It goes without saying that modern hospitals are a hive of activity. Humming quietly in the background, sustaining all of that vital work, you will almost always find a sprawling, intricate web of wired and wireless network connections being run by dedicated teams of tireless network engineers. It hasn’t always been this way. From their rudimentary beginnings decades ago, hospital networks have grown in importance and reliability. Today these networks and the people who implement and maintain them face mounting pressure to enable higher standards of patient care and security.
From this perspective of network growth, we can see that advancements in technology and data storage have played a pivotal role in improving patient outcomes at hospitals and healthcare facilities around the world. At the same time, we must acknowledge that introducing new, ever-more advanced medical devices or communication tools, together with more stringent healthcare regulations for enhanced patient confidentiality and data security, have created the perfect storm of complexity for healthcare IT professionals. These are the people, after all, who stand on the front line when it comes to deploying, managing, and troubleshooting these networks.
There is no doubt that enhancements to patient care have brought about incredible, life-saving changes to millions of people around the world. In fact, the demand for new and innovative treatments at facilities around the world has been an enormously successful driving factor in the modernisation and expansion of hospital and clinical networks, where speed and reliability are often critical to patient outcomes.
These modern networks carry huge burdens, particularly with regard to Wi-Fi-connected devices used in patient testing, monitoring, and general care functions. Not only do physicians and nurses use the network to review lab results, prescribe medication, and access patient records on a daily basis, other connected devices such as MRIs and CT scans require stable throughput in order to deliver data-intensive, high-resolution patient scans to radiologists in a timely manner.
On the back end, these networks must also support critical business functions that include email, billing and payment services, scheduling, Human Resources, and more. On top of this, most hospitals provide patients and guests with Wi-Fi access and other internet-enabled services for their personal use and entertainment. It’s a lot for any network to deal with.
We need only look at the UK’s own National Health Service to understand the scale and geographical footprint of its operations. According to the NHS’s own information, this government funded organisation is the fifth largest employer in the world, with over 1.5 million staff working across hundreds of facilities in England, Scotland, Wales and Northern Ireland.
With an annual budget just shy of £120 billion, the NHS provides a wide range of services that includes everything from antenatal screening to treatments for long-term conditions, organ transplants, emergency treatment, and end-of-life care. In England alone the NHS deals with over 1 million patients every 36 hours. Can you imagine the kind of data network that is required to support the flow of all that information? It’s truly a mammoth task.
Reliable networks save lives
Unlike enterprise networks, hospital networks have no breathing room for downtime. This is an enormous responsibility for every person on the IT team, and it makes constant network troubleshooting a vital part of best practices within the healthcare system in order to ensure the ongoing health of the network. Having said that, there are certain issues that are unique to hospital networks, which often cause extra headaches for the teams who manage them. Although this is not an exhaustive list, these provide some good examples of the challenges involved.
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As mentioned above, hospitals support a vast array of wired and wireless equipment. One of the areas showing particular growth is that of communications. You can see many of these devices in the form of badges that can be worn by hospital staff. They are often voice-controlled, and designed to enable real-time, hands-free communication between doctors and nurses. When every second counts in an emergency situation, ensuring that these devices have uninterrupted access to the network can literally mean the difference between life and death.
Wireless technologies are common-place in the business and consumer environments, however the freedom of movement afforded by Wi-Fi inside a hospital environment is often much more visible. Hospital buildings typically have thick walls, making it difficult to deploy Wi-Fi access points effectively. Adding to the complexity, there are a huge number of devices competing for bandwidth, all needing to switch to the next access point seamlessly as they move throughout the hospital facilities.
Many hospitals today have multiple campuses and dozens of smaller clinics that need access to information such as patient medical records, test results, and other shared services. Network performance and even security at these remote or distributed offices pose unique challenges of their own in terms of reliability and troubleshooting. While managing the network from a central location is possible, gaining adequate visibility into network health all the way to the edge of the network requires the deployment of specific equipment, which is often overlooked in the original network designs.
Next on my list is lifespan. The lifespan of a typical mobile phone these days is around two years. For a laptop that may stretch to five or even six years. In the hospital setting, equipment commonly used in patient wards and examination rooms might easily be in service for 15 – 20 years with few firmware or middleware upgrades. This means that hospital networks—more than almost any other environment—must cope with the demands of legacy equipment. In practical terms, it’s not uncommon to see medical equipment being used that was manufactured in 2003, when 802.11a and 802.11b Wi-Fi protocols were first becoming popular, and we started seeing people toting chunky laptops to cafés for free WiFi. Remember those days?
Did I mention that older devices have security problems? Well, they do. Having products on the hospital floor without providing the software updates that we’ve come to expect from our consumer electronic devices poses potential risks to patient safety and privacy. It’s not just the infamous case of hackers possibly gaining access to a pacemaker, it’s the issue that all devices face as they get older – they simply do not receive patches to help address security vulnerabilities.
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Another issue facing hospital IT teams is the number of different vendors with equipment accessing the WLAN. In the corporate environment, there are some compatibility and security issues created by lax BYOD policies, but in the hospital, this is greatly magnified. Corporations typically standardise equipment by deploying a limited number of laptop models or a handful of other peripheral devices. In the hospital, there are all manner of monitoring devices, wireless communication devices and other appliances from a huge number of vendors, all competing for bandwidth. Ensuring that traffic can be intelligently prioritised is a difficult task, but it is also a vital aspect of ensuring positive patient outcomes. You wouldn’t want a heart monitor being booted off the network because a hospital guest is trying to stream a video.
Networks often experience issues such as latency, jitter, and dropped packets. When wireless communication is thrown into the mix, this can be exacerbated by interference. Hospitals have so many departments, with some many electronic appliances, that they often interfere with nearby wireless equipment. Security cameras are one particular culprit but there are many more.
Last but certainly not least, having to cater to so much legacy equipment isn’t bad, it simply means that healthcare IT teams need to have a very clear roadmap when planning any kind of upgrade. For example, if support for the 2.4GHz Wi-Fi band is going to be phased out to help reduce interference problems, the staff needs to know exactly what equipment will be affected by this change, and ensure that any medical or support staff relying on that technology also has a clear and robust transition plan. Considering the churn that many IT teams go through, keeping proper records and having the right procedures in place is yet another layer of complexity for healthcare providers.
When you consider the sheer number of connected devices on any given hospital network, particularly if it is part of the National Health Service, the incredible volume of traffic created is bound to create some problems. But because patients’ quality of treatment is on the line, it’s imperative that they use tools to identify and resolve the root cause of network issues quickly. Visibility and troubleshooting insight help resolve network issues. In the high-stress world of patient care, seconds and minutes can make all the difference.
Shift to a proactive mindset
With such complex and distributed network environments supporting connected medical devices, business critical systems, as well as patient and guest services, hospital IT teams and engineering teams require tools that cut down on troubleshooting time and enable resolution of network issues before patient care is impacted.
Let’s look at a very simplistic example of network troubleshooting at a hospital. If and when a network issue arises at any location within the network, the IT team will typically find out via an alert or a trouble ticket. The team then needs to swing into action to isolate the problem and work out an appropriate solution. This is where good packet capture tools and diagnostic software are invaluable. By initiating a packet capture at the source of the problem, it is possible to quickly find the root cause of the issue, whether it happens to be caused by a misconfigured router, the ISP, an application problem, or perhaps even a cloud service provider.
Whatever the problem may be, these issues need to be dealt with quickly. In the modern hospital environment, these tools provide the additional benefit of being able to go beyond short-term diagnostics. Having access to long-term network data and analytics will allow these teams to accurately benchmark network and application performance throughout the hospital chain, enabling them to much more easily identify where and when specific problems began.
This information allows IT teams to find anomalies and resolve performance issues with greater speed and efficiency. Just as preventative medicine is seen as an incredibly important and powerful way to reduce the risk of disease for patients, hospital networks, like those at any large organisation, need to shift away from being reactive when it comes to network management. The tools now exist for IT teams to be proactive, which ultimately saves time, reduces cost, and saves lives.
Sourced by Jay Botelho, Senior Director of Products, Savvius, Inc.