14. What should I look for in a medical device and the company that supplies it in terms of wireless capabilities, expertise, and support?
The medical device needs to meet the functional and clinical requirements for the job to be performed. The manufacturer should have a solid and demonstrable understanding of the wireless technologies they have chosen for their device. The manufacturer also should be able to provide documentation adequate to ensure that it meets the interoperability and security requirements of your facility, as well as adequate instructions to ensure that the device can be supported in a manner that ensures its safety and efficacy when installed on the chosen wireless infrastructure. The manufacturer should provide a network disclosure statement to the HDO detailing the constraints and capabilities of the device, as well as the requirements from the organization’s infrastructure. The manufacturer should also provide information mentioned in the Security section.
15. What wireless specifications should I be writing into my RFPs for medical devices?
The RFP (request for proposal) should include specifications that reflect the HIPAA, wireless security, and wireless operational policies of your facility. It should include requirements for the vendors of both the medical equipment and IT equipment to provide information necessary to ensure the proper functioning of the medical equipment and continued support. For more detailed information, you should consult the IEC 80001-1 risk management standard and its technical reports covering wireless network design considerations and responsibility agreements. Support of hospital authentication/encryption requirements and specific wireless standards are two specific concepts to include. Please see Appendix A, Example Prepurchase Questionnaire, for a sample of questions that might be asked of MDMs.
16. How can I engage my C-suite and encourage them to invest in the wireless infrastructure?
One option is to consider security, consistency, and timeliness of data, as all of these have an impact on clinical outcomes—the heart of quality and affordability agendas that guide decisions made by virtually every health system. To support your argument, be prepared to discuss how your particular initiative (strategy and tactical plan) can improve quality (perhaps including impact to brand) and be affordable.
A healthcare technology management leader at a large health system shared these experiences:
“We removed the veil of technical secrecy from the requests and communicated very clearly the value of the investment from the standpoint of clinical efficiency and improved patient outcomes. Including very specific data on how proposed wireless and wired infrastructure upgrades would improve clinician access to the system, reduce downtime, and speed up transactions made it very obvious to the C-suite that the resources needed to be approved.
“It was common several years ago for IT infrastructure requests to be among the first items cut when there was a need to cut the capital budget. The turning point was the integration of mobile and fixed computing devices into the clinical workflow. When we were preparing to implement our EHR at our first sites, it became readily apparent that our existing infrastructure would negatively impact clinical workflow and ultimately patient outcomes.
“Wireless VoIP (Voice over Internet Protocol) phones transitioned from being ‘nice to have’ to a critical part of the clinical workflow. Communicating how the investment in better phones and enhanced wireless infrastructure would better support clinical workflow and patient outcomes helped the C-suite understand the importance of the investment.
“Quantifying costs using indirect measures such as communicating return on investment (ROI) in dollars may be difficult. Executives realize that every clinician waiting an extra 30 seconds for a refresh from the EHR server multiple times per day adds up to wasted dollars. Similarly, the count of lost connections that have to be restarted due to inadequate wireless infrastructure adds up to wasted dollars and clinician frustration. Frustrated clinicians lead to turnover, and the costs of clinician turnover have been well documented. Similarly, the cost of EHR downtime (estimated by a large hospital chain at more than $10k per hour) may be used to justify upgrading the system to reduce downtime.”