Wireless woos doctors

Healthcare network executives are discovering that wireless access to data can have a dramatic effect in boosting the number of patients served, improving quality of physician diagnosis, and speeding payments and billing cycles.

Healthcare network executives are discovering that wireless access to data can have a dramatic effect in boosting the number of patients served, improving quality of physician diagnosis, and speeding payments and billing cycles.

Wireless and mobile technologies are top spending priorities for healthcare organizations, according to a recent report from Forrester Research. Although wireless LANs have been used in hospitals for some time, the rollouts are getting bigger, and the applications are more sophisticated. Several factors are spurring this trend:

• New applications specifically designed for handheld deployment.

• Devices that are high-quality, powerful and reliable, yet affordable.

• Faster data rates of up to 54M bit/sec with 802.11a in the 5-GHz band, and the same rate with soon-to-be-released 802.11g wireless LANs in the 2.4-GHz band.

Administrators and physicians view these developments as a foundation for improved efficiencies in billing and quality of patient care, says Rick Shoup, vice president of healthcare solutions for management consultancy Infosys.

“One of our [healthcare] customers told me recently, ‘We lose millions and millions of dollars each year because we don’t accurately capture data about tests that have been ordered or other services,’ ” he says.

Wireless LANs can let staff with handheld computers instantly record all charges and update billing databases. But in many cases, return on investment takes second place behind improved patient care.

Doctors and related professionals increasingly are pushing for the most current and accurate patient information. To get it, they have to be able to access hospital databases and records via wireless LANs coupled with handheld devices.

“Our entire clinical perspective on wireless has changed,” says Michael Minear, CIO for the University of Maryland Medical System in Baltimore. “It used to be a ‘Buck Rogers’ [science fiction] kind of thing. Now, it’s a fundamental part of every discussion about clinical information technology.”

The organization was one of the first to deploy a newly designed mobile version of Cerner’s Cerner Millennium clinical application suite on Tablet PCs and handhelds. “We’re one of the few hospitals doing wireless synchronization [directly] with the laboratory databases,” CIO Michael Minear says. “A physician walks in the front door, switches on the PDA, and in 5 to 7 minutes, he has the latest data on patients, including lab results.”

Although the hospital uses Enterasys Networks’ 802.11b wireless LAN access points, Minear planned the architecture as if he were deploying the shorter-range 802.11a wireless LAN. “When 802.11a technology comes out [and we decide to deploy it], we can just unplug the 802.11b cards and replace them with 802.11a cards,” he says. The facility will save money by not having to position new access points or run cabling or electricity to them.

Washington Hospital Center also is tapping wireless to aid doctors. The 900-bed facility in Washington, D.C., has about 60 Symbol Technologies wireless access points and a few hundred wireless PDA and laptop clients.

“Wireless is being driven by user demand and by the need to deploy point-of-care applications that can only work wirelessly, such as point-of-administration medication records management, and bedside medical data retrieval,” says Craig Feied, director of informatics for Washington Hospital Center operator Medstar Health. “It really impresses people that any clinician can actually see an X-ray or a CT scan image on his PDA, while sitting in the cafeteria.”

Feied launched a pilot program that gave one member of the physician team on morning rounds a PDA with a wireless LAN card. The team moved from patient to patient to review chart data and decide on treatment changes, including drug prescriptions.

“At the moment the team concluded its patient review, one of our doctors whipped out the PDA and checked to see if there was any new data,” Feied says. “In 30% of the cases, there was new information: information that had been missed or only became available to the doctors during that interval.”

The effect of having such data is startling. “It is very clear,” Feied says, “that no matter how well-computerized a hospital is, it’s not sufficient if the stumbling block [to accurate data] is that you have to walk 50 feet to a wired PC or leave the patient’s bedside. You have to go ‘the last 10 feet.'”

Writing prescriptions electronically is another application that is ideal for wireless. A 2001 study at Medstar found all the group’s doctors thought e-prescriptions would be more accurate than hand-written ones. Yet Feied says only 40% of Washington Hospital Center’s prescriptions were being entered via desktop PCs. Once doctors had handheld computers linked to the wireless LAN, the percentage nearly doubled to 70% of all prescriptions. Feied expects that to increase as more physicians see the ease and accuracy of wireless prescribing.

Wireless usage raises security and safety concerns, but executives say these are manageable with today’s products and technologies. Beth Israel Deaconess Medical Center suffered a major network outage last month, but CareGroup CIO John Halamka says it didn’t affect the Boston hospital’s Cisco Aironet wireless LAN. He protects it with the Cisco-specific Lightweight Extensible Authentication Protocol security protocol. He’s also deploying BlueSocket’s gateway that sits between the wired and wireless network.

For IT groups, it’s unclear precisely how the federal Health Insurance Portability and Accountability Act will affect security. The rules that specify how privacy restrictions are implemented securely will be finalized this month, and hospitals then will have two years to comply.

Wireless LAN safety issues focus mainly on the potential for interference with, or by, other hospital equipment such as cardiac monitors. CareGroup’s clinical engineering group oversees wireless LANs as just one part of the total wireless spectrum used by a range of hospital equipment, much of it on the same 2.4-GHz band that 802.11b wireless LANs use.

Halamka formed a group of 100 engineers and physicians to create an enterprisewide policy for wireless use in the group’s hospitals. “We’ve concluded that wireless, used more than three feet from a patient, is always safe,” he says.