Monday, 15 September 2008

WIFI in healthcare = too many arrows


updated: 2008-10-13

Never in my life i have underestimated a buyers decision more than the one I am facing right now. This decision is about replacing the current PABX business phone system in a home for the elderly.

As we are building new rooms for new customers, we will have to change the current system as it's maximum capacity will be exceeded.
Replacing the current PABX/DECT solution by a new one seems most obvious. But I am frustrated by the high costs, the limitations and inflexibility towards rapid evolving technology. It is very difficult to add value (through improved team-communication, better response to customers, better logging, better compatibility with third party software, etc.). Buying a telephone solution with PABX/DECT looks like trowing away your money.
Wading through enormous piles of information and brochures, I quickly understood that WIFI gives me the best (future-proof) possibilities and added value. Team communication can be optimized (imagen an interface like MSN/Gtalk/AIM), data and voice is integrated (and coupled) in one system, integration of WLAN and web-based applications, ... flexibility galore, without expensive cabling! Moreover I can improve communication for elderly customers: big button WIFI-cellphones, big screen devices, softphones, message boards (kiosk), free possibilities like Skype, Netmeetings, etc.

The theory is obvious, the practicalities not. I spoke with 9 firms, some once, some 3 times. Each firm contradicting the opinions of their opponents, some firms making mistakes in areas/technologies they are not familiar with, each firm giving more questions and doubts than answers. As a customer I'm forced to study the possibilities and impact of the technology for an objective view.
In this study it's very easy to get completely lost in information overload. As a technical minded user it is very easy to get blinded by the thrill of the chase of new technology.

Bottom line is that WIFI is entangled in so many disciplines within my care organisation that I end up with too much different technologies, too many questions, too many sales reps, too many technicians, ... each defending their technology. I have too many arrows on my diagram ...

WIFI Plus
  • No slowly dying technology like DECT. "It is clear that VoIP technology will replace traditional circuit-switched telephony in the enterprise. It is no longer a question of if, but when enterprises will migrate to IP-based telephony solutions. This is where WiFi holds a clear advantage over DECT, or any other proprietary TDM-based wireless solution. WiFi allows for end-to-end IP telephony making it the most elegant — and cost-effective — technology for enterprise wireless in the long run."
  • Connectivity: all WIFI devices can be connected (no propriety installation like DECT)
  • Compatibility: all (current + future) applications can be coupled to this one voice + data-highway
  • Limitless configuration- and management- possibilities
  • Flexibility: end solution being *exactly* what a customer wants, dataflow (like for example UMS) can be tailor made
  • Possibility to add "tracing" to your network
  • Cost of communication will go down as more people will use VOIP (instead of landlines)
  • No expensive wiring.
WIFI Minus
  • Battery-life of mobile WIFI-devices is 8 hours maximum. In a care-environment this could be insufficient.
  • Range of WIFI-transmitters is smaller than it's DECT counterpart. You need more transmitters (about 30% more).
  • Maximum length of an UTP (cat 5) cable is 100 meter.
  • What if the switch has a defect? Default backup-solution is essential.
  • Power-out = no communication possible.
  • Cost of installation (a lot higher than traditional solutions, although no cabling is required)
  • No completely integrated and proven solution in a healthcare-setting. Where can I personally witness a working WIFI-installation and ask for user-feedback?
Questions
  • Is quality of voice communication with WIFI inferior to other solutions? As i've used different Java-communication-apps frequently, I can't say I've ever experienced any quality loss though. But this situation is a single user situation.
  • Is it possible to have different ringtones on a DECT-phone. This is, can the receiver perceive a distinction in ringtones on a mobile dect-device, if it's origin differs. Origin could be: inbound call, room service, fire-alarm, etc.
  • How much will internal WIFI communication cost? I fail to see any costs, 3 sales reps claim the opposite.
  • Is seamless handover (from one transmitter to another) guaranteed with WIFI-handsets?
  • Alarms-handling: How are alarms handled? Is it possible that a certain alarm(-signal) gets lost?
  • Is WIFI secure? This is the communication itself, access to the network and usage (bandwidth).
  • How much capacity should the switch have? How many lines are needed for, as example, 10 staff people and 70 customers?
  • Will WIFI-devices interfere with one another?
  • How much different actions do i have to perform to make an internal call, to accept an alarm, to put calls through, ... how easy can regular users perform these everyday actions?
Good Reads
http://www.howstuffworks.com/search.php?terms=voip&x=0&y=0
http://en.wikipedia.org/wiki/Voip
http://www.pcmech.com/article/taking-your-phone-line-online/
http://www.tmcnet.com/voip/0205/WiFi-Telephony-All-Grown-Up.htm
http://www.intel.com/healthcare/ps/mca/index.htm?iid=healthcare_mcadevelopers+tabs_overview
http://blog.abptech.com/blog/the-dect-versus-wlan-wifi-debate/
http://blog.voipsupply.com/mobile-voip/dect-vs-wi-fi-death-match%E2%80%A6who-will-be-victorious
http://www.chcf.org/documents/chronicdisease/HealthCareUnpluggedTheRoleOfWireless.pdf
http://www.texting4health.org/slides/Landscape%20of%20Texting4Health-R%20Adler.pdf
http://www.ehealth-connection.org/files/conf-materials/mHealth_%20A%20Developing%20Country%20Perspective_0.pdf
Considerations for deploying Voice over Wireless LANs (25' webcast registration required)

Thanks to
Nextel http://www.nextel.be/
Essec http://www.essec.be/
Telecom-IT http://www.telecom-it.be/
Newtel http://www.newtel.be/
Avaya http://www.avaya.be/
Televic http://www.televic.com/
CLB http://www.clb-belgium.be/
AMR-ICT http://www.amr-ict.nl/
Tadicom http://www.tadicom.com/



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13 comments:

Bart Collet said...

Two good reads (thanks to Stefaan from Telecomcenter.be):
http://blog.abptech.com/blog/the-dect-versus-wlan-wifi-debate/
http://blog.voipsupply.com/mobile-voip/dect-vs-wi-fi-death-match%E2%80%A6who-will-be-victorious

Anonymous said...

There are many articles about Wireless VoIP. And depending on the author you can get some brand -dependend information. Al depends on the architecture used for the Wlan, and in lesser degree from clients (phones, pc's, etc.). There are many solutions on the market, and not al solutions are ready for VoIP, data and video.

Informing yourself and a good study of your building can give you perfect results. Many inustries are already working completely on Wifi.

Bart Collet said...

updated article 2008-10-13
Thanks for excellent feedback:
Philip Demeyere
Christof Delsupehe
Stefaan Delagrange
Peter De Baets
Luc Thierens
Dirk François

Preliminary conclusion is that I have two choices:
1) Buy a DECT-solution and replace it within 5 to 7 years with a mature WIFI-system
2) Proof ROI for the WIFI-premium and invest in the future

Evertb said...

Bart, great to read your blogpost as it raises very valid questions. I might be able to answer some of them but it would be too much info to put in a comment. Feel free to contact me directly.
Some pointers though:
1) Look at Ruckus wifi equipment; these are very capable to handle high throughput/low latency VOIP at an affordable price.
2) Don't ask to hardware salespeople or solution providers about the costs. Talk to independent experts about this and then tell the salespeople that those figures decide the limit of your spend.

As for answers to the questions in your post: no, yes, no more than the running costs of the network, yes, not sure, yes, your current need +25%, yes to a certain extent but not to a worrying level, not a wifi relevant question but actions should be no more than any other solution.

Unknown said...
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The WIFI in health care has too many arrows, and I think this is some thing that needs to be see, it is good to have WIFI in Health Care but the Arrows that has been talk about it is some thing thing that needs to be see also.

Custom Home Detailing said...

Is WIFI going to make good sense for the long run? That is a good question. I will read on but I wish I had the right answer for you. Good job on the post. Lets see what this year has instore for us.

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This is a good diagram and helps to explain. We will show this to the class.

CNA Traning said...

I am a bit too much excited after reading your article but I am just not able to tell you how better I feel after reading this.
CNA Traning

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I am impressed with your CV and the areas you are involved. Elderly care homes and technology do not go side by side. I wish I could have multitask like you.

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