The New Wireless Utility at Scripps Health Bruce A Rainey, Corporate Vice President Facilities Design & Construction, Scripps Health Marty Miller, CIO, Children s Hospital Los Angeles
Agenda Who is Scripps Health? Why is this discussion important to you? What Changed What is Medical Grade Wireless Utility Who is schildren s Hospital Los Angeles Benefits of Medical Grade Wireless Utility Opportunity
Scripps Private, $2 billion, nonprofit community health hsystem, San Diego, Calif. Integrated delivery system caring for approximately 500,000000 patients annually Two of San Diego s six trauma centers Forefront of clinical research and graduate medical education 1,368 total licensed beds 2,900 Physicians & 145 residents/fellows 13,100 employees
Scripps Specialized programs include: Diabetes Institute Accredited Cancer Center Network Center for Integrative Medicine Robotic Surgery Program Graduate Medical Education Genomics & Clinical Research Translational Science Institute West Wireless Partnership
> 1.6 Million Square Feet Scripps Memorial Hospital Encinitas Scripps Mercy Hospital (San Diego Campus) Scripps Green Hospital Scripps Mercy Hospital (Chula Vista Campus) Scripps Memorial Hospital La Jolla
> 1.1 Million Square Feet Scripps Clinic Carmel Valley Del Mar Coronado Encinitas La Jolla Mission Valley Rancho Bernardo Rancho San Diego Santee Torrey Pines
Encinitas Escondido Hillcrest Oceanside Vista Scripps Coastal Medical Center Carlsbad Del Mar Eastlake Various Administrative Facilities
The Next Decade $2.3 billion investment State-of-the-art the art Imaging New hospital facilities Renovations & expansions Medical technology Emergency & Trauma Cardiovascular Institute Earthquake retrofits Cutting-edge research New ambulatory centers Right: Scripps Mercy expansion
The Problem May 20, 2009 Study identifies top five wireless challenges Physical Connectivity Security Considerations Technology Connectivity Issues Meeting User Demand Network Management Issues
New Technologies Body Area Networks The Problem Communications in and around the body Utilizes sensors, actuators,,processing elements Mobile Clinical Devices Linkage to EMR Security Expanding the Chipset Venue Marketplace Dynamics
The Problem
The Problem Wireless Data Growth 108% CAGR Through 2014 Wireless Data Use 3,600,000 4% 5% 8% Exponential growth 80% within buildings 70% of staff and physicians already using smart devices Handheld computing deployment exploding TB per Month 17% 1,800,000 66% 0 2011 2012 2013 2014 Mobile VoIP Mobile Gaming Mobile P2P Mobile Web/Data Mobile Video Source: Cisco VNI Mobile, 2010
The Problem Wireless Infrastructure is often vendor-specific More vendors creating more wireless devices More devices in the built environment creates noise Portions of the wireless spectrum not covered with current 802.11 solutions Emergency operations Police Fire Cell
Our Current Situation WiFi (802.11a/b/g/n) Single Channel coverage Production network Visitor hot spots WMTS for patient monitoring Several different solutions Low frequency wireless headsets and phones T-Mobile Nano Pico cell in building coverage AT&T/Verizon broadband for remote Users
Current Situation - continued Device Frequency Vocera VoIP badges (b/g) 2.4 GHz Laptops, tablets, lifebooks, desktops (802.11b/g/n) 2.4 GHz, 5GHz Alaris pump p (802.11b) 2.4 GHz MUSE EKG (802.11b) 2.4 GHz Smartphones (T-Mobile, AT&T, Sprint, Verizon) Phillips patient monitoring (WMTS) 608 to 614 MHz & 1429 to 1432 MHz Patient monitoring Welch Allyn (Aruba 802.11b) 2.4 GHz Wireless NEC DTR phone 900MHz frequency Ascom wireless phones IP-DECT 1880-1900 MHZ Bluetooth 2400-2483.5 MHz Inhouse T-Mobile pico cells
Challenges Over the Air Intrusion Detection System In building spectrum management and interference detection Device Management and dsupport In building cell carrier coverage (i.e. AT&T, Sprint, Verizon, etc.) Data Transmission Security Discrete WMTS infrastructure for telemetry
The Goals Own the architecture Create open architecture for future wireless devices Be vendor neutral, not driven by clinical needs Allow for equipment changes without infrastructure changes
The Goals continued Expand the coverage while maintaining control Lower Costs Ongoing operations Capital expenditures over time
Resolution Cross-functional Leadership Information Services Facilities / Construction Biomed West Wireless Health Institute (Advisor to Scripps)
Solution Create a Medical Grade Wireless Utility as the platform for wireless health going forward
Medical Grade Wireless Utility An expected utility, much like electricity, plumbing and HVAC Installed as part of the base building An open and vendor neutral converged wireless infrastructure, supporting transport for any wireless signal across 3 grades of service and 4 networks
Children s Hospital Los Angeles Founded in 1901, first pediatric hospital in Southern California Research hospital Nonprofit, academic, pediatric i Medical Center The only Level 1 Pediatric Trauma Center in Los Angeles County
Children s Hospital Los Angeles Over 4200 employees 588 medical staff 603 Licensed Beds Affiliated with the Keck School of Medicine at University of Southern California Annual Statistics 10,920 inpatient visits 301,838 outpatient visits 65,919 ED visits 15,459 pediatric i surgeries performed
MGWU for Children s Hospital LA Wireless historically problematic in hospital environment Clinicians i i and Physicians i the need for mobility In search of better wireless method
MGWU for Children s Hospital LA MGWU first deployed in 2007. MGWU deployed in new 480,000 000 s.f. building in 2010 1.2 million s.f. currently covered by MGWU
Medical Grade Wireless Utility An open, vendor neutral & converged wireless infrastructure, supporting transport for any wireless signal across 3 grades of service and 4 networks Consumer Enterprise Medical
Three Grades of Service ime Critical T Low Medi um Hi igh Consumer Grade Enterprise Grade Medical Grade Low Medium High Acuity
Medical Grade Wireless Utility An open and vendor neutral converged wireless infrastructure, supporting transport for any wireless signal across 3 grades of service and 4 networks WWAN WLAN WCDN LLAN
Four Wireless Networks
Each with a Defined Assurance WWAN Facilities WLAN IS/IT WCDN BioMed LLAN IS/IT Coverage Driver = WWAN Medical 95% or better 100% in Clinical Areas Driver = 802.11 Medical 95% or better 100% in Clinical Areas Driver = WMTS Medical 100% in Clinical Areas Signal Quality Driver = WWAN Medical + XX dbm above noise Driver = 802.11 Medical - XX dbm & -XX dbm Driver = WMTS Medical + XX dbm Driver = WWAN Medical Capacity Per Zone (~150k ft 2 ) RF Carriers/Zone/Service Driver = 802.11 Medical Per Segment (4K ft2) # Channels / Segment Driver = WMTS Medical Channel(s) ()per area # users per area Security Base Station Hotel Zone IDF Physical security Physical security Certainty Shared Engineered Shared Engineered Guaranteed Dedicated
Medical Grade Wireless Utility Infrastructure Independence Ubiquitous it coverage inside id & outside 802.11 Bluetooth ANT Zigbee UWB Future Wireless Local Area Network Room Area Network Personal Area Network Body Area Network Democratize Healthcare Data Pervasive, open, low cost monitoring Break the proprietary hold on healthcare PCS/Cellular Paging Fire Life Safety 2 Way Radio Future Wireless Wide Area Network Medical Grade Wireless Utility Wireless Clinical Data Network The Killer Apps Voice, Data, Video, Location 802.11 Zigbee IR Ultrasound UWB RFID Future Location Local Area Network Assets People Clinically Relevant Information Pervasive, low cost medical sensors Turn data into wisdom
MGWU Benefits Lower Implementation Costs One antenna system instead of one per technology Lower Operating Cost Fewer FTEs to manage ecosystem Fewer calls to help desk No retro-fitting for unknown dead-zones
Lower future cost MGWU Benefits Known capacity Add devices without touching the infrastructure Smart pump deployment New technology doesn t require closing rooms for gy q g replacement of legacy systems
MGWU Benefits Safer use of wireless in medical settings No interference problems associated with wireless in high acuity settings Future Ready design Enables speed of implementation New-tech is coming, design now and turn on later
Flip the Paradigm Enable the hospital to make device decisions based on infrastructure and NOT infrastructure decisions based on the device
Opportunities For Integrators & Healthcare Design Professionals Trend toward future ready wireless infrastructure Projected high h growth in Medical Grade Wireless Utility implementations Training and certification Designers and consulting engineers Installers and System Integrators
Q & A