Adoption of wireless healthcare held back by clinical caution

Wireless technologies have been used in healthcare for many years, but the rise of smartphones and tablets means the opportunities to do more wirelessly – and save money too – are proliferating, writes George Malim

Adoption of wireless healthcare held back by clinical caution

Addressing healthcare markets can be divided up into specific healthcare systems and the more standard connectivity propositions that are common to other enterprises. Reliability and security set healthcare applications apart from a standard enterprise environment. However, the fundamentals of robust bandwidth, routinely available ata specified level, remain the same.

Add to that an increasingly mobile workforce within healthcare providers, and it is clear that wireless technologies will have a far greater role to play. 

‘The driver is the mobility of the staff,’ explains Tony Arnold, senior network and systems manager, Infomatics Department, NHS Lincolnshire, which has recently deployed an Aerohive Branch on Demand system to provide not just wireless, but remote office connectivity for its users. 

Other prerequisites included scalability for the organisation’s broad range of online needs, and the ability to effectively access the UK’s NHS N3 system easily and efficiently. 

‘Health visitors and district nurses move around the county all the time, dropping into sites to do their paperwork,’ Arnold adds. ‘3G connectivity around the county is not so clever for that type of communication, so they can drop into a local surgery and connect wirelessly. It saves time and makes their job easier, in addition to saving money.’

Home working

Arnold is also looking to wireless technology to enable home working. ‘In the past, this has been quite difficult to do,’ he adds, ‘but it has become easy and affordable. We’re already starting to pilot tablet devices in the hospital, so I’m sure mobile devices are going to be rolled out [to mobile workers] very quickly.’

The applicability of wireless technologies is highly dependent on the business model of each healthcare provider. ‘In private healthcare, some of the applications are effectively hospitality,’ explains James Calderbank, director of enterprise sales, EMEA, at Wi-Fi solutions provider, Ruckus Wireless. ‘In the UK we’ve had some success with a wall-mounted access point, which involves a single wire putting out Wi-Fi, and four ports for monitoring equipment or IPTV.’

Perry Correll, director of product marketing at Wi-Fi provider Xirrus, adds: ‘As far as we can see in the industry itself, we see it breaking out of retirement homes, rural hospitals and continuing care [providers]. Those are interested in Wi-Fi in a very similar way to a regular enterprise. There isn’t a tremendous amount of things that are different.’

However, hospitals are not standard or easy, especially the larger establishments. ‘These are aggressive environments with thick walls and issues such as X-ray equipment to be addressed,’ adds Calderbank. ‘There are machines that don’t want interference – the ones that go beep and keep people alive.’

That’s a critical factor. Reliable, secure services in these environments really are a matter of life or death. As more is done wirelessly, innovation has to be approached carefully to ensure nothing is done to threaten patient safety. Even so, the bulk of innovation happens in the applications that run on the wireless network. 

‘Once the wireless is in place, you can build out what is applicable to you,’ says Bryan Hall (pictured above), regional sales manager at Ruckus Wireless. ‘For example, you can have a very secure network for patientrecords running on the same infrastructure as a network set up for patients to use.’

Slow adoption

Healthcare is at times a rather rigid industry, often constrained by regulatory pressures, and that holds back rollout of new technology and applications. ‘What you have to consider is that healthcare is very large and somewhat conservative, so any change will take time to filter through,’ explains Tim Phipps, business developer at Cambridge Consultants. ‘When it does, it won’t be linear – we haven’t seen anyone going for it and rolling out with nationwide scale.’

Correll sees Wi-Fi as the core infrastructure on which applications and services will be distributed. ‘The larger hospitals – those with 200 or more beds – or the smaller private hospitals, are looking at wireless as a utility, a mandatory thing,’ he says. 

‘Hospital wireless needs to be built at three different levels. It starts at providing connectivity for patient access; the next level is the enterprise grade, and on top of that is the medical grade part, which can be a matter of life or death.’ 

A significant challenge remains in bringing two disparate industries together. Technology providers are used to moving rapidly to introduce new innovations, but medical providers take a measured approach to new system deployment. 

‘In the past five years there have been two big challenges in getting connected technology into the healthcare arena,’ says PA Consulting’s Frazer Bennett. ‘The first is about the regulatory considerations of mobile healthcare, and there has been a lot of confusion there. We’ve helped a number of organisations, including the GSMA, to broker the relationship between these two worlds.’

Generating returns

‘The second challenge is the business model,’ adds Bennett. ‘In healthcare it’s called the care pathway, and is focused on how money ends up in the right pockets to make [projects] work. How do I spend money to generate a return?’

The archetypal example of efficiency gained by a patient wirelessly monitoring their own pulse from home, rather than having a nurse take it is often told, but Bennett thinks even this example is challenging. 

‘On the face of it, it’s a no-brainer,’ he says. ‘But even in an apparently simple situation like this, providers have struggled to put forward a body of evidence that this sort of project makes business sense. Wireless heart rate monitoring may save time, but you only see the benefit if it results in you having fewer nurses.’
Bennett does see some services making it to market, though.‘There are pockets of success,’ he says. ‘This industry suffers from what I call “pilotitis” – there’s always appetite for a pilot project, but it’s difficult to get into the mainstream. The successes come where the benefit is easy to articulate, and is tangible.’

The healthcare sector remains reticent. ‘Everywhere we see pilots being done,’ adds Xirrus’ Correll. ‘One hospital we know of has being doing a pilot for over a year – they’re just waiting to see how it works. People are very concerned about being leading edge, they want to wait to see others do it first.’

Hall also sees that and points out that demands are fragmented. ‘A lot of people have done a lot of trials and testing – certainly hospitals know they need to do something,’ he says. ‘Sometimes they will be focused on clinician access, sometimes on machine-to-machine, and sometimes on patient access. It doesn’t matter once the infrastructure is there.’

Even so, successes are becoming more numerous. Bennett gives the example of a company called Monica Healthcare, which has developed a foetal heart rate monitor to determine the heart rate of an unborn baby. 

‘You don’t need a trained physician to use it,’ he points out. ‘It’s a patch that detects the heart rate and transmits it to a nearby machine. That product is approved by the FDA in the US, and is used by mothers with a history of complications. Of course, in the US your [medical] insurer will insist you go to a hospital quite a long time before the due date if you have that history, and incurs huge cost because of that. This technology means you can stay at home, and the savings can be really easily demonstrated.’

Insurance sector

The insurance sector is likely to be more keen to push through cost-saving innovations than public health authorities. For example, wireless applications on consumers’ smartphones for the monitoring of chronic conditions are expected to take off. 

‘The US will probably lead this innovation because people are more used to taking personal control and financial responsibility for their healthcare,’ says Phipps. ‘By extension, their insurance companies may pay more for services that can save hospital costs, and this might be where the industry starts to gain the most.’

Robert Milner of Cambridge Consultants also sees funding being apportioned to wireless technologies for applications that provide a clear path to saving money. ‘I always think of high-value drugs as a classic example suited to a wireless application because the business case will always be there,’ he says. ‘From inhalers to pills, to the simple monitoring of blood pressure, there are applications for wireless.’

There is also a burgeoning market in the non-regulated wellness market. ‘There are two parallel universes here: regulated healthcare and the unregulated wellness market,’ explains Bennett. ‘In the wellness market you, as an individual, choose to monitor aspects of your health. This is less a question of need and more of a question of discretionary desire. Providers that address this worried wellness market are not making any medical claims.’

In general, as technology becomes more cost effective, wireless will be rolled out to more and more devices within healthcare. ‘The chipsets are so cheap that Wi-Fi is in everything,’ says Correll. 

Bennett similarly sees the cost of enabling technology coming down in a way that will enable new services and applications. ‘We will continue to see more and more innovation, not least because the mobile phone industry has caused the cost of all these things to fall dramatically,’ he says. ‘NFC and other sensors are being opened up for use in healthcare applications.’


eHealth Application: GE Healthcare uses wireless to return dignity to patients

Headquartered in the UK, GE Healthcare is a $17bn unit of General Electric Company. The company provides transformational medical technologies and services that are shaping a new age of patient care, helping clinicians around the world re-imagine new ways to predict, diagnose, inform, treat and monitor disease.

GE Healthcare’s aim was to deliver a more effective and user-friendly hospital experience. Patients with long-term care can easily find themselves confined by the needs of their treatment, so being able to regain as much independence as possible is an important element of their recuperation.

GE Healthcare envisaged a new, non-intrusive way to monitor serious complaints suffered by patients admitted to hospitals. By observing vital medical signs, health staff could be alerted to take immediate action if a patient was, for example, to suffer a cardiac arrest or breathing difficulties. In order to achieve this, GE Healthcare opted to create a more effective wireless monitoring system for use within hospitals, enabling patients to be safely and securely monitored 24 hours a day. 

The patient-worn devices would need to be compact and easy to use, yet boast the highest levels of reliability to prevent exposing patients to harm, especially as hospital environments are prone to high levels of electronic and radio interference.

Wood & Douglas provided a system of wireless transmitters and receivers offering an effective solution for patient monitoring. Delivering highly reliable and cost-effective wireless data communications from point to point, Wood & Douglas’ ST and SR range radio transmitter and receiver modules were designed to be integrated into products that must conform to, or exceed EN 300 220 requirements. 

This ETSI standard adheres to rigorous intermodulation requirements, which ensure that interference does not impact the performance of the product.

eHealth Application: The iPhone as a personal health manager

Mobile phones will play a growing role in medical care in the future, according to a poll from research institute 2guidance. The study showed that 67% of healthcare companies expect a majority of doctors to use apps for transferring and saving patient information by 2015. The apps will make it easier to treat primarily lifestyle diseases, such as diabetes, obesity, blood pressure and asthma.

Medisana’s VitaDock range of devices has been designed to address the needs of these users. The company’s CardioDock blood pressure module allows people with high blood pressure to monitortheir stats at home, to reduce the number of doctor visits. 

CardioDock takes five measurements, and then calculates an average to eliminate natural swings during individual readings.

In addition to CardioDock, GlucoDock allows diabetes patients to check their blood sugar quickly and comfortably with their iPhone – the results are available just five seconds after a reading. The app also eliminates the cumbersome handwritten collection of blood sugar levels because all data is automatically recorded in a digital diary.

Another application, TargetScale, transforms iPhones into weight-management devices. The app notices every time the user steps on a scale and uses rings of light to illustrate how near they are to their target weight. The closer the rings are to the middle, the closer they are.

The Balancetest function also shows if users are standing evenly on both feet. Targetscale can then determine a user’s body fat, muscle mass, water retention and bone mass, as well as their Body Mass Index (BMI). When in athlete mode, active athletes can check their fitness level.

Written by Wireless magazine
Wireless magazine

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