Healthcare Beyond the Office with Mobile & In-Vehicle Networks. Healthcare IT Enabled by 4G LTE WHAT YOU LL GET: White Paper / Healthcare

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1 White Paper / Healthcare Healthcare Beyond the Office with Mobile & In-Vehicle Networks Healthcare IT Enabled by 4G LTE WHAT YOU LL GET: ++ An overview of how wireless connectivity is enabling healthcare to be more flexible and competitive ++ Considerations for choosing healthcare solutions that ensure secure, reliable, and cost-effective network connectivity ++ How 4G LTE improves the delivery of care and patient satisfaction ++ A customer success story featuring St. David s Foundation Mobile Dental Program

2 It s time for healthcare providers to change the way they think about their services. No longer is healthcare simply about healing sick patients in the confines of the office or hospital. Growing competition driven by changes in public policy and consumer expectations mean that healthcare organizations must find ways to meet patients where they want and need healthcare the most which requires extending care, and connectivity, beyond the boundaries of traditional healthcare facilities. With the Internet at their fingertips, patients now feel a greater sense of empowerment and choice, which is driving the consumerization of healthcare. Today s consumers are savvier, have higher service expectations, and are more comfortable with technology. They seek providers who not only care, but whose service offerings enable wellness. Additionally, sweeping changes ushered in by the Affordable Care Act, along with growing business pressures, have begun to turn the standard reimbursement model on its head, shifting from a pay-for service model to a pay-for-value model that focuses on wellness and prevention. THE HOME HEALTHCARE MARKET IS PROJECTED TO REACH $303.6 BILLION BY 2020.¹ New paradigms in healthcare IT promise care providers the best of both worlds: superior care with greater flexibility. The growth of 4G LTE networks now lets medical professionals sever traditional ties to the office and use high-speed, reliable connectivity to enable key wellness programs and bring advanced care to patients anywhere and everywhere. The growing number of healthcare professionals who see patients at home or even in their workplaces use mobile networks to ensure secure, compliant connectivity from anywhere to quickly update charts, check patient prescriptions, review reference materials, and communicate with the patient s team of providers, all without having to return back to the central office. Similarly, from first responders to public health providers, healthcare professionals who do their work on the road rely on in-vehicle networks to transmit lifesaving information and update patient records without having to return to the central office. This white paper explores how healthcare IT administrators are enabling mobile Internet access through 4G LTE; considerations for choosing healthcare solutions that ensure secure, reliable, and cost-effective network connectivity; and the advantages of 4G LTE connectivity over traditional wired solutions Cradlepoint. All Rights Reserved cradlepoint.com 2

3 IN-HOME CAREGIVERS Global home healthcare device and service revenue are expected to grow to around 12.6 billion U.S. dollars by As many families seek skilled nursing for aging loved ones, they are choosing in-home care as a more cost-effective and convenient alternative to nursing homes or assisted living facilities. Additionally, patients with chronic diseases or physical disabilities may be unable or unwilling to leave their homes to receive care. Finally, a growing expectation for personalized medical treatment and more convenience means that some patients simply prefer to be treated at home. All this means that healthcare organizations must grow their footprints and find the most effective ways to deploy more personnel out of the office and into homes. Cloud-managed mobile routers with 4G LTE connectivity let healthcare providers take the network wherever the demand for care calls them. With their own mobile routers small enough to fit in an easily transported bag, caretakers enjoy a secure and reliable Internet connection for accessing reference materials, , and patient medical and prescription histories. At the central office, network administrators can remotely monitor and troubleshoot hundreds or even thousands of deployments, manage employee mobile devices, and more easily meet security compliance requirements. TELEHEALTH & M-HEALTH Providers, public health organizations, and researchers searching for ways to make wellness a regular part of every patient s life are pioneering new ways to meet (and sometimes treat) people where they already are whether that happens to be at work, at home, at the mall, or on the street. Emerging trends in Telehealth focus on connecting providers to one another from remote locations. For example, a healthcare professional deployed outside the office perhaps at a home or office visit, or at a mobile diagnostic station, or even at another clinical location may use Internet connectivity for video conferencing to consult a specialist back at the office in real time. The clinicians may share electronic medical records and review scans or X-rays together. In this way, healthcare providers can better leverage their own resources, as well as provide more convenient service and better preventive care to patients who might otherwise be left undiagnosed or untreated. As competition continues to grow among healthcare organizations, Telehealth also provides significant competitive advantages. By making it possible for highly trained specialists to treat patients in tandem with an on-site professional in a remote location, healthcare organizations can more effectively leverage their top professionals and offer superior service. EMERGENCY RESPONDERS In the past, emergency paramedics arrived on scene with the tools and knowledge to assess the patient s status, but physicians in the emergency room, without the ability to receive that information in real time, were often largely left in the dark. Today, in-vehicle Internet connectivity allows emergency medical personnel to send triage information and patient medical histories ahead to the emergency room from the road. While the patient is en route, emergency room staff can monitor vital signs, review photos or videos that might help diagnose the patient, check for potential prescription interactions, and offer treatment instruction to paramedics. Armed with to-the-second information when the ambulance arrives, emergency room personnel can hit the ground running, saving time (and lives) in the process Cradlepoint. All Rights Reserved cradlepoint.com 3

4 MOBILE CLINICS Location, location, location: underserved populations face many challenges in getting needed healthcare, but just getting there is one of the biggest hurdles. Over the past two decades, healthcare providers and public health organizations have taken to the streets in droves to provide care where it s often needed most. In the past, lack of Internet access created massive challenges and administrative redundancies. With the advent of cloud-based applications and 4G LTE, patients at today s mobile clinics can receive some of the most advanced healthcare services without ever setting foot in a traditional doctor s office. With in-vehicle connectivity, mobile clinics can: + Connect patients to physicians and specialists in a remote location via a Telehealth video system + Update electronic health records in real time and store them in the cloud + Conduct testing, monitor vital signs, and transmit results for review by a physician or specialist in a remote location + Provide secure text messaging between providers and patients 2015 Cradlepoint. All Rights Reserved cradlepoint.com 4

5 Recently, Verizon, Miami s Children s Health Fund, and the University of Miami partnered to launch a mobile healthcare clinic for the city s underserved children. Among other advanced functions, the clinics allow highly trained medical experts at the University of Miami to meet via video with children who would otherwise likely go untreated due to financial hardship or geographic barriers. Mobile clinics equipped with wireless Internet connectivity are playing an integral role in making healthcare more accessible to those populations who struggle most to obtain care. CHALLENGES Mobile healthcare has the potential to completely transform medicine, but technologies that enable mobile healthcare are still relatively untested. Regardless, those providers who work to be among the first to successfully implement these technologies will find themselves on the cutting-edge of patient care. The following are some challenges and best practices network administrators should consider when implementing mobile connectivity in healthcare contexts. CENTRALIZED MANAGEMENT For optimal operation, wireless routers require regular software and firmware updates, configuration, maintenance, and troubleshooting. Depending on the application, a deployment may include dozens or even hundreds of routers, making it logistically unrealistic to dock all deployments each week in a centralized location in order to install updates or troubleshoot. Solution: A connectivity solution should utilize cloud-based management software to enable software/firmware updates, configurations, security patches, and maintenance of wireless devices from a remote location while ensuring that sensitive data stays safe. VEHICLE COMPATIBILITY Mobile routers use the vehicle s battery as a power source, but the device can drain battery voltage in cars and buses, causing brownout or blackout when the vehicle starts and eventually ruining the router. Solution: Identify a router that features a 9-36 DC voltage input range, has built-in transient and reverse polarity voltage protection, and uses ignition sensing for an optimal in-vehicle network. This ensures that both the vehicle and the router stay safe, particularly when starting the vehicle, and that the battery is not drained when the vehicle is shut off. DURABILITY Routers should be able to withstand extreme temperatures, both when the vehicle is in operation and when it is being stored. Consumergrade, non-ruggedized hardware cannot withstand these environmental challenges. Solution: Devices should be designed to endure temperatures between -20 degrees and 60 degrees Celsius. Additionally, because vehicles often experience high levels of vibration, routers must be capable of withstanding rough terrain without coming loose from the vehicle or breaking Cradlepoint. All Rights Reserved cradlepoint.com 5

6 INTEROPERABILITY With multiple carrier options available and a patchwork of service areas along any given route, choosing a 3G or 4G provider can be confusing. Solution: Unique reception needs should be studied and evaluated prior to choosing a carrier to ensure the proper plan and carrier for each situation, including an analysis of service and route maps and a test drive. Better yet, a router that includes dual modems will allow for multi-carrier interoperability in the same device. NETWORK SECURITY SECURITY BREACHES OCCUR AT ONE IN FIVE HEALTHCARE ORGANIZATIONS.² Security considerations are often the top hindrance for network administrators. Indeed, security considerations are complex and multi-faceted. Should a data breach result in patients personal, medical, or financial data being stolen, the resulting fallout could damage the provider s brand, potentially scuttling any pilot projects not to mention that the provider could be subject to fines for failure to comply with HIPAA or Payment Card Industry (PCI) guidelines. Fortunately, advances in hybrid to cloud solutions now offer healthcare providers the ability to create highly secure environments. It is critical to note that before any other security measures are considered, network administrators should ensure PCI 3.0 and HIPAA-compliant encryption of all health, personal, and credit card data. The following additional considerations represent a slate of important but by no means comprehensive safeguards to consider. NETWORK INFRASTRUCTURE One of the first steps to ensure robust security is to choose the correct network infrastructure for the application. Network administrators should consider whether their applications and security policy require using a private network. If using a public network, network administrators should choose an encrypted Virtual Private Network (VPN) Cradlepoint. All Rights Reserved cradlepoint.com 6

7 In some settings, such as remote branch office locations, if network administrators anticipate that public IP access and visibility are required, and credit card or patient health and personal data will be stored locally, the administrators should consider employing Parallel Networking through 4G LTE connectivity. Parallel Networking creates complete air-gapped separation between devices that are most likely to be hacked and those that store patient health and personal data by placing those devices on their own completely separate networks. In this way, Parallel Networking helps ensure that devices that make easy security targets are not leveraged by hackers to pivot to lucrative information in harder-to-crack areas on the network. MANAGEMENT The chosen network management solution should offer controls that separate management data from user data. In this case, configuration, statistics, and monitoring data will be transmitted from the router over a secure Internet connection to the cloud management platform, while user data is transmitted directly to its destination on the Local Area Network (LAN) or across the Wide Area Network (WAN). UNIFIED THREAT MANAGEMENT, PAYMENT CARD INDUSTRY, AND HIPAA COMPLIANCE Administrators managing mobile and branch office applications may seek a Unified Threat Management (UTM) solution to comply with HIPAA and PCI requirements. UTM provides layered security to combat the newest methods that hackers use to access sensitive data. Gartner defines UTM solutions as possessing the following capabilities: + Stateful Firewall + VPN & Network Segmentation + Network Intrusion Protection + Secure Web Gateway (SWG) + Content Filtering + Web Security SUCCESS STORY: ST. DAVID S FOUNDATION MOBILE DENTAL CLINIC Based in Austin, Texas, the St. David s Foundation Mobile Dental Program operates a fleet of mobile dental clinics that serve the Central Texas region. Connecting the clinics to its main office using 3G technologies resulted in recurring network interruptions and slow speeds, both of which caused problems with The Foundation s ability to synchronize each clinic s sensitive patient healthcare database with the central database. By upgrading to Cradlepoint s 4G LTE platforms and Enterprise Cloud Manager, The Foundation now has stable, highly available network connectivity, the ability to quickly synchronize each dental clinic s database, and centralized cloud-delivered network control. Our Cradlepoint-enabled network connectivity has brought new efficiencies to our clinical and operational workflow. It enhances productivity and facilitates smooth delivery of clinical services for patients and staff. MADGE VASQUES, DIRECTOR OF DENTAL OPERATIONS 2015 Cradlepoint. All Rights Reserved cradlepoint.com 7

8 Network applications within the scope of Payment Card Industry (PCI) Compliance guidelines must have Intrusion Detection Services and Intrusion Protection Services (IDS/IPS). Likewise, HIPAA guidelines strongly imply that networks transmitting patient health data should use IDS/IPS. Additionally, whenever there is an opportunity for a network user to invite threats onto the network (either accidentally or purposely), administrators should utilize an Internet security solution such as Zscaler Internet Security, which is scalable, agile, and provides to-the-minute security. To reduce the risk of compromising patient data, some providers use cloud-based data storage as a means to comply with HIPAA and PCI physical safety requirements while enabling mobility. Keep in mind that HIPAA and PCI standards provide guidelines on configuration, encryption, and more that should be referenced throughout the planning and deployment process. UNIFIED THREAT MANAGEMENT & BEST-IN-BREED SECURITY APPLICATIONS CP Secure Threat Management is a comprehensive intrusion prevention (IPS) and intrusion detection system (IDS) that can be deployed instantly through the cloud. Combined with Cradlepoint cloud-managed networking solutions, Zscaler Internet Security enables enterprises to embrace cloud applications and mobility, all while delivering a superior user experience. ABOUT CRADLEPOINT Cradlepoint is the global leader in cloud-delivered 4G LTE networking solutions, providing secure, business-grade connectivity for mobile and in-vehicle healthcare solutions. Cradlepoint was the first to pioneer and fully enable high-speed LTE in its solutions to maximize the potential of the cloud for enterprises worldwide. Sources 1 Cheatsheet.com 2 Securedgenetworks.com Cradlepoint s 3G/4G/LTE solutions enable Parallel Networking, which keeps credit card and other sensitive data completely separate from other applications and third-party networks. Cradlepoint s Enterprise Cloud Manager combined with Advanced Edge Routing (AER) solutions enable best-in-breed network security applications. Powered by Trend Micro s industryleading Deep Packet Inspection (DPI) engine, GO TO CRADLEPOINT.COM/HEALTHCARE TO LEARN MORE Cradlepoint. All Rights Reserved cradlepoint.com 8