A Partner in Curing

— June 01, 2006

Last summer, when an executive from Intel checked into a hospital for a routine procedure, he wasn't concerned about the quality of the facility or the competency of the medical staff. After all, this was one of the most well-respected, not-for-profit hospital groups in the Northwest. What did bother him, however, was spending time away from his email, corporate network and the daily ebb and flow of business operations. Like many executives, he was reluctant to kick the connection habit for even a few days, even when it was for medical reasons.

If he were to check into that same hospital today, however, he would not only have wireless access to the Internet and his corporate virtual private network (VPN), but he could also access medical information related to his condition and keep tabs on his billing. Eventually, he could even get a peek at his personal medical records, check out test results and communicate directly with his doctor--all through the same public Wi-Fi network.

"Our wireless strategy is to make our functioning transparent, so patients have immediate access to their records and other medical information," explained Dr. Dick Gibson, chief medical information officer at Providence Health System in Portland, Ore. "As a result, our patients and their families are better equipped to research medical issues and make informed healthcare decisions."

Since adding its first public Wi-Fi network to an existing private network used by doctors and nurses at hospitals in the multi-state network, the hospital group has expanded its public Wi-Fi campaign to seven sites, including hospitals in Washington State and Alaska. All of the public systems used in the hospitals are based on a mix of Bluesocket and Cisco Systems equipment.
A Wireless Plug for Patients

Hospitals across the country have discovered what coffee shops, hotels and airports have known for years: Wireless networks are not only good for business, they are quickly becoming an expected service for people who may not be comfortable being unplugged from their business networks or personal email for too long.

Nearly 80 percent of hospital executives polled last year by the Healthcare Information and Management Systems Society claimed they used or planned
to deploy wireless networks within their organizations in 2005. Market researcher International Data Corp. uncovered similar results in its own healthcare IT study conducted last year.

Many hospitals install public wireless networks more as a customer convenience than a way to extend mission-critical applications. Placing a Wi-Fi hotspot in a hospital waiting room or lobby is viewed as a good business practice that might attract customers. Most hospitals, however, look at them as ways to extend existing medical information networks right to the point of patient care and eliminate the need for doctors and nurses to run back to a wired data station to update patient records or access needed information.

This was the strategy when the Winchester Hospital, located just outside Boston, launched a wireless network to extend its Meditech information system to patients at its 200-plus-bed facility. "Anything available on a desktop computer at a nurse's station we wanted to be available mobile as well to a nurse or physician," said Gerald Greeley, hospital CIO.

Winchester is presently working to expand its wireless and mobile network from simple patient assessments and record-keeping to real-time electronic medication tracking. Late last year, it also started evaluating a Bedside Medication Verification (BMV) system consisting of optical scanners and coded patient wristbands. Like many hospitals, Winchester is using wireless voice over IP devices that allow hands-free communications between healthcare workers over the Wi-Fi network. The small, badge-like devices, manufactured by Vocera Communications, can be worn on a lapel and employ voice recognition technology to instantly connect Star Trek--style with specific doctors or nurses within the wireless network.

Other hospitals have the more ambitious goal of using wireless and remote systems to get their patients more involved in the healthcare decision process. "We want patients to be as educated and aware of the issues as possible," explains Gibson. "Patients are being asked to absorb more of the expenses of healthcare and need to trust hospitals to do the right thing." So it is important "to hear the pros and cons and tradeoffs of treatments."

A Secure Cure
Securing these wireless nets is obviously a key concern with hospitals since they routinely deal with highly sensitive information and must comply with privacy and data-integrity rules mandated by the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the Sarbanes-Oxley Act of 2002.

"We wanted to be sure we put a scalable solution in place that could be centrally managed and support both wireless guest access and wireless clinical access to the applications that are available," said Marvin Reece, network and telecom services manager at Health First, a group of three hospitals located on Florida's Space Coast that have been recognized as some of the most wired hospitals in the country. Having control and the proper security in place were very important in designing the system, Reece added. "We wanted to make sure that when a physician needed access he or she would not be hindered by those people casually browsing or playing games."

Providing dependable and secure wireless access is only a first step in creating a system that is not only available but can keep a few steps ahead of the unique needs of healthcare workers within the hospital. This is why many hospitals are looking into systems that include highly defined, role-based policy management controls and tools that automatically channel different types of information to different users within the same hospital.

ROAM with a View
Some hospitals have taken role-based remote networks a few steps further by developing systems that can be used by specific groups of patients to keep tabs on their own medical conditions, generate reports for the hospital staff and automatically alert doctors when something is out of the ordinary.

The Atlantic Health Sciences Centre in New Brunswick, Canada, for example, is in the middle of a pilot program that lets diabetes patients use their home and mobile computers to get information on the disease, chat with other participants in the program and enter vital blood test results that can automatically be channeled to doctors and others at the hospital. The unique system, which is still in its early phases of development, is based on role-based identity management and routing technology developed by The AnyWare Group, a solutions developer in St. Johns, Canada. The Role Oriented Access Management (ROAM) system essentially creates a personal portal for each user, which can be accessed anytime and extended to specific users--in this case the doctors and nurses at the Atlantic Health Sciences Centre.

Plans are to eventually expand the hospital pilot project to track a number of different chronic diseases and automatically alert the right doctors if a patient's blood tests, for example, indicate there is a problem. In June, the Centre also planned to add up to 75 new patients per month into the pilot project.

The system basically lets a patient be more accountable for their healthcare, said Jill Barton-MacPhee, administrative director for internal medicine of the Diabetes Education Program at the Centre. "If we can avoid one renal failure and one stroke, then we have done a good thing." //

Tim Scannell is founder and chief analyst at Boston-based Shoreline Research.

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