Staying Healthy With Wireless

Health care is an industry that has always had two masters: the patient and the bottom line. Often operating perilously close to the break-even point, health care has felt the pinch of a receding economy more than most industries. As both profits and IT budgets have shrunk, managers are looking for technology that not only saves money, but saves lives. And they're finding it not necessarily on the cutting edge, but slightly behind.

"The financial realities surrounding health care in general make it hard for hospitals to commit to cutting-edge technology," says Craig Mathias, a Farpoint Group analyst. "If you're a health-care provider, there's just no way you can make the investments you'd like to."

Faced with a lack of capital to sink into experimentation, industry leaders are finding innovative ways to use tried and tested technologies to improve efficiency and cut costs.

One area of health care that's set to take off is wireless technology. In a recent industry survey by the Healthcare Information and Management Systems Society, half of all respondents say wireless information devices will be the top emerging technology they would deploy within the next two years, up from 29% last year.

In some ways, wireless is nothing new to health care. Hospitals were one of the first institutional users of pagers, embracing them as a way to keep in touch with doctors long before the devices became a fashion accessory. But somewhere along the line, the industry began to lag behind in the deployment of new wireless technologies. "The uptake rate isn't what it is elsewhere," Mathias says.

But uptake is picking up, and IT vendors are revving up to meet the demand. In May, IBM revealed a deal with PatientKeeper Inc. to help run its record-management software on mobile devices. Wireless software company WirelessMD Inc. has a partnership with IT company Fujitsu-ICL Systems Inc. to design wireless applications for its hardware. And Intel is working with Allscripts Healthcare Solutions to put billing and prescription information on handhelds.

Nowadays, patients entering a hospital might run into wireless technology as soon as they register. Staff with wireless notebook PCs go to a patient and enter critical information directly into the hospital's network. "If a patient can't make it to the desk, you can go out and see him where he is," Mathias says.

Once a patient has been admitted, he might find his body wirelessly connected to the hospital. Some hospitals are experimenting with sensor devices placed directly on a patient to record medical data, such as heart function, and beam it directly into the network, where it can be viewed and analyzed by doctors around the hospital or around the world.

Wireless results retrieval applications work in the same way, recording the results of lab tests and making them available via a network. That lets doctors access diagnoses the moment they've been made--a time-saving function that also could be a lifesaver.

An emerging wireless application is the tracking of equipment and people. Devices attached to critical machinery--or critical staff members--communicate with a wireless network in a hospital, maintaining a real-time record of where everything is inside an often-huge building. Tracking technologies also are being applied to monitor patients, assuring that Alzheimer's patients don't wander off or that babies don't leave the maternity ward with the wrong person.

One of the biggest applications is wireless prescription and order entry. Using PDAs or notebook computers connected to the hospital's network, doctors can order tests or prescribe medications at bedside for their patients. The medical benefits of this application are vast. A request for an X-ray gets beamed directly to the radiology department, meaning faster service and less paperwork. By ordering drugs electronically, the system can automatically check for drug interactions and adjust the dosage for body size. Electronic order entry also eliminates the sometimes difficult job of interpreting physicians' handwriting.

"Think about the process today," says Dr. John Halamka, senior VP and CIO of CareGroup Healthcare System, a Boston health-care provider that ranks as one of the largest in the country. "A doctor handwrites in an illegible way on a piece of carbon paper that's faxed to a pharmacy. It's crazy."

For many health-care providers, the wireless application that's most appealing is the one that helps them get paid. "Instead of doing multiple entry of the same data for billing purposes, the use of a handheld eliminates double entry downstream," says Brad Holmes, an analyst in the health-care group at Forrester Research.

Most of these applications are being built to operate on the 802.11b wireless specification, Holmes says. "802.11b is pretty clearly the mode of choice for both hospitals and group practices." 802.11b LANs allow data transmission speeds of up to 11 Mbps at distances of up to several hundred feet, making them ideal for use in big buildings such as hospitals.

But wireless technology isn't just used by health-care providers, it's also driving efficiencies for suppliers.

"For me, it's the next big thing," says David Guzmán, senior VP and CIO of Owens & Minor Inc., a medical and surgical supply company in Richmond, Va. Owens & Minor uses wireless devices for inventory control, helping customers make sure they have the supplies necessary to run a hospital and easily place orders for refills.

Owens & Minor has equipped the operating rooms of client hospitals with a par level of supplies, Guzmán says, and labeled each item with a bar code. When doctors use an item during surgery, a wireless handheld computer scans it, and a computerized inventory is updated. The system keeps track of how much inventory is left in the operating room and automatically places an order for refills.

Another way Owens & Minor automates the supply chain is through collaborative Web exchanges, building direct connections with several major online exchanges including Neoforma.com and Broadlane.com. It's an area set to boom. A survey in January by Millennium Research Group found hospitals spend more than $10 billion in online buying, and 52% of all hospital purchasing executives believe E-procurement will account for more than half of their total buying by 2003.

Owens & Minor also uses the Web to provide its supply-chain partners with online information about the demand and use of products. Using a Web-based interface called Wisdom, the company can help its partners better plan their manufacturing, control inventory, and deal with transportation issues.

Meanwhile, health-care providers use Web portals to foster collaboration between doctors and patients. Portals are an efficient way to handle information, with the added benefit of improving care.

During the past year, Baptist Memorial Health Care Corp. in Memphis, Tenn., has been putting its efforts into building BaptistMD, a physicians Internet portal developed, designed, and supported by VP Dick Escue's IT shop. Doctors can use it to review their patients' medical data from home or office, getting access to insurance data, latest test results, surgery schedules, and even radiology images. It's the sort of thing that not only improves the quality of medical care, Escue says, but saves the company money by integrating databases, cutting paperwork, and reducing administrative overhead.

Reactions to the portal have been mixed, but it's catching on, Escue says. "There are still doctors who refuse to use the Internet, but many doctors love it, particularly obstetricians and cardiologists," who can use the portal to access a patient's fetal monitor or EKG readings from their homes or offices.

CareGroup's Halamka says his company is using the Web to empower consumers. On PatientSite, CareGroup's customer-relationship-management portal, consumers can do everything from view their medical records to make appointments.

Even labs, which generally don't deal directly with patients, are using the Web to improve quality of care. New Jersey clinical testing company Quest Diagnostics Inc. has just launched QuestDirect, a site where consumers can order certain tests without the aid of a physician. They have samples taken at a lab, then visit the Web site again to get their results. A library of medical information and relevant analyses helps patients understand the diagnosis.

With the site, Quest is able to tap a market it might not have access to elsewhere and, in the process, empower consumers. It's a good example of the way health-care businesses are using IT to improve the health of both company and consumer.

"People want information; they want to be able to get help easily," says VP and CIO Gerald Marrone, "and the Internet is going to play a key role in that. Consumers have grown up."