Wireless Healthcare

10.05.2011
Cardinal Santos Medical Center (CSMC), an upscale hospital located in San Juan City, is blanketed with WiFi signals.

But unlike most establishments offering free WiFi connectivity to its patrons, CSMC's use of wireless Internet goes beyond mere surfing or casual browsing.

"Our short-term objective for installing wireless Internet on the hospital is to provide Internet connectivity for our people," relates Allen Bacallan, vice president and chief information officer, CSMC. "But our overlying objective is to satisfy the needs of our clinical equipment."

CSMC was able to break barriers in terms of healthcare offerings, specifically in establishing a pioneering network infrastructure that would improve patient safety, deliver better services, and increase employee productivity.

Connecting Doctors

The typical topology of hospitals consists of the main hospital and the medical arts building, which usually houses the doctors' clinics, Bacallan shares.

CSMC's medical arts building houses four floors of more than 400 clinic rooms, shared by about 600 doctors who come to the medical facility every day.

The main hospital, meanwhile, is made up of seven floors.

Bacallan says they were able to blanket both buildings with WiFi connectivity through the help of wireless Internet solutions provider Ruckus Wireless.

In a project that started early 2010, CSMC deployed around 52 wireless access points provided by the vendor throughout the facility, blanketing the hospital in a WiFi mesh that spans through all its nooks and crannies.

"By having an Internet connection, doctors can prescribe laboratory procedures through our online system, without having to go to the main hospital themselves," Bacallan explains.

With the wireless connectivity, doctors can also access the hospital's clinical management system, which houses the medical history of all their patients.

But why did CSMC decide to go wireless, when all these things can be similarly achieved using a wired connection? "I can't imaging [having to wire] admore than 400 rooms!" Bacallan confesses. "We would also need to extend a wide pipe of =data link from the doctors to the hospital."

With such a set-up, the CSMC CIO said going wireless was the most logical thing to do for them.

Bacallan adds that they are looking into leveraging the wireless connection to deploy electronic prescription of medicines to patients using tablet computers, but that it may be troublesome since there is a "need for doctor to have eye-to eye contact with their patients [during prescription]."

Connecting Devices

Doctors are just one part of CSMC's wireless Internet strategy. For the most part, Bacallan says the decision to go wireless was bolstered by the want to deploy more high-tech medical equipment that would require wireless data connections to function properly.

One of these medical equipment is called a patient workflow management system, which tracks the whereabouts of patients in each step of the medical treatment process.

"It logs patient status from admission to transfer to rooms, and even when they are taking various laboratory tests," Bacallan explains.

Traditionally, this is done on paper, through the patient's medical chart. But with such a system in place, hospital administrators would be able to gauge time performance of each medical employee and system in the treatment process.

Another system which could benefit from the wireless connection is a medical equipment which measures and deploys medication to patients.

A newer technology called infusion pumps, Bacallan shares, does away with the need to rely on gravity to inject different medications to a patient's circulatory system.

"These machine-calibrated boxes are actually [small] computers that give off alerts when patients have adverse reactions to medications," he explains. "They also have built-in recommendations that send out an alert when any of the patient's vital signs are not within normal range."

Bacallan stresses that these devices are centrally managed from a server linked through a wireless data connection, which underscores the need for a reliable wireless infrastructure.

CSMC has around 100 of these pumps already deployed in the hospital. And unlike traditional infusion methods, multiple infusions can be performed with just one pump.

Connecting Records

Under the Health Insurance Portability and Accountability Act (HIPAA), medical institutions are urged to establish mechanisms for interchange of electronic data, giving birth to the era of electronic health records (EHR).

"[Under the act], all patient information has to be in electronic format so that the information is available in whatever hospital," Bacallan expounds.

"But to stretch the argument further, why can't we make patient information electronic at the point of logging, so that medical histories of patients are not the only ones in electronic format?" he adds.

Bacallan says this will make WiFi connections relevant, since the data would have to be transmitted to a central server for safekeeping. "This will also make us compliant to having a fully electronic environment in the hospital," he adds.

The CSMC CIO says they have already piloted the deployment of tablet computers to replace patient charts to achieve this goal, but that they had to stop at some point since "electronic media is not admissible as evidence in court," and it would only cause legal repercussions if ever a lawsuit arises.

Connecting Hospitals

Getting CMSC blanketed with WiFi signals all around is no easy feat, however. But with the hospital's partnership with Ruckus Wireless, Bacallan says they were able to deploy a cost-effective solution that meets all their requirements.

The first requirement is the number of access points that have to be deployed in order to cover the whole medical facility. The more the number of access points, the more expensive the entire solution becomes.

"The second requirement is the quality of the WiFi signal--it should be constant all throughout the hospital," Bacallan points out.

The hospital's third requirement involved controls within the network, to effectively manage the bandwidth that goes all around the compound.

Bacallan says Ruckus Wireless fulfilled all of their requirements.

The provider's access points use planar and downward signal propagation modes, which not only covers an entire floor, but the floors above and below it as well.

Traditional signal propagation modes for ordinary access points are only planar, Bacallan explains.

The access points also have a management utility which allows for control of bandwidth usage, access to content, and billing requirements.

CSMC has free and paid zones for WiFi access, the bandwidth of which are throttled through the management utility, "so that other zones wouldn't have to suffer if users tend to abuse the connection," Bacallan relates.

More interesting, though, is CSMC's capability to offer connection to their tenants--such as restaurants and other such establishments--and charge them accordingly for their monthly WiFi usage.

Because of this, CSMC's services are not only improved, but new revenue streams are created as well.