"Our doctors look like Batman with a utility belt" because they're carrying multiple cell phones and pagers to connect with the people and data they need, says Chuck Christian, CIO of Good Samaritan Hospital, Vincennes, Ind. "We would like one device to take the place of all those things, and then to create a single conduit for communications."
These days, the technology has advanced to the point where a single, reliable network can replace a hodgepodge of disjointed proprietary networks, says Don Kinser, CEO of EDI Ltd., an Atlanta-based communications technology consulting firm. Some vendors, especially for functions like telemetry and PACS, have been reluctant to give up the control that comes with having their own separate, single-function networks, but he says they're coming around. "When you bring everything onto the same network, you reduce overall infrastructure cost, and all of a sudden systems that couldn't communicate can now share information. All kinds of improvements in workflow can result from that," he says, adding that hospital networks are evolving toward being the fourth building "utility," along with water, electricity, and ventilation systems.
The change is being driven by clinical staff, says Scott Johnson, vice president of communications planning at engineering firm Smith Seckman Reid, Nashville. "Clinicians are telling I.T. leadership to make this work," he says, noting that virtually all new construction relies on a single network for voice, data, building automation, security, and bandwidth-heavy applications like operating room video and videoconferencing. "It has done a lot to streamline operations."
Kinser's company recently completed a single network installation at the new 223-bed Capital Medical Center, Hopewell N.J., which opened in November. A combination of equipment from Cisco Systems, San Jose, Calif., and Avaya, Basking Ridge, N.J., configured into 20 virtual local area networks, handles almost everything: phones, patient monitoring equipment, IV pumps, EKG machines, building management systems, pharmaceutical dispensing systems, security cameras and card readers, interactive television, and, of course, Wi-Fi. The nurse call system integrates as well, and nurses carrying wireless phones can receive alerts, room status updates, and even text messages from patients, sent through the room TV. "There's still a phone on the nurses' desk, but they're hardly ever at their desk," says Ryan Hochworter, EDI Ltd. senior consultant.
Mike Kincaid, manager of network services for UC Health, Cincinnati, is installing a 10-gigabit, wide area fiber network connecting four of the system's buildings, including two hospitals, a long-term acute care facility, and the data center. The network is structured in a ring, so that if any part of it fails, traffic is automatically rerouted the other way. He's swapping out old switches that topped out at 10 Gb with new equipment from Ciena Corp. that starts at 10 Gb and can scale to as much as 100 Gb.
"My tendency is to have a lot of headroom on the network so everyone is achieving the speed we're paying for," Kincaid says. Pressure from radiologists at 466-bed University Hospital prompted the upgrade initially. Radiology and cardiology PACS had been their own islands because the departments didn't want to entrust their data to a centralized staff and didn't want to deal with sluggish performance on the main hospital network, but the need to share data outside department walls finally won out.
Maintaining the efficient performance of a stand-alone network was vital. "If you're going to keep a radiologist happy, the whole study has to pop up as fast as he presses the button," Kincaid says.
Once the organization looked at supplying 10-Gb connections to the two image-heavy departments, it concluded that the most sensible thing was to deploy a 10 GB WAN, to accommodate capabilities like high-definition videoconferencing and full image access in operating suites, intensive care units, and the emergency department. Some areas of the university hospital will get 10 Gb connections right away, a ten-fold increase in bandwidth, while other parts of the organization will start with 1 Gb and increase if necessary.
Kincaid expects to have to scale the WAN up sooner rather than later. "You blink and you're behind," he says. "As soon as we get the new network in and polished up, someone's going to be talking 40 [Gb]."
For most community hospitals, a 10-Gb backbone should provide enough room to grow, at least for now, says Kathy English, Cisco's director of global healthcare practice. However, they should expect to expand. "The minute everything goes digital, it raises infrastructure questions that you have to address," she says. "You have to build infrastructure that's highly available."
Simpler administration
At 76-bed Citizens Memorial Hospital, Bolivar, Mo., CIO Denni McColm wants to wrap as many functions as possible into her main network to simplify administration and centralize the responsibility. For example, the former intensive care unit director had been responsible for maintaining the unit's network. When the monitors went down one day, the I.T. staff discovered the director had let the ICU network's service contract lapse, leading to an expensive encounter with the vendor. "That's what we get when we have these little networks," McColm says. "If it's on our network, at least we know about it."
McColm's department is currently taking ownership of the obstetrical monitoring system. She's also exploring how to draw information from several sub-networks-for example, security, fire protection, and nurse call-into the main network so that the organization can use it for tracking. "We would like to be able to analyze how things are going with nurse calls," she says. "Are people waiting too long to get care? Do we need to shift resources?"
