Connecting to Patients

In August, when George Washington University Hospital moved from a cramped old building to an airy new one across the street, the staff gained a new partner in improving patient care -- an 11M bit/sec. wireless network.

"It's a whole different paradigm," the hospital's emergency department director, Andrew Robottom, says of the new LAN. "The flow of events is based on patient care as the primary mover, not paperwork."

That's a huge change from most hospitals, where paperwork determines who gets which treatment and where. The changes under way at the hospital are revolutionary not only for the health care industry, but for any service business.

"It's a travesty that there's not a much greater investment in this technology. It's a no-brainer for health care," says Ken Dulaney, mobile and wireless computing analyst at Gartner Inc. in Stamford, Conn. "There is no [industry] with a higher return on investment for the use of mobile and wireless technology."

With new wireless laptops, registration is brought to the patient, says Robottom. "Now, if someone comes into the [emergency room] with chest pains, we can take them right to treatment," he says. Rather than being a separate task, registration is now integrated into the flow of a patient's stay.

The workflow improvements enabled by the wireless LAN extend beyond the emergency room. On the wards, nurses used to record patient data such as temperature, pulse and respiration on paper, then input that data into a computer terminal at a nursing station. Nurses now enter the data directly into a cart-mounted laptop wheeled into patients' rooms.

Broader Availability

A hundred Compaq Armada laptops are available in addition to stationary PCs that run terminal emulation software. In the old building, there was one terminal per floor, says Dr. Katherine Goodrich, assistant professor of medicine at the Washington-based hospital. The new building has seven nursing pods per floor, and each pod has its own terminal. "On the old system, with one computer per ward, people were always fighting for access to a terminal," she says.

Goodrich and other physicians each use a mobile unit on morning rounds. For doctors making decisions on patient care, having the most recent patient records and test results at their fingertips is crucial, Goodrich says. This easy access is also essential in getting patients released from the hospital in a timely manner, she says.

Security of sensitive patient data was a top priority in planning the network, says Mark Fehling, CIO at George Washington. Before gaining access to any data, users are first authenticated and then connected to the virtual LAN via a virtual private network.

Such an implementation "might be a bit of overkill, but people are very concerned about the security of their health records," says Dulaney.

This new workflow process has added some complexity to the staff's normal routine. "Training and adapting to the new technology has been a challenge for our users," Fehling says. To learn the ropes, new nurses are paired with experienced staffers, he explains.

Although training is also offered to doctors and residents, most pick up the essentials from colleagues. "That's what most of us are doing. It's easy," says Chris Entwisle, a medical resident.

The WLAN also supports a radio frequency phone system. Each hospital staffer checks out one of the 90 available handsets when his shift begins and clips it to his belt. Staffers within the hospital can communicate directly with one another without having to go to the nursing stations. This improved communication has made them more efficient, Robottom says.

But perhaps the most eagerly awaited addition to the WLAN is support for personal digital assistants (PDA) on the hospital system, which is expected by year's end.

Residents and doctors will be required to buy PDAs, although many of them already have. But it remains to be seen how the 17-person IT staff will support the devices.

Although investment in mobile technology has lagged in the health care industry, it's starting to accelerate, Dulaney says. "The prices are fairly low, it's reliable, it can be made secure -- anyone who says it can't just hasn't looked at the options," she says.

Lais is a Computerworld contributing writer. Contact her at

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