As wireless networks grow, hospitals are discovering the pitfalls, especially in older technology.

When George Washington University Hospital in Washington, DC, opened its new facility in 2002, it boasted one of the most technologically advanced wireless systems in the country. By mid-2006, administrators had budgeted for upgrades in 2007.

“But as it happened, we couldn’t wait that long,” said Gretchen Tegethoff, the hospital’s information system director. “A state-of-the-art wireless network was installed, but we simply outgrew it.” Before 2006 was over, GW had already begun revamping its entire wireless system.

“Wi-Fi was designed for a home or small-office environment. The creators were not envisioning that it would be rolled out the expansive way companies have done it now,” said Bruce Eckert, senior manager with Beacon Partners, a health IT consulting firm based in Weymouth, Mass. “This is a case where even the technology people, I think, were fooled into thinking it was just as easy as doing it at home, but it isn’t.”

In a typical hospital, medical staff often rely on laptops, tablets, or PDAs to review records and order medications. Patients may be assigned radio frequency ID bracelets. “I’ve even seen IV pumps with wireless networking cards in them,” Eckert said.

Add to that a growing expectation from patients and visitors to freely use their laptops and cell phones, and possible interference from antennas outside the building, and you’ve got what Mark Gibson calls a wireless mess.

“The hospital is the most complex electromagnetic environment most people will encounter,” said Gibson, senior director for business development at Comsearch, a spectrum management firm based in Ashburn, Va. “The only thing more complicated is a Navy battleship or aircraft carrier, and most people are not going to encounter that.”

Floor-to-floor conflict
As hospital wireless networks grow, the complexities become more obvious, Eckert said. “The biggest problem is getting decent coverage through the building. The way hospitals are built, with lots of walls, some of them being very solid, and lots of electronic equipment, makes it difficult to get uniform coverage.”

If a medical center’s information systems staff doesn’t already know where the lead-lined walls and reinforced concrete stand, they’ll find out as the network grows. But the solution is not always as simple as adding more access points.

“The closer you get the access points, the more they interfere with one another, and that can exacerbate the interference problem,” Eckert said. “Hospitals tend to have a lot of floor-to-floor conflict issues with access points.”

On the other hand, sometimes the problem can be too much signal. If the wireless signal leaks out of the building, as it often does, it raises security concerns. “There are a variety of wireless security technologies that encrypt the information on the wireless network, and that should be the first line of defense,” Eckert said. Hospitals can enhance these measures, such as Wi-Fi protected access (WPA), with directional antennas that help isolate the signal, he said.

Wireless problems are not all technical, however. Many of the biggest challenges involve hospital policy. “Across the hospital space, there are lots of stakeholders in the wireless network,” Gibson said. “One thing we see is that stakeholders don’t communicate or coordinate with each other.” For example, the nursing staff might bring in a new phone system that interferes with physician PDAs or even medical equipment.

Before life-threatening conflicts arise, hospital leaders should bring those stakeholders together to look at the wireless space from the policy standpoint, Gibson said. An internal or third-party group can help managers establish planning and procedural guidelines for the entire institution and address broader issues such as cell phone and laptop use on the premises by patients and visitors.

Dropped calls
“It’s always important to assess where you are to know where you need to be,” said GW’s Tegethoff. Most consultants suggest that hospitals conduct regular surveys of the wireless landscape. The idea is to measure signal strengths throughout the facility across frequencies and catalog the operating frequencies of equipment.

“Do that at least once a year,” Gibson said. “Things that can happen even outside the hospital that you may not be aware of. So the first step is to identify what is going on. The second step is to troubleshoot any known problems or potential problems, and the third step is to bring together the stakeholders. Finally, you need to pull that together into a plan.”

At GW, it was the increased use of RF phones that accelerated the update schedule. “Our physicians and resident teams rely on the RF phones to communicate with each other, more than their pagers,” Tegethoff said. “They run off the wireless network. More and more doctors wanted them, more nurses needed them, and more ancillary staff were relying on them.”

As the usage grew, so did the problems. “There was interference and problems with dropped calls,” she said. “It also impacted our wireless laptops, which are heavily relied upon by the clinical staff.”

The hospital engaged a consultant, World Wide Technology, Inc., to conduct a site survey. It included the number and positioning of access points, the load on individual access points, the programming of the channels, and the levels and sources of interference, both inside and outside the building.

“There’s not much you can do about it when big companies like Verizon and Sprint are putting up antennas that might be interfering, but it’s good to know,” Tegethoff said.

Ultimately, the hospital took action based on the results of that survey and a proposal from World Wide Technology. “In a nutshell, we replaced the entire infrastructure,” she said.

The new system includes redundancy to improve network uptime, security features, and a software tool to manage and troubleshoot access points from a central location. RF intelligence evens out the load on individual access points.

GW also added a feature called wireless guest access, Tegethoff said. “This allows patients and family members to bring in their wireless laptops during their stay and stay connected.” Virtual segmentation enables guests to tap into only so much bandwidth on the Internet, she said. “Nothing they do on their computer will in any way affect our network.”

The upgrade readies the hospital for new technology with the latest network capabilities and protocols. For instance, although the hospital’s RF phones run on the 802.11B protocol, new phones are coming out that run on 802.11G. The hospital is prepared to run either protocol. “Once we have the newer phones, we can just start running the G protocol,” Tegethoff said.

Now that the upgrade is completed, the hospital’s interference problems have been resolved, and Tegethoff can turn her attention to other projects. “I’m hoping we have several years before we need to do it again,” she said.

Deborah Geering, This e-mail address is being protected from spam bots, you need JavaScript enabled to view it , is an Atlanta-based freelance writer.