Hospital CIOs are constantly working to break down barriers between point solutions to bring enterprise-wide solutions to technology acquisition, deployment, and most importantly, ongoing management. Years ago the challenge was the proliferation of departmental information systems, then referred to as “islands of information.” One of today's challenges is the proliferation of various wireless technologies, including cell phones, wireless phones, pagers, indoor location systems, 802.11a/b/g WLANs and wireless medical devices in both the WMTS and ISM bands. Many hospital CIOs are looking to bring order to what is becoming a wireless wild West as hospitals adopt more wireless solutions.
In announcing this agreement (pdf press release) with MobileAccess, GE Healthcare has thrown down the gauntlet and staked out a position in the wireless space. Exactly what that position is and the resulting implications, are not so clear. There are so many interesting things about this announcement, on both the medical device side and the network side. Let's touch on a few starting with this story in CIO Insight about the agreement.
enable hospitals to use a common infrastructure for their wireless
applications, such as cell phones, pagers, public safety radio and
A midsize hospital could have as many as 15 different wireless
systems, including pagers, and a multihospital chain could have as many
as 40, said Steve Lorenc, general manager of GE Healthcare.
As the numbers and types of wireless applications used in hospitals
grow, several companies are offering to replace parallel networks in
hospitals with infrastructures that support multiple kinds of devices.
Most of these companies, including MobileAccess, Airwave, InnerWireless Inc. and Meru Networks, have experience installing their networks in large private and public buildings as well as university campuses.
But whether or not hospitals will use these companies is “the golden
question,” said Steve Tobin, an analyst in health and life sciences IT
with Frost and Sullivan. “You're talking about a plethora of products
to be managed. It's the hospital's choice” how it will do so. The deal
between GE Healthcare and MobileAccess is an attempt to better
penetrate a difficult hospital market.
The biggest value provided by these vendors is reducing the need to get into the ceilings of patient care areas to install or service access points and antennas. MobileAccess and their competitors connect site wide transmitters to a “head end” – sort of like a cable TV system – and put access points together in wiring closets for better access. Some of these solutions also provide better coverage as a consequence of the engineering work done to design their system – theoretically, traditional point solutions could offer coverage just as good. What's not mentioned in either the press release or the story is that putting all these different frequencies of radios on the same infrastructure requires planning and trade offs; you can't put just any combination of radios and frequencies on these systems and have them all work. Wireless infrastructure solutions like this also puts a major wrinkle in RFID planning and deployment. Your wireless infrastructure vendor becomes your wireless partner, unless you only want to use their system for some of your radio applications (which some hospitals are doing). A medical device vendor who also provides enterprise-wide wireless infrastructures might have certain preferences in choices and trade-offs made by the client.
The term “exclusive” in a contract between vendors is always attention
getting. What's not clear here is exactly what is exclusive.
Under the agreement, GE Healthcare will be responsible for installing
and maintaining the wireless infrastructure and for selling the product
to health care providers. The companies have an exclusive agreement to
create a GE Enterprise Access solution to support GE's wireless
telemetry devices. Lorenc said that in this case, working exclusively
on a wireless infrastructure is a means to creating universal
Supporting the operation of GE's WMTS service over an infrastructure solution from any vendor requires going through a verification and validation process. Different vendors will require different levels of verification and validation, depending on their product's regulatory strategy and how they approached their design history file. How this regulatory hurdle (and any relevant contractual exclusives) might play out in competitive situations will be interesting to watch. This is a win/win for GE – they can lead with their preferred solution (especially in “GE hospitals”) and always agree to run on InnerWireless or some other vendors' infrastructure if that's the hospital's preference. GE's competitors will have to validate their wireless 510k regulated medical devices on MobileAccess if they want to compete in GE sites.
For some time, GE has been touting “life critical” data as justification requiring a separate network infrastructure. With the introduction of Draeger's OneNet and Philips recent support of VLANs across hospital backbones, GE's position was less tenable.
GE Healthcare entered the partnership with MobileAccess because of
plans to expand its offerings in medical telemetry. This technology
transmits data from devices like glucose monitors and ECGs directly to
a computer system. The technology can automatically track patients'
conditions over time and alert clinicians of life-threatening problems,
but it also requires absolutely reliable connectivity.
As use of telemetry applications expands, said Lorenc,
hospitals need a wireless infrastructure that is simple to manage and
that never loses or delays data.
The MobileAccess technology means that GE Healthcare can offer
an infrastructure compatible with all of GE Healthcare's telemetry
equipment and that will meet hospitals' other wireless needs as well.
The foregoing sounds like GE will replace wireless patient monitors using 802.11FH with WMTS – no big surprise here. Using a proprietary infrastructure (the protocol running on the WMTS radios) will increase switching costs and lock in customers using their telemetry and future wireless medical devices hinted in the story above. In fairness to GE, I'm sure they'll also leverage their approach to provide some unique product features as well. (Surely customers will expect more benefits than just a “single vendor solution” in exchange for higher switching costs.) Since GE's wireless patient monitoring solution will cost more than one from someone like Draeger (due to the proprietary WMTS technology), they'll have to discount their solution to meet the lower price – but the cost to the customer to replace the WMTS infrastructure will remain. Another wrinkle in GE's medical device wireless networking strategy is the other products like infusion pumps that are adopting 802.11a/b/g rather than WMTS. Ventilators and other devices will eventually go wireless, and these vendors having no stake in WMTS will probably go Wi-Fi as well.
For MobileAccess, this deal puts them at par (or maybe ahead) with InnerWireless who has a similar deal with Johnson Controls.
With all the talk about wireless telemetry and enterprise solutions, I'm reminded of connectivity at the point of care. You know, the poor nurses who juggle overhead pages, pagers, wireless phones, and nurse call systems, while caring for patients, delivering meds and responding to alarms at central stations and from devices in patient rooms? This chaotic (and arguably unsafe) environment needs an enterprise solution. GE has more than a few more acquisitions to make if they want to offer a single vendor solution at the point of care. How or whether this plays into GE's wireless strategy remains to be seen.
UPDATE: The nice thing about blogs is that they're easy to change (clarify, correct, update, revise). After sleeping on it, I made a couple of additions and a few tweaks to the above. As always, anyone with insight, comments, criticism or corrections is encouraged to leave a comment.