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February 2014

New Best Practices Optimize Wi-Fi
By Joe Zeto
For The Record
Vol. 26 No. 2 P. 8

With the rapid growth of mobile computing and Wi-Fi–enabled devices, today’s medical institutions have gone from viewing wireless as a matter of convenience to a matter of life and death.

Medical staffs now routinely use wireless networks and devices to communicate and gain instant access to EMRs, test results, and provider information throughout a facility. Wireless local area networks support mobile patient monitoring, infusion pumps, medical imaging systems, and other specialized devices and applications. And the bring-your-own-device trend continues to gain steam among clinicians, patients, and visitors who favor using smartphones, tablets, laptops, and the like.

All in all, Wi-Fi networks in health care facilities are being pushed to their limits while the risks associated with poor performance—dropped calls, choppy videos, low patient satisfaction ratings—are on the rise. The modernization of facility networks to comply with health care reform introduces still more risk that must be monitored and mitigated.

With user expectations higher than ever and applications growing in complexity, the health care industry as a whole is adopting new best practices for approaching major Wi-Fi product launches and initiatives. As the volume and diversity of mobile devices continue to grow, health care facility IT teams and medical device manufacturers alike must become more proactive and aggressive in guaranteeing performance out of the gate and over time.

The Challenge
Patient care depends on the secure exchange of accurate, actionable information. Many hospitals have become full-service facilities, offering emergency and intensive care to thousands of patients per month and requiring hospital IT staff to ensure high quality and availability of that care. Doing so is rife with challenges, including the following:

• verifying network capacity;

• providing high bandwidth in all areas requiring wireless connectivity;

• measuring individual Wi-Fi client device performance (eg, roaming, coexistence, throughput);

• assessing the quality of experience users can expect for voice, video, and other real-time mobile applications (eg, determining the voice quality at nurses’ stations where voice-over Internet protocol handsets are concentrated); and

• evaluating future upgrades needed to support industry regulations and individual hospital IT road maps.

For hospital IT departments and their integration partners, the pressure to achieve hospital-grade Wi-Fi connectivity translates into the need to thoroughly assess environments and measure the impact of new mobile medical devices on existing hospital wireless local area networks and vice versa. As the sheer volume and diversity of mobile devices continue to grow, facility administrators must know how each new system, device, or application will perform; interact with other devices; and impact existing ecosystems before they’re deployed.

Fortunately, the quality challenge does not rest solely with IT staff. Manufacturers of life-critical mobile devices must work in conjunction with hospital teams to optimize device and application performance for specific needs and environments.

With many medical devices going mobile for the first time, manufacturers new to Wi-Fi must adopt strategies for ensuring products can maintain wireless connectivity in challenging health care environments and under diverse traffic and environmental scenarios.

Even with strict compliance to standards and routine certification by the Wi-Fi Alliance, deployments in health care facilities face unique complexities and challenges that must be modeled early in development. Manufacturers must validate in advance that new devices will meet user and regulatory expectations for intended use or risk an adverse event. For example, missed alerts resulting in a delay in patients receiving critical care can lead to financial loss, liability, regulatory recalls, and damage to brand reputation.

Both device makers and those deploying Wi-Fi networks in health care environments are adopting new strategies for evaluating performance prior to introducing products and applications.

Prepare for Increased Traffic
In many hospitals, wireless local area networks already support hundreds of devices used by nurses, clinicians, and other staff members as well as patients and guests. In optimizing networks to support these and other life-critical devices, the best practice is to assess network readiness for additional clients and services, and the quality each is likely to expect. The following factors must be addressed to help ensure success:

Capacity vs. coverage: When wireless access first was introduced into health care environments, any connectivity was considered better than none, and virtually any level of application performance was deemed acceptable. Focusing primarily on connectivity, network architects attempted to minimize installation costs by using the minimum number of access points required to blanket an area. Unfortunately, this typically created an unsatisfactory user experience. Modern health care networks must be designed with actual network capacity in mind to ensure the necessary quality in high-density, heavily trafficked areas.

Device selection and interoperability: During network design and vendor/device selection, site surveys must be conducted using actual devices to measure their impact on each other and the existing or intended network and applications. Those designing Wi-Fi networks must determine the best choices for both wireless local area network infrastructure equipment and specialized wireless medical devices based on their individual performance requirements.

Optimal roaming: Because people and devices both are constantly on the move, roaming tests must be conducted. Actual traffic and devices should be used to benchmark the impact of various roaming procedures on users and applications.

Target rates and service-level agreements: A comprehensive evaluation of an intended site should be conducted during the planning stages to help set and gauge performance against target rate and service-level agreements for each traffic type. Traditional site surveys conducted prior to embarking on Wi-Fi initiatives must evolve into comprehensive site assessments.

Modern site assessments eclipse traditional surveys with their ability to generate real application traffic to measure the quality of the experience from the user perspective instead of inferring it from rudimentary signal strength measurements; replicate live network environments, including facilities’ unique traffic mixes, environmental challenges, and peak conditions; assess true network capacity to allow IT teams to determine optimal repositioning of access points and the power configurations needed to maximize capacity; and model what-if scenarios to assess growth and future upgrades.

Fortunately, modern site assessments can be conducted quickly and cost-effectively, often assessing multiple devices and variables impacting performance during a single sweep through a facility.

Increased Mobility on the Horizon
For health care device makers, the new best practices center chiefly on re-creating live network conditions in development and quality assurance labs. By simulating deployment conditions, various access points, and traffic from numerous other devices, manufacturers can fine-tune the capabilities of new devices to roam, interoperate with existing Wi-Fi networks, and deliver a high-quality user experience.

Early evaluation of real-world performance in the design and development cycles aids in choosing the appropriate radio-frequency components that play a pivotal role in determining a device’s ultimate performance. Manufacturers also can tweak and recommend configurations that are optimized for specific application and service-level requirements.

The Future of Mobile Health Care
If the risks associated with poor performance can be effectively mitigated, innovations in mobility will continue to revolutionize health care. With network and data system health affecting patient health like never before, reliability precludes liability. But armed with actionable insights gleaned from new best practices, the industry can look forward to leaps in speed, efficiency, and accuracy that only new degrees of mobility can deliver.

— Joe Zeto is director of product marketing for Ixia.