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To the Bedside and Beyond
Patient safety, mobility drive advances at Most Wireless facilities
By Elizabeth S. Roop

Patient safety, mobility drive advances at Most Wireless facilities

For many organizations, wireless technology is initially an adjunct to the main event—a clinical information system or computerized provider order entry can become even more efficient or provider friendly through mobile access. Once the infrastructure is in place, however, wireless takes on a life of its own. It becomes an inspiration for improvements throughout a hospital, such as more efficient asset tracking and Internet connectivity for patients and families. The organizations on the 2008 Most Wireless list fit this profile: System deployments were the catalyst for wireless adoption, but they have since gone beyond the basics of mobile access to clinical applications.

For these facilities, wireless is a long-term strategy for improving care and quality, streamlining processes and meeting the growing demand from clinicians, patients and guests for connectivity both within and beyond the boundaries of the hospital campus.

“We are breaking down the walls of the traditional hospital,” says Russ Branzell, vice president and CIO of Poudre Valley Health System, Fort Collins, Colo. “Community care is no longer centered on the hospital, it’s centered on the patient.”

High-Speed Communication

Poudre Valley began exploring wireless five years ago. To achieve its goal of virtually unlimited wireless access across the system, existing buildings were retrofitted to eliminate dead spots, and interfaces were built to provide authorized access to any application via a handheld device.

Medical Center of the Rockies (MCR), a Poudre Valley facility that opened in February 2007, was designed for optimal wireless performance. It features a medical-grade wireless network designed for constant connectivity, voice over Internet protocol, radio-frequency location systems and a communication application that links call lights and bed alarms to providers. MCR also provides wireless bedside medication verification, which boasts a 92 percent utilization rate.

“That is a huge patient safety initiative, and we believe the technology has helped us be successful in the prevention of critical medication administration errors,” says Kay Miller, vice president and chief nursing officer.

MCR uses the GetWell Network, which turns in-room televisions into a network interface that delivers patient education, entertainment services and Internet resources. The patient accesses the network through the use of a wireless keyboard. GetWell also enables real-time feedback, lets patients request special services and “has helped impact our patient satisfaction scores in the sense that it is a phenomenal diversionary activity for both the patients and their families,” Miller adds. 

Mission Hospital, part of Mission Health System in Asheville, N.C., launched its wireless program six years ago with bedside computers and wireless devices for the clinical staff. Since then, the hospital’s infrastructure has expanded to include VoIP and wireless phone systems.

The system created “a wireless environment for physicians and other caregivers that allows a more efficient, high-speed way to communicate patient information among caregivers,” says Joseph F. Damore, Mission president and CEO. “The faster we can give treatment to the patient and get information to the caregiver, the better the quality of care.”

All of Mission’s Asheville campuses and most off-campus facilities are wireless, and authorized access is available to any application in the organization’s information system. Advanced wireless capabilities have also been integrated into the design of a critical care tower, the first five floors of which are slated to open in 2009. In the meantime, Mission continues to focus on ways the technology can expedite communications across the organization.

“What wireless has done is brought the caregiver to the bedside, to the point of care for the patient. Regardless of where the patient is, we are able to accommodate,” says Arlo Jennings, vice president and CIO. “The foremost benefit we’ve received is improved processes of patient care.”

Continuum Health Partners in New York launched its wireless initiative with the rollout of CPOE in 2005. At the heart of its strategy were computers on wheels that allowed clinicians to access patient information and document at the bedside and helped speed up processes such as registration in the emergency department.

Wireless represents a way to “make some real differences in terms of improving efficiencies within the communication structure without contaminating the environment with useless information,” says Gregg Husk, M.D., director of clinical management for Continuum and chair of the Beth Israel Medical Center emergency department. “When you have mobile providers who need to communicate with other [physicians], managing that so it’s efficient really represents the key benefits” of wireless.

Access To New Applications

Like others, the initial wireless push by Baystate Health, Springfield, Mass., was done in conjunction with the rollout of its clinical information system.

“But at the same time, we wanted to enable true remote and mobile access to any of our applications,” says Mark Gorrell, vice president of information services and CIO. “What we did was to reengineer and redesign our entire means of gaining access to all our applications [so] anyone with a laptop or PDA would be able to access any of the applications via the intranet.”

Currently, all three Baystate hospitals and 50 remote physician offices are wireless, which has helped achieve 97 percent usage for its CPOE system. Baystate also has expanded its wireless initiative to include Bluetooth connections and bedside bar coding for medication administration and specimen draws. 

A new clinical information system was also the impetus behind Spectrum Health’s decision to go wireless. The Grand Rapids, Mich., organization launched a bedside initiative centered on wireless tablets but expanded it into an infrastructure designed to accommodate a plethora of handheld devices in use by its community physicians, public access to the Internet in patient rooms, VoIP and wireless capabilities for system-owned physician practices.

“It’s really been about accessibility to our information systems and having the technology that allows clinicians to work more efficiently in the clinical setting and access information in a manner that is least disruptive to the clinical process,” says Patrick O’Hare, Spectrum’s senior vice president and chief information officer.

Responding to clinician preferences played a part in Spectrum Health’s efficiency gains. The organization eliminated tablet computers in favor of COWs and docking stations in patient rooms. Handheld scanning devices have also been introduced for medication administration and phlebotomy as well as for inventory management.

The result is “increased productivity from the clinical side and a time savings businesswise,” says Tom Bronken, M.D., Spectrum Health’s medical director of medical informatics. “Those are the biggest benefits.”

Moving to the Next Level

Despite how far they’ve come with their wireless strategies, these Most Wireless organizations aren’t satisfied with the status quo. By its very nature, wireless technology is constantly evolving, which requires that its users do the same.

“When we first started, there was no good way of roaming from one access point to another,” says Rick Oliveri, Baystate’s director of technology management. “As those technologies [became available], we had to push them out. It’s dynamic, to say the least.”

That’s why a $259 million expansion to Baystate Medical Center has been designed from the outset to accommodate advances in wireless technology. The organization is expanding its current VoIP infrastructure and evaluating the potential to use radio-frequency identification to manage both asset and patient tracking. RFID is currently used in Baystate’s Women’s and Infants’ Building to track newborns. Identifying ways to use wireless to manage infusion pumps and patient monitoring devices to take advantage of safety and efficiency benefits is another priority.

Continuum also plans to pilot RFID applications, as well as converge multiple wireless systems into one infrastructure that can support biomedical devices in addition to IT applications. The goal is better access and enhanced management capabilities.

“Wireless is always about getting closer to our patients,” Continuum CIO Bonnie Sessa says. “The evolving relationship between quality and outcomes will always be at the heart of every decision we make about wireless technology going forward.”

Elizabeth S. Roop is a writer in Tampa, Fla.

Top Wireless Projects

Baystate Health, Springfield, Mass.

Mission Health System, Asheville, N.C.

Poudre Valley Health System, Fort Collins, Colo.

Spectrum Health, Grand Rapids, Mich.

Top Wireless challenges

Baystate Health, Springfield, Mass.

Continuum Health Partners, New York

Mission Health System, Asheville, N.C.

Poudre Valley Health System, Fort Collins, Colo.

Spectrum Health, Grand Rapids, Mich.

This article first appeared in the Fall issue of HHN's Most Wired Magazine.

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