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Solution

After comparison with other options, the hospital installed 32 Meru AP150 access points, operating as a Virtual Cell on a single channel and managed by two MC3050 controllers. The network was supplied by Meru integrator Synaptic Solutions.

Benefits

Because of Meru’s Virtual Cell architecture, Meru’s solution performed better and was cheaper and faster to install than the Cisco offering and other options. Therapists can now access and enter data securely wherever they see their patients, including in the gym and at a hydrotherapy pool on the hospital site.

Meru’s ease of deployment made it possible to meet a very tight installation deadline. The high throughput, capacity and reliability of the wireless network enables a variety of applications to run simultaneously, such as digital X-rays, voice calls and patient internet access from the hospital beds so patients can stay in touch.

Background

The Royal Orthopaedic Hospital in Birmingham, England, is the largest orthopaedic unit in Europe, providing planned joint surgery such as hip replacements, as well as spinal surgery and cancer treatment, and caring for children with orthopaedic problems. Its history stretches back almost 200 years: founded as the Royal Orthopaedic and Spinal Hospital in 1817, it now occupies a 40 acre site on the outskirts of the city, donated a century ago by the philanthropist and chocolate manufacturer George Cadbury. As a National Health Service Foundation Trust, the hospital still embodies his principles of community involvement.

It is also committed to using the best technology for its patients. In April 2008, it switched on Tiara, a hospital IT system which brought together patient information that had previously been divided between three databases.

In Tiara, an electronic patient record (EPR) includes each patient’s history; new data on assessments and interventions can be recorded directly into it. This means therapists can access and update their patients’ information quickly and banish the paper notes which could previously be lost, or else had to be entered into the computer systems manually.

But Tiara can only be used to the full if therapists can connect to it from anywhere on site - and that means wireless access. "We’ve seen Tiara implemented without wireless, but we wanted to be able to use it while at the patients’ bedside or alongside them in therapy rooms and gyms," says Chris Aspland, a physiotherapist at the hospital and a project leader for Tiara.

Pervasive wireless access to Tiara across the site, plus reliable support for current and future Applications, would require a large network. The team investigated several options.

Solution: fast to install and maintain

Before implementing a larger wireless LAN, the hospital looked at alternatives: "We evaluated several solutions, including one from Cisco," says Alan Kidner, IT Manager at the hospital. "But the Cisco solution was double the price, and there were certain things it could not do." The hospital also looked at a solution based on standalone Belkin access points.

Supplier Synaptic Solutions guided the Hospital towards Meru. A wireless specialist, Synaptic Solutions has two other wireless vendors on its books, and was able to put the Meru benefits in context. Synaptics Solutions demonstrated that the Meru system was the only one capable of the large scale data access the Hospital required, and the only one able to support toll-quality voice in future.

The Meru solution performed better because it covers the whole hospital with a single "virtual cell", in which all the access points use the same radio channel. Staff can roam from one part of the hospital to another using wireless devices, without having to wait while their laptop reconnects to the network. The network covers all the hospital’s clinical areas.

After the hospital made its decision, the network had to be installed quickly to meet a deadline set, in part, by the financial year. "The whole thing had to be turned round in five weeks," says Nigel Townsend of supplier Synaptic Solutions, who worked with network contractor Midland and the hospital’s IT department to meet the deadline.

Luckily, Meru’s single channel architecture also makes installation easy. Other networks require tedious RF planning, in which every access point is set to a defined channel and signal strength, to avoid interfering with other access points. Meru’s access points can be simply plugged in and used.

"You un-box the access point, and fix it to the wall," says Alan. "Connect it to the LAN, and it updates its firmware and starts working."

The access points are all powered over Ethernet, so there’s only one wire required to connect an AP. Two Meru MC3050 controllers were installed in the server room for reliability, and 32 access points, mostly the single-radio AP150, but with some AP208 dual-radio devices, cover the hospital. Security is paramount when dealing with medical records. The wireless traffic is encoded using 256-bit encryption, and access to the records is by password, managed by the hospital’s existing Radius authentication server.

Currently the Tiara system has about 55 users, most of whom use standard Dell wireless laptops and tablets, with some splashproof models for use at the hydrotherapy unit.

Since installation, the network has operated without any significant problems. As the access points are managed centrally, any problems with them are easy to fix. "If an access point fails, we just plug in a spare," says Alan.

Benefits: wireless access anywhere

The wireless LAN and the Tiara system it supports have changed the way therapists work at the Hospital. Therapists use laptops or tablet PCs anywhere in the hospital where they’re seeing patients. This includes the hydrotherapy unit, where splash-resistant laptops are used by the pool.

Clinical records can be viewed from anywhere, by several users with appropriate security, so different departments can share information far better than before; the days of dealing with lost files are over. Tiara is also collecting data on the Hospital’s work - which will help plans to improve care in the future.

The performance of the wireless LAN itself has impressed the staff. The ability to move a laptop to a less crowded area is a boon, making it easier to share workspace. Staff have found, given the choice of connecting using an Ethernet cable, that they can work better on the wireless LAN.

The future: Setting other applications free

It is sometimes hard to find budget for an infrastructure item like a wireless LAN. The applications which use it are implemented one at a time, over a period of several years. Usually, no single application can justify the cost of new infrastructure. In the case of the Royal Orthopaedic Hospital, Tiara and EPR provided the justification for a wireless LAN, which is now available for other applications. "We needed the WLAN backbone for EPR, but now it has been justified, it’s easy to move other applications onto it," says Alan. For instance, X-ray images can be transmitted across the wireless LAN, because they have been moved to a digital system, and are already going across the wired LAN, says Aspland. "We went filmless a year ago."

"We’re currently only using about seven percent of the wireless LAN capacity," says Alan. "If we put everything on the wireless LAN, we’d still only use about fifty percent of it."

Some future applications could use the wireless network to locate and track staff or valuable equipment - a task that is particularly important in a hospital. Getting hold of a doctor or some specialist equipment quickly can be a matter of life and death in extreme cases, or at the very least, save a patient from hours of uncomfortable waiting.

"We need really precise location tracking, and we’re considering this for the future," says Alan.

He is also looking at the possibility of running voice over the Wi-Fi to dual-mode mobile phones, which could improve internal communications and replace (or augment) the hospital’s system of bleepers currently used to alert staff.

There is one application that’s definitely going ahead. It serves a need that’s not specifically clinical, but will help patients greatly: web access. Communication is crucial in people’s lives, but in most hospitals patients are isolated from friends and family, and limited to shared phones that are clumsy and expensive to use.

"Early in 2009 we will allow patients access to the guest network," says Alan. The Meru network can completely separate traffic, so patients and staff can be given access to the web for private use without risking confidential data. Patients will be allowed to bring their own laptops into the wards and log into the guest network for a small fee. Access points will also be extended to nurses’ accommodation on the site.

The guest network will allow email and web browsing, as well as VoIP applications such as Skype, says the trust, as well as allowing access to streaming media.