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Boston Medical Center's communication strategy sets future groundwork

By keeping a flexible network based on common standards, Boston Medical Center hopes to avoid past mistakes while connecting its nurses and doctors with the latest in communications technology.

At Boston Medical Center, director of technology Brad Blake is building out an infrastructure that will support the teaching hospital's communications needs for years to come.

But Blake recognizes that getting buy-in for his communications plan from key staff constituencies, including nurses, doctors and staff technicians, is as important as the technical attributes of a hospital's infrastructure.

Modern healthcare's frantic pace -- where precise, instant communication can mean the difference between life and death -- could be an ideal launch pad for unified communications (UC) if these conditions are met, particularly as stimulus dollars flow into the industry and electronic health records requirements are introduced.

"There is definitely an interest [in UC]," said Nora Freedman, a senior analyst with IDC. She said the size and multiple locations of many medical centers, as well as the fact that nurses and doctors are always on the move, made unified communications a perfect fit.

In addition, she said that because time spent tracking down nurses, doctors or the right expert was time wasted, and could potentially lead to loss of life, the so-called "soft benefits" of unified communications, such as reduced human latency, become invaluable.

Getting staff support on any deployments, however, is critical to actually seeing those benefits in the real world.

"I think that hospitals have to be really cautious about how they broach it with nurses," Freedman said. "They can be a champion behind it if they get buy-in early on, but if the IT guy just drops it in their lap ... they can be a real obstacle."

Blake said Boston Medical Center's teaching environment made the staff natural proponents of change.

Students and residents now consider constant access to communication technologies to be a way of life. He said these expectations required him to build a communications infrastructure that would support all the advances this generation of medical professionals would demand in the future.

That infrastructure already includes a dizzying array of EKG machines, wireless carts, laptops, tablets and PDAs, all wirelessly connected and constantly sharing data.

"I would guess from a day-to-day perspective, we're probably supporting about a thousand wireless devices," Blake said. "Being able to supply that level of connectedness was very important for us."

One early use has been the deployment of about 300 wireless IP phones, a combination of Vocera and Cisco 7920 VoIP devices.

At the beginning of each shift, a nurse signs out a device and associates it with his or her own unique account. This way, any caller trying to reach that nurse will be connected directly to the mobile IP phone, rather than a fixed telephone line. This has allowed nurses to stop sitting by a wired phone to wait for an expected call.

"The nurses love those because normally they would page a doctor, then wait by the phone for the doctor to call them back," Blake said. "This gives them much more flexibility to be contacted."

The phones are then similarly linked with that nurse's patient, so any doctor calling for information on that individual, for example, would instantly get the appropriate nurse.

At the end of the shift, the device's associations are wiped, and it is placed in a charger to await its next deployment.

In addition to focusing his strategy on the way hospital staffs actually work, building a sound foundation for future growth is a key element when laying out plans for upgrading communications infrastructure, Blake said.

For years, an outdated wireless infrastructure had held back the hospital's push to modernize communications. It was closely tied to the Cisco LEAP protocol, rather than the industry standard 802.11x technology that is popular today.

"We had drunk the Kool-Aid back in the day and went full-bore with the LEAP protocol. Finding devices that we could get up and running with LEAP was very challenging," Blake said. "With what was really about a year's worth of just chasing our tails and finding and resolving all of these problems, IT definitely took a bit of a black eye."

Boston Medical Center has since switched over to a standard wireless LAN from Aruba Networks that has allowed end users to connect in ways never before possible.

Frances Drake, director of Cisco's healthcare practice, agreed that it was important to build out infrastructure with a long-term strategy in mind and not to focus on low upfront costs to the detriment of future flexibility.

"There's an opportunity cost to [not investing in a quality network] because if they built a more robust infrastructure, they could make their nurses more efficient and improve the quality of care by connecting their caretakers more quickly," Drake said. The improved efficiency a quality network provides, she said, would more than pay for itself in reduced overtime and other savings.

The upgraded infrastructure has made life easier for Blake's team.

"My team spent a significant amount of time putting out fires left and right, just on wireless networking issues," he said. "Now, we have lots of ambitious stuff, and I think this is going to be the foundation for that. It's a very robust, stable environment to launch things."

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