Located in Richmond, Va., Virginia Commonwealth University Health System (VCUHS) is a $1.4 billion organization that includes the VCU Medical Center, a top-ranked hospital by U.S. News & World Report. MCV Hospitals is the teaching hospital component of the VCU Medical Center, which also includes outpatient clinics and a 600-physician faculty group practice. The 779-bed VCU Medical Center is a regional referral center for the state, and is the area’s only Level I Trauma Center. Recently, HCI Associate Editor Kate Huvane Gamble spoke with VCUHS CIO Rich Pollack about a number of issues, including the health system’s major wireless transformation, the challenges involved in balancing different clinician preferences, and the decision to offer EMR access via smartphones.
KG: How long have you been CIO at VCU Health System?
RP: About three and half years.
KG: So the wireless transformation started pretty much as soon as you got there.
RP: Yeah, I got here in December of 2005, and at that time, the extent of wireless was pretty limited. We had a pilot area on the inpatient side, maybe about 2,000-2,500 square feet that was lit up with some Cisco-based 802.11 point solutions for data. That was more of a pilot for the technical guys to gain some understanding and knowledge around what it would take. We had a lot of desire for wireless from our customers and from the clinicians and nurses who wanted greater mobility, but that’s all we had that that time. We had an older version of Ascom phones — the portable nurse phones — that was in place in a number of the inpatient units, and then of course we had point solutions for telemetry of patients in specific areas. There was also use of pagers throughout the organizations and cell phones in some areas, but just the individuals’ own cell phones.
So what I started in 2006 was a push toward an aggressive deployment of wireless infrastructure, both on the inpatient and outpatient sides. On the inpatient side, we have about a 780-bed acute hospital.
We were in an early stage of our EMR roll-out; we were less than halfway when I got here. But it was pretty obvious that in order to affect completion of the electronic medical record — in other words, completely roll it out with capability and functionality in the patient space — we would need to provide at least the facility for wireless use. It kind of went hand-in-hand. So in having that understanding and also that feedback from our clinician partners, I quickly determined that I had to get the wireless out in front of this EMR roll-out. So that’s why fairly shortly after I got here, in early 2006, I gave the directive to my technical staff and my CTO to aggressively pursue rolling out wireless in the hospital and the clinics, primarily focused on the 802.11 data piece.
KG: I imagine you had to lay quite a bit of groundwork in terms of the infrastructure.
RP: We had to invest in both the infrastructure and the equipment. It required upgrading of our backend wired switches in many cases. Because at some point in time, any wireless infrastructure eventually connects t o the wired infrastructure. So if you deploy pretty extensive wireless infrastructure, you find that you are sometimes putting a significant load on your backend wired infrastructure and you need to upgrade that. So we went for a significant upgrade of network switches, the network backbone, etc., to accommodate this ever-increasing deployment of wireless across the enterprise, across both the inpatient and outpatient space.
Around the same time, a couple other things were also going on concurrently. Looking back, we had so many balls in the air at the same time. We were building a critical care tower of about 250 beds that would replace 250 beds in our older building. It had all private rooms and was designed as a state-of-the-art facility. So that was just getting underway at the time that I got there. They basically just had the hole in the ground. I drove toward a complete state-of-the-art wireless infrastructure for this new building. There’s always the advantage when you have a new construction project where you can start clean.
So in the new building, unlike our existing facilities, I wanted to go with a distributed antennae system — we selected InnerWireless — so that we would have guaranteed wireless coverage, wall to wall and floor to floor, and floor to ceiling, wall to wall, for all of the various wireless technologies; not just 802.11, but everything. So we put in a distributed antenna system, we put in a newer Ascom phone system, and we put in connectivity for telemetry. We have wireless connectivity between the nurse call system and the wireless phones, we have five bars of cell phone coverage for the major carriers, we’ve got pagers covered, and everything else. So in that new building, we really are very state-of-the-art, cutting-edge. And we still continued to roll out in the existing building.