Wireless networks are the lifeblood health IT infrastructure, but developing and deploying reliable WiFi to support present and future IT initiatives can be a challenge.
Clinicians and staff are becoming dependent on mobile and connected devices which need to function constantly everywhere on campus. As mobile devices become mission critical, the threat of a service outage may impact organizational operations - or even jeopardize patient safety.
“In a healthcare setting, the network has to be extremely reliable because it’s literally life or death,” Aruba Networks Product Marketing Manager Rick Reid told HITInfrastructure.com. “You have to plan coverage capacity, backup systems, and application intelligence just to make sure that things work - and that they work 24/7.”
The planning required to support an entire IT infrastructure of connected solutions takes serious consideration of all physical and digital obstacles, not to mention an understanding of the data flow and priority of devices connecting to the network and how to gain visibility to manage the network.
What are some of the biggest challenges facing healthcare wireless network deployments and how can organizations employ industry best practices to overcome these issues?
Planning for coverage and connectivity
The most obvious, but perhaps one of the most complex, challenges facing healthcare wireless deployment is coverage. Mobile devices, including smartphones and laptops, require reliable wireless internet connectivity no matter where their users travel.
“You have to build a network for coverage, the devices have to work everywhere,” said Reid. “Once a hospital moves to that critical communication method you have to make sure it works in the stairwell and it works in the hallways, and you can’t have any dead spots.”
The active nature of healthcare professionals adds to the urgency of coverage everywhere. Clinicians need connectivity to access communication tools even when they are outside of the building taking a break.
“We find clinicians tend to run up and down the stairs rather than wait for elevators, and if they're carrying WiFi enabled phones that they're using for messaging and alerting, then that area needs connectivity. We have to look at the workflow habits even around the hospital,” Extreme Networks Director of Healthcare Solutions Bob Zemke told HITInfrastructure.com.
Planning and implementing a wireless solution is more involved than implementing any other part of a health IT infrastructure because there are often physical barriers, such as building materials, that block radio frequencies (RFs). Hospitals in urban environments also have to contend with conflicting signals emanating from other networks in the area.
“Urban areas aren’t necessarily what we would call planned construction,” Reid commented. “A hospital will start off relatively small, and will acquire the building next door and another building next door. There’s a lot of old construction and a lot of concrete, not designed for the open plans we’re seeing in new construction. There’s a lot of hallways, especially in certain areas of the hospital. In radiology, for example, there’s a lot of metal in the walls, a lot of shielding, which makes RF propagation very difficult.”
"You have to build a network for coverage, the devices have to work everywhere."
Organizations often need to retrofit a wireless network to their facility rather than constructing a building with certain wireless requirements in mind. Reid stated that generally, healthcare organizations in newly constructed buildings have an easier time deploying their wireless network.
Instead of deploying an entire upgraded infrastructure at once, organizations can work through departments, buildings, or systems, upgrading one piece at a time until the entire system is complete. Newer wireless deployments such as 802.11ac are backwards-compatible so legacy devices can still connect to the new system and new devices can take advantage of the wider bandwidth and faster speeds.
Wireless site surveys are an option for organizations assessing their environment for a wireless upgrade. A site survey can identify areas where the signal may be having trouble reaching. Site surveys assist organizations in effectively placing access points (APs) where they are needing and not wasting resources on redundant APs.
Ensuring network capacity matches anticipated use
Along with mobile devices used for communication with other users, the healthcare industry has seen rapid growth in Internet of Things (IoT) tools and connected medical devices. Medical IoT devices include biomedical devices, physiological monitors, mobile medical apps, and MRI/CT/ultrasound scanners.
The increasing number of devices demanding access to wireless networks can overwhelm legacy systems, leading to access problems. Once an organization has their entire facility covered with a basic network, it must ensure that the network is robust enough to meet expectations.
“An average hospital room will have between 15 and 20 medical devices, and almost all of them will be networked,” said Reid. “That’s a pretty high density if you think about the size of an ICU room, which is usually about 15’x15’ with 20 devices in it - and the room next door has 20 devices in it. A ward typically has 20 beds, so that’s quite a lot of devices in a relatively small area.”
Reid advises that providers operate on the assumption that there are three to four times more IoT devices on a hospital network than laptops, phones, or traditional networked devices. A large organization with 30,000 computers connected to the network may also be supporting around 85,000 connected medical devices. These connected IoT devices put massive strain on the network and can cause outages if the traffic is not managed and monitored properly.
“It has to be designed just like air traffic control,” stated Zemke. “We have to look at the critical devices and how to prioritize them. We start with mission critical systems, life critical, telemetry, emergency communications, nurse call, then we look at maybe the business applications and systems, and everything else needed to support the clinicians' access and their devices. What bandwidth is left you typically have to provide for the patients.”
Wireless networks don’t just need to support all connected devices during periods of high traffic. They also need to be able to prioritize signals and tell the difference between a clinician looking at a patient record during a routine checkup and a clinician looking at a patient record in the ICU or emergency room. The network needs to determine which action is more urgent.
Dealing with network capacity limits begins with understanding all of the devices connected to the network and what kind of information they are communicating. Mission-critical data needs to have priority over IoT devices “chatting” with the network.
“There are so many different connected machines inside of a hospital environment that other markets really don’t have to deal with,” Zemke said. “We have to think in terms of not just the connectivity of these machines and these devices but what are they doing on the network? How are they behaving? And that's a struggle for most hospitals today.”
Network management and planning
Network visibility and control are key to successful wireless deployments. Zemke noted that many healthcare organizations looking for wireless network upgrades are seeking visibility as a way to control the devices connecting to the network. Network management solutions are key to providing IT administrators the control necessary to support the number of devices accessing the network, and to prioritizing the traffic so mission-critical data gets through.
Network visibility tools give IT administrators full view of their network and all the devices accessing it, both on-premise and remotely. The visibility offered by management solutions can protect the network from malfunctioning devices or unwanted traffic bogging down the network.
For example, management solutions will identify that an infusion pump is trying to send a web request out to the internet instead of just communicating with the management server. Devices communicating abnormally can cause security problems for the network and without a management solution, administrators may never detect small and potentially dangerous malfunctions.
Visibility management solutions provide IT administrators with the option of per-connection troubleshooting. Instead of looking at the device as a single entity, management solutions can examine the connection between a smartphone and an app, or from the app to the controller, to determine exactly where the communication error resides.
Managing access points and mission-critical devices also gives IT administrators a better perspective on planning additional deployments, upgrading current deployment, and planning for potential outages.
"We have to look at the critical devices and how to prioritize them."
Hospitals function around the clock, and maintenance windows are short. Hospitals need to perform all the preventative maintenance possible because they cannot shut down operations in an ICU unit or emergency room to perform routine maintenance on the network APs.
A management solution that recognizes connectivity patterns can identify periods of low activity so that organizations can plan updates and deployments that will cause the least amount of disruption possible.
Reid suggests that healthcare organizations of all sizes bring in expert consultants who specialize in hospital or healthcare wireless network deployments. Experts will recognize physical or network obstacles IT departments may not realize, and help plan the best wireless deployment unique to an organization’s building and layout.
As more advanced technology continues to be added to health IT infrastructures, wireless networks will be the key piece that will make or break the success of the solutions it supports.