The Passive Approach

June 24, 2011
Harold Dupper The growing demand from staff and patients for greater access to mobile devices means hospitals are feeling the pressure to implement
Harold Dupper
The growing demand from staff and patients for greater access to mobile devices means hospitals are feeling the pressure to implement wireless networks throughout their facilities.

The big question for most healthcare institutions is whether to go with an active or passive network—active systems are able to control electrons, while passive systems are incapable of controlling current. Although the debate is not new, it has been intensified as the cost and performance gaps between the two architectures have narrowed.

Platte Valley Medical Center recently selected Horizon, a medical grade wireless utility provided by InnerWireless (Richardson, Texas), to deploy at its new medical center. "The biggest challenge for us wasn't really the implementation of the network, but was making the decision to go with a passive network over an active one," says Harold Dupper, CFO of Platte Valley Medical Center, Brighton, Colo.

Passive versus active

Dupper claims that Vienna, Va.-based Mobile Access (active network) and InnerWireless (passive network) were the clear frontrunners in the wireless arena. However, what sparked his attention was hearing the CEO of InnerWireless, Ed Cantwell, describe Horizon as a wireless utility. "It's similar to many of the utilities you place in your building. For example, with an electrical system, you can plug any number of electrical devices into the wall, whether it is a toaster, a computer, or a TV. InnerWirless' distributed antenna system operates in a similar way—we can run a whole host of wireless applications off the same unified infrastructure," he explains.

Another significant benefit of selecting a passive system contends Steve Tobin, industry analyst at Frost & Sullivan, San Antonio, is that the total cost of ownership is often less than purchasing an active network. "Although an active system gives you modularity—it's divided into multiple active components that emit different signal strength and capacity—it consists of numerous elements which can get costly," he says.

In addition, because a passive system has fewer components and "around one third of the access points required for an active system," it requires less maintenance and repair. "You're getting more longevity out of a passive system than you are an active system," says Dupper.

However, Tobin says that having a number of active components gives the system a "tremendous ability to scale, not just during installation, but when you need to go back and add additional applications in the future." Scalability is an important issue for facilities, he says, not just in terms of adding new devices to the network, but also adding capacity to a network, especially as the amount of people using mobile devices increases.

The "deal clincher," says Dupper, was that Inner-Wirelss guaranteed signal strength, outreach capacity and containment for the system. "They said they would engineer a system in which we would receive 99 percent coverage in our building, and that it wouldn't leak outside the facility's walls, which can weaken signals and sometimes cause interference."

Supported devices

Similar to most healthcare institutions, Platte Valley needed its wireless network to cover the full gamut of wireless services and applications, including WiFi, VoIP, first responder communication, two-way radios and paging. "We were particularly concerned with the ability to integrate WMTS (wireless medical telemetry service) throughout our hospital," he explains. Wireless telemetry allows staff to continuously monitor a patient's vital signs from anywhere in the building.

Another important factor for Platte was ensuring that PCS (personal communications services) and cellular devices had consistent and reliable coverage. "The issue of maintaining a fail-proof PCS signal became particularly apparent after the Sept. 11 disaster. A lot of firefighters and first-responders couldn't maintain contact with people in the building because there were so many dead-zones within the twin towers," explains Dupper. The Brighton Fire Department now mandates that hospitals provide full in-building coverage for the department's two-way radios, which the InnerWireless network does, he contends.

Platte has also seen success with coverage of its paging devices, with the rate of coverage improving from 57 percent to 100 percent after the implementation of InnerWireless' antenna, says Dupper. Although paging devices are traditionally used by physicians, Platte has extended its paging services to include "hospitality-like" capabilities.

"There is a strong trend towards providing wireless coverage for patients and family members throughout the hospital. We have taken this one step further and implemented hospitality pagers at Platte. Patients that are waiting for results or to see a staff member no longer need to be tethered to the waiting room—they can go to the cafeteria or gift shop, and be paged when what they're waiting for is ready," says Dupper.

Challenges of implementation

A major challenge of implementation was not the actual installation of the wireless network infrastructure, but working with the vendors that were running applications off the network. "It was difficult to convince vendors that this was going to be a reliable network because the technology was so new, and most of them didn't have any real-world deployable experience with it," explains Dupper. Cisco (San Jose, Calif.) was convinced that it would never work, or at least wouldn't work properly, he says. "Vendors were leery of putting their system in an SLA (surface level agreement) with such a new technology," he explains. "However, if you were to ask them now whether they would go with an InnerWireless antenna, they would do a complete 180—they're all 100 percent behind the system."

Tobin agrees that getting vendors to co-operate and integrate with a facility's chosen wireless network can be difficult. "It's a problem that not a lot of vendors are talking about, but it's a very significant concern for hospitals. Because you're trying to cover a spectrum of applications, all of which run on different frequencies, it's impossible to find a single vendor that offers every wireless application you need. This means that you have numerous devices all running off the same network," he says.

According to Dupper, Platte had a great deal of difficulty finding a WMTS vendor to partner with. Tobin agrees that WMTS is still in its early stages, and that finding a reliable wireless network is tough. "You're throwing around life-critical signals across different departments, trying to carry them over a wireless infrastructure, so it's really important that your bandwidth and payload (the amount of data and the speed of transfer) is sufficient," he explains. In other words, a vendor needs to feel secure that the wireless infrastructure its applications are running on is reliable, and won't experience drop-outs.

"Again, because the technology was so new, there was no blueprint or step-by-step instruction manual. What we did was look for a vendor that would integrate their signal onto the antenna. This meant that they had to ride on the same network as all the other business and communication applications," explains Dupper. Most vendors wanted to disperse their signal on a discreet antenna or AP system. "Out of the telemetry vendors, Phillips (Baltimore, Md.) was the only one who had the courage to do this," says Dupper.

The biggest concern with installing a telemetry system is ensuring that there is no drop out of signal—which can be life threatening if a critically ill patient is being monitored. "With the InnerWireless antenna, we are experiencing no drop-out in any of our applications," says Duper. For this reason, he contends Phillips now prefers to work in an InnerWirelses distributed antenna environment.

The key to successfully implementing a wireless network "will come from infrastructure, application and medical equipment vendors all working together to fit the needs of a particular enterprise," says Tobin.

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