Spotlight on Mobility/Wireless June 8, 2010
Featured Article
Distributed antenna system improves communication at Florida Hospital

With in-building coverage in place, the hospital is poised to take advantage of the next level of collaborative services and devices leading carriers may supply in the future.

An ER patient's chest pain suggests a heart problem. The patient must be moved to the cardiac catheterization laboratory within minutes, and the cardiologist and anesthesiologist must be available for the patient immediately. The fastest way to make this happen is via cell phone, an item commonly carried by the medical staff. Six years ago, Florida Hospital lacked this option; wireless signals couldn't penetrate the cath lab's shielded walls, leaving the doctors without coverage.

While enabling cell coverage in the cath lab was the catalyst driving the hospital to examine its in-building wireless solutions, the IT department soon realized that the hospital's requirements were far more extensive. With more than 16,000 staff and 2,200 beds, Florida Hospital in Orlando is one of the busiest hospitals in the nation and has "the needs of a small city, including cell phone coverage," according to Florida Hospital CTO Herb Keller.

With healthcare workers increasingly relying on mobile devices for everything from lab results to consults, indoor cell coverage is no longer a luxury. Today, it is an infrastructure necessity - as basic a need in hospitals as air conditioning.

Doc, can you hear me now?

Like all hospitals, Florida Hospital faced the challenge of dense construction, which blocks carriers' signals. Yet today this technology is foundational to the hospital's efficiency and quality care. From physician and provider interaction to patient care, referrals and consultations, cell coverage is necessary for doctors to do business.

It is even becoming common for nurses to bypass calling a physician's phone service or office and connect directly via cell phone. In this environment, dropped calls or the inability to get service is unacceptable.

One of Florida Hospital's current initiatives to ensure that critical results get to physicians quickly is centered on smart phones. The hospital's 2,000 physicians need timely data at their fingertips, wherever they are. "By cutting out the middle man, we can get immediate access to the physician and be more efficient," says Dr. Andrew Svetly, Florida Hospital's chief medical information officer.

In-building antenna system

Florida Hospital considers itself an industry leader for its use of wireless. A wireless network user since the mid-1990s, the hospital now has nearly ubiquitous 802.11 wireless coverage from Cisco.

The hospital also distinguishes itself in the wireless realm for its use of a distributed antenna system (DAS), a network of antennas connected to an RF source that provides wireless phone coverage in designated indoor areas.

In 2005, Florida Hospital deployed its first DAS. After evaluating multiple vendors on ease of deployment, technology and price, Florida Hospital selected MobileAccess for its flexible, "future proof" modular architecture, low maintenance and cost-effective price point. The MobileAccess 2000 series includes voice and data coverage for all major wireless carriers in central Florida, including AT&T, Sprint/Nextel, AT&T, T-Mobile and Verizon.

"There was a need across the whole business as people were becoming very mobile," says Keller.

Keller explains that since hospitals are always expanding, MobileAccess provides flexibility to extend or upgrade at any time. "We can deliver a core level of service today, and upgrade later to accommodate new or more advanced services," he says.

How it works

Florida Hospital worked with engineers and MobileAccess partner Coleman Technologies to install the DAS, following these steps.

  • Install central head-end equipment to receive the carrier signals. These may be sourced from the towers or directly connected.
  • Connect fiber optic cables between the head-end and the MobileAccess 2000 equipment in IDF closets. The fiber allows minimal signal loss over great distances.
  • Install DAS antennas in the ceiling, connected back to the closets. These antennas distribute the conditioned signal and represent the cell tower to a mobile phone.
  • Test the system to ensure fidelity of the signal throughout and to validate the coverage.

Keller suggests getting carriers on board early in the process to keep them on track with project deadlines. Ideally, carriers should be ready to connect their equipment at the same time that the hospital is ready to bring the system up.

Keller shared that "a significant distinguishing point for MobileAccess is that once the DAS is in place, other carriers can be attached with a small incremental cost." Though Florida Hospital only needed four fiber optic cables from the head-end equipment to each closet, they pulled six cables at install, knowing that they would eventually add new services.

One of the best ways Florida Hospital was able to justify the cost of in-building cellular coverage was by hiring an engineering team from C-Squared Systems. The firm conducted a wireless RF assessment, which the IT team could then share with the CFO and other executives to help justify the cost of a multi-carrier in-building wireless solution.

Keller further justifies the cost of the MobileAccess system by explaining that: "Cell coverage is a mainstay of life, and a small price to pay for patient and doctor satisfaction. With over a million people walking through the doors every year, it was easy to justify."

Lessons learned

For hospitals considering deploying a DAS solution, the Florida Hospital IT team shares the following advice:

  • Integrate DAS into the budget early. In order to cut costs, it is important to include in-building wireless solutions into new construction rather than waiting to retrofit. The MobileAccess DAS is now part of all design plans and construction budgets for Florida Hospital's new buildings.
  • Consider complementing your 802.11 network with DAS WiFi antennas. Florida Hospital uses Cisco WiFi access points that have embedded intelligence and therefore require direct handling when repair is required. With the MobileAccess solution, the intelligent equipment is kept in the IT closet, making it a good fit for emergency areas and surgical suites that cannot afford downtime for repairs. If the access point requires work or troubleshooting, IT does not have to enter a critical medical area.
  • Manage expectations. Keller explains: "The industry has already moved past the phase of 'wow this is cool.' We are now at the point where facilities without [in-building coverage] are in trouble." Know that prioritization can be a challenge; as physicians discover cell phone coverage gaps can be solved with today's technology, they encourage hospital administration to fund these projects immediately.

Quality coverage, quality care

Keller explains that there's so much more that people can do on their phone, and Florida Hospital is open to exploring all of it. He says, "As you push the envelope and as new things get developed, great opportunities arise."

With the in-building coverage in place, Florida Hospital is poised to take advantage of the next level of collaborative services and devices that MobileAccess and leading carriers may supply down the road, be it 4G services (such as LTE) or medical telemetry applications.

"The MobileAccess DAS clearly contributes to better communication," says Keller. "And better communication is what makes everything happen."

For more information on MobileAccess solutions, click here.

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Nelson Publishing, 2500 Tamiami Trail North, Nokomis, FL 34275