19_IBW_healthcareThis blog first appeared in Health IT Outcomes on Aug. 8 2019.

As the wireless industry evolves toward 5G, indoor mobile communication is becoming more prominent in connecting people with one another and with information. Nowhere is that more important than in the healthcare industry. In a hospital, a reliable, high-speed indoor coverage network is essential—for EMS en route, surgeons in need of lab results, visiting doctors needing to communicate with their offices, and patients who want to stay in touch with their loved ones. However, it has been a challenge to find a wireless infrastructure solution that’s cost-effective, reliable and manageable. Now, new approaches to indoor mobile communications infrastructure are eliminating some age-old problems for hospitals and other healthcare venues. 

CLICK TO TWEET:  Experts from CommScope and Accu-Tech explain the right in-building wireless solutions for the healthcare industry. 

Hospitals And Wireless Infrastructure

With a pressing need to connect doctors, nurses, patients and equipment as they move throughout a facility, hospitals have been pioneers in using wireless for connectivity. Initially, doctors used pagers to stay connected with nurses who needed them. As smartphones came to prominence, doctors and nurses began using them to communicate. To ensure consistent mobile service within facilities, hospitals deployed distributed antenna systems (DAS) to bring outdoor cellular signals indoors. Hospitals were also early users of Wi-Fi networks for nurse call systems, mobile charting and other applications.

With the onboarding of telemedicine and telehealth and the number of devices used within a hospital on the increase, hospitals are going to need more bandwidth than they can get out of current Wi-Fi and DAS infrastructure. Mobile wireless infrastructure is evolving with the advent of 5G technology, which promises up to ten times the bandwidth of previous generations. 5G is also the first mobile wireless technology to offer built-in support for the Internet of Things (IoT), which will factor heavily into healthcare use of wireless.

New applications like wireless telemetry, remote surgery, asset tracking and others will all run over wireless networks. There are more than 10 wireless devices in every patient room (i.e., heart monitors, telemetry, nurse call systems, and access control systems). All of them will rely on upgraded wireless networks. For example, with asset tracking hospitals will use asset-tracking tags on equipment to track the locations of everything from heart monitors and portable X-ray systems to wheelchairs and gurneys. To support these new applications, hospitals are preparing to upgrade their DAS infrastructure for 5G networks.

DAS Deployment Challenges

Traditional DAS infrastructure is complex and costly to install, manage and scale. These legacy DAS products are based on analog technology, and rely on thick, heavy coaxial cable for transport. Since the signal is analog, there’s no flexible way to manage bandwidth in different areas of a hospital, and the signal tends to fade the longer it travels from the DAS headend. To deal with these challenges, DAS architects deploy myriad antennas and a lot of coaxial cabling, using a strategy known as “spray and pray.”

When it comes time to upgrade the DAS to deliver more bandwidth and support upgrades to 5G technology, hospitals present unique challenges. In a hospital, old cable must be removed when a new network is deployed. The cable is in the ceiling, and hospitals have strict requirements about managing dust and contaminants when ceilings are opened. Hospitals are concerned about the spread of infectious diseases, so whenever a work crew opens up a ceiling, they need to use HEPA filtering systems. In all cases the removal and replacement of DAS systems must be done with patient safety in mind, and it must also be done so as not to disrupt normal hospital operations.

How DAS Is Evolving

Today, new DAS solutions address hospital challenges. Rather than relying on analog technology and heavy coaxial cabling, new DAS solutions use an enterprise-friendly approach based on all-digital technology, Category 6A Ethernet cabling, and a local area network (LAN)-like architecture. In many ways, these products change the game for upgrading hospital DAS.

In the first place, Category 6A Ethernet cabling and a LAN-like, hub-and-spoke architecture is much easier to deploy and configure. Instead of heavy coaxial cabling which requires special hangers, takes up a lot of space in hospital ceilings, and requires specialized installation, digital DAS is thin and easy to install. Digital DAS transport is between 70 and 90 percent smaller than analog DAS infrastructure, so it can be installed quickly and economically. Configuration is also easier, because digital DAS eliminates the need for RF engineers to tune signals across the infrastructure, and many functions that were traditionally restricted to specialized hardware have been replaced with multi-function software-defined hardware.

Digital DAS also gives hospitals more control over capacity across the network. For example, to deliver more bandwidth to a remote surgery suite, network managers can use software to reassign bandwidth from other, less-demanding parts of the network. In addition, digital DAS carries more bandwidth than analog systems. Using common network wave division multiplexing, digital DAS networks can carry up to 90 percent additional bandwidth when compared with analog solutions.

Digital DAS also facilitates the use of multiple-input multiple-output (MIMO) technology. MIMO involves the use of additional antennas to double the bandwidth of a network and it will be a key technology for 5G wireless. With analog DAS, supporting MIMO requires adding a second layer of cabling. With digital DAS, MIMO can be deployed by attaching additional antennas to the existing SISO infrastructure. In fact, a digital DAS allows users to deploy interleaved MIMO with a simple software reconfiguration to obtain up to 70 percent of the performance of MIMO without having to deploy additional antennas. This novel software-based approach offers significant performance improvement for very little incremental cost.

Finally, digital DAS can be deployed today to support 4G LTE wireless and then upgraded via software to support 5G when it becomes available. Most 5G wireless systems will rely on LTE technology for the first few years anyway, so deploying LTE now makes it easy to transition to 5G.

Digital DAS Is The Future

Digital technologies are replacing older analog technologies in many areas of life, and now digital DAS is making it possible for hospitals to meet their wireless infrastructure needs with systems that are cost-effective, easy to deploy and easily capable of migrating to 5G technology when it becomes available. For upgrading mission-critical wireless communications infrastructure in healthcare facilities, digital DAS is the obvious choice.

About the Author

Nate Fuentes & Tim Flannagan

Nate Fuentes is business development manager, North America, for CommScope’s Distributed Coverage and Capacity Solutions team, responsible for technical sales and strategic partnerships for distributed antenna system and small cell solutions. Nate joined CommScope through the acquisition of TE Connectivity’s Broadband Network Solutions business in 2015. He has served the wireless industry for 13 years in previous roles at TE Connectivity and ADC. Nate has proven technical expertise and business acumen providing advanced product application solutions to all tiers of customers. He has a bachelor's degree in electrical engineering from the University of Texas–Austin and holds many industry certifications. 

Tim Flannagan is director of Healthcare for Accu-Tech. With almost 20 years of experience in the healthcare technology field, he manages and leads Accu-Tech’s dedicated healthcare sales team. Tim established and leads the sales execution for Accu-Tech healthcare initiative nationally across 35 sales branches. Tim is also veteran of the United State Marine Corps.

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