Feature Story

April 12, 2004

by Charles Waltner, News@Cisco

Florida Hospital turned to Cisco wireless technology to get closer to its patients.

Florida Hospital, a division of Adventist Health System, is a comprehensive network of 17 hospitals and 14 urgent care centers, Florida Hospital treats more than one million inpatients each year, making it the busiest system in the country. For the last five years, U.S.-News & World Report has recognized Florida Hospital as one of "America's Best Hospitals."

In 2001, Florida Hospital decided to expand its wireless network. For years nurses and doctors had been using the organization's conventional computer network to record and track patient info. But such things as vital statistics and medication history had to be entered by hand, often at patient bedsides, and then typed into the computer system at nurses' stations or other computer locations away from a patient's room. The process had inherent disadvantages, mainly from re-typing errors and difficulty quickly entering and accessing information. Also, doctors or nurses often need such information at the patient's bedside to assess progress and determine further treatment.

"We needed to be doing our care analysis in the patients' rooms," says Gil Sturgis, network services manager at Florida Hospital. "That way, doctors and nurses could quickly and accurately enter information about the patient as well as having all the information they needed to make further treatment decisions while directly involving the patient."

To move its advanced information technology care systems closer to patients, Florida Hospital wanted to deploy a mobile patient care work cart and application from Siemens Medical Solutions. The mobile computing stations include IBM laptops on specially designed, adjustable carts with electrical outlets and cords to avoid battery management issues with the laptops. The Siemens application delivered over the mobile computing station covers three areas of patient information: intravenous (IV) administration history; vital statistics, such as blood pressure, heart rate and temperature; and X-ray and lab reports for services ordered for the patient.

But to make these carts go, Florida Hospital needed a wireless network. Since 1997 it had been using a proprietary wireless system to bring patient case management files to nurses using laptop computers, but the four-year-old system had become out-of-date, falling behind the rapid advances in wireless technology standards. So the company undertook a thorough search for the best of today's wireless networking equipment. It picked Cisco and its Aironet line of wireless networking products, key components of the Cisco Structured Wireless Aware Network (SWAN).

Deployment, which finished in the first quarter of 2003, lasted 18 months, totaling 400 access points in seven hospitals. Sturgis says the deployment could have happened faster but Florida Hospital paced the rollout for financial reasons.

Most of Florida Hospital's wired network uses Cisco routers and switches, so the Cisco wireless access points were an obvious choice. But the Cisco Aironet Wireless network portfolio offers a host of advantages, in addition to excellent integration with Florida Hospital's existing network.

Hospitals could well be the most challenging environments to deploy wireless networks, Sturgis says. The lead-lined walls of X-ray rooms, for example, completely block any radio signals from passing through. Also, wireless signals must negotiate a phalanx of interference from wired medical diagnostic and monitoring devices.

But by using the Cisco Wireless LAN Solutions Engine (WLSE), a key component of the Cisco SWAN, Sturgis was able to manage the deployment of the wireless networks with a comprehensive system-level view of the wireless LAN. In particular, WLSE provides special tools for diagnosing radio frequency interference, which greatly eased problem solving for creating contiguous coverage throughout the seven hospitals.

Sturgis says the WLSE lets him push out standard configuration settings to all 400 access points, greatly simplifying management.

Network security is an especially important issue for Florida Hospital--or any health care organization--because of the sensitivity of medical records. In addition, recent government regulations, such as the Health Insurance Portability and Accountability Act of 1996 (HIPAA), require hospitals to meet specific privacy and security safeguards. Sturgis is using the Cisco proprietary lightweight extensible authentication protocol (LEAP) to mitigate a variety of network attacks. To further ensure the security of its wireless LAN, Florida Hospital will soon deploy version 2.5 of the Cisco WLSE, which includes advanced rouge access point detection.

The Cisco Aironet wireless system brought other advantages as well. Hospital electrical power systems are highly regulated because of dangers from sparks igniting oxygen or other gases and chemicals used for patient care. Installing new power outlets for each of the 400 wireless access points would have been a major logistical and regulatory burden, greatly slowing the wireless network's deployment, Sturgis says. Fortunately, Cisco has developed special technology to run electrical power over Ethernet cables, hence eliminating the need for additional cabling, as well as avoiding regulatory concerns with power lines.

Despite the logistical challenges of deploying wireless networks in hospitals, Sturgis says the biggest hurdle to success has not been technical but human. Nurses, doctors and other personnel charged with recording and reviewing patient information simply were use to doing things a different way and were slow to adopt a "newfangled" approach.

But the convenience of wireless computing is winning them over, Sturgis says.

"Wireless computing is growing on them," he says. "We don't see the mobile carts in the halls or by the nurses stations much anymore. And that's good because it means they are where they should be, close to our patients."

But beyond all the perks of running a Cisco wireless network, most importantly the Cisco Aironet products work dependably, Sturgis says.

"Unlike most companies, our networks are needed 24-hours a day, seven days a week," Sturgis says. "Our customers can't afford to wait."

Charles Waltner is a freelance journalist in Oakland, Calif.