Wireless Remedies

atients at Miami Children's Hospital may not realize it, but an invisible safety net is helping to protect them. Each time they receive medication from a nurse, a series of complex wireless transactions is taking place to make sure they get the right medication, in the right dose, at the right time.

The system, based on Bridge Medical's MedPoint MedAdmin bar-code point-of-care application, can significantly reduce errors that can cause the death of an ill child, said officials at Miami Children's Hospital. It can prevent the kind of mistake that led to the death of 7-year-old Ben Kolb after he received an injection of the wrong medication during routine surgery at Martin Memorial Hospital in Stuart, Fla.

The Kolb case and others like it prompted the Institute of Medicine to publish a report in 1999 estimating that every year 770,000 adverse drug events lead to injury and death in U.S. hospitals. These mistakes result in average increased hospital costs of $4,700 per admission, or about $2.8 million annually, for a 700-bed teaching hospital, according to the study.

At Miami Children's Hospital, nurses who dispense medication first scan a bar code on their ID badge and then a similar bar code on the child's wristband and medication, said Jackie Gonzalez, vice president and chief nursing officer at the hospital. Information about the patient and medication is then transferred via an 802.11b wireless LAN (WLAN) to a central computer.

The system, which went online in November 2002, "verifies the 'five rights' of medication administration,the right patient, drug, dose, time and route of administration,and checks for safe dosing levels," said Gonzalez. "It also alerts nurses of potential hazards with look-alike, sound-alike medications."

Bridge Medical has been setting up such systems since 1996, but an increased focus on wireless networking has boosted interest in error-management applications, said Mike Wisz, vice president of the Solana Beach, Calif., solution provider. "Five years ago, [WLAN technology] was much less mature, and interoperability between different products was an issue," he said. "Today there is more promise, or reality. WLAN is more of a commodity and a lot easier to install."

WLANs, of course, are becoming the backbone of choice for the type of wireless system installed at Miami Children's Hospital. Although wireless is no stranger to hospitals,many have been using older frequency-hopping and Wireless Medical Telemetry Service Band technologies,health-care CIOs are beginning to standardize on Wi-Fi, solution providers said. Still, experts estimate that only about 10 percent to 20 percent of U.S. hospitals are using Wi-Fi networks today. Most Wi-Fi-connected hospitals initially installed the network for a specific application or department but have since expanded based on the efficiencies they experienced, solution providers said.

"Once a hospital has a wireless overlay in a location, they start to say, 'I can use that for other things,' " said David Hope, director of sales and marketing at solution provider Datanet Services, Greensboro, N.C. "That's where the application growth is coming in."

While there is always concern about new wireless networks conflicting with vital life support systems, Hope said Datanet Services has yet to encounter a situation where conflict is a significant problem. "Originally, there was some concern about wireless connectivity because of equipment conflict. That's why we do a spectrum analysis for our customers."

Amith Viswanathan, a wireless analyst in Frost & Sullivan's health-care practice, said solution providers will be installing most wireless networks this year in midsize to large hospitals where bed capacity is more than 200. The networks, he said, likely will be placed first in high patient-throughput areas such as emergency rooms, critical care wards and nursing care floors.

Other industry experts said safety will be a key application driver this year. The bar-code-based medication applications, for example, have been receiving a good deal of attention over the past several months. The Federal Drug Administration (FDA) is expected to issue a rule that would require drug manufacturers to issue bar codes on all single-dose medication packets,the kind used by nurses who dispense medications to hospital patients.

The safety movement has clearly had an impact on health-care providers. A study released by the Healthcare Information and Management Systems Society in February 2003 found that the top concern of health-care IT executives is patient safety, eclipsing concerns about the Health Insurance Portability and Accountability Act (HIPAA).

The study said 52 percent of the 300 IT executives polled ranked the implementation of technology to reduce medical errors as the top IT priority today. The executives placed computer-based practitioner order-entry systems and bar-coded medication management among the top three most important applications over the next three years, according to the study.

Jeff Schou, director of worldwide health-care markets at Symbol Technologies, Holtsville, N.Y., said the move to standardize medication bar-coding through the FDA will have a positive impact on medication safety systems. "In the past, everyone has been using a proprietary bar-code system," he said. "Medications were sent to hospitals through the distribution chain, received a bar code, and were sent throughout the hospital." After the FDA ruling takes effect, he said, hospitals will be able to standardize on one bar-code database, making medication management and lookup much more effective.

Solution providers, meanwhile, said another application,wireless voice-over-IP (VoIP),will gain traction in hospitals this year. Cisco Systems is expected to release a wireless VoIP phone this year, according to solution providers, and vendors such as Hewlett-Packard are adding wireless VoIP capabilities to handhelds.

Hope said Datanet Services replaced an older and erratic 900MHz system with a Wi-Fi system at High Point Regional Health System, a hospital in High Point, N.C. The new network was installed primarily to support a medication safety application like the one deployed at Miami Children's Hospital and for patient care coordinators. Now the hospital is exploring wireless VoIP technology, Hope said. The technology would allow doctors or nurses to carry wireless IP phones to make and receive calls from any point within the hospital.

Schou said Symbol is also working on some wireless VoIP pilots in emergency rooms. In one case, he said, a hospital currently employs dedicated clerks to track down emergency room doctors when a consult phone call arrives. "With wireless VoIP," he said, "a doctor calling back for a consult isn't waiting on the other line. The call goes right through."

Whether it be wireless VoIP, patient management or a variety of other emerging applications, solution providers said the beauty of wireless technology is its ability to help save lives as well as money.

Kristen Kenedy is CRN Online Editor.