Cabling is the backbone on which IT networks function. And yet, as much as 50 percent of healthcare network problems are related to an inadequate or underperforming cabling infrastructure.
As we move forward in the 21st century, digital connectivity and networking technologies have become increasingly important in our everyday life. Just as our homes, offices, schools and factories have joined the “Digital Revolution,” so too has the healthcare industry.
Cabling is the backbone on which IT networks function. And yet, as much as 50 percent of healthcare network problems are related to an inadequate or underperforming cabling infrastructure.
As we move forward in the 21st century, digital connectivity and networking technologies have become increasingly important in our everyday life. Just as our homes, offices, schools and factories have joined the “Digital Revolution,” so too has the healthcare industry.
Today’s hospitals, medical centers and clinics are challenged by a growing and aging population base, increased regulatory compliance, and an overwhelming volume of data generated by advancements in medical technology. At the same time, management is under constant pressure to hold down operational costs while increasing patient safety, care and service levels. Fortunately, technology advances have empowered healthcare facilities to automate many business, administrative and clinical processes to achieve higher levels of efficiency and productivity, and ensure patient privacy, security and quality care.
High-performance, IP-based Ethernet networks are becoming the industry standard. These digital networks enable rapid and accurate transmission of large volumes of data. They also provide an integrated connectivity platform for real-time collaboration, monitoring and control, as well as myriad voice, data, video and multimedia applications designed to improve the overall quality and delivery of healthcare services. One critical success factor in designing a fully integrated, flexible and accessible network is the cabling infrastructure which provides the “on-ramp” to today’s healthcare information superhighway and its near limitless possibilities–the Structured Cabling System.
Structured Cabling Framework
A cabling network is said to be structured when all components are engineered and manufactured to provide optimal performance levels according to accepted industry standards. A properly designed and installed structured cabling system provides a solid framework that delivers predictable and consistent performance, as well as the flexibility to allow the network to grow and change over an extended period of time without making significant changes to the backbone. An optimal structured cabling system should provide resilience, reliability (i.e., maximum uptime), and easy management of moves, adds and changes. A structured cabling infrastructure provides the physical pathways required to transfer data, voice and images between connected computers and other digital devices in real time. Two key elements of an efficient, high-performance network are:
- Transmission speed–the time it takes for information to travel through the system, expressed as Gbps (gigabytes per second);
- Bandwidth or capacity–a measure of how much information can travel through the system at one time, expressed as MHz (megahertz).
“The cable plant is the foundation of the entire network,” says Gartner Inc., a provider of market research on the IT industry. This is especially true in the construction and modernization of mission-critical healthcare facilities. With digital convergence of healthcare information on the upswing, the demand is for these facilities to incorporate enterprisewide networks that encompass:
- Environmental control systems–HVAC, power monitoring;
- Hospital security systems–CCTV, security alerts and surveillance;
- Fire and life safety systems–alarms, sprinkler systems, the Master Clock;
- Internal communications networks–nursing stations, intercom systems, call systems, interactive and on-demand patient TV;
- Patient information systems–admissions procedures, coordination-of-care databases, diagnostic testing and results, blood data and medications, food services;
- Clinical equipment monitoring and control–heart monitors, laboratory information systems, blood refrigerators, cart-based equipment;
- VoIP (Voice over Internet Protocol) capabilities;
- Wireless and mobile communications–mobile computers and PDAs at patient point of care, RFID (radio frequency identification) systems;
- Telemedicine–remote consultations, digital image transfer of X-rays and diagnostic imaging test results.
Convergence of such diverse and complex applications demands an open, standards-based network cabling infrastructure that allows for both a public and private network, utilizing advanced Ethernet, Power over Ethernet and IP technologies. Components of a structured cabling system include:
- Cables to link computers and other networking devices;
- Connectors to terminate the cables and allow simple and flexible “plug-and-play” operation;
- Cross-connect or patch panel fields to allow easy redeployment of cables when network moves, adds and changes are required (Figure 1).
Lack of a robust and solid foundation can put the network itself in jeopardy. In a healthcare network, network performance problems–or failure–are far more than mere irritants, they can be life threatening.
Independent research shows that while the cabling infrastructure represents only 2 to 5 percent of a typical organization’s IT budget, an inadequate or poorly implemented cabling system can account for up to 50 percent of network problems (Figures 2 and 3). An incremental increase in the cabling investment has the potential to provide an exponential increase in network performance, reliability and availability. It can also increase productivity for healthcare service providers and hospital employees, help to ensure patient safety and provide measurable return on investment for the enterprise.
Given these statistics, hospitals across North America should be built not just for the present, but also for the future, especially since most healthcare facilities are constructed for a lifespan of 50 years or more. As Gartner Inc. concludes, “The wiring plant is arguably the most important part of the network. Spend the time and money to ensure that what is installed will be able to support the environment well into the future. …”
Industry Standards: A Major Factor
Standards play a major role in providing uniformity of cabling infrastructure design and offer performance benchmarks that may be used to evaluate and compare different systems. However, when it comes to the design and installation of a standards-based cabling infrastructure, the healthcare industry is unique. In a commercial premise installation, the focus is typically on optimization of the telecommunications system. In healthcare facilities, the primary consideration must be patient and operational safety.
This dynamic is fully recognized by the Telecommunications Industry Association (TIA). In June 2004, the TIA TR-42.1 Engineering Subcommittee formed a task force group to examine the requirements for structured cabling within healthcare environments, and provide recommendations relative to any changes, modifications and/or additions required to the existing ANSI/TIA/EIA-568-B.1 Commercial Building Telecommunications Standard of 2001.
The project leader of that task force is Henry Franc of Bell Canada. According to Franc, the purpose of the task force is to increase awareness in the healthcare industry of the potential benefits of having a comprehensive strategy for structured cabling system design and installation.
“With the increased adoption of computerized clinical systems in hospitals, the data network is even more mission critical than in the past,” notes Franc. “For this reason, cabling system designers, integrators and contractors need to work closely and collaboratively with a design team comprised of the architect, engineers and system designers, as well as the facility’s management, security chief and clinical experts who are knowledgeable about the specialized requirements of clinical operations, hospital administration and patient services. Without new and universal standards, healthcare facilities will continue to be designed, built and managed as they have been over the past 25 years, and this would be ineffective, inefficient and costly. Building and managing a state-of-the-art centralized network not only reduces implementation costs, but will also dramatically reduce ongoing administration time and costs.”
This year, the healthcare cabling task force group completed its standards review and made multiple recommendations to the TIA relative to reliability, redundancy, and diversity, security and disaster recovery. The resounding message from task group members is that, although reliable and efficient networks are critical in healthcare facilities, the infrastructure requirements must take a back seat to clinical operations–but they must do so in a predictable, planned and consistent way.
“Formulating a team-based ‘technology vision’ right from the start is the best way to ensure a networking system that meets all requirements for network consolidation and integration–even with legacy systems. It is also the surest way to provide a ‘plug-and-play’ Ethernet over IP structured cabling system designed to meet current and future needs for many years to come,” Franc concludes.
Selecting a Structured Cabling System
Typically, in healthcare environments, the ideal cabling framework will include an optimized mix of copper and fiber-based cabling, designed to fulfill mission-critical functions within each network area, while taking into account patient safety, network performance, and reliability and cost factors. Since performance requirements may vary throughout the network, the structured cabling system may include Category 5e, Category 6, Beyond Category 6, and Fiber-to-the-Desk components, depending on the functionality being supported in each area, and the speed and bandwidth required for these functions.
Key elements to look for in specifying a “future-proof” cabling system infrastructure include:
- Superior quality system components engineered for network optimization;
- Holistic system design incorporating the new industry standards;
- Quality installation by a team of skilled and certified field technicians;
- A robust and reliable cable management system, including remote diagnostics and repair;
- Networking system certification and long-term warranties from the manufacturer and installer.
There is no denying that convergence is driving a dramatic transformation of the healthcare industry–a transformation in which medical and information technologies play a huge role. Careful and collaborative planning of the cabling infrastructure, at the design stage of healthcare building construction or modernization, can not only save millions of dollars over the long term, but can also ensure that the network it supports will perform reliably for many years to come.
For more information about structured cabling solutions from Belden CDT,
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Paul Kish is director of Belden IBDN Systems and Standards for Belden CDT Networking, with corporate headquarters in St. Louis, Mo. Contact him at [email protected].
Henry Franc is marketing manager of cabling and power systems for Bell Canada. He can be reached at [email protected].
The Telecommunications Industry Association (TIA) is a leading non-profit trade association serving the communications and information technology industry.
For additional information on the TIA TR-42.1 Engineering Committee’s task force group review and recommendations, visit www.tiaonline.org.