University of Maryland = Medical=20 System in Baltimore. "It used to be a 'Buck Rogers' [science = fiction] kind=20 of thing. Now, it's a fundamental part of every discussion about = clinical=20 information technology."

The organization was one of the first to = deploy a=20 newly designed mobile version of Cerner's Cerner Millennium = clinical=20 application suite on Tablet PCs and handhelds. "We're one of the = few=20 hospitals doing wireless synchronization [directly] with the = laboratory=20 databases," CIO Michael Minear says. "A physician walks in the = front door,=20 switches on the PDA, and in 5 to 7 minutes, he has the latest data = on=20 patients, including lab results."

Although the hospital uses Enterasys=20 Networks' 802.11b<= /A>=20 wireless LAN access points, Minear planned the architecture as if = he were=20 deploying the shorter-range 802.11a wireless LAN. "When 802.11a = technology=20 comes out [and we decide to deploy it], we can just unplug the = 802.11b=20 cards and replace them with 802.11a cards," he says. The facility = will=20 save money by not having to position new access points or run = cabling or=20 electricity to them.

Washington Hospital Center also is tapping = wireless=20 to aid doctors. The 900-bed facility in Washington, D.C., has = about 60=20 Symbol Technologies wireless access points and a few hundred = wireless PDA=20 and laptop clients.

"Wireless is being driven by user demand = and by the=20 need to deploy point-of-care applications that can only work = wirelessly,=20 such as point-of-administration medication records management, and = bedside=20 medical data retrieval," says Craig Feied, director of informatics = for=20 Washington Hospital Center operator Medstar Health. "It really = impresses=20 people that any clinician can actually see an X-ray or a CT scan = image on=20 his PDA, while sitting in the cafeteria."

Feied launched a pilot program that gave = one member=20 of the physician team on morning rounds a PDA with a wireless LAN = card.=20 The team moved from patient to patient to review chart data and = decide on=20 treatment changes, including drug prescriptions.

"At the moment the team concluded its = patient review,=20 one of our doctors whipped out the PDA and checked to see if there = was any=20 new data," Feied says. "In 30% of the cases, there was new = information:=20 information that had been missed or only became available to the = doctors=20 during that interval."

The effect of having such data is = startling. "It is=20 very clear," Feied says, "that no matter how well-computerized a = hospital=20 is, it's not sufficient if the stumbling block [to accurate data] = is that=20 you have to walk 50 feet to a wired PC or leave the patient's = bedside. You=20 have to go 'the last 10 feet.'"

Writing prescriptions electronically is = another=20 application that is ideal for wireless. A 2001 study at Medstar = found all=20 the group's doctors thought e-prescriptions would be more accurate = than=20 hand-written ones. Yet Feied says only 40% of Washington Hospital = Center's=20 prescriptions were being entered via desktop PCs. Once doctors had = handheld computers linked to the wireless LAN, the percentage = nearly=20 doubled to 70% of all prescriptions. Feied expects that to = increase as=20 more physicians see the ease and accuracy of wireless prescribing. =

Wireless usage raises security and safety = concerns,=20 but executives say these are manageable with today's products and=20 technologies. Beth Israel Deaconess Medical Center suffered = a=20 major network outage last month, but CareGroup CIO John = Halamka says=20 it didn't affect the Boston hospital's Cisco Aironet wireless LAN. = He=20 protects it with the Cisco-specific Lightweight Extensible = Authentication=20 Protocol security protocol. He's also deploying BlueSocket's = gateway that=20 sits between the wired and wireless network.

For IT groups, it's unclear precisely how = the federal=20 Health Insurance Portability and Accountability Act will affect = security.=20 The rules that specify how privacy restrictions are implemented = securely=20 will be finalized this month, and hospitals then will have two = years to=20 comply.

Wireless LAN safety issues focus mainly on = the=20 potential for interference with, or by, other hospital equipment = such as=20 cardiac monitors. CareGroup's clinical engineering group oversees = wireless=20 LANs as just one part of the total wireless spectrum used by a = range of=20 hospital equipment, much of it on the same 2.4-GHz band that = 802.11b=20 wireless LANs use.

Halamka formed a group of 100 engineers and = physicians to create an enterprisewide policy for wireless use in = the=20 group's hospitals. "We've concluded that wireless, used more than = three=20 feet from a patient, is always safe," he says.

Related Links

More=20 Sector Spotlight articles

Healthcare = Information and=20 Management Systems Society 2002 Annual HIMSS Leadership = Survey

2002=20 HIMSS/AstraZeneca Clinician Wireless Survey (PDF)

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Some hospitals are sidestepping = traditional=20 IPSec VPNs for newer SSL-based products.
Network=20 World, 11/25/02.

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Network World,=20 07/22/02.

Network=20 World on Wireless in the Enterprise
Sign up for our free = e-mail=20 newsletter.

Breaking wireless-LAN news=20

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