Wireless Hospitals See Bigger Picture

Peter Weller, a senior lecturer at the Centre for Health Informatics at City University London, estimates that less than 10% of hospitals have currently adopted the technology across their organisations. Where deployment does take place, it is most likely to be in more traditionally high-tech departments such as radiology.

"There's not massive uptake and adoption is flat, with projects mainly taking place when hospitals are moving to new sites or are undertaking expansion," he says.

Where they do occur, however, such initiatives do not tend to be an end in themselves. Instead they are generally integrated with a wider project such as introducing electronic patient records (EPRs) or picture and archiving communications systems (PACS).

One organisation that chose to go down this route as part of a move to a new building in July 2006 was University Hospitals Coventry and Warwickshire NHS Trust. It considered that support for wireless technology was important in order to enable the introduction of PACS, EPR systems and other future mobile applications, which the organisation expects will grow in number.

Danny Roberts, head of programme delivery at the trust, explains the rationale: "The principle was one of flexibility and an overarching benefit was that clinicians could record and review data at the patient bedside."

PACS was the first application to be introduced and clinicians now access X-rays and other images as well as patient administration data using trolley-based PCs. Nurses are also able to input data about patients' vital signs at the bedside using PDAs running the Learning Clinic's VitalPAC software, enabling practitioners across the hospital to view and share pertinent information.

Roberts warns that good user engagement is key to making such projects work effectively, because they involve "big changes to people's way of working". As a result, the trust set up an integrated project team, which included both clinical and technical personnel, in order to "engage with them and identify and maximise resources based on their requirements".

This activity included developing models of care, evaluating appropriate hardware devices and deciding how many should be allocated to each ward, with figures being tweaked based on feedback in the field.

A further consideration included ensuring that the network was "future-proofed" in terms of both bandwidth and density of coverage so that it could cope when more applications were added.

Another was ensuring that monitoring tools were put in place. Rather than simply relying on user complaints, the goal here is to alert technical staff through a console, email or SMS messages if the network slows or goes down so that they can proactively sort the situation out.

Act of faith
Gloucestershire Hospitals NHS Trust's business case for deploying its wireless network was likewise about supporting patient care more effectively. Steve Edwards, head of IT development services at the trust, explains: "It wasn't based on direct financial benefits, but on quality of patient care and more flexible service delivery. So it was a bit of an act of faith, for which the trust's board deserves plaudits."

The organisation started introducing Aruba Networks' technology across the organisation at the end of 2008 in order to support mobile access to its patient administration applications, PACS results and internal email system.

"One of the issues that we faced was that there simply wasn't enough space in the ward area for IT equipment. It's a real challenge as everyone tended to cluster around the nurses' station and so it was a very busy area. But this provides a way of opening things up relatively easily," Edwards says.

Implementation of the network across the trust's 63 wards at two sites in Cheltenham and Gloucester took "quite a long time", however, as the aim was to minimise disruption to both staff and patients by tying it in with other activities such as redecoration.

It also required thorough design and planning due to the nature of both buildings. Because the Cheltenham site was built in 1854 and has walls that are four feet thick, it was necessary to undertake a physical survey of the entire facility in order to ensure good coverage and prevent black spots.

The Gloucester site also had to be handled with care. Although it is housed in new premises, it – like many modern structures – includes a lot of metal studding, which interferes with wireless signals. This design and planning activity was initially based on recommendations from the vendor, before being tweaked by in-house staff.

Edwards adds that security was another major area for consideration. The trust deployed data encryption, user profiles and smartcards to control system access by staff using authorised laptops only. But Edwards believes that it is important not to underestimate the value of good user training. "Security is as much to do with user education as anything else. You can have all of the technology in the world, but if it's not used properly, you'll still have a problem," he says.

The next step, meanwhile, will be to extend use of the wireless network to home users. By early 2010, the aim is to provide clinicians that are on call with a wireless router and laptop to enable them to access information through a secure virtual private network as if they were still on site.

"It minimises the impact at home as it's just a box on the wall and a laptop and not everyone has the space for a lot of equipment. But it also means that people don't have to spend time driving to the hospital if they don't need to or can get there quicker if they do, so it solves a lot of issues," Edwards says.

The trust is also evaluating whether to introduce RFID-based asset tracking system in future, which might also be used to track patients, using its wireless network. The aim would be to cut costs by improving asset maintenance and retrieval.

Danny Roberts will be speaking at the Smart Healthcare Mobile & Wireless Healthcare one-day conference in Birmingham on 24 February 2010.

For further information and registration, please visit:
http://www.smarthealthcare.com/mobile-wireless