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advertisement Articles :: More Healthcare IT Articles Email a friend Comments Wireless Technology and Healthcare By Obi Igbokwe - Email Obi Igbokwe Can wireless techonology offer healthcare organizations another option of using technology to improve the delivery of healthcare?

Wireless technologies have been used to transmit medical information for almost 80 years. In the early 1920s the US Army Corps developed a wired wireless electron ic stethoscope for potential use in ship-to-shore transmission of cardiac sounds . Today, many healthcare providers and administrators are considered mobile empl oyees and often require mobile information access and messaging tools to improve communications, control accessibility and enhance decision making capabilities. The driving force for IT during the 1970s, 1980s and 1990s was the advance in se miconductor design and manufacture with emphasis being placed on smaller sized a nd lower powered components as a means of increasing physical mobility and perfo rmance of systems and other electronic devices. This has led to a proliferation of such devices as laptops, personal digital assistants and wearable computers w ith an increase in the demand for wireless networks. With affordable wireless communications technology and availability of inexpensi ve wireless-based laptops, portables and CD-ROM based problem resolution and dia gnostic technology, the value of wireless technology is clearly seen in improvin g service productivity, efficiency and profitability. Though healthcare organizations have been slow to embrace wireless technology, m

ore and more organisations are finding that they can save money and improve care with this technology, and as it eliminates the need for wired connections, it i ncreases mobility of the patients and healthcare professionals, invariably impro ving treatment outcomes. At the Baylor College of Medicine, Houston, Texas, wireless technology has allow ed the transmission of 12-lead electrocardiogram (ECG) waveforms from remote loc ations to handheld computers of cardiologists. There is no significant differenc e between in interpretation in the results using the handheld liquid crystals di splay (LCDs) screens and the traditional paper but the immediate accessibility o f the results leads to a reduction in treatment time. At Nottingham University, wireless cardiotocography via RF telemetry has been us ed to monitor the condition of the fetus during labor and has potentials for bei ng adapted for other multi-patient monitoring applications. Wireless terminals h ave also been used to access medical data during ward rounds at the renal unit o f the Glasgow Royal Infirmary. Wireless technology has been motivated by the increasing importance of portable computing applications. At its very basic, wireless technology refers to the use of radio or infrared signals instead of physical connections to link two or mor e components - a wireless network. However mobile computing devices have been so metimes been lumbered as wireless as well. Although they probably will not replace wired networks completely, wireless netw orks will be used to fill several niches in network applications. Wireless netwo rks are principally classified into three broad categories: Wireless wide area networks (WWANs): These cover wide areas such as cities and a llow mobile devices to connect on to the Internet. It also makes provides of wir eless telephony services for voice communication and data transmission. Wireless local area networks (WLANs): These cover a smaller area, from a couple of meters to a city block or university campus. Functions like a wired LAN. Personal area networks areas (PANs): These allow for peripheral devices such as mobile devices, keyboards, mice and printers to be connected to printers without any wired connections. Wireless LANs are often used in medical environments but with multimedia capabil ities such as CD-ROM drives and MPEG decoders making their migration towards por table devices, wireless extensions to broad band networks would be needed to sup port user requirements. The basic idea is to provide a network that is both wire d and wireless with an environment that has uniform protocols applications acros s both mobile and fixed devices. In 1997, IEEE (Institute of Electrical and Electronics Engineers) adopted IEEE 8 02.11, a family of specification, as the standard for wireless LAN with the most popular version being IEEE 802.11b (commonly referred to as Wi-Fi). Using this standard, wireless LANs can be safely installed in hospitals as they hardly caus e any malfunction of medical equipments. Although WLANs do not transfer as much data, nor as quickly as wired LANs do, on e of the advantages they offer is devices that communicate over the network can be used virtually used anywhere within the reach of the network without having t o have hardwired terminal, and they are often easier to install as they no not r equire wires. At the Jikei University Hospital in Minato-ku, Japan, a wireless reporting syste m was developed using a wireless LAN. The system consisting of a DICOM (Digital Imaging and Communications in Medicine)-based picture archiving and communicatio n system (PACS), a diagnostic server, and portable laptops, is used by radiologi sts, physicians and technologists to review current radiology reports and images

and instantly compare them with reports and images from previous examinations. The systems provides the bling infrastructure and radiology departments of outpatient departments, same functionality as a wired systems, but with less ca has currently been incorporated into the emergency and the hospital with future plans for the operating rooms, hospital wards, and intensive care units.

Meanwhile other wireless networks such as the wireless personal area networks (P AN) connect users with mobile and stationery devices usually within a range of t en meters are becoming increasingly more prevalent in the teleradiology and tele medicine industry. Wireless PAN communications can occur over optical, magnetic, electric and elect romagnetic channels. However the most promising one is the Bluetooth technology. Bluetooth was developed using short-range radio network for personal networking. The original concept was to enable the universal wireless connections for lapto ps to cellular phones but it has become apparent that there are many other appli cations for Bluetooth. Bluetooth supports voice and data transmission and is currently a global standar d meaning that any two devices that are Bluetooth certified would be able to com municate with each other. Bluetooth devices transmit and receive in 2.4GHz radio range and the technology allows up to eight devices to be connected in what is called a Piconet. This Pic onets can also connect to form larger networks called Scatternets. More work is being done using Bluetooth applications for Ethernet access. However Bluetooth has capabilities to provide a universal bridge to existing dat a networks, a peripheral interface, and a mechanism to form small private groupi ng of connected devices from fixed network infrastructure. Even though there is support for data and voice transmission, there are developers who would like to connect other services using this technology. These limitations of Bluetooth have led to emphasis in low-level hardware connec tivity. Thus using technologies such as Sun s Jini or Microsoft s Universal Plug and Play (UPnP) which allows hardware or software services to find and use each oth er in an already established network (regardless of operating system or processi ng platform) will definitely add more weight to the Bluetooth Technology. Thus one can walk into an office with a mobile Bluetooth certified, Jini enabled device which checks the network and communicates with other Bluetooth certified devices within range and would be able to uses the services of other Jini enabl ed hardware or software. At the Glenrose Rehabilitation Hospital, Edmonton, Canada, a Bluetooth wireless databases consisting of a Bluetooth-enabled laptop or PC and a Bluetooth-enabled PDA (personal digital assistant) was developed in aid the data mining of resear ch studies and increase the efficiency of their scoliosis clinics. Each patient has their details in the database which can be viewed and updated b y physicians over a Bluetooth wireless connection. This has improved both the ef ficiency and accuracy of the records, as well as save time as there is no duplic ation of work and no dictation is required. In Germany, vitals signs have been transmitted to a PDA for interpretation using Bluetooth wireless connectivity. The benefits of wireless technology in healthcare could be far reaching if used

in an appropriate manner. Doctors could store information in real-time, access p atient records and medical reference materials from the Internet, send e-mails t hrough handheld devices that are connected to a server. This would ease the burd en of doctors and medical students alike as it impossible to store all the infor mation one needs for patient care in one s memory. The practicality of having a hand held device, which can access and transfer inf ormation could prove to be life saving. In a study done by the Department of Inf ormatics, Columbia University, New York, it was found that wireless computing le d to better access to information and the key success element of the study was t he recognition of critical priorities. Doctors would able to, through hand held devices, transmit prescriptions to pharmacies, check efficacy and side effects o f the possible drugs regimes before making a choice, all at the patient s bedside. Wireless networks would allow doctors in a hospital, with their hand held device s, to stay in touch with each other at all times, arrange their schedules instan taneously and receive results of procedures and investigations not just at any t ime but also almost anywhere within the hospital s vicinity. This would lead to better and more efficient care. Doctors in remote areas can b e equipped with a hand held device and be able to send details of their patients from their homes to a hospital s database, receive the results of any investigati ons or procedures done and access the Internet for any medical reference no matt er where he is and what time it is. This could be especially useful when applied in medical disaster response where communications is frequently inadequate and medical responders need access to adequate, effective and reliable communication . The Bluetooth technology would get rid of computer cables, which are not only a health risk, as it is possible to trip over them but would allow for better spat ial arrangement of connected hardware, freeing up more needed space in hospitals . Moreover it makes for a neater and tidier environment. Bluetooth together with a Jini-aware device would allow a physician into a ward find the network enable printer and a PC running a contact database. The physici an can, through this device, access consent forms and have them printed out in t he nearby printer and without leaving the patient s bedside or hook up his device through the use of cables to either the printer or the PC. He does not need to g o his office to have this done or delegate someone else to do it. Wireless technology does offer healthcare organization options on how to improve the delivery of health care. The European Union have financed a telemedicine pr oject, MERMAID, with global reach and 24 hours, multilingual capability and take s all categories of telemedical applications with the full range of networks cho ices including wireless networks, that would make specialist care available to t he remote patient. A healthcare professional does not have to be in an office to have access to the services of a PC, the possibility of being available anytime, anywhere and from any device, greatly increases the mobility of a doctor. Broadband networks such as WLANs would allow for faster, more stable and much ea sier connectivity to the Internet and other available networks. Being able to se nd and receive information when and where it is needed will not only improve the delivery, speed and efficiency of healthcare but it would also reduce costs, wh ich is an important factor, especially in this era of finite resources. Hopefully having global standards such as Bluetooth and IEEE 802.11 would encour age more healthcare organizations to embrace wireless technology.

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