Added Technology Expands Telemedicine at Children’s Mercy

December 19, 2016 - As hospitals build more advanced health IT infrastructures to support more advanced technology, healthcare organizations are seeking better ways to use the technology to improve patient care.

Children’s Mercy hospital in Kansas City, Missouri, is a free standing, non-profit hospital with two inpatient locations and several satellite locations. Children’s Mercy implemented a telemedicine program to enable in-home patient visits and provide better, more convenient care for patients.

Children’s Mercy implemented Cradlepoint technology to provide secure and reliable wireless connections for healthcare professionals visiting patients at home using 4G technology. Both Children’s Mercy and Cradlepoint spoke to HITInfrastructure.com about the technology and how it has improved remote wireless technology at Children’s Mercy.

What drove Children's Mercy to seek better networking technology?

Children's Mercy was experiencing a lack of reliable connectivity when clinicians were out in the field and could not continue using technology that was not providing them with the connectivity they needed.

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“Because we’re in the business of telemedicine, it’s not like a business conference where you can tolerate some poor quality and metal through it,” said Morgan Waller, Director of Telemedicine at Children’s Mercy. “Poor quality connection is a total dealbreaker for us.”

“When we need to be at an access hospital or someone’s home, it’s very difficult to implement different security systems,” Waller continued. “If it’s an access hospital, you need to meet with their IT and there’s troubleshooting- it takes days or even weeks to set up.“

Before Cradlepoint, Children’s Mercy was using cellular connection and consumer-grade MiFi devices, none of which were giving the hospital the connectivity they needed to successfully treat patients. Patient wireless networks were not always reliable and some patients lived in areas with low wireless coverage which could not be used at all.

“It’s all about reliable connectivity wherever we go without having to ask people for access to their networks,” added John Baker, Senior Analyst of Telemedicine and Video Conferencing at Children’s Mercy. “Especially in patient homes, some of the population we serve just don’t have access to internet that’s fast enough or reliable enough to give us the quality we would need to do video reliably. We need to do video to make the business worth while.”

The benefit of telemedicine was too great to pass up so Children’s Mercy decided to begin testing Cradlepoint technology about a year and a half ago and have been using it in practice for about a year.

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“What Children's Mercy recognized was that when you are able to bring healthcare to a patient’s home, not only is it more convenient for the patient, but it’s also more cost effective for the hospital because they don’t have to use up space in the hospital to provide that care,” Ken Hosac, vice president of business development at Cradlepoint told HITInfrastructure.com. “When a clinician goes out there, a specialist back in Kansas City can be viewing in real-time the testing the clinician is doing in the home. They have audio and video where they can ask the patient’s questions and provide healthcare remotely.”

Children’s Mercy could not continue using technology that was not providing them with the connectivity they needed.

How does the telemedicine technology work at Children’s Mercy?

Children’s Mercy came to Cradlepoint at the recommendation of their service providers to increase the quality of connection for telemedicine. They began using Cradlepoint technology for inpatient care and then extended the technology for remote care.

“Cradlepoint is providing very high speed and reliable connectivity though 4G in a very secure way using a VPN to bring the information back to the data center in a way that is HIPAA compliant," Hosac explained. “They can do everything they need to do over that high speed internet connection without having to rely on wires. Some early attempts tried to use patient in-home networks but it doesn’t work reliably because there is a different environment in every home.”

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Cradlepoint enabled Children’s Mercy to do everything they were doing in telemedicine at their fixed locations using wired connections at remote in-home locations using 4G.

Children’s Mercy chose Cradlepoint’s IBR 650, a non-WiFi, portable machine router which is set up with a VPN connected to the VPN concentrator in the Children’s Mercy data center. One of the router ports is plugged directly into the laptop and has two antennas for 3G and 4G.

The routers have the same advanced security protocols found in many enterprise grade routers. Users are able to set up VPN tunnels from the router and direct traffic to their VPN concentrator.

For rural areas that do not have 3G or 4G coverage, Hosac says that Cradlepoint has relationships with some satellite providers to provide coverage when 3G or 4G is unavailable. Organizations can also switch carriers to find the one that best suites their area.

“We provide the ability for organizations to switch carriers through cloud based management and carrier switching,” Hosac noted. “It’s a software-defined modem so you can essentially switch the carrier out in the field from one service provider to another. Our latest routers can detect the SIM, so if you switch the Sim from one service provider to another, we will detect which carrier that is and automatically configure the modem to talk to that carrier.”

How does the technology benefit Children’s Mercy?

Children’s Mercy saw a difference in quality of care especially in homecare and transport initiatives. Children’s Mercy has taken Cradlepoint’s technology after its success in homecare and applied it to their fleet of ambulances.

“We’ve done a lot of testing with Cradlepoint around the city, making sure that we had reliability before we rolled out,” said Baker. “Recently we have been equipping all out ambulances with a version of Cradlepoint technology to have more reliable internet access in transports.”

Cradlepoint is no stranger to providing vehicles with reliable network connectivity and their deployments can be found in every police vehicle in San Jose, California.

“The connectivity we’ve been getting in the ambulances since we started testing with Cradlepoint has been a huge plus and I think that’s really going to be the biggest difference maker for us,” Baker continued. “Previously we weren’t able to do this at all, the reliability wasn’t there. The technology is what makes it actually possible. The testing we had done with MiFi lacked the quality we needed to even make an attempt.”

Children’s Mercy has had much success with Cradlepoint technology and continues to apply the technology to initiatives to help improve hospital operations with remote, in-home care and transportation network connections.

“Our organization has strong leadership support for telemedicine as a way to improve access and quality of care,” Waller concluded. “This technology is one way we are able to overcome barriers of telemedicine delivery.”

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