Wi-Fi IN HEALTHCARE
Healthcare’s growing mandate for Wi-Fi
networks in hospital settings
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I. INDUSTRY METRICS
T
he importance of Wi-Fi networks in hospital settings has grown substantially in the past few years as healthcare providers aggressively adopt mobile devices, medical device companies add connectivity, andadministrators seek out more efficient ways to manage their facilities.
The Wi-Fi Alliance, a global non-profit industry
association devoted to evangelizing Wi-Fi technologies, points to the widespread interoperability that Wi-Fi brings to medical IT networks. The Alliance says there are millions of devices, ranging from smartphones and laptops to specialty-built medical devices that are Wi-Fi enabled and used in healthcare settings.
Healthcare’s uptake of Wi-Fi technology grew 60 percent between the summer of 2009 and the summer of 2010, according to ABI Research. At the time the research firm expected adoption to continue to grow at a double-digit rate for the medium term. Despite the recent financial downturn, last year ABI said that the healthcare market represented the second most attractive market for Wi-Fi equipment vendors after the US federal government.
The American Medical Association reported that ABI estimated more than 500,000 wireless local area networks (WLAN) would be implemented in healthcare settings during 2010 and that number was expected to double to 1 million new network implementations in 2015. The 500,000 figure also marked a 50 percent increase from 2009 launches. The AMA said that one reason that Wi-Fi networks were finding traction within healthcare settings was that cellular signals are sometimes less reliable or even prohibited inside care facilities.
ABI also predicts that worldwide sales of Wi-Fi-enabled healthcare products will reach nearly $5 billion by 2014. That marks an increase of almost 70 percent over sales of those products during 2010.
“Wi-Fi adoption has helped overcome initial concerns about complexity and reliability of wireless within healthcare,” ABI Research principal analyst Jonathan Collins stated in a company release. “The growing number of wireless technologies and wireless applications being developed, piloted and deployed within healthcare further underline the level of interest in using wireless to improve the flexibility and efficiency of healthcare services around the world.”
The Wi-Fi Alliance points out that while the healthcare industry is one of Wi-Fi’s most promising markets today, it is also one of the most challenging. The Alliance characterizes hospitals as dynamic environments that change day-to-day and even minute-to-minute, but more advanced Wi-Fi networks are able to automatically sense some of the characteristics of their RF environment and re-configure to work around obstructions or interference.
Consulting firm Frost & Sullivan acknowledges Wi-Fi’s popularity in hospital settings but believes cellular-based wireless networks might more effectively address issues including range, security and quality of service (QOS).
By all accounts, however, Wi-Fi continues to dominate.
“It’s a pretty big business,” ABI Research vice president Stan Schatt said in a statement. “The strong uptake of Wi-Fi in the health industry is underpinned by its need for improved asset management, staff mobility, transfer of digitized records, and standardized administration of medications. In addition, government security requirements including HIPAA often mean replacing older wireless equipment with modern versions.”
I. INDUSTRY METRICS (continued...)
I
ncreasingly hospital IT administrators are bombarded with requests to Wi-Fi-enable medical devices, connect patient monitors, track portable assets, and support mobile internet devices. In part this connectivity helps to improve patient care, increase efficiencies in clinical workflow, and even lower costs.As mobile internet devices -- especially the new generation of tablets -- find their way into physicians’ hands, a laundry list of applications become dependent on Wi-Fi networks.
The following use cases are not by any means intended to serve as an exhaustive list of Wi-Fi-enabled devices, services or applications in hospital settings. These are, however, some of the most popular examples adopted by the healthcare industry today.
II. USE CASES
Without a doubt the healthcare industry’s aggressive adoption of mobile devices -- including smartphones and tablet devices -- is a key driver of Wi-Fi network implementations in hospital settings today.
Chilmark Research estimated that 22 percent of US physicians had an iPad at the end of 2010, while a survey conducted by Knowledge Networks concluded that 27 percent of primary care providers and specialists in the US own some form of tablet device.
USE CASE #1
Knowledge Networks’ survey also found that about 64 percent of US physicians have a smartphone today, which squares with Manhattan Research’s estimate that more than 72 percent of US physicians owned a smartphone or PDA. Manhattan Research continues to bundle smartphones and PDAs together for its estimates because it has found that some physicians do not know the difference between smartphones and PDAs.
“It’s a funny quirk of physicians that we found as
smartphones came on the market,” Manhattan Research President Meredith Ressi said. “We’d ask if they have a smartphone and they’d say ‘no’, but then say that they do have a PDA, which was often actually a smartphone when we asked the types of devices.”
A third survey recently conducted by online physician community Sermo, which counts 120,000 physicians as members, estimated that “more than 50 percent” of physicians were using smartphones.
In any case, it is now widely believed that a majority of US physicians are using some form of smartphone and a growing number of doctors are adopting tablets.
While the mandate for Wi-Fi networks in care settings does extend beyond the need to provide connectivity for the growing number of devices that healthcare providers have in their lab coat pockets, perhaps the sheer number of those devices is reason enough.
Which medical applications look most promising for the mobile platform? While it’s still early days on the adoption curve, clinical reference applications are far and away physicians’ preferred use case for their mobile internet devices. Other use cases that are beginning
Mobile Internet Devices (continued...)
to find adoption include charge capture, e-prescribing/ CPOE, accessing EMR data and imaging. The FDA has only recently cleared a diagnostic imaging app for mobile devices. As a result imaging apps for mobile internet devices is a particularly green use case. Imaging apps for tablets, however, hold a lot of potential because of the size and improved resolution offered by the latest generation of these devices. No need to lug around medical dictionaries, calculators or drug information atlases -- a doctor can now access all of the information that he or she needs on a single, portable device. Of course, it’s also far easier to update a medical reference app than an outdated medical tome. Top-line results from a recent research report from Chilmark Research found that 63 percent of doctors regularly used clinical reference apps. The most popular medical reference apps have reported hundreds of thousands of app downloads from smartphone users.
Far fewer physicians in the US use charge capture apps on their mobile devices, but Chilmark ranks this use case as the second most popular after medical reference apps. It’s not difficult to understand why: by streamlining the charge capture process through the use of mobile devices, hospitals can increase the efficiency of rounding, transfer information between doctors more quickly, eliminate time wasted searching for patient information and push out real-time alerts to physicians. Some hospitals have also found that efficient, mobile charge capture systems can help to attract and retain talented physicians.
While it is often one of the applications of most interest to physicians, very few are using mobile apps to access electronic medical records (EMRs) today. Unlike with clinical reference apps, enabling doctors to use mobile devices for EHR access requires a considerable amount of work on the part of the IT department and poses numerous challenges, security and patient privacy being chief among them. What’s more, many of the industry’s largest Health Information Systems (HIS) vendors don’t yet offer native support for mobile in their products. For a use like EHR, one where doctors demand speed and stability but also robust security, a native application will always be the best solution. Using a web interface to interact with an EHR system introduces lag, reduces stability and raises a number of security concerns. While it’s unfortunate that so few of the more than 300 major EHR vendors are offering native tablet apps at this stage, expect to see many more vendors hop on board during the next year, as demand for mobile EHR systems grows.
Mobile Internet Devices (continued...)
The other notable use cases for mobile internet devices in care settings are computerized practitioner order entry (CPOE) and e-prescribing. These two use cases are likely to take off during the coming year. Of the 7,000 deaths attributed to prescription mistakes each year, some can be traced back to errors stemming from handwritten prescriptions. While there are many ways that tablets can improve the quality of care, e-prescribing is perhaps one of the most obvious.
Of course, it’s not just healthcare workers who expect Wi-Fi in care settings -- patients do too. Hospitals typically offer wireless internet access to patients and their guests to help them stay in touch with family members, access entertainment services, or keep up with work while they’re away. In many cases Wi-Fi services are not available in critical care wards as a conservative measure to prevent interference with life support devices.
Mobile internet devices may be dominating the headlines, but in most every discussion of Wi-Fi in healthcare the use case cited first and foremost is connecting infusion pumps. While this use case overlaps with a couple of those broader categories discussed below, infusion pumps deserve special attention. That’s because more than any other medical device, infusion pumps seem to be the first to receive connectivity.
By connecting infusion pumps via Wi-Fi, medical staff can more easily locate particular pumps if they have a real-time location service (RTLS) installed (more on that ahead). While most any portable device or asset could benefit from location tracking, connecting infusion pumps via Wi-Fi also enables staff to receive automatic alerts through email or other electronic communications from the devices when they require maintenance. The connectivity also enables clinicians to download data from the pump to remotely monitor care.
According to ABI Research, wearable wireless devices used on-site in care settings are expected to rise from 1.67 million devices to more than 294 million in just five years, the Wi-Fi Alliance reported in a recent white paper. The growth of these wearable devices coupled with the continued addition of connectivity to more traditional patient monitors makes for a bright future for Wi-Fi-enabled patient monitoring. Of course, not all patient monitors will move to wireless connectivity. Some mission critical devices and many fixed monitors will not migrate to hospitals’ Wi-Fi networks.
Those medical device companies developing wireless monitors - like the wearable ones ABI is bullish about - are concerned about networking issues inside medical facilities, according to the West Wireless Health Institute.
“Assurance is the number one fear for new wireless sensor companies looking to work in the hospital environment,” Ed Cantwell, Senior Vice President, West Wireless Health Institute said.
West Wireless Health Institute describes the growth of wireless medical devices inside hospitals and the increased number of wireless consumer devices in care settings as “explosive.” The institute wants to help hospitals better tame their wireless environments and ensure that connectivity becomes a “medical-grade wireless utility.”
Cantwell is leading the not-for-profit institute’s initiative to help create standards by forming a steering committee made up of hospital executives, mobile operators and regulators from the FDA and FCC.
USE CASE #2 - Infusion Pumps
USE CASE #3 - Patient Monitors
While physicians often bring in their own personal smartphones, tablets or other mobile internet devices, hospitals sometimes provide other caregivers, especially nurses, with mobile communication devices that run over the facilities’ WLAN. A growing number of vendors are developing software based communication services that run on consumer devices, including Apple iOS devices and BlackBerry smartphones.
BlackBerry-maker Research In Motion recently announced a SIM-optional BlackBerry device, which could find a home in hospital care settings that have wards where cellular-enabled devices are not allowed. Microsoft’s recent move to acquire consumer VoIP service provider Skype could also lead to an increase in VoWi-Fi. Microsoft is likely to integrate Skype’s VoIP on its Windows Phone 7 and Windows Mobile devices, which many industry onlookers believe could prove to be popular among healthcare workers.
Smartphone-based VoIP services often include advanced features like presence, which enables members of the care team to know the availability of every other member of the care team who uses the system. These services are beginning to integrate with patient vital sign monitoring apps to provide seamless – or at least more convenient – collaboration amongst the care team.
Nurses are mobile workers in a high-stress and data-intensive environment where these devices can come in handy for receiving texts, alarms and voice communications. Other voice over Wi-Fi (VoWi-Fi) service providers equip caregivers with simpler, dedicated devices that can take the shape of handhelds, pagers, or mostly hands-free pendants that caregivers can wear around their necks. In many cases caregivers are required to use a number of these devices: one for critical messages and one for non-critical alerts, for example.
Wi-Fi-enabled real time location services, also known as RTLS, are designed to help hospitals track the location of various assets inside the facility or throughout a campus. These assets might include medical devices, wheelchairs, and beds. They could also include people: patients, physicians, nurses or other staff.
RTLS systems help care facilities better manage inventory by locating the nearest device or wheelchair when one is needed. They also help prevent assets from being lost, misplaced or stolen.
Location systems also help hospitals make the most efficient use of their care teams. By having a real time picture of where physicians, nurses and other support staff are located, the right person can be sent where and when they are needed.
As with most of the other use cases described in this white paper, RTLS can run on any number of wireless technologies. Consulting firm Frost & Sullivan, however, previously stated that despite a plethora of location technologies on the market, Wi-Fi was best positioned to help hospitals most efficiently cut costs in misplaced assets and labor.
USE CASE #4 - VoWi-Fi
USE CASE #5 - RTLS
Spyglass Consulting Group conducted a survey in 2009 that concluded more than 66 percent of hospital-based nurses were using some kind of voice over IP service to enable greater mobility and efficiency at the point of care.
The Wireless Life-Sciences Alliance CEO and Co-Founder Rob McCray recently predicted that within ten years all medical devices will be required to have connectivity. Care providers will realize not connecting medical devices will result in less efficient care and increased liability.
The hospital setting already demands Wi-Fi to
accommodate the growing list of ways that caregivers are using that network today. If McCray’s prediction is true, then those care facilities that have not upgraded to a robust Wi-Fi network had better get a move on.
However, Medical Connectivity Consulting principal analyst Tim Gee, the leading expert on wireless networking inside care facilities, describes healthcare, especially hospitals, as “one of the most demanding Wi-Fi markets in existence.”
Gee points to the increased level of mobility, larger number of users, myriad advanced applications, and safety demands as some of this vertical’s most prominent challenges.
Regardless, Wi-Fi’s role in healthcare is already prominent. As indicated by the growth potential that still exists within many of the use cases discussed above - and countless others as yet unimagined - the impact that Wi-Fi networks will have on healthcare has also only just begun.
