© 2005 University of Chicago Hospitals Joint Wireless/ICS Meeting The Wireless Utility in Healthcare Todd Hollowell Director, Information Technology University

© 2005 University of Chicago Hospitals

Joint Wireless/ICS Meeting

The Wireless Utility in Healthcare

Todd HollowellDirector, Information Technology

University of Chicago Hospitals

October 18, 2005

© 2005 University of Chicago Hospitals 2



Discussion Topics» Introduction

» Today’s Objectives

» Standard Technologies

» Leading Edge Approaches and Solutions

» The Wireless Utility in Healthcare

» Conclusions




Introduction» The University of Chicago Hospitals

– In July’s U.S. News & World Report 2005 "Best Hospitals" issue, the University of Chicago Hospitals (UCH) is ranked 14th nationally overall. This year marked the ninth time UCH made the Honor Roll since 1995.

– Closed Staff Model (600 residents, 620 attending faculty)

» Key Facts– Bernard A. Mitchell Hospital, the primary adult inpatient care facility – Chicago Lying-in Hospital, a maternity and women's hospital – New Comer Children’s Hospital opened in February 2005– ~28,000 patient admissions annually– ~420,000 outpatient visits to the Duchossois Center for Advanced Medicine

(DCAM)– Over 80,000 ED visits (Level 1 Peds, Level 2 Adult)– ~5,500 employees– Regional Doctors Offices located throughout the Chicagoland area




Today’s Objectives» Review standard technologies at the “top of mind” with all healthcare

providers

» Discuss a handful of up-and-coming technologies

» Focus on the Wireless Utility for Healthcare– Discuss how UCH has implemented and why it will continue to implement a

wireless utility approach– Current vs. Future applications– Benefits gained




Standard (but ‘hot’) Technologies» Clinical Information Systems

– Electronic Medical Records (EMR)– Computerized Physician Order Entry (CPOE)– Electronic Medical Administration Record (eMAR)– Picture Archiving and Communication Systems (PACS)

» Business Applications – Enterprise Resource Planning (ERP)– Patient Accounting/Revenue Cycle Management– Enterprise Content Management

» Infrastructure– Medical Grade Networks (wired)– Storage, Back Up and Disaster Recovery solutions– High Availability Computing environments– 802.11/Wi-Fi infrastructures




Leading Edge Approaches and Solutions» Medical Device and IT Convergence

» Radio Frequency Identification (RFID) and Locator Systems (RFLS)

» Robotics (surgery, pharmacy)

» Enhanced Medical Imaging Solutions (e.g. 64 slice CT scanner)

» Blended Shore/Off Shore delivery models

» “The Wireless Utility in Healthcare”




History of Wireless in Healthcare » Wireless systems in healthcare are not new

– Two-way radios– Voice/text paging systems – Telemetry and wireless portable bedside monitors

» New wireless devices and applications are emerging – Voice badges– CPOE – eMAR– RFID/RFLS

» The predictable consequences– Multiple uncoordinated, discretely managed, wireless systems– Added risk - quality, safety, and security – Inadaptable infrastructure – High total cost of ownership (TCO)




Why is the Wireless Utility Important?» Health care organization’s workers are mobile (nurses, physicians, etc.)

that need access to their applications and tools…anywhere, anytime

» Wireless technologies and applications are proliferating healthcare - requires a coherent IT strategy, plan, and policy around wireless technologies

» Benefits for traditional wireless applications for staff communication and IT applications are well documented

» Wireless will not replace wired networks – at least in the near term

» Life safety and mission critical applications require a ubiquitous and reliable wireless service




All IT Infrastructure Should be Virtual» IT Virtualization: (noun) the pooling of IT resources in a way that masks

the physical nature and boundaries of those resources from resource users. - Gartner, 2004

Technology Yesterday Today The Future

Computer Hardware

Individual standalone processors

Blade computers Dynamic computing with

auto-load balancingSeamless virtual

computing environment

Examples

IBM On Demand HP Adaptive Enterprise EDS Agile Enterprise

Operating Systems

A single operating system per box.

Multiple operating systems run simultaneously on same box.

Data Storage Separate disks Volume managers

Storage arrays Storage area networks

(SANs) Network attached storage

(NAS)

Enterprise Networking

Multiple infrastructures Protocols –IPX/SPX,

TCP/IP, etc. Topologies – Ethernet, token

ring, etc.

Converged IP networks Grid and mesh networks




Future Vision for Wireless» Wireless Virtualization

– Enables mobile workers to experience seamless communications and information access from any device and from any location

– No knowledge of underlying wireless technology or infrastructure required– In buildings, enabled by a ubiquitous common wireless infrastructure

» Requires a Wireless Utility!

Technology Yesterday Today The Future

Wireless Proprietary technologies

Few standards Point solutions

Many standards and technologies

802.1x standards Convergence

opportunities

Seamless mobile environment enabled by

virtualization and a Wireless Utility




Does a Wireless Utility really provide the solution hospitals need?» Questions we asked ourselves as we were assessing our position in

UCH’s new Comer Children’s Hospital two years ago:– Should we deploy multiple single-point, in-building wireless systems?

– Each requiring its own equipment and distribution infrastructure, technology standards and communication protocols, and maintenance, management and operational overhead

OR

– Was the technology ready today to build a shared wireless distribution utility?

– We chose the latter



Point solutions are more costly and difficult to manage than enterprise solutions. An HVAC analogy…

You wouldn’t cool your building with individual window units…

… you would build a single HVAC infrastructure – an in-building utility.





In determining what we wanted out of a Wireless Utility, theUCH IS team established the following technical goals:

» Build a shared, broadband wireless infrastructure» Provide consistent, reliable radio frequency (RF) coverage» Minimize interference potential with hospital biomedical equipment» Ensure the utility is managed and secure» Guarantee predictable, low total cost of ownership» Provide flexibility for new services and applications» Ensure it is open…make it protocol and service provider independent




UCH Wireless Utility Design» Reliable wireless communications (designed for > 95% coverage) using a

single infrastructure that will support current, as well as future, wireless voice and data services

» Ability for 2-way radio (450 MHz), Paging (900 MHz) and PCS/Cellular Carriers (800 and/or 1900 MHz) to distribute their wireless services at their licensed frequencies throughout the facility

» Provide uniform coverage for wireless LANs (802.11) for immediate and future installations

» Ability for UCH to add capacity at any time without modification to the system

» Ability to operate the system with little maintenance, due to the passive design

» Ability to add any current and anticipated frequency between 400 MHz and 5 GHz




What is it?» InnerWireless® solution» Universal broadband RF access» Passive design/no electronics» Multiple services today including WiFi,

cellular (from multiple carriers), paging, two-way radios

» Insertion of new services (First Responders, Wireless Medical Technology Service, Building Automation Controls) as needed and available




Excellent performance

Threshold performance

Intentionally below

threshold

Comer Hospital Floor Plate

Engineered Coverage is Essential




Expandable to any size



Wireless Utility





Physician’sOffice

OutpatientCenter

ImagingCenters

Long-termCare

OtherHospitals

HomeCare

ConsultingPhysician

In-Transit

Care-givers

The Future Role of Next Generation Cellular (3G) in the Enterprise




Wireless Utility – Comer Results:» Greater than ninety-five percent coverage, including elevators/stairways

– Load balanced– 100% redundancy– 70 to 80% reduction in network access points

» 50 to 1 improvement in exterior RF security over other typical installations

» Improved physical security– Access points in controlled equipment closets– Hidden antennas and coax distribution environment

» “Utility Grade” reliability– Less Access Points = less points of failure

» Lower maintenance costs– No periodic maintenance required…system is passive– Fewer access points to procure and maintain

» Low cost evolution– Update few centralized access points




Security andCoordination

Two-way radio Paging

BuildingControl

HVAC/Energy Security cameras Monitoring devices RFID/RFLS

Personal Communications

Cellular/PCS Paging Blackberry

and PDAs WiFi/802.11,

including Wireless VoIP

Wireless MedicalTelemetry Service (WMTS)

Sensors

Medical Data

UCH Wireless Utility Applications Today and in the Future




Wireless Utility – Other Results and Plans» Wireless telephones are integrated with the nurse call system and the

Philips monitors and has had several positive impacts – Lower noise level on floors with nurse call alerts coming through telephones vs

being broadcast throughout the floor– Nurses are able to be connected via the wireless telephone anywhere in the

building reducing cycle time– Sense of nurses being very satisfied with these new tools and feeling that it

helps them do their jobs better

» Paging and two-way radio systems have worked flawlessly using the Wireless Utility

» Cellular providers are connecting to the environment currently (Cingular is on; Nextel, T-mobile, and Verizon are coming)

» RFLS solution will be in beta test mode within 60 days

» Proximity locators should be in place within the next 12-18 months

» UCH is retrofitting its legacy facilities with the Wireless Utility




Partnership with InnerWireless/JCI » Entire Comer Children’s facility covered, including stairwells and elevator shafts» Incremental capital costs mitigated by integrating with the JCI portion of the

construction program» Early adopter status provides additional discounts and attention to implementation» Early estimates are that it will be expensive to retrofit current adult hospital and

outpatient building, but we will do this in preparation for our new clinical system rollout

» May have revenue opportunities with cellular providers» Have uptime warranty and performance warranties» Guarantees for coverage (and leakage)» Commitments to work with Cisco and other vendors (RFID)» Representative list of current healthcare customers

– Barnes-Jewish

– Baylor Healthcare

– St. Luke’s Health System (Kansas City)

– Mass General

– Children’s Memorial




Conclusions…» The Wireless Utility is here and is a critical convergence opportunity that

helps to manage costs and speed implementation of new applications» UCH Results

– System installed and tested to specifications in Comer Children’s Hospital– System live in production and supporting patient care (e.g. wireless telephone

integrated with monitors and nurse call system have resulted in quicker response to patient needs)

– Cost effective convergence opportunity; avoided costs for distribution systems for other wireless technologies (paging, two way radio, cellular, etc.)

– Provides ability to manage and secure the wireless infrastructure– Well-positioned to integrate future wireless technologies (e.g., RFID/RF locator

systems, medical equipment, etc.)– Vendor committed to our success and delivered

» Next Steps include…– Estimating costs and planning the implementation of the wireless utility into

existing hospital spaces in preparation for new clinical system and other wireless applications

– Working with medical device manufactures to validate compatibility and speed industry adoption

Documents

© 2005 University of Chicago Hospitals Joint Wireless/ICS Meeting The Wireless Utility in Healthcare Todd Hollowell Director, Information Technology University