Candid Comments on Wireless - Industry Trend or Event - Column

Health Management Technology, July, 1999 by Donald M. Jacobs

Constructive advice on wireless. A new definition of ROI for technology.

Until major vendors embrace wireless technology as an integrated part of their product line, it's going to be an add-on product that comes after primary systems are installed. More and more major IS vendors were announcing wireless as part of their product line--and then we had Y2K.

That's made everyone stop and take stock of where they are and re-focus. Providers now consider wireless as an add-on and not an integral ingredient in having an effective HIS.

In talking to healthcare professionals today, we would say as they evaluate clinical systems and bring caregivers into the mainstream of selecting the information technology tools for the 21st century, wireless has to be very close to the top of the list in all of their considerations. Treat it as an integrated product. Don't treat it as an add-on or separate function, and don't leave it out in any of your evaluations.

Checklist for Wireless

[check] What are you focusing on in wireless? You're focusing on the mechanism for data input and output.

[check] What do you already have in terms of ease of input and ease of output? You're going to have to make decisions on the output side as to what is comfortable for caregivers to use. More importantly, how easy is the input portion of the wireless?

[check] Does the primary vendor offer wireless? That's where we usually encourage organizations to go to vendors like SMS, Meditech, or HBOC and ask them who are their wireless vendors. How do they work? Have them include it as a component of their product offering.

A major medical center in Chicago, or Atlanta, or Denver probably has the technical resources to deal with another vendor who provides wireless systems. But for a typical community hospital that's scarce on knowledgeable IT people and must support this as another system, we recommend that they leave the primary vendor responsible. They may not get all the functionality out of it, but they'll have the advantage of support.

We advise the smaller providers to look for a single source vendor. In most hospitals we deal with, we engage in strategic planning and ask them if they want to be a best of breed. Do they want to get the best systems possible for each department? Or would they rather get something that is a primary system, realizing they're not going to have the best functionality department by department? Almost 95 percent of CEOs say they would rather get a primary system from one vendor rather than try to deal with 10 to 20 vendors.

Mainstream Wireless

We're introducing another technology with wireless. We know it's going to have advantages. How do you approach it? I am conservative enough to say approach it in the mainstream way. Don't approach it as trivial. It will be a technology product you have to deal with and especially support.

With wireless and related standards today, you place the onus on the major HIS vendor who is supplying the product. It's their problem, not yours. You don't have the expertise, nor do you have the impact as a community hospital to do anything about it, other than try to follow it and project what's going to be the common standard.

Let's say you buy a wireless system. Then the vendor comes to you a year from now and says the frequencies that you're using for your wireless are not the proper ones and you're going to have to do a changeover. If that happens and you bought your system from HBOC, the question is what's HBOC going to do about it. It's not your problem. You have a support agreement; your technology is not obsolete--they can't call it that. They have to upgrade you. Do you see how your problem changes?

Whereas, if you bought it yourself, you're responsible. You're in the driver's seat. That's where the support comes in. And you're the one who has to answer to the CEO and say, "You know that $100,000 or $300,000 wireless investment we made? Well, I need another $250,000."

Wireless for Patients

Wireless is just not being used or accepted widely enough in the healthcare field to judge its effectiveness. Healthcare people are talking about cell telephones and pagers as wireless and using them a lot for communication, but we really want to use wireless for treatment of patients. And that's where it's just starting to be used.

The professionals in IS understand it's not just about cell phones and pagers. We want to be a little careful when we deal with healthcare providers--who are actually our focus. We're trying to make wireless easier and more effective, so that it will improve the quality of care for providers. There are downsides to applications of wireless because it should not be purchased as a new technology, but rather as an extension of the information technology an organization already has. If the organization doesn't have all of its clinical systems, then buying wireless will be premature and ineffective.

Everybody's sensitive to that. The worst risk an organization suffers is to go with a new wireless vendor who's product is not integrated into their systems. The result is another separate system to deal with and, in addition, a new technology. Organizations ought to proceed in an integrated way to make sure that wireless is evaluated for its strengths and that it's integrated into the organization's existing clinical system. Again, there's risk of dealing with a new vendor who doesn't have a proven track record.