February 17, 2003
By Galen Gruman, editorial director, IT Wireless
A free newsletter to all IT Wireless subscribers.

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A Hospital Goes Thoroughly Wireless

Health care is one of those industries that is perfectly suited to the use of wireless technology: Its staff is very mobile, patient data is needed fast and on demand, and there's already a ton of wires for electrical power, monitor hookups, and other equipment that leave little convenient space to plug in computer equipment. That's why an increasing number of hospitals are going wireless, integrating wireless access to their wired networks. The Veterans Administration was a pioneer in such deployments two years ago, but now even smaller hospitals are finding they can implement wireless effectively.

Consider Memorial Medical Center in Springfield, Ill. A teaching hospital associated with the Southern Illinois University School of Medicine, it is one of two medical centers in the city of 112,000 people, and has about 2,000 staff members and physicians who access medical records. Last year, the hospital decided to introduce electronic records access to physicians, nurses, and other medical staff. The goal was to improve patient care by having standardized information and fast access to it. The hospital wanted doctors and nurses to be able to access patient information as they needed it wherever they happened to be, as well as eliminate error-prone paper documents, prevent unintended drug interactions, and eliminate illegible handwriting with electronic forms, called order sets, that ensured procedures were documented and followed hospital, insurance, and government regulations. Even though the hospital expects the system won't lower its per-patient care costs, providing such access should improve care and patient safety, preventing potentially costly mistakes.

Part of a three-year, $30 million effort, Memorial Memorial originally planned on having 802.11b wireless access in just a few locations that were hard to wire or where staff was very mobile, such as in patient wards. But CIO O.J. Wolanyk argued that it made more sense to make the entire hospital wireless -- including the parking structures and cafeterias -- so doctors and nurses can access information anywhere. He also wanted the full coverage so he could later implement voice-over-wireless-IP (VoWIP) phones, whch he's now evaluating. In November, the hospital adminsitartin OK'd his wireless-everywhere approach, which will cost $900,000.

Wolanyk first thought he'd need about 300 access points, based on the square footage of the hospital. But his system integrator, Daow, hired a spectrum-analysis firm, Consolis, that did a three-week-long spectrum analysis of the hospital to determine optimal access point placement. The result: The hospital will need fewer than 150 access points. "They paid for themselves," Wolanyk says.

The wireless network will have three levels of security to protect patient data and ensure only authorized users can log in: Windows NT Active Directory authentication, policy-based firewall access (to ensure that users get only access to the information they are allowed to see), and 128-bit Dynamic IPSec 3-DES data encryption. Although federal regulations don't dictate the technology used, they are very strict in their patient-records protection standards. Wolanyk is also using redundant servers and edge controllers from ReefEdge, whose systems allow seamless roaming and session-keeping handoff between access points, to eliminate downtime.

The system does require the use of Windows 2000 or XP, so initially only notebooks, tablets, and PCs can be used. ReefEdge is working on a Pocket PC version for handhelds, which Wolanyk expects to be available this summer. Other devices won't be supported.

Wolanyk is enthusiastic about the project, even though it means no cost savings. Having better, safer operations is payback enough, he says. "I want to experience this myself," he says, so Wolanyk uses a notebook as his primary computer and works throughout the hospital -- he has no office -- connecting wirelessly in the administration section that already had some wireless access and via Ethernet jacks elsewhere. He recognizes that doctors are not technology adopters, so it's critical that they find the system easy to use and that it make their patient care easier to deliver -- a reason he's asked doctors to help design the applications and work methods, as well as why he has tried to live a mobile worklife himself.

Still to be decided is how the hospital will connect to the outpatient services wing across the street, connected via a walkway. Although the staff that work in the main hospital don't go into the outpatient building, and vice versa, Wolanyk would like to have both on the same network. But first he has to work with other tenants in the outpatient building, since several have wireless networks that overlap the outpatient unit's space. Wolanyk is also working with the other major hospital in town (St. John's, which is three blocks away) to try to standardize the medical information systems, including the wireless access, so physicians can work at both without changing procedures or technologies. (Physicians are typically private businesses that affiliate with one or more hospitals so they have the right to practice there, such as for surgery.)

Three other technology issues await:

  • One is the use of thin-client devices that don't store data locally, so patient information doesn't leave the building even if the devices do. (Wolanyk says he does not expect theft to be a problem based on his experience at other hospitals, and recognizes that doctors will likely want to use their own notebooks so they have the data at their offices. But for hospital staff, it would reduce the chance of data being compromised because someone accidentally lost a notebook or handheld.) He's heard that Dell Computer will be reselling such thin-client systems from Fujitsu this year.
  • Second is choosing a VoWIP system that can run over his wireless network, so staff can communicate anywhere without incurring phone-call expenses. Wolanyk had used Avaya phones on two floors but said the devices didn't work well and that Avaya later discontinued support for them. He's looking at several vendors, including Avaya, for VoWIP phones.
  • Third, he wants to build power racks and deploy them throughout the hospital. He notes that no company makes recharging racks so multiple devices can be recharged from one power outlet; instead, every recharger takes its own power jack. He wants both visiting doctors and hospital staff to be able to recharge their devices easily without having to find an open power jack.

From our editors


A subscriber exclusive! IT Wireless's Essential Products Guide is now available to subscribers. The 10-page PDF file contains a listing of key vendors and service providers, with summaries of their offerings and contaft information. Categories include wireless network and client hardware, network and client software, and IT services.
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The Latest in Wireless Products and Tech

With the CTIA Wireless show coming up in mid-March, vendors have focused on their carrier offerings, but there have also been a few enterprise-oriented developments of note:

  • Expect to see 802.11g access points released this spring from most vendors. The 54Mbps-maximum-rate technology uses the same spectrum (2.4GHz) as 802.11b (11MBps maximum rate) hardware, and supports 802.11b clients automatically. Some vendors have already released versions of their hardware based on preliminary 802.11g specifications, though they've been mum on whether these premature devices will be upgradable to the final standard. Be careful if you buy 802.11g access points and client adapters.
  • Vivato has announced its Wi-Fi switch, a flat panel that has three 802.11b beams to cover an area of up to 300 feet such as a floor in a building. A single Vivato 2.4 GHz Indoor Wi-Fi Switch can support about 150 enterprise users, tracking active users as they move about the office within its 100-degree field of view. The company says the switch can eliminate the need for multiple access points. The $8,995 Indoor Wi-Fi Switch's security support includes 802.1x authentication with per-station keys, virtual private networks (VPNs), and virtual LANs. Vivato's switch supports the Wired Equivalent Privacy (WEP) and Temporal Key Integrity Protocol (TKIP) standards for data privacy and have the hardware required for supporting the future IEEE 802.11i standard.
  • Proxim has announced Maestro, a platform for integrating, configuring, and centrally managing wireless LAN infrastructure to support the mobile delivery of voice, data, and video across heterogeneous wired and wireless networks.
  • Proxim also has a new guide to wireless deployments available for download (registration required). So does Intel, with a PDF document focusing on security issues (no registration required).
  • GoAmerica and EarthLink Networks are offering cellular data services of up to 144Kbps with the Outlook Companion application to manage whether and how attachments are downloaded over the cellular network onto notebooks equipped with a Sierra Wireless Aircard 555 for CDMA2000 1XRTT networks. Plans start at $25 per month for 5MB of data.
  • AirMagnet has updated its AirMagnet Wireless Analyzer, which helps determine access point placement, to support more security protocols and work with non-U.S. 802.11 frequencies.
  • Alcatel will deliver carrier and enterprise wireless networking hardware that delivers IPWireless's UMTS-TDD-based cellular data service, which provides connection rates of up to 3Mbps. It's designed for wide-area use, as opposed to 802.11-based wireless LANs, but is faster than the CDMA2000 1XRTT and WCDMA cellular technologies more commonly deployed because they also support voice calls.
  • Meanwhile, Nortel Networks has demonstrated in the lab a 20Mbps version of the UMTS (the European standard for what is called WCDMA in the U.S.) data/voice cellular technology using multiple-beam smart antennas.
  • Intermec Techologies is adding 802.11x authentication capabilities to several of its wireless handheld scanners.
  • McGraw-Hill has released two new books on wireless deployment: Installing, Troubleshooting, and Repairing Wireless Networks by John Aspinwall and Wi-Fi Security by Stewart  Miller.

Got a great product or technology tip? Send it to news@it-wireless.com.


The Latest in the Wireless Marketplace

Research firm Synergy recently reported on the fourth-quarter 2002 wireless hardware sales, showing strong growth overall:

  • Overall, vendors shipped more than 15.8 million Wi-Fi devices in 2002, earning $1.8 billion. That's up from $1.4 billion in 2001, and $577 million in 2000.
  • In the enterprise, Cisco Systems accounts for 31.5% of sales, followed by Symbol Technologies at 13.8% and Proxim at 8.9%. Proxim increased its revenue market share significantly because of its acquisition of the Orinoco wireless hardware line from Agere Systems.
  • Sales of home and small business Wi-Fi products accounted for 55% of the total market. In that market, Buffalo Technologies, Linksys, and D-Link dominate, at 18%, 16%, and 13%, respectively.
  • For voice-over-wireless-LAN (VoWIP) phones, Spectralink had 68.8% of the revenue market share and sold 32.7% more units than in 2001.

This issue's sponsor: Oracle
For advertising information, contact Manny Sawit at (510) 583-0855 or msawit@it-wireless.com

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