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Cornwall hospital races ahead on wireless technology

By Jerry Zeidenberg

Cornwall Community Hospital, in Cornwall, Ont., has become one of the first hospitals in Canada to implement a brand-new wireless technology that runs as fast as 2.6 gigabits-per-second – as rapidly as a high-speed wired system.

The installation means the Cornwall Community Hospital could conceivably go with a completely wireless strategy in the future – where no computer workstation, phone or medical device requires cabling.

It is also an important step in the organization’s mission to reach HIMSS Analytics Level 6 in the EMRAM scale, which requires it to be a completely paperless hospital.

“That means no more jotting down vital signs or other notes on paper,” commented Mario Alibrando, director of information technology.

“We’re soon going to acquire an integrated system that can wirelessly transmit all information to the electronic health record,” he said. “So all IV pumps, and all medical devices, will automatically transfer information wirelessly.”

The benefit, of course, is an increase in patient safety, as the automated transfer of vital signs and other information would reduce the transcription errors that occur when data is keyed-into computers. AsCornwall Community Hospital, in Cornwall, Ont., has become one of the first hospitals in Canada to implement a brand-new wireless technology that runs as fast as 2.6 gigabits-per-second – as rapidly as a high-speed wired system.

The installation means the Cornwall Community Hospital could conceivably go with a completely wireless strategy in the future – where no computer workstation, phone or medical device requires cabling. It is also an important step in the organization’s mission to reach HIMSS Analytics Level 6 in the EMRAM scale, which requires it to be a completely paperless hospital.

“That means no more jotting down vital signs or other notes on paper,” commented Mario Alibrando, director of information technology.

“We’re soon going to acquire an integrated system that can wirelessly transmit all information to the electronic health record,” he said. “So all IV pumps, and all medical devices, will automatically transfer information wirelessly.”

The benefit, of course, is an increase in patient safety, as the automated transfer of vital signs and other information would reduce the transcription errors that occur when data is keyed-into computers. As well, it would reduce the paper burden on nurses and allow them more time for patient care.

The new wireless standard that’s supporting all of this is called IEEE 802.11ac.

It just became available last year, and it is a dramatic improvement over 802.11n, which it supersedes.

Cornwall has acquired the leading-edge systems from Meru Networks, of Sunnyvale, Calif., a leader in wireless and a supplier of solutions to more than 12,500 customers in 59 countries.

802.11ac’s operating speed of 1.3 gigabits per second, per radio, compares with just 300 megabits per second, per radio, for 802.11n – which was considered to be incredibly fast just a few years ago.

Just as importantly, the new standard can support a huge number of users without a drop in performance. “On any given day, we have about 200 wireless users connecting to the network at the same time,” said Alibrando. “Nobody has experienced any degradation with the new system.”

Alibrando noted that most hospitals have implemented wired systems that deliver gigabit speeds to the desktop – which is considered to be a major achievement.

However, they’re still struggling on the wireless side, as they’re using the older 802.11n at a time when demand for wireless bandwidth is exploding.

That’s because large groups of clinicians and administrators want to make increasing use of wireless devices, such as iPhones, iPads and Android phones.

According to Alibrando, the new 802.11ac wireless technology is more reliable than traditional cabled systems – something strange but true. He explained that 802.11ac has complete failover capabilities; by contrast, wired systems make use of routers and hubs that require manual resets if they go down.

Cornwall tested the 802.11ac technology before acquiring it, and found that it delivered even large image files to radiologists using wireless devices – quickly and without system degradation.

Alibrando said that radiologists wouldn’t typically work on mobile devices, but in the future, their workstations could be outfitted with wireless cards and wouldn’t need cabling. It’s possible that cabling won’t be needed at all, in any area of the hospital.

“That will save us $300 per cable drop,” he said, explaining that hospitals require a special way of running cables above ceiling tiles to avoid contaminating the rooms with dust and potentially infectious particles.

“It takes four times as long to run cable in a hospital as it does elsewhere,” said Alibrando. “The installers need to use rolling hoarding units, and they move only one ceiling tile at a time. It’s very labour intensive.”

“If we had this technology when we constructed our new building, we could have saved $120,000 in cabling,” he said. Cornwall Regional recently constructed a gleaming 95,000 square-foot wing at a cost of $120 million.

Wireless computing throughout the hospital has been optimized by creating three levels of access, based on the priority of the users.

The first tier consists of ‘Life Critical’ applications, such as wireless IV pumps and telemetry.

The second level is called ‘Mission Critical’ and covers applications such as EMR, VoIP, Citrix-based CPOE and barcode medicine administration.

The third category consists of ‘Patient Critical’ applications, such as WiFi for patients and their family and friends.

Wireless channels are dedicated to each, but Meru does the job in a virtual way, meaning that performance is enhanced and fewer radios or access points are needed.

Alibrando noted that Cornwall Community Hospital installed only 150 access points to cover the entire facility; by contrast, other hospitals using older technologies typically use a far larger number.

According to Meru, the company’s 802.11ac runs on standard power over Ethernet supplied by existing network switches. Most other 802.11ac solutions need additional voltage, requiring complete switch infrastructure upgrades.

Given the increased throughput, the new 802.11ac technology could even support wireless TV sets. The limitation right now, however, is that devices in current use don’t have the cards needed to take full advantage of 802.11ac’s blazing speed.

New devices will likely contain them in the future, as the standard catches on. Until then, devices equipped with other wireless cards can still benefit, as they will run at speeds of up to 300 megabits per second without experiencing any signal loss.

Meru customers, including Royal Caribbean Cruise Lines and the University of Houston, have publicly reported as much as 40 percent increased throughout when using the old 802.11n devices on the 802.11ac network.

Older 802.11n wireless systems boast a top speed of 300 megabits per second, but in reality, “you never get 300,” commented Manish Rai, Meru Network’s vice president of corporate marketing. “You might get half of that,” he said.

Cornwall Community Hospital has also deployed many VoIP phones that use the high-powered wireless network. Instead of using cellular or wired technology, they run on the 802.11ac network.

Overall, the hospital is well placed to move ahead with a completely wireless strategy in the future, if it chooses. It also has the wireless infrastructure in place to support the move to the paperless hospital, with its attendant benefits of reduced medical errors and increased productivity.

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