Two Ontario hospitals have opted for voice over IP and wireless LAN technologies to help improve internal communication.
Earlier this month at the Wi-Fi Power conference in Toronto, Gerry Dimnik, director of information systems for North York General Hospital (NYGH) in North York, Ont., outlined why the hospital turned to wireless technology for its emergency department (ED).
According to Dimnik, NYGH has one of the busiest EDs in Canada, with about 74,000 annual visits. Before the days of the wireless ED, “we depended on one-way and overhead paging,” he said. When receiving one-way pages, physicians or other medical staff would have to drop what they were doing and search for a landline phone. “It caused a whole bunch of delays,” said Dimnik, estimating that staff was wasting 10 per cent of their day trying to answer pages.
The hospital’s overhead paging system was “more effective, but it was loud and disruptive to patients and staff,” he added. NYGH decided to look for a solution that would address noise level issues as well as reduce critical response times and securely communicate and deliver patient information.
Along with being cost-effective and easy to implement, “we also needed absolute redundancy and failure protection” as well as 24/7 support.
NYGH opted for Stouffville, Ont.-based Lcomm Inc.’s LC2020 passive radio frequency (RF) distributed antenna system (DAS), which, according to Dimnik, gives NYGH 30,000 square feet of wireless coverage, including the triage (patients admission), the resuscitation room and ambulatory areas. Wireless access enables staff to use computers on wheels to retrieve information at the point of care, and contact each other via wireless phones made by Boulder, Colo.-based SpectraLink Corp.
To mitigate security risks, NYGH enlisted in the help of consultants and “third-party validation” including ethical hacking. A single WEP 128-bit key encrypts the network, and is shared between the wireless clients and the access point, creating a single point of failure if the key is compromised.
He said future enhancements include connecting the wireless phones to the Connexall Notification Server, the hospital’s nurse call system.
Changes to the physical structure of Toronto’s University Health Network (UHN) hospitals created a need for wireless technology, according to David Eagan, architect, infrastructure development for UHN. T
he UHN is an umbrella organization that includes three hospitals – Toronto Western (TW), Toronto General (TG) and Princess Margaret (PM) – as well as two foundations and a partner lab. It has a staff of 10,000, and has 47,000 inpatient and day surgery cases per year, as well as 900,000 annual outpatient visits.
In late 1999 UHN introduced a new information management strategy that included a five-year plan to move to electronic charts. It also wanted its staff to access a standard clinical desktop and point-of-care access for information and communication.
UHN planned a physical redesign, mostly for TG and some of TW, to help coordinate inpatient and ambulatory services; it expects to finish the project by January of 2005. But the physical changes involved new workflows.
“The communication piece was falling through the cracks,” Eagan explained, adding that the hospital was losing $127 a minute because room preparation for patient transition was not adequately being communicated. Currently the wireless infrastructure is completely installed in TG’s New Clinical Services Building (NCSB), floors one through 12, with 500,000 square feet of coverage.
A porter call solution for the NCSB’s operating rooms was installed on June 27, 2003, and the ECS was implemented on the NCSB’s inpatient floors from July through December, 2003.
