WLAN-Based Location-Aware Applications for Hospitals

WLAN-Based Location-Aware Applications for Hospitals PanGo Networks, Inc. January 2005 2005 PanGo Networks, Inc. All Rights Reserved

Introduction Hospital environments inherently involve mobility. The constant movement of medical staff, support personnel and critical medical equipment creates an environment different from most office settings where the majority of time is spent behind a desk. Given this intrinsic level of mobility, combined with the tremendous need for timely and accurate patient information and hospital efficiency, it should be no surprise that hospitals have been early adopters of wireless local area network (WLAN) technology based on the IEEE 802.11 standards family (commonly known as Wi-Fi). Today, in fact, many hospitals are engaged in a second phase of planning and deployment of campus-wide 802.11 WLAN infrastructures, augmenting basic network connectivity with higher level services such as voice communication and location awareness. These second-generation WLAN deployments follow on the success of earlier generation pilot deployments which proved that 802.11 WLAN technology worked well in operational hospital environments. This white paper examines how hospitals can achieve rapid ROI by leveraging their 802.11 wireless network for more than just data connectivity. It reviews the key organizational, business process and technological factors that contribute to the rapid deployment of 802.11 WLAN infrastructures within the healthcare environment. Finally, this paper shows how adding complementary 802.11 wireless capabilities, i.e., active RFID (radio frequency identification) location awareness for asset and personnel tracking, enables better patient care, delivers bottom line financial benefits and effectively addresses recent JCAHO regulations for better asset management. WLAN Drivers in Healthcare Numerous factors are contributing to the rapid deployment of 802.11 WLANs by hospitals, including organizational and business process requirements, government and industry healthcare regulations and standards, and new technological developments. These include the increased demand for mobile information access by medical and support personnel, as well as the maturation of 802.11 standards, the proliferation of 802.11-enabled devices, and HIPAA security guidelines. Among these critical drivers are healthcare regulations guiding hospitals towards better asset management. For example, The Joint Commission on Accreditation of Healthcare Organizations' (JCAHO) 2005 Critical Access Hospitals Standard Management of the Environment of Care mandates that all healthcare organizations must develop a "written management plan describing the processes it implements to manage the effective, safe, and reliable operation of medical equipment... and identifying, evaluating and creating an inventory of equipment to be included in the medical equipment management plan before the equipment is used and implement a plan by which they can manage and maintain all equipment used for diagnosis, treatment and other patient care devices." The following are ten key drivers for the rapid deployment of 802.11 WLANs in the hospital environments: 2005 PanGo Networks, Inc. All Rights Reserved 2

Key Organizational, Business Process and Technological Drivers 1. Intrinsically high levels of mobility for medical and support staff who demand access to the same information whether they are mobile or at their workstation. 2. Strong benefits for patient care and hospital efficiency through more timely and accurate information access that drives workforce and workflow efficiency. 3. Government and industry initiatives to advance healthcare, i.e., replacing paper patient files with electronic records and automating workflow using technology such as a unified Electronic Patient Record (EPR), Operating Room of the future, Emergency Department of the future, etc. 4. Healthcare regulations guiding hospitals towards better asset management, e.g. The Joint Commission on Accreditation of Healthcare Organizations' (JCAHO) 2005 Critical Access Hospitals Standard Management of the Environment of Care. 5. Consensus based on numerous studies that the 802.11 family of radio technologies do not cause harmful interference to medical equipment and telemetry devices. 6. Maturation of the 802.11 family of standards to provide high speed (802.11a/g), secure (802.11i), and reliable networks offering good quality of service (802.11e/k) 7. HIPAA security guidelines that are driving the need for strong security measures such as those specified by the latest 802.11i standards. 8. Proliferation of 802.11 enabled devices including notebook/tablet computers, PDAs, VOIP phones, and even new Wi-Fi enabled medical equipment. 9. Economies of scale are rapidly driving down price points for Wi-Fi equipment, which will continue to decrease as annual shipments of 802.11 radios grow from 70+ million units in 2004 to 125+ million units in 2008 (Source: IDC). For example: An 802.11 NIC can be purchased for less than $25, a low-end Access Point (AP) for less than $60, and a full-featured enterprise class AP for about $500. Clearly, 802.11 is becoming the wireless equivalent of the wired Ethernet. 10. The ability to add new services such as location awareness to the standard 802.11 infrastructure will deliver additional ROI from the infrastructure by enabling active RFID capabilities such as tracking of people and assets, and delivery of location-aware content to devices such as PDAs and tablet computers. Providing hospitals extended visibility into their mission-critical assets can drive significant cost savings and efficiencies. 2005 PanGo Networks, Inc. All Rights Reserved 3

The Emergence of Location-Aware Applications Considering the drivers outlined above, hospitals are now rapidly replacing various point wireless solutions with a single wireless network based on 802.11 technologies to provide their mobile workforce un-tethered access to both voice and data services. As hospitals commence these deployments, they are realizing that their existing 802.11 infrastructure can also be used to solve one of their biggest headaches locating things and people. Location-aware applications address the needs of the medical staff, biomedical equipment and facilities team, transport department and the hospital operations team for greater efficiency and improved medical care. Department Medical Staff Transport Biomedical Equipment Team Hospital Operations Team Organizational Needs and Benefits Rapidly locate equipment including IV pumps, vital signs monitors, patient charts and even patients and other medical staff to provide the highest level of patient care. Optimize workflow and improve efficiency by quickly locating equipment, e.g., wheelchairs with IV drip poles. Locate assets for break/fix and preventative maintenance, and understand usage patterns to drive the appropriate asset allocation. Maximize asset utilization and mitigate risk by ensuring the best possible patient and equipment care; continuously drive improvements in overall hospital workflow and efficiency. Recently emerging from companies such as PanGo Networks are software-only location-aware solutions and active RFID asset tracking applications operating on standard 802.11 WLAN infrastructures. These software-only 802.11-based active RFID applications bring to healthcare environment the ability to: 1. Track items affixed with 802.11-based active RFID tags, e.g., medical equipment including IV pumps, vital signs monitors, wheelchairs, etc. or people, including medical staff and patients; 2. Identify the location of devices that incorporate 802.11 Network Interface Cards (NICs) such as notebook computers and PDAs; 3. Integrate location information into asset management and patient monitoring systems. These newer approaches offer advantages over traditional active RFID technologies. First, they use the existing 802.11 WLAN infrastructure which offers significant cost reduction in terms of initial installation and on-going operation/maintenance. Second, they enable opportunities to deliver exciting new applications that combine voice, data and location awareness which can improve patient care and increase the efficiency of processes such as Admissions, Discharge and Transport (ADT). In sum, these new approaches represent a superior, more efficient and cost-effective alternative to first-generation RFID technology that required hospitals to deploy separate, single-purpose networks of proprietary readers, cabling and tags in order to provide location/tracking capabilities. 2005 PanGo Networks, Inc. All Rights Reserved 4

Determining Location The software-only 802.11 location-aware systems use a RF signal strength locationdetermination approach. It is somewhat analogous to the way people can be identified by their fingerprints, which is based on the premise that each individual has a unique fingerprint. For example, if we first capture individual fingerprints and build a database that associates the fingerprints with names, then given a fingerprint to match, we can later search this database to find the identity of a person. The process of implementing 802.11 location-awareness begins by conducting an initial hospital survey that captures RF fingerprints (based on signal strength readings) at various important places throughout the hospital, i.e., each patient room, every operating room, spots throughout the emergency department, in the corridors and at hospital egress points. The principle is that a unique RF fingerprint can be established at each of these locations. These RF fingerprints are then stored in a database and used later at runtime to match the currently observed RF environment to the previously stored data. Using pattern-matching and a series of advanced locationing algorithms, the system can then determine the current location with reliable room level accuracy (~3 meters) of a device or person with either the 802.11 NIC or an 802.11 asset tag. Location information is used by 802.11 active RFID asset tracking systems to display the current location of different types of hospital equipment as well as enable users to search for specific assets (see the figure below). Real Time Asset Tracking System for Hospitals (PanGo Locator ) 2005 PanGo Networks, Inc. All Rights Reserved 5

Implementation Steps for a Location-Aware Solution With an 802.11 WLAN infrastructure in place, deploying a location-aware solution is straightforward. It involves these four steps: Installation of the software, surveying of the hospital environment, installation of the client software and/or asset tagging, and the realtime location and tracking of assets and people. Implementation Step Installation of location-aware services software platform and applications Surveying of hospital environment A locationing site survey not a recurring activity is performed to characterize the RF environment as part of the deployment process. Installation of LBS agent or tagging The LBS agent works in conjunction with the LBS server to determine the location of the device. The 802.11 tag works in collaboration with the LBS server to determine the location of the tagged item. Location and tracking of assets and people Once you have installed software agents and affixed tags, you can locate and track any asset or person via the LBS platform application. Description 1) Install the LBS platform software on a server hosted on the hospital network. 2) Install the monitoring software on any desktop which tracks assets or people. This software can also be accessed on a thin client via a web browser. 1) Obtain electronic images of the floor plans for the buildings where the location capability will be available. 2) Identify points of interest on these floor plans as landmarks. 3) Group landmarks into logical spaces or locations, i.e., patient room 123 or operating room 7. 4) Load preparatory information onto a PDA. 5) A designated individual walks the building with the PDA, visiting each of the landmarks to collect the RF fingerprints. 6) Download the data captured during the survey the locationing platform server, which now contains the radio maps that will be used at runtime to determine location. 1) Install a small locationing software agent on devices such as notebook computers, tablet PCs or Wi-Fienabled PDAs. 2) Affix an 802.11 tag for devices such as mobile medical equipment or people without Wi-Fi devices/cards. The LBS platform can generate a notification or alert when an asset enters or a particular location. This capability can be integrated with other applications to automate workflow processes, such as scheduling bed cleaning after patients have been discharged and transported from their rooms or notifying transport personnel that wheelchairs have been moved to the storage area and are ready for use. 2005 PanGo Networks, Inc. All Rights Reserved 6

Summary The inherent mobility of hospital environments, coupled with the maturity of 802.11 WLAN technologies, is driving a rapid deployment of 802.11 WLAN infrastructures in healthcare. Importantly, all of these capabilities can be deployed in a cost-effective manner by leveraging a single shared infrastructure, the 802.11 wireless network. Hospitals are deriving rapid ROI from this investment in a single, wireless infrastructure for both voice and data. By adding complementary capabilities such as location awareness, hospitals are now able to solve problems like the tracking of critical assets and personnel. The deployment of location-aware applications enables hospital environments to better manage their critical assets and effectively address healthcare industry and government regulations. Real-time asset tracking can help hospitals improve their focus on patient care, deliver better service, comply with JCAHO/FDA regulations, increase revenue/throughput, decrease costs and increase asset utilization. For example, better asset management can ensure greater availability of critical equipment while optimizing the deployment of equipment and systems for faster patient response. In sum, location-aware solutions such as location-aware wireless applications from PanGo Networks precisely respond to these increasingly growing demands of the healthcare environment to enhance business processes, including real-time asset tracking. As a result, the deployment of location-aware wireless applications can help hospitals maximize performance to deliver better patient care and realize improved financial results. 2005 PanGo Networks, Inc. All Rights Reserved 7

About PanGo Networks PanGo Networks is the leading provider of location-aware wireless applications for the enterprise market. PanGo s software transforms off-the-shelf WLAN infrastructure into a platform for intelligent applications that improve important business processes. Through its flagship PanOS platform and mobile applications, PanGo offers the industry s first comprehensive system for real-time asset visibility and context-aware information delivery. Specializing in a range of markets including healthcare, manufacturing, retail and government, PanGo delivers reliable and accurate information about the location of connected devices, people and assets. PanGo s location-aware systems enable optimal information management and workflow, and provide measurable and significant return on investment. For more information, visit http://www.pangonetworks.com. PanGo Networks, Inc. 959 Concord Street, Suite 100 Framingham, MA 01701-4862 Tel: 508.626.8900 www.pangonetworks.com 2005 PanGo Networks, Inc. All Rights Reserved