The Wireless Remedy

While wireless technologycan cure a range of efficiency ills in any given enterprise, untethering health care businesses carries benefits far beyond the bottom line. Wireless offers an up-to-the-minute way to track down a caregiver, check a patients lab results and more. And in an industry where even seconds can make a difference, thats more than Band- Aid technology.

John Spindler, vice president of marketing at LGC Wireless, which makes in-building cellular propagation systems and offers them through carrier marketing programs, VARs and consultants, says health care is among the most progressive verticals. In health care, the big requirements are response time and productivity, which directly impact patient care, he says. The cellular device can be the lifeline, literally, so hospitals are open to what wireless can do for them.

Quickly finding people and things is perhaps the first and most obvious driver for wireless in health care. Tracking assets such as crash carts, ventilators and other equipment means saving time in a crisis, and it also stymies inventory loss and theft. Parco Merged Media Corp., a wireless health care vendor, offers RFID tags and door readers for the hospital environment, through a distributor program. The tags have a four-year battery life and can be attached to wheelchairs, litters, infusion pumps, patientworn cardiac monitors and other mobile assets. The tags signal between one and eight times per second and work with the Parco RFID Tracking System to give staff a realtime, centralized picture of where all assets are at any given moment. The door reader mounts above a door in the hospitals lobby, and has a bright strobe light. When a tag is 10 feet or less from the door, the light flashes, alerting security guards that a tagged asset is about to leave the building.

Knowing where people are is another concern for hospitals. For instance doctors many of whom are affiliated with more than one hospital and may work at clinics as well as in private practice must be reachable no matter where they are. In health care, you have a huge mobile workforce, says Bill Montgomery, national director of health care at Sprint Nextel Corp., who was CIO at an academic medical center for 25 years. But unlike a remote sales force, these workers are mobile within one building. Plus theres a doctor on call, or between offices, the home health care nurse, the EMTs out on the road. There are a lot of people to coordinate.

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Because of this, voice is still a killer application. In the old days, you used to hear overhead pages, and staff members found a phone and called in to find out the issue, Spindler explains. More recently, standard pagers are everywhere in the hospital, but they are not efficient; you still have to call back to find out what the issue is. A response time of five minutes or more can potentially have a big impact on the patient. And a doctor can work in four different hospitals and not be on premises. The best way to connect is the cell phone not just in waiting areas, but the ICU and the labs, too.

A key issue in deploying cell phones is RF interference. When a handset tries to find a cell network from a hospital, the medical gear, people and walls mitigate the signal. So, while searching for the network, the phone throws off high-power RF signals that can interfere with medical equipment. LGCs system takes a signal coming into a facility and distributes it via small antennae. So a phone is 50-to-100 feet away from the connection at the most, meaning it throws off far less RF and solves the issue, Spindler says.

Beyond voice, a range of data applications offer information availability, so caregivers can get information when and where they need it to make a diagnostic call. Some applications run on specialized PDA-type devices to access X-Rays or CAT scan results, or to look up patient records. Others will run on a Palm OS or Windows Mobile, opening up a range of device platforms.

The No. 1 thing thats driving wireless health care will be the applications, says Montgomery. In the typical workplace, we use devices like a BlackBerry tied to Outlook, and the contact list, calendar and e-mail are critical to getting things done. In health care, its different. Caregivers need access to electronic medical records, billing, patients, appointments, where they are in the hospital, X-ray results, scripts … and extending that to a PDA will be very valuable. But its just starting now.

Electronic records systems from software players like GE Healthcare, Siemens AG, Epic Systems Corp., Medical Information Technology Inc. and McKesson Corp. are starting to embrace mobility, while other software apps like DrFirst Inc. (e-prescribing), PatientKeeper (medical records), M D Technologies Inc.s MDCoder Plus (charge capture) and others are already optimized for the mobile device. Also, the Physicians Desk Reference, a 700-page tome on drug interactions is available on the Palm Treo device.

The Palm OS supports 24,000 applications, and Windows Mobile can support 18,000-plus. Many of the things we enable are around accessing vital information and communicating with colleagues for a collaborative view of managing practices and schedules, says Tara Griffin, vice president of enterprise markets at device manufacturer Palm Inc. Applications are the future of wireless health care.

One of the biggest benefits wireless can offer is the reduction of medical errors. Entering information at the bedside means doctors are no longer handing a nurse a scribbled note, so transcription errors go down, says Griffin. Many caregivers want to e-prescribe, capture info on a pull-down menu for far less opportunity for incorrect information. Managing the patient, checking clinical references, sending in a script theres a lot of room for error when done manually.

Sprint, which gets half of its health care business through the indirect channel, bundles partner applications and has its own as well. The carrier is looking at launching a voice recognition program, already available as a horizontal app called Mobile Voice Control, that would allow a doctor to, for instance, say patient Tara Seals and meds, and the system would retrieve the information and text it to the phone. If it takes you two-to-four minutes to find a computer, log on and get the information, a wireless device saves a lot of time, says Montgomery. If you dont have to input anything, it saves even more.

For a distributor selling into this environment, the sale is a consultative one. In a health care facility, people dont know a lot about wireless as a technology, says Spindler. They do know a little about WLANs and cellular, but there is a knowledge gap and it can get complex to understand what theyre trying to achieve and how to get there. You have to ask the right questions.

For instance, distributors should ask how many users are within a given facility, what applications they need and what are their future plans. What might look good today might not look good later, so you have to plan for growth, says Spindler. Voice and lowspeed apps are one thing, but when you start getting new users, then adding higher-speed data apps, you have to calculate how much horsepower and management you really need. You dont want to make wholesale changes down the road, which is expensive and labor-intensive.

Applications are driving the opportunity for many distributors. Palm works with Cingular Wireless, Sprint and Verizon Wireless and uses their sales channels, and also has regional solutions experts; it partners with VARs and integrators for implementations. Gone are the days of dropping off 25 phones and thats it, says Griffin. Physicians want a device to arrive ready to go with the applications preloaded; there is an incredible opportunity for systems integrators and resellers to be the organization that provides that. Wireless health care has to be managed by a group that knows how to put it all together and also manage multiple carriers, potentially.

Distributors also have to keep in mind the unique mindset of the health care vertical, which is primarily focused on patient care and efficiency. Most hospitals are nonprofit and non-income-oriented, says Montgomery. They arent looking to grow the business or revenues. Also the government and the insurance companies control the flow of money pretty well. So the sales question is often, how to save money, while improving care and reducing medical errors. To make the sale the wireless benefit often has to be an equal swap in terms of money or saving lives.

For instance, he says wireless discharge applications are a big opportunity for wireless distributors. Often, meals and medications are delivered to empty rooms or rooms of transferred patients, while manual processes for hospital bed matching, patient tracking or patient transport makes it difficult to keep on top of what types of patient beds are available and when, resulting in lengthy waits to admissions. Hospitals are paid on prospective payment, based on diagnosis, so an insurance company will pay one lump sum regardless of whether the patient is there for four or five days, he explains. And if a hospital can get the patient out in four days instead of five, it gets paid twice for the one night. A wireless discharge program that coordinates bed availability InfoLogix offers one called BedCentral allows patients to go home sooner and the hospital to maximize its capacity. They can leverage their fixed assets to be more efficient, Montgomery says.

Management will be another concern prospective clients have. Rob Israel, CIO at John C. Lincoln Hospital (JCL) in Phoenix, says managing the mobility has been the greatest challenge since deploying wireless three years ago. The hospital has wireless bedside registration to get patients in rooms faster and a wireless dietary system to take patient orders the same day, as opposed to asking people to order food the day before. JCL also uses Wi-Fi for data access for guests and patients, and facilities maintenance and IT trouble-ticket applications. It will be adding RFID asset tracking later this year.

I wont put all my eggs in one basket, so we have redundant 100-percent-wired coverage as well, says Israel. Caregivers are given a choice of devices that give the greatest functionality range. We sat down and decided which ones well support, and they can only connect with those specifications. Even so, it is definitely more management than we ever dreamed of.

Israel says the wireless program has been a huge success, but there are caveats. Once you open the wireless basket, you cant ever close it again, he explains. It solves some, not all, of the problems, and opens up two new ones management and security. Dont believe what the vendors tell you.

Security is a big concern for hospitals due to HIPAA regulations for patient privacy. JCL has security consultants come in every six months to do a thorough check of systems; Israel rotates the consultants as well. HIPAA requirements also mean the devices themselves must have extra security, round-the-clock help desks and 24-hour device replacement. Those devices carry billions of dollars worth of data and critical patient information, says Griffin. Devices need to be able to authenticate users and encrypt the data.

Players in the wireless health care space say the space is growing the fastest by far, out of all the public sectors, including federal, state, local, education and utilities. The remedies it offers are fiercely compelling. Wireless brings the point of care closer to the patient, says Israel, who says enhancing patient care is a primary goal for JCL. Inward and outbound information is right there, so the appropriate decision can be made faster. That alone decreases patient stay times and results in better care.

Cingular Wireless
DrFirst Inc.
Epic Systems Corp.
GE Healthcare
John C. Lincoln Hospitals
LGC Wireless McKesson Corp.
MDCoder Plus
Medical Information Technology Inc.
Palm Inc. Parco Merged Media Corp.
Siemens AG
Sprint-Nextel Corp.
Verizon Wireless

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