What the doctor ordered

With rising healthcare costs, hospitals and healthcare providers are increasingly faced with the challenges of improving quality of care while simultaneously reducing related staffing, facility, and equipment costs. In light of that, health professionals are looking at the benefits associated with the convergence of medical devices and reliable wireless networking technologies for new ways to streamline process and reduce unnecessary expense. A typical patient room in a modern care facility may consist of a number of different monitoring devices including EKG units, blood analysers, infusion pumps and ventilators. It is critical to the goal of improved healthcare that doctors, hospital staff, technicians, and administrators have access to these devices, as well as medical software applications. To ensure interoperability and communication among differing devices from various medical vendors, a big focus remains in the medical sector on open, non-proprietary, standards and protocols. IP based networking is one such example of an open protocol that has gained wide acceptance over the past decade. IP based networking delivers end users real time access to patient information, reductions in operational costs through remote monitoring and management, and the ability to leverage existing Ethernet wiring, corporate IP networks, and the Internet. For the masses of legacy medical equipment deployed in the field – which may be limited to only serial connectivity (RS232, RS422/485) – IP based network enablement is quick and easy by means of a wired device server. Wired device servers include all of the elements needed for device networking medical equipment: a processor, an RTOS, a robust TCP/IP stack, a Web server, and a wired network connection to provide an Ethernet bridge to the downstream medical device. In addition to using open communication protocols, hospitals and care facilities are increasingly shifting focus from wired to wireless technologies in an effort to more flexibly and cost effectively manage, monitor, diagnose and control equipment. Examples of medical wireless technologies include IEEE802.11a/b/g/n, Bluetooth, Ultra wideband, ZigBee, and WiMAX. Each of these wireless technologies offer differing attributes, strengths, and characteristics, and were designed with differing applications in mind. Commonly referred to as Wi-Fi, IEEE802.11 is currently the most common method for wireless communication in a medical setting. While not without its faults, IEEE802.11 deployments are easy to support, readily available and deliver on the promises of reliable performance while being relatively cheap to deploy. Additionally, IEEE802.11 offerings are popular with medical device manufacturers because they are available in both embedded and external ready-to-use device server forms. Similar to the wired device servers noted earlier, wireless device server modules include a processor, a real time operating system, a robust TCP/IP stack, a Web server, IEEE802.11 RF radio, radio drivers, a wireless protocol stack, and memory. By using a wireless device server, medical manufactures can quickly and easily integrate IEEE802.11 into their equipment, saving time and avoiding resources to develop protocols. Legacy systems already deployed in the medical field will typically not include the preferred IEEE802.11 connectivity as standard, but by adding an external device server as a connection bridge, one can simply add Wi-Fi connectivity. This process costs a fraction of that which would otherwise be incurred in replacing expensive and often trusted legacy equipment, resulting in a significant cost savings. In addition, IEEE802.11 is increasingly being adopted on account of its ability to deliver a robust and secure offering in sometimes harsh or hostile environments. As with many applications where sensitive data is being exchanged wirelessly, security comes into question. Commonly referred to as the 'man in the middle' situation – whereby a third party eavesdrops on the communication between two systems – data being shared over wireless connection is theoretically susceptible to attack. With this in mind, the Wi-Fi Alliance has recommended using IEEE802.11 and Wi-Fi Protected Access (WPA or WPA2) to secure wireless networks. It is essential for developers to choose components and device servers that come complete with WPA and WPA2 Enterprise. These levels of security have been accepted by many medical organisations. With the addition of WPA and WPA2, Wi-Fi has matured to a point where it can provide a cost-effective path to wirelessly enable many medical device endpoints, while also satisfying stringent security and privacy concerns. As the number of Wi-Fi medical deployments increases, we can expect to see a number of interference and bandwidth issues as many wireless endpoints will be working in close physical proximity. This is especially true in the 2.4GHz band of IEEE802.11b/g which is also home to Bluetooth based devices, cordless phones, microwave ovens and other consumer based IEEE802.11b/g Wi-Fi networks. As an alternative to IEEE802.11b/g, bandwidth and interference issues can be alleviated by designs which supporting IEEE802.11a and IEEE802.11n. Both IEEE802.11a and IEEE802.11n are capable of operating in the 5GHz band, thus providing comparably less interference than may be experienced in the 2.4GHz band. In addition to bandwidth and interference issues, those deploying IEEE802.11 need to also consider the number of Access Points (AP) required to setup a reliable Wi-Fi service, because the effective range of IEEE802.11a is less than that of IEEE802.11b/g. While having more APs addresses range issues, there are obvious cost implications. However, if networked intelligently, an appropriate number of APs can guarantee optimum coverage, performance and reliability. Wirelessly networking medical equipment, new or legacy, allows operators and care providers the ability to connect, control, and monitor these devices regardless of location. This type of connection permits authorised users to manage such equipment remotely; something that is becoming a major consideration for improving the quality of healthcare cost effectively. Wireless network connectivity can play a key role in automating and safeguarding data collection and dissemination, remote patient monitoring, and asset tracking, ultimately reducing service costs – all key considerations for the decision maker in the health care sector. Wireless networking helps to speed blood glucose testing Maintaining patients' blood glucose levels within a very narrow range has been shown to reduce mortality and morbidity among critically ill patients. However, this approach presents a logistical challenge because of the frequency at which blood glucose testing must be performed. To improve operational efficiencies, healthcare institutions – particularly in the US – are requiring information faster, if not in real time. LifeScan looked for a solution that would provide this functionality for its OneTouch DataLink Data Management System. Their ideal solution would be a small, wireless, scalable device that could integrate into the existing product suite and connectivity solutions. Using its WiBox wireless device server, Lantronix helped speed LifeScan's time to market by developing a small, battery operated unit specifically designed to meet the mobility requirements of the point of care environment. After performing a blood glucose test, the unit wirelessly transmits the results, then powers down to save battery life. This feature is especially important because of the need to perform many tests in a single day combined with the large power draw required by the 802.11 wireless standard. When equipped with Lantronix technology, the OneTouch Flexx Meter and OneTouch DataLink offer additional flexibility to customise glucose testing for individual locations. The most significant benefit is said to be the ability to provide better patient care: more frequent testing of blood glucose levels allows for better monitoring of patient health status.