VA medical center puts wireless LAN to the test

VA medical center puts wireless LAN to the test

System uses bar code scans transmitted by radio frequency to access data on patients' medication

By Richard W. Walker

GCN Staff

Officials at the Veterans Affairs Department medical center in Phoenix recently got a taste of the world of wireless LANs when they tested a small-scale system designed to ensure that patients were being given correct medications.

They liked it.

Here's how the system works: Using a portable computer attached to a medication cart and equipped with a PC Card wireless LAN adapter, a nurse wheels the cart into a patient's room.

The nurse scans a bar code on the patient's wristband to retrieve the patient's record from a database. The data is transmitted via access points'radio-frequency transceivers that provide links between the portable computers and the wired network'in the ceiling that are linked to the center's wired Ethernet LAN.

The nurse then scans a bar code on the medication's label and the system checks it against the patient's database record. The database is based on M, a programming language used almost exclusively in health care information management.

'If it doesn't match, it reports it immediately'before the medication is given,' said Richard Moore, chief information officer at the Phoenix medical center. 'If it's a match, it registers it as given and the nurse administers the medication.'

Over about six weeks last summer, Moore deployed and tested various components of the system, including PC Card wireless LAN adapters and access points from Aironet Wireless Communications Inc. of Fairlawn, Ohio; Lucent Technologies Inc. of Murray Hill, N.J.; and several other vendors. VA recently decided to go with Lucent's WaveLAN wireless LAN products.

The system is expected to be fully operational next month, Moore said.

'We'll iron out any bugs as we work along in February, but it will be a full-blown deal then,' he said.

It looked easy

Setting up the system proved to be a lesson in the ins and outs of wireless LANs.

For starters, installing the access points proved to be easy, Moore said. 'There's a base that mounts real easily to the wall,' he said. 'In some cases we pop-riveted it to the ceiling grid.'

But positioning the access points for optimum radio-frequency performance was tricky, Moore found.

'When we started off, I didn't do any site surveys' to measure signal density, he said. 'I just bought the equipment and set it up. Retrospectively, without a site analysis to see where the signal drops off, it was really just guesswork.'

As a result, there were dead spots. 'For all practical purposes, [the system] worked, but where the signal dropped off it frustrated the users and frustrated us,' Moore said.

A signal analysis done by Lucent has ended the guesswork. 'We know exactly the density and how many [access points] we need and where,' Moore said. 'There will be some glitches but not what we had early on.'

Moore also decided to add a second wireless element to the system: a cordless laser bar code scanner from Welsh Allyn Inc. of Skaneateles, N.Y.

Using a scanner attached to a cable was too cumbersome for the nurses. The battery-powered Welsh Allyn scanner, which rests in a base on the medication cart, lets the user freely move around the patient's bed without having to worry about the cable.

In initial testing, Moore used a Dell Latitude notebook PC mounted on the medication cart. The permanent system will use a combination of Dell notebooks and pen tablet computers from Fujitsu PC Corp. of Santa Clara, Calif.

Time for change

The battery life of the portable PCs and the wireless scanners also is an issue, but that's more a matter of user education, Moore said.

'We bought extra batteries and plan to put a shelf near the nursing station where the chargers can be plugged in with a reminder that when you change shifts, change your batteries,' he said.

In the long run, Moore expects the system to be a spectacular success.

Even in the early stages of testing, with signal glitches, tangled scanner cables and all, it found a significant number of medication errors.

'That's the biggest driving factor because we've seen the results on a short scale,' he said. 'We'll see a tremendous drop in medication errors this year because we'll be implementing [the system] in all seven hospitals here, and I think throughout VA in the course of this year.'

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