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From the November 2003 Issue PACS as an Enterprise Resource |
The Strategic View of Now that wireless technology has come of age, so should the way healthcare organizations manage it. By John Smaling Who would have predicted two years ago that a new wireless network in the healthcare environment would be considered legacy today? Indeed, one would be hard-pressed to cite any other technology that has evolved so rapidly. Technology limitations that only a short time ago kept healthcare organizations (HCOs) from implementing wireless more widely are obstacles of the past. Problems like inconsistent RF propagation, weak signaling, poor radios, antennas and receivers have been, for the most part, resolved, thanks to the adoption of standards in the wireless industry. Just in the last six to 12 months, radio frequency technology in particular has made tremendous advances, leading many executives to wonder: How do I get the most from wireless technology now that it has come of age? An Enterprise Perspective First of all, an enterprise perspective is vital to any consideration of wireless technology today. Such a perspective represents a fairly radical shift in the way wireless technologies have been evaluated up to now. Many early adopters of wireless technology implemented it in small “pockets”—in an emergency room, for example—where coverage requirements were no greater than a 150 x 50-foot area. In other cases, a clinical systems or materials management vendor would sell an application to an organization and an adjunct module that made the application mobile. “Great,” said the vendor. “Great,” said the CIO. Everyone was happy—for a while, at least. While those early implementations served their purpose well, the movement to computerizing more clinical processes calls for a broader, enterprisewide view of mobile technology rather than a “pocket” approach. Today, it is imperative to design a wireless infrastructure much the same way that traditional network infrastructure is designed and managed. Many leading healthcare organizations have a rotating, next-generation strategy for their network infrastructure. They build it to last five years, and they start redesigning it at year four. Taking the same approach with a wireless infrastructure design could go a long way to helping healthcare organizations get the most from today’s wireless technology. Seven Key Steps An HCO’s strategy should consider workflow, applications, user constituencies and voice/data. These elements will help define the design requirements of the underlying mobile infrastructure such as coverage, bandwidth, device types, WLAN/WWAN, etc. Here are some important steps to consider in designing a wireless infrastructure that is consistent with the organization’s strategy: 1. Focus on workflow. Multiple segments of the work force can be untethered through the use of wireless technology. Materials management, for example, can improve the way it tracks floor stock and replenishes inventory. Transport services can be notified the moment a patient is ready to be transported out of the hospital. A workflow analysis will help the HCO identify who will be using the technology and how they will need to use it. This can broaden organizational understanding of where to provide wireless coverage, what the HCO needs to provide (voice and/or data), what kind of end-user device recommendations to make and any other necessary steps. 2. Perform a detailed site survey and spectrum analysis. An HCO’s IT department would never consider doing a traditional network design without ensuring that the cable plant supports its network infrastructure and its end-users. Be sure to take a similarly careful approach in developing a well-crafted view of the organization’s wireless coverage requirements. One of the biggest mistakes we see in our work with healthcare organizations is that someone has been tempted to take the easy way out, using a handheld PDA with scanning software on it to roll through an area and do a high-level site survey and spectrum analysis. As a consequence, either too many access points are purchased, or there are far too few and they are placed in the wrong areas. The other consequence of cutting corners is the likelihood of interfering with telemetry or other types of equipment used to care and treat patients. By the same token, microwaves and other equipment can adversely affect wireless performance. 3. Classify mobile end-users into groups by their functions, and control the number of different devices that the infrastructure supports. A lightweight wireless device may be the top priority of one group of end-users. Another might require a large, clear, crisp screen to view medical images. Another’s top priority might be a device with a long battery life. The IT department will be expected to support and manage any and all devices. If the IT department allows for a wide-open playing field and ends up with 15 different device types, it’s going to be very difficult to service and maintain them. In addition, the more devices an HCO supports, the more it runs the risk of the “Batman utility belt syndrome,” where users end up carrying around so many different devices that they grow frustrated and hinder the adoption of the wireless system. 4. Develop a layered security model. Securing the wireless realm is different from securing traditional environments. It is simply more difficult to control radio waves than it is to control where cables exist in an organization. The risk of attack is further compounded by the portability associated with wireless. The dynamics require a layered security architecture that provides multiple protective rings around the various components of the mobile infrastructure. That way, if a breach occurs in one ring, a succession of other rings still must be breached before the organization faces a security risk. 5. Devise a set of management tools that addresses both core infrastructure and end-user devices. Be sure to include tools for managing antennas and access points—particularly rogue access points—such as a wireless transmitter that someone plugs into a jack. A tool for managing these is an important one to add to the organizational arsenal. Also, be sure to identify any inability of the existing tool set to manage the end-user device types selected and fill those gaps appropriately. 6. Emulate the production environment in a lab and thoroughly test it so that, once deployed, expectations are met. Be sure to include all the end-user devices that will be deployed into production, and test those devices for coverage and connectivity. Test the full application suite as well, particularly those that are time-sensitive. Be sure users can switch to different antenna sources—if walking across the campus, for example—and still maintain connections with those applications. In addition to security, RF coverage, redundancy and fail-over, thorough load testing is critical, too. An average rule of thumb is 25 users per access point; rarely should the HCO exceed 40, but everything is contingent on traffic, the types of applications being used and the environment—whether fat-client or thin-client—through which the devices are accessing the network. 7. Select a pilot initiative that will produce an early win and publicize it. With wireless, the IT department is asking an often-difficult user community to adopt new technology and is changing workflow and the way business is done. Which initiatives are most likely to produce that early win? The emergency department is a great first step, as long as it is viewed as exactly that: the first step in a comprehensive plan that carefully maps the current and future role of wireless. The Enthusiasm Factor
John Smaling is the vice president and general manager, infrastructure services, of Daou Systems, Exton, Pa. For more information about services from
Daou Systems © 2003 Nelson Publishing, Inc |
For any IT department considering a wireless implementation, don’t underestimate the importance of making a big deal out of it. All IT departments have an obligation to involve the end-user community from the beginning, with good solid training not only around the technology, but also around the required changes in workflow. Get them excited and chances are the wireless implementation will be an even greater success.