Whether installed in a new hospital construction or as part of the modernization of an existing facility, a standards-based, IP-enabled communications network can deliver many benefits.
With healthcare networks expanding to support an increasing number of applications, as well as to transmit and store voluminous digital information, the migration toward Internet protocol (IP)-based convergence of clinical information systems in hospitals is well under way.
Clinical information systems (CIS) comprise numerous network-based systems designed to provide medical professionals with digital collection, storage, manipulation and access to each patient’s clinical information using standards-based communication technologies. One example of CIS in action is the movement toward electronic health records (EHRs), a trend that is strongly encouraged and supported by the governments of the U.S., Canada and other countries as a means to reduce administrative time and costs, streamline information flow and improve the safety and accountability of national healthcare systems and the patients they serve.
Additional technology-based patient information systems also fall under the CIS umbrella. These may include advanced diagnostic imaging such as digital x-rays, MRI and CT scans; picture archiving and communications systems (PACS); computerized physician order entry (CPOE) systems; and individual patient monitoring systems, in which each patient bed is connected to a nurses’ station and often to a centralized monitoring system.
The ongoing development of innovative digital medical technologies is driving hospitals to upgrade their technology infrastructures to support EHRs and other CIS applications. In fact, approximately 60 percent of healthcare facilities have cited adoption of an EHR system as one of their top three technology priorities.
The new Patient Care Pavilion at St. Peter’s Hospital in Albany, N.Y., includes a high-tech patient-monitoring system that instantly and accurately communicates each patient’s vital information from the bedside to the nurses’ station.
Benefits of an IP-converged network cabling infrastructure
The CIS applications discussed here operate over low-voltage cabling infrastructures and are increasingly communicating via Internet protocol over converged Ethernet-based networks that optimize efficiency. Typically designed and installed using high-performance optical fiber and copper-based cabling, the IP-converged infrastructure provides the foundation for all communications, tying together CIS applications and systems and providing the bandwidth, signal performance and scalability required. In many facilities, the IP-enabled network also supports non-clinical applications and systems, such as building automation systems, in-room patient information and entertainment services and interactive voice communications systems. Whether installed in a new hospital construction or as part of the modernization of an existing facility, a standards-based, IP-enabled communications network can deliver many benefits. For example, such a network:
• Allows for faster, more open flow of information and integration to enhance patient care;
• Facilitates deployment of new clinical and non-clinical systems across multiple sites within the network;
• Enables greater mobility for healthcare providers, administrative and non-clinical staff, and allows for remote monitoring of systems, equipment and patients; and
• Enhances patient care, while lowering the facility’s overall cost of operations.
Some early adopter healthcare facilities have realized up to a 20 percent savings in time and labor costs, simply by implementing an IP-converged network. Clearly, convergence is here to stay and it is integral to the new TIA-1179 standard guiding network infrastructure design for healthcare facilities.
At the same new facility, the IP-converged network supports a multitude of both clinical and non-clinical systems and applications. Some hospitals have realized up to a 20 percent savings in time and labor since installing an integrated IP-based network infrastructure.
The new healthcare standard: What’s different?
Recognizing that existing TIA-568-C commercial building standards for network cabling infrastructures were no longer adequate for healthcare facilities, the Telecommunications Industry Association (TIA) responded in August 2010 by ratifying the ANSI/TIA-1179 Healthcare Facility Telecommunications Infrastructure Standard.
The new standard specifies requirements above and beyond the scope of general commercial building guidelines. Why did the TIA deem this necessary? Primarily because the healthcare network cabling infrastructure must now support a wide range of mission-critical clinical systems requiring greater bandwidth and reliable performance to ensure that healthcare providers can continue to provide responsive, time-sensitive patient care. New CIS applications continue to emerge and evolve. Forecasts estimate that the global digital x-ray systems market will reach USD $4.8 billion by 2016, making an even more compelling case for healthcare facilities to implement a robust and reliable network infrastructure.
Many of the TIA-1179 standards are identical to those that apply to commercial buildings. For cabling system design, for example, the new standard specifies the same hierarchical star topology and backbone and horizontal cable lengths. For transmission performance, test requirements and administration, the new standard also refers back to commercial standard specifications.
The standard’s new guidelines relate specifically to healthcare facilities because of their unique physical layout and mission-critical requirements. Among the issues addressed are: room size and cabling/connectivity density in equipment rooms and telecommunications rooms to allow for growth, work area location and work area outlet density, physical transmission media specifications, environmental considerations, network security and segregation of certain network areas to ensure adequate support of life and safety protocols.
TIA-1179 responds to healthcare network challenges
While the TIA-1179 standard is changing how healthcare facility network infrastructures are designed and deployed, it also addresses the overall IT requirements of such facilities. Here are just a few of the key requirements and considerations.
High-speed performance: Hospitals today need to quickly transmit larger file sizes, such as digital diagnostic images (CAT, MRI, PET scans, etc.), some of which can run as large as 300 MB per image. One patient case file alone can contain many such images, for a total of up to 9,000 MB. A file of this size would take more than a minute of download over a 1 Gb/s network, but the same size file would take only about seven seconds over a 10 Gb/s network. In an emergency situation, that time differential could mean life or death for the patient. Addressing this need, a key specification of TIA-1179 relates specifically to signal transmission media selection. For all new healthcare installations, the standard recommends using the highest performing media whenever possible, and specifies category 6a cabling capable of supporting 10 Gb/s transmission speeds.
Maximum reliability: Because hospitals exist to provide essential services necessary to ensure patient health and safety, many areas therein can be severely impacted by network downtime. This is particularly true of the ICU, OR and other critical care areas. To address this issue, the new standard provides for route diversity and redundancy in the cabling infrastructure by requiring a minimum of two diverse cable pathways between the main service entrance facility, data center, telecom rooms and any space designated as a critical care area.
Higher density: One of the most significant differences between the healthcare facility and commercial building standards is that hospitals require greater density to support more data-intensive applications and they are urged to allow for future growth, both in terms of physical space and cabling density. Cabling for various systems must be able to share pathways between telecom rooms and healthcare spaces without experiencing performance degradation and, in TRs and data centers where cabling terminates to patch panels for connecting to switches and routers, higher density installation solutions are needed to manage the higher number of terminations in less space.
Maximum safety, security and administration: Because healthcare networks directly support life systems, network safety, security and administration are of utmost importance. In particular areas of a hospital network, such as pediatrics and psychiatric wards, it may be appropriate to deploy tamper-proof work area outlets to avoid downtime and/or costly damage to network connections. The TIA-1179 standard recommends the use of colored cables, colored jacks or keyed connectivity to maintain segregation for certain networks, enhance security and assist in network management and administration.
The new standard also provides guidelines on a host of other network infrastructure challenges, including sustainability and growth, infection control procedures, resistance to EMI/RFI interference and more. Information can be found at