By Dean Richmond / Special to Healthcare Facilities Today

 Healthcare facilities have long recognized the critical and evolving role of clinical mobility when it comes to patient care. And while some hospitals still maintain no-cell-phone zones to mitigate the potential for interference with sensitive medical equipment, for the most part, patients, visitors and employees can use their cell phones with few restrictions inside the facility. 

In a study conducted by Spyglass Consulting Group, 90% of hospitals surveyed revealed they are investing in smartphones and secure mobile communications to help drive clinical transformation. These investments also aim to address the communications needs of mobile healthcare workers – clinical or administrative — who are involved in the care continuum and are becoming increasingly frustrated with outdated communications tools such as pagers and landline phones. 

Enter the smartphone, and the cellular-enabled tablet, which, when coupled with a bring your own device (BYOD) strategy, mobile device management software, and the cloud, makes it secure and easy for clinicians and administrators to provide the level of care and oversight required in a bustling healthcare environment. That is – assuming they have a strong cellular signal inside the healthcare facility to enable reliable connections. 

Diagnosing the cause and finding the cure for poor indoor coverage 

It’s not uncommon for hospitals to be plagued with poor indoor cellular reception. This is largely due to facility construction. For example, many hospital walls are fortified to prevent X-rays from penetrating through. This can be exacerbated by a number of other factors, including the size of the building, location, and environmental obstacles such as other buildings or hilly terrain. All of these block cellular signals from penetrating into and throughout a healthcare facility.  

The number of users on a network can also affect cellular coverage, which is why coverage can vary between time of day, or day of the week. However, there are technologies that can ensure a good, strong signal indoors regardless of these obstacles, at different price points, installation and maintenance requirements, and coverage footprints.

Distributed Antenna System (DAS) technology is commonly used to improve cellular reception inside buildings. These systems use an outdoor antenna, usually placed on the roof of the building, to capture the signal from a cell tower and then distribute that signal to antennas located inside the building, which then rebroadcast the signal to occupants. 

There are three types of DAS solutions: passive DAS, distributed over coaxial cable; active DAS solutions, typically based on fiber-optic technologies, deployed to larger facilities 500,000 square feet and up; and newer active DAS hybrids, that combine components of passive and active systems, and are the most cost-effective and fastest to install in the 50,000- to 500,000-square-foot range. 

Many healthcare facilities have unique construction that needs to be considered when evaluating indoor cellular coverage solutions. For example, a national healthcare provider needed to boost cellular service inside one of its Chattanooga, Tennessee hospitals – specifically, in the facility’s eight cath labs where patients with cardiac health issues undergo diagnostic testing. Doctors performing procedures in the cath labs had no cellular signal, so could not connect to their various apps, receive text messages or make calls regarding patient care. Recognizing the urgency of the matter, the healthcare provider asked RCS Wireless Technologies, a communications system integrator based in North Carolina, to resolve its cellular reception issues.

“The biggest challenge was the lead-lined walls. As the building was also built to a newer construction standard, which included the use of Low-E Glass and brick exterior, this also diminished the cell signal coming in,” said Steve Klingensmith, President at VAST Signal Booster Solutions. 

Complicating the matter, the hard ceilings and lead-lined walls of the cath labs prevented RCS from installing equipment and cabling inside the labs, so the antennas had to be placed in the hallways surrounding the perimeter. As a result, passive DAS systems don’t have the power to penetrate the lead walls into the lab, and a high-end active DAS solution was too costly for the amount of space required to cover. According to Klingensmith, “An active DAS takes a lot more time to design and install, and it’s also a lot more expensive. The price starts at $2 a square foot and can go up to $5 or $6 a square foot versus an active DAS hybrid, which is far less than that.”

RCS chose to install Cel-Fi QUATRA, an active DAS hybrid. “We were able to solve the problem with the active DAS hybrid because it can deliver a cellular signal that is powerful enough to penetrate through the lead lined walls to provide coverage inside those cath labs,” said Klingensmith. “Since the installation was completed, there have been no complaints about poor cellular reception.”

The right dose of care and experience

The Parkland Health and Hospital System sees approximately 3,700 patients each day across its entire campus. As the Dallas community’s public health system and one of the country’s largest public hospital systems, Parkland is committed not only to the well-being of its community, but to the experience of every patient who walks through the door.

“In our line of work, wait times can sometimes be longer than we’d like,” said Tom Stanfield, New Facilities Technology Integrator at Parkland Health and Hospital System. “Many patients use their phones to pass the time—whether it’s to check their social media or access their patient records on MyChart in preparation for their appointments.”

For example, patients may use the lab services at the Hatcher Station Health Clinic prior to seeing their doctor. They can then view their test results on the MyChart application, which runs over a protected network, before their appointment.

However, the poor signal from two nearby cellular towers, combined with the clinic’s newer construction materials and the layout of the facility, made it difficult to get and maintain a strong indoor cellular signal. Patients and staff alike were unable to communicate externally either by voice or text.

Through a bidding process, Stanfield chose PWR Wireless to provide a solution. PWR Wireless, based in Texas, installs public safety and large active DAS systems all over the USA. After a site survey and reviewing the challenges faced by the clinic, they proposed an active DAS hybrid installation.

“We chose the active DAS hybrid because we are very impressed with how the product works. Plus, it is readily available and easy to commission versus an active DAS that requires months of contract negotiation,” said Paul Rice, founder and president of PWR Wireless. “We were able to install the system in one weekend in a 40,000 square foot building, with no tenant disruption at all.”

Patients and staff of the Hatcher Station Health Clinic can now send and receive texts and calls from their phones. Patients are also able to pass the time by checking their social media or completing other activities from their phones thanks to the strong indoor cellular signals. 

An effective treatment for poor cellular coverage

Increasingly more healthcare facilities are adopting patient-centered care models to provide a more personalized level of care and quality of experience. It’s no surprise, then, that clinicians feel hamstrung by legacy technology that prevents them from providing the kind of timely, personalized care patients have come to expect in the digital age. 

There are a variety of solutions now available to deliver the indoor cellular reception desired by both healthcare staff and patients, but some are definitely a better fit than others. System configuration flexibility, power, price point, and ease of installation and maintenance can vary widely from one system to another. By consulting with cellular or communications systems integrators that have a proven track record, experience installing solutions in similar facilities, and access to more than just a single product in their toolboxes, a medical facility IT administrator can find the best fit for their particular needs. 

For a deeper technical dive into the cellular coverage solution installed at Parkland Hospital, download the case study here. 

Dean Richmond is the Senior Director of Marketing at Nextivity. For more information, visit www.cel-fi-com