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Seattle's Swedish Medical Center WLAN lessons learned


Some hard-won, expensive, and time-consuming lessons learned... and the resulting rewards... from Seattle's Swedish Medical Center deployment of its Wireless Local Area Network (WLAN) are described in a pair of February 4, 2008 articles in Network World.

Healthcare firm offers wireless lessons learned. (There is also a longer version of the same article.)

Hospital reaps healthy returns from wireless. (There's also a podcast available with the Director of Information Technology at Swedish.)

Several years ago I visited a friend who was a patient at Swedish, and I was impressed with their use of wheeled "computer stands" for recording patient information. Instead of trying to juggle a laptop, or tablet, or handheld device, when it's time to record information like periodic vital signs, medical personnel simply wheel a small, compact cart into the patient room. There are multiple carts available in the hallway and each holds a laptop, high-capacity (external to the computer) battery, and some other peripheral devices . The laptop is securely attached to the cart so it's not easily detached / stolen. From talking to the nurse who came in to attend to my friend, the computers on the carts were fully connected to the Swedish network via Wireless LAN. (Apparently the Swedish WLAN project was still in development at the time I saw it being used.)

The main thrust of the former article is that Swedish has gone through several time-consuming and expensive shifts in technology over the years it has been using / deploying its WLAN. It's also considering doing it again to take full advantage of 802.11n, which would allow Swedish to consolidate its use of 5 GHz and 2.4 GHz, which are currently separate networks.

The latter article gives an excellent overview that the WLAN is an integral component of a systemwide initiative at Swedish to automate processes and eliminate paper-based workflow. The WLAN is integral because it efficiently eliminates paperwork at the "source" and the "destination" of much of the information generated, and used, within Swedish - the (in)patient's bedside.

One of the most intriguing items from the latter article is that apparently Swedish has just begun implementing a Vocera Communications System for voice communications via its WLAN. If you're not familiar with Vocera... but you've seen the chest-worn "Communication Badges" in the television series "Star Trek, The Next Generation", then you know approximately how a Vocera Communications Badge works. That is - reach up to your chest, tap it, speak into it, the Vocera software / server figures out how route your request appropriately. Vocera explains it thus: The Vocera Communications Badge - B2000 is a wearable device that weighs less than two ounces and can easily be clipped to a shirt pocket or worn on a lanyard. It enables instant two-way voice conversation without the need to remember a phone number or manipulate a handset. The Vocera Communications Badge is controlled using natural spoken commands. To initiate a conversation with Jim and Mary, for example, the user would simply say, "Conference Jim Anderson and Mary Garman."

(An article in Forbes states that the Vocera Communications Badge was actually inspired by the intuitive communications devices used on the Star Trek television shows.)

Another interesting application that Swedish will attempt to implement using its WLAN is to track high value devices that are moved around within its buildings... possibly easily implemented by attaching "mute" versions of the Vocera Communications Badge to the high-value devices.

I'm very impressed with how Swedish uses its WLAN not as a mere "convenience" (such as using WLAN instead of wired network connections), but that the WLAN has become not only integral to improving existing processes at Swedish, but that the WLAN enables entirely new types of productivity and efficiencies.

Not stated... but quite possible... is that if Swedish does implement, as seems likely, a new WLAN based on 802.11n, perhaps inpatients will be able to use their laptops to have something to do besides watch television or read while they are recuperating. Enterprise-grade WLAN systems are easily able to "sort out" competing / mixed security WLAN (and, of course LAN) usage through the use of Virtual Local Area Network (VLAN) and other technologies such as multiple Service Set Identifiers (SSIDs). There wouldn't seem to be an issue with a inpatient's laptop causing "interference"; with deployed an intensively-used a WLAN, Swedish would have discovered any "Radio Frequency issues" with medical equipment.

How about it readers - would you want the option to use your laptop if you have to spend time in a hospital? Or would you rather just "hit the button", zone out on your pain medication, and catch up on your sleep?

8 comments
S,David
S,David

Last summer a family tragedy unfolded in the CCU at Integris Baptist Hospital in OKC. They had guest internet access via a hotspot, and I could also see two other networks that were not accessable. About every 100 feet there was a rubber duck antenna stuck through the ceiling. Much of the medical equipment ran on one of these other wireless networks, but I didn't find out much of the details. They would let us laptops and cell phones in the CCU, as long as we kept away from the medical equipment by about an arm's length. Interestingly, they had signs at the CCU entrance that warned against cell phone use, yet the doctors and nurses were using cell phones and UHF radios everywhere. When I asked, they said the signs were from the days of the analog phones where some of the bag phones could crank out 3 Watts of power, and that the modern digital phones were not a problem for modern medical gear under normal conditions.

edgtan
edgtan

If I'm in the hospital, and in recoup mode, then give me Wi-Fi (or any flavor of wireless broadband)... Or give me death.

Michael Kassner
Michael Kassner

Hospitals in MN are already using many of the latest 802.11 technology and feel that if they don't they are very much behind the curve. For example, I posted in this blog that they all use the Vocera communications badge or something similar and have for a few years already. http://blogs.techrepublic.com.com/wireless/?p=168 Also I doubt seriously that there would be any cross over allowing the patients to use the main hospital wireless network, regardless of security measures. There are just too many regulations and protocols guaranteeing security of patient information. There are some members that responded to my blog post that work in this world. I am sure they have a much better understanding of this topic than I do. Hopefully they will find time to expand on the subject.

horssw1
horssw1

As the author of the Swedish article we're discussing, let me clarify a point. We have "guest wireless" available for all of our customers at our hospitals and clinics. We use the same 802.11 a/b/g network that the system uses, but we isolate their use to b/g and we limit the available bandwidth. For security, we use a Cisco product (BBSM) which allows an outbound connection to the Internet, but no access back into our network.

Larry the Security Guy
Larry the Security Guy

I've been in medical centers in the north- and southwest U.S. that offer WiFi for patients and guests. I don't know what they did to provide that, but I hope they sufficiently locked down the regulated segment. My biggest concern with WiFi is its inherent security, and I would hope that auditors look closely for vulnerabilities. I'm sure we don't need our vital signs or medical notes ords being snatched out of the air and posted in public space.

Michael Kassner
Michael Kassner

I appreciate the clarification. I was curious as to what you plan to use in the near future as the BBSM is EoL? I would like to humbly add that I would still be concerned having a single device as the focal point between a hostile network and the hospital's internal network. I seem to remember three separate rather significant Cisco fixes for that device dealing with penetration avenues. Also if you do not mind, could you please go into more detail as to how you separate the guest user from the hospital worker?

horssw1
horssw1

You are correct that the BBSM is EoL. We are planning to migrate to Cisco's Lobby Ambassador within the next few months. Essentially today we created an SSID that has a tunnel to the DMZ where the BBSM lives. If you want more detail, let me know and I can connect you with the technical experts on the team.