 Already ubiquitous in
hotels, coffee shops, schools, libraries, airports, and homes, wireless
(or Wi-Fi) networks are making inroads in physician offices, too.
They're
spreading because electronic health records are spreading. As more and
more doctors review and enter patient data on glowing screens, they
increasingly want to be as mobile as any laptopper at Starbucks.
Going wireless is easy—maybe a
little too easy. For home computer users, it's as simple as buying a
piece of networking hardware that costs less than $100 and which, after
software installation, works as soon as they plug it in and turn it on.
On average, the installation time is only about an hour, according to
the Wi-Fi Alliance, an industry umbrella group.
You also need more reliability from your wireless networks than the
average home computer user. After all, you can't afford to lose the
all-important network connection on your tablets and laptops while
you're seeing patients ("I'm sorry, Mrs. Jones, but I can't call up
your lab results."). And it's often harder to establish a reliable
wireless network in a medical office than in a home. Just ask a doctor
who's experiencing interference because five or six neighbors down the
hall have Wi-Fi.
For the sake of greater security and reliability, then, you must
carefully choose your wireless hardware and know how to configure and
install it for top performance. We interviewed computer consultants and
other experts to give you a game plan.
First, select the right hardware Going wireless doesn't mean abandoning
your current network of wired computers. In most cases, medical
practices are creating hybrid networks, says Mark Johnson, president of
MediNetwork, an IT firm in Dallas. That translates into wired desktop
computers for the front desk and the back office, wireless tablets or
laptops for doctors and nurses. Transmitting and accessing data on
wireless computers will be a little slower than on wired ones, but you
won't see a significant difference in performance unless you're dealing
with data-heavy files like diagnostic images.
The hardware you need for the wireless side depends on the wired gear
you use now. If you're connected to the Internet—and most doctors are,
according to Manhattan Research—you may already have a router. This
piece of hardware directs traffic between one computer network, like
yours, and another one, like the Internet. You can create a wireless
network by simply plugging a piece of hardware called an "access point"
into the router. The little antennas on an access point transmit radio
signals and receive them from wireless computers. Larger offices may
need two or more access points to cover every nook and cranny. What you
get is a connection between your mobile computers—via your server—to
the entire office network as well as the Internet.
If you don't have a router now, or want to replace the one you have,
you can buy a wireless router that incorporates an access point in
addition to other important features, such as a firewall and controls
that keep employees from visiting, say, gambling websites. You may need
to add one or more free-standing access points to extend the reach of
your network. Count on spending between $50 and $500 for a single
free-standing access point. That's also the price range for most
wireless routers. Inexpensive brands of access points and wireless
routers like Linksys and Netgear are aimed mostly at individual
consumers, while expensive brands like SonicWALL and Cisco are designed
for businesses.
There are good reasons for the big price differentials. Wireless
networking devices generally have shorter lives than wired hardware,
but business-grade brands probably will work longer, says John Lubrano,
president of Protis IT Solutions, an IT support firm in Austin, TX,
that caters to medical practices. Just as important, access points and
routers designed for businesses tend to provide greater security and
reliability, giving users such capabilities as "seamless roaming," says
Lubrano.
"This means that as you go from the signal of one access point to the
signal of another, you never lose your connection," he explains. "Most
consumer-grade devices don't offer this." Another essential piece of
hardware is what's called a wireless adapter that your laptop or tablet
needs to send and receive radio signals. Fortunately, it's built into
most new and late-model mobile
devices. If your machine lacks an adapter, you can buy one, either in
the form of an internal PC card r an external USB adapter, for as
little as $20. Whether it's an adapter card or a router, wireless
hardware is based on various technical standards, which are constantly
evolving. The dominant standard—and the one you should look for on
hardware—is 802.11g, which will give you a theoretical indoor broadcast
range of 100 to 150 feet. Devices built on 802.11g can talk with those
on the older—and slower—802.11b standard, but not those on 801.11a,
which operate on a different frequency. To accommodate older laptops
and tablets that use "a," buy dual-band wireless routers and access
points using both the "a" and "g" standards.
The final version of another standard, 802.11n, is due for release in
early 2007. The "n" standard promises at least four times the network
speed possible with 802.11g, and it theoretically could make wireless
networks faster than their wired counterparts. How much "n" will
supplant "g" remains to be seen, but fortunately, "n" hardware will be
compatible with "g," "a," and "b" hardware. How to get a strong signal
throughout the office Signal strength is the name of the game in
setting up a wireless network. The stronger the signal, the faster
information flows between your mobile device and the rest of the
network. Conversely, a weak signal could sever your connection or slow
you down as you chart a patient visit.
The antennas on an ordinary wireless router or access point transmit a
radio signal in all directions. If you're relying on only one device
like this for broadcasting, try to place it in the middle of your
office to get maximum signal strength everywhere. Count on a lot of
experimentation, though, to find the sweet spot that gives you the best
overall coverage. That's because you have to contend with signal
interference, and there's plenty in a doctor's office. Metal is one
source. The lead walls of an X-ray room, for example, are murder on
reception. In fact, the sheer number of ordinary walls in a medical
office—think of all those exam rooms—degrades signal strength. Such
obstructions can create dead spots in your network.
Another source of interference are electrical devices ranging from
power outlets to microwaves and cordless phones that operate on the
same 2.4 GHz frequency as wireless hardware on the 802.11g standard.
You never know what will pose a problem. "One doctor I know lost his
connection whenever he took his tablet next to a big laser," says
consultant Mark Johnson.
For best results, place your router or access point as high as possible
off the floor and away from electrical devices. Johnson favors
installing wireless transmitters in the ceiling for maximum
performance. Simply swiveling the antennas in a different direction can
extend signal range.
Still having problems with dead spots? You can replace the antennas on
your access point or wireless router for $30 to $50 with ones that
transmit a stronger signal, or you can push the signal out further with
a device variously called a range extender or an expander. Likewise,
you can replace the wireless adapter card or plug-in on your mobile
device with one that has greater signal strength and receptivity, notes
John Lubrano.
Another solution is to simply stud your network with more access
points. However, configuring and coordinating an array of access points
is tedious. SonicWALL centralizes and simplifies all that work with a
so-called security appliance called the TZ 170. It also includes a
firewall that protects the network from viruses, spyware, and hackers.
There also are cures for competing radio signals that weaken your
signal. Put as much distance as possible between access points or
wireless routers and microwaves and cordless phones that share the 2.4
GHz frequency. Wi-Fi devices and cordless phones come with channels;
setting them on different channels should keep them from clashing. As a
last resort, consider switching to a cordless phone on a different
frequency.
Mark Johnson notes that many doctors have set up wireless networks that
functioned perfectly at first but deteriorated over time. The culprit?
The spread of wireless networks in neighboring homes and businesses.
Boosting signal strength with better antennas and range extenders can
reduce this interference. Directional antennas that aim stronger but
narrower radio beams at portions of your office may pick up less noise
from nearby networks than omnidirectional antennas. And again, change
the channel of your network. Johnson notes that many wireless devices
are left on the default channel of six, which puts them head to head.
"Some of the higher-end devices will automatically change the channel
if they detect interference," he says.
Consider hiring an expert to set up your Wi-Fi network
While computer technology aimed at individual consumers is as easy as
"plug and play," creating and managing a wireless network, especially
one intended for the business world, is more like "read the manual all
night." The installation guide for one particular Cisco access point
runs 148 pages.
Accordingly, you'll probably want to hire an IT pro to help you go
wireless. Expect to pay between $50 and $175 an hour for expert help.
Vendors of electronic health record programs might help you install the
necessary wireless hardware as part of product implementation, often
through a local IT shop. They may even recommend hardware brands that
they trust. If you're on your own, look up IT shops in the Yellow Pages
under headings like "Computer Network Design and Systems." The websites
of the National Association of Computer Consultant Businesses
(www.naccb.org) and the Independent Computer Consultants Association
(www.icca.org) allow you to search for members in your community. Ask
your hospital and colleagues for leads on good firms.
Ask your hospital and colleagues for leads on good firms. Wireless
computing may require you to sweat a few more details, but doctors who
have gotten rid of the wires have no regrets.
"I've been happy with the ability to chart anywhere in the office,"
says Elizabeth Pector, a tablet-toting FP in Naperville, IL. "The
technology moves with me. And I don't have to worry about toddlers with
sticky fingers exploring a desktop terminal in the exam room."
By: Robert Lowes
Source: Medical Economics Magazine
|
