Wireless networks in healthcare: critical information at the point of care - Storage Networking

Computer Technology Review, Dec, 2002 by Curtis Franklin

Dr. John Halamka enables doctors, nurses, and other healthcare professionals to have immediate access to what's happening with their patients. As associate dean of Harvard Medical School and CIO of CareGroup Healthcare Systems, Halamka has armed thousands of healthcare professionals at the six CareGroup hospitals with wireless laptops, tablets, and PDA's. In fact, a key part of CareGroup's IT infrastructure includes a wireless network used by healthcare professionals to access diagnostic, drug interaction and patient history wherever a patient receives care.

Halamka said the mobility that wireless networks provide is crucial in the modern hospital. "Many places in the hospital are hubs of activity--the ER, ICU, the surgical recovery room--where there are nurses running around getting orders and needing test results."

"Every day there's more medical knowledge published than a doctor could read in a lifetime," said Halamka. The flood of information extends beyond that generated by universities and research centers, though, he adds.

Jon Bogen, managing principal of HealthCIO said, "A lot of clinicians in the field want to do point-of-care charting and ordering." He explains that immediacy and accuracy are each improved by immediate record keeping. "Wherever they're delivering the care, they want to record the information and have it stored centrally. You tend to get more accurate information recorded, and if you can look up a central database to check on a patient's condition you improve quality of care because you don't have to rely on human memory."

Caregivers are pushing for wireless networking technologies that allow for quick access to patient information. The relationship between patient and caregiver shapes the nature of the technology chosen to implement the information service. "Using a small handheld computer looks much more personal than when you're sitting behind a big computer monitor that sits between you and the patient," said Bogen.

The list of advantages is long enough that you would expect every hospital and clinic to rush towards implementing a wireless network. Serious concerns on two fronts have slowed that rush, however, and, in some cases, prevented institutions from seriously considering a wireless infrastructure.

Dangerous Energy?

The first concern is, in the eyes of most physicians and nurses, the most important: Will wireless network devices harm a patient? There is some concern, based on research and observation, that radio-frequency (RF) devices such as cell phones, public service radios, and wireless networking devices may interfere with critical medical items such as ventilators, infusion pumps, apnea monitors, and EEG machines. However there is more fiction than fact to this.

"Rumors of wireless handhelds causing pacemakers to arrest are grossly exaggerated to the point of silliness," said Halamka.

Many medical centers have responded by limiting the operation of wireless devices in areas where patients and medical electronic devices are in use. Others restrict wireless devices to ranges outside of certain limits depending on the transmitted power of the device. Wireless network access points lend themselves well to this approach since ideal placement is near the ceiling of rooms.

When laptop computers and other user devices are kept several feet from patients and medical electronics, risks are minimized on the client side of the technology. As with the use of computers on commercial airline flights, experience with wireless networks in hospitals and clinics is leading many institutions to approve their use with fewer and fewer restrictions.

Hyper About HIPAA

Hospital administrators share the physician's concern for patients' well-being, but have additional worries, as well. The most serious administration concerns lie with the requirements of HIPAA, the Health Insurance Portability and Accounting Act, concerning patient privacy and confidentiality. HIPAA requires healthcare institutions to take precautions safeguarding patient information from unauthorized access. The requirements of HIPAA vary in their impact on various phases of information operations, but they all have teeth; failing to protect patient information can results in fines of up to $25,000 per incident.

Administrators frightened by the prospect of massive fines have sometimes responded by declaring that wireless networks are incompatible with the demands of HIPAA. Network managers facing the demands of information-hungry users, counter administration prohibitions on wireless networks by exploring architectural solutions to the perceived weaknesses of 802.11b networks.

One architectural solution involves carefully segmenting the network into segments that can access (and be accessed by) users on the Internet, and those that cannot. HealthCIO's Brogan said that HIPAA makes a clear distinction between private networks that are separate from the Internet, and those that 'are accessible from outside the organization. Private networks have an assumption of security, even if a "war driving" hacker manages to find a wireless access point. Once there is a point of contact between the local area network and the Internet, the situation changes.