Deploying WLANs in Hospitals

By Jim Geier

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One of the most compelling places to install wireless LANs (WLANs) is in hospitals. More and more hospitals are deploying them to improve operational efficiency and convenience, usually in high patient-traffic areas including emergency rooms, critical care wards, nursing stations, as well as in doctor office and patient waiting areas.

A common trend is that many of the newer doctors and nurses are demanding mobile applications rather than use of traditional paper-based methods. Doctors generally influence spending in hospitals (and they carry sharp instruments), so hospital IT groups generally give the doctors what they want.

This change in paradigm is fueling adoption of WLANs in hospitals. In fact, the demand for Wi-Fi in hospitals is so strong that the Frost and Sullivan Research Firm predicts the hospital market for wireless LAN hardware will grow at a compound rate of 52% a year and reach $175.1 million in sales by 2005.

Good for Patients

Healthcare centers, such as hospitals and doctors' offices, must maintain accurate records to ensure effective patient care. A simple mistake can cost someone's life. As a result, doctors and nurses must carefully record test results, physical data, pharmaceutical orders, and surgical procedures. This paperwork often overwhelms healthcare staff, taking 50-70 percent of their time. The use of a mobile data collection device that wirelessly transmits the data to a centralized database significantly increases accuracy and raises the visibility of the data to those who need the information. This results in better care given to patients.

Doctors and nurses are also extremely mobile, going from room to room caring for patients. The use of electronic patient records, with the ability to input, view, and update patient data from anywhere in the hospital, increases the accuracy and speed of healthcare. This improvement is possible by providing each nurse and doctor with a wireless pen-based computer, such as a tablet or PDA, coupled with a wireless network to databases that store critical medical information about the patients.

A doctor caring for someone in the hospital, for example, can place an order for a blood test by keying the request into a handheld computer. The laboratory will receive the order electronically and dispatch a lab technician to draw blood from the patient. The laboratory will run the tests requested by the doctor and enter the results into the patient's electronic medical record. The doctor can then check the results via the handheld appliance from anywhere in the hospital.

Another application for wireless networks in hospitals is the tracking of pharmaceuticals. The use of mobile handheld bar code printing and scanning devices dramatically increases the efficiency and accuracy of all drug transactions, such as receiving, picking, dispensing, inventory taking, and the tracking of drug expiration dates. Most importantly, though, it ensures that hospital staff is able to administer the right drug to the right person in a timely fashion. This would not be possible without the use of wireless networks to support a centralized database and mobile data collection devices.

Issues Run Rampant

Hospitals may be a fantastic place to install wireless LANs, but there are lots of issues to consider. The following are the main ones to consider:

Need for Privacy: By far the principal concern of wireless LANs in hospitals is the need for protecting patient information. Hospitals must comply with the Health Insurance Portability and Accountability Act (HIPAA), which requires that all electronic patient records meet stringent security measures. In order to comply with HIPAA, hospitals must apply other security mechanisms in addition to WEP. The use of Wi-Fi Protected Access (WPA) is certainly a good solution in this case because of effective encryption/authentication and cross vendor support.

Spotty Coverage: This is an issue that becomes prevalent in hospitals. There is lots of metal in medical facilities that causes multipath propagation and signal attenuation. Almost every hospital uses stainless steal carts to roll around surgical equipment and other patient related materials. These carts are moving obstacles to a WLAN, which causes sporadic holes in radio frequency (RF) coverage. This is a very big problem when there is dependence on the WLAN, especially when people's lives are at stake.

As a result, be sure to perform an RF site survey that specifies range boundaries that have adequate overlap to compensate for changing conditions. The problem, however, is that radio waves from access points set to the same channel will likely overlap, which causes inter-access point interference. The resulting overhead isn't much of problem for low to moderate levels of utilization. Consider the use of WLAN switches, though, if the the network needs to support higher performance applications.

Roaming: Hospitals are a highly mobile environment. Users often need continuous access to wireless applications as they roam throughout patient rooms, clinics, and offices. The wireless LAN will provide a lower level of roaming by allowing user devices to re-associate with different access points as users move about the facility. If access points reside on different subnets, users won't continue to have access to TCP/IP-based applications (a big problem).

One solution to this is to place all access points on the same subnet, assuming the hospital has a spare subnet. Another method to facilitate roaming is to implement MobileIP, a solution which is somewhat vendor specific.

Denial of Service: Because of the importance of applications running over WLANs, hospitals must consider the impacts if the network is hit by a Denial of Service (DoS) attack. There are many ways that a mischievous person can disable the operation of a wireless LAN, and there are few effective counter measures. As a result, hospitals must have a "plan B" that will fall in place if the wireless LAN becomes inoperative.

Wireless LANs in hospitals will definitely reap benefits. Just be sure to carefully consider the issues before moving forward.

Jim Geier provides independent consulting services to companies developing and deploying wireless network solutions. He is the author of the book, Wireless LANs and offers computer-based training focusing on wireless LANs.