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May 1, 2007
by David Raths
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Nick Christiano warns that when spending on wireless infastructure, paying now is better than paying later.

A revolution is under way at Vassar Brothers Medical Center. Clinicians and staff at the 365-bed hospital in Poughkeepsie, N.Y., are experiencing a new kind of freedom — liberation from medical and communications devices tethered to electrical wall sockets and traditional phone and computer networks. With the installation of a robust wireless network and several new applications, the IT staff is seeking to match the hospital's data gathering and dissemination to the mobility of its employees.
Nick Christiano

The driving force that led to Vassar Brothers' wireless revolution was patient safety, not efficiency.

In early 2004, concerned by national studies about clinical errors and adverse drug events, CEO Daniel Aronzon, M.D., wanted the hospital to consider moving to computer-based physician order entry (CPOE). But because Vassar Brothers is a community hospital with no physicians on staff, hospital executives realized that getting physicians to change their work habits would be difficult.

Nick Christiano, vice president and CIO of Health Quest, parent company of Vassar Brothers, says he warned Aronzon that his chances of success at implementing CPOE were "probably less than 10 percent, just because of the cultural issues."

Christiano and Aronzon next considered nurse-administered medication bar coding. Because nurses are hospital employees, the CEO and CIO pair figured the implementation would have a better chance of success. But after studying some solutions, Christiano wasn't convinced. "This is a very busy hospital," he explains. "Everything is in motion, but these systems were reliant on static devices plugged into the wall. It seemed obvious to me then that we had to go wireless."

After some research, he found a wireless system from Bridge Medical Inc. (purchased in 2005 by Cerner Corp., Kansas City, Mo.). The system allows nurses to quickly cross-check patients' wristbands, medical records and medications.

But once they made the decision to go wireless, Aronzon and Christiano stepped back and envisioned a wireless environment that could help with everything from doctor-nurse communication to patient registration and asset tracking. They decided to invest in a broadband system robust enough to support current and future voice, data, telemetry and RFID applications.

After sending out a request for proposal to several wireless vendors, Christiano was disappointed by the limited response. He says many vendors told him they chose not to bid because the implementation was too large or too complex or they hadn't worked in a hospital setting before.

Vassar Brothers chose a network infrastructure from InnerWireless Inc. (Richardson, Texas). The company describes its passive antenna system as acting "like a wireless utility" that supports wireless LANs, BlackBerrys, cell phones, PDAs and pagers.

Because it involved a complex multi-vendor solution, the hospital chose IBM Corp., Armonk, N.Y., to handle project management. The infrastructure project cost just less than $1 million, Christiano says. While that's almost three times more than a plain-vanilla 802.11 wireless network, he says "every wireless application we consider going forward will plug into it."

He believes some hospitals make the mistake of not investing enough in infrastructure. "They find themselves supporting lots of different individual wireless projects and their network isn't built out to support it," Christiano says. "Well, you've got to build for success, not failure."

New applications

In July 2005, IBM started work at the 515,000-square-foot hospital and adjoining 130,000-square-foot ambulatory care center and finished the build-out within five months. "I only had one complaint in that period," Christiano recalled, "and it was about a little dust left on someone's desk."

Besides the medications bar coding, the infrastructure allows the hospital to address other inefficiencies:

  • Nurses and doctors often had difficulty locating each other via pagers and phone calls. Now, they communicate quickly through wireless devices from Vocera Communications (Cupertino, Calif.) worn around their necks.

  • The registration staff, which uses Invision software from Siemens Medical Solutions (Malvern, Pa.), has shifted from using desktop computers to mobile wireless laptops.

  • Employees are using the "Spot" RFID asset tracking system from InnerWireless to keep tabs on the whereabouts and usage rates of 134 IV pumps. As the asset tracking system is expanded, it is expected to slash the time clinicians spend searching for medical devices.

Marc Holland, program director in health provider research at Framingham, Mass.-based IDC's Health Industry Insights, calls Christiano "very visionary." Holland says that although Vassar Brothers is not a large teaching hospital, Christiano has been able to create an environment that allows it to take advantage of the second generation of wireless network technology. (See sidebar.)