Sydney Children's Hospital, at Westmead, Sydney, Australia, has completed a trial of integrated wireless networking technologies to streamline manual processes and improve patient care.

With some 46,000 patients admitted to the hospital every year, a solution was sought to reduce the amount of time clinicians spent walking through the wards to consult each other.

About 12 months ago the hospital began a trial of wireless technology and installed the infrastructure to support access to patient records and a rapid voice communication system using portable badges rather than phones.

Some 80 registrars, surgeons, visiting medical practitioners and nurses were involved in the trial.

The hospital's director of information services, Dr. Ralph Hanson, said his department is not focused on putting in IT for IT's sake and makes sure it assists clinicians in doing their job.

"We know IT brings benefits to health care delivery and we have made great progress over the past decade [and] done it in an environment where there is a strong service improvement culture," Hanson said. "You have to have it all in sync together with clinicians and their processes. We can't put systems in that lock doctors and nurses down to desks and if we don't implement systems to facilitate mobility we are not providing the best service."

Hanson said the project has been about the connectivity and it's "all around us."

"When you translate that to the care clinicians give you can see the immediate benefits," he said. "The journey doesn't stop there - we need to get the systems to operate on more mobile devices like PDAs, and vendors need to look at those solutions."

A multi-vendor project

The mobile and communications solution involved quite a few vendors, including Cisco, Dell, and Intel all claiming some input into the project.

The infrastructure consists of 40 Cisco 1200 Series wireless networking access points, 40 Vocera hands-free communication badges, 10 Dell notebook computers, which operate on customised, battery-powered trolleys known as COWS, or 'computers on wheels,' and six Dell PDAs. IBM designed the installation, upgrade and integration of the Cisco wireless network and the Vocera communications system.

Hanson thanked the vendors for their input and is confident the security of the new WPA network is "medical grade."

With a voice badge worn over the neck, clinicians can use voice-activated dialling to call a co-worker, saving "a lot of running around," according to one nurse. The badges are also integrated with the hospital's PBX allowing them to make and receive external calls as well.

The badge can also act as an emergency beacon by sending a voice stream to all the other badges simultaneously.

Auditing shows it worked

In order to verify the feasibility of the project, the hospital also contracted an independent research firm, The NTF Group, to conduct a business process audit from June 2005 until December last year.

NFT Group Director Joan Nelson said observational research involving monitoring clinician's processes was conducted, along with the analysis of admissions data.

"We analysed all the admissions data and modelled it to see how long it took for a patient, from the time they came into the hospital to be seen by clinicians," Nelson said, adding data continued to be collected after trial "and the results continued."

The NTF Group's research, based on staff time saving, estimated the hospital will save about $450,000 (Australian dollars) per year.

With the wireless infrastructure still contained in the emergency and surgery departments, the goal is to expand its use throughout the hospital, and to expand its scope with other applications like RFID.

"We need to think about RFID so we can track our patients so we know where they are [as] patient logistics is a real problem for us now," Hanson said. "There is enormous potential to support all clinical initiatives across the state."

Existing framework made it a success

Both the hospital and vendors agreed that this project was a success because of the hospital's existing application framework which has been modernised to support electronic medical records, document-imaging, and an electronic admission and scheduling system.

"The applicability is there [but] you will see failed implementations of the same solution," Hanson said. "For us it was right at the time."

Cisco's Asia Pacific public sector director, Martin Stuart-Weekes, said there is now an enormous amount of research and development into the notion of "connected health."

"We've been trying to put it to the test in an Australian environment and needed an institution that was willing and ready to do it," Stuart-Weekes said.

Hanson said so far the response from clinicians has been very good with most leveraging the benefits of the new technology quickly.