3. Network performance. Even with security vigilance, traditional network implementation issues remain. For example, the use of routers and virtual LANs can introduce some delays as users roam among access points, notes Stettheimer: Smaller devices such as PDAs that have less powerful radios to save on battery life are more likely to drop connections as a user roams, he says, while some access points don’t reliably forward user log-in information to the next access point as the person roams.

Reconfiguring access points’ radio power levels solved the first issue, while upgrading access point firmware addressed the other. Stettheimer’s staff also had to adjust LAN settings to optimize traffic between the wireless and wired segments to prevent signal gaps that caused firewalls to reject some roaming users.

Ironically, it’s the use of standard network security tools that can create hand-off issues among wireless access points, says Meta Group’s Kozup. The 802.11b standard allows for and enforces efficient roaming, he says, but the use of security mechanisms separates the unified 802.11 networks into segments. The need to reauthenticate users when they pass from one network segment into another can lead to service disruptions. Some of this may get simpler as wireless standards are updated, Kozup says.

4. Access-point placement. This is not so much a hurdle as an important consideration. Wolanyk of Memorial Medical says he originally thought he would need 300 access points to provide wireless network coverage. A radio-placement consultant helped him cut that in half, and in the process paid for its fee, he adds.

Not Ready For Prime Time

Tablet PCs and slate computers are all on hospitals’ radars because they are most akin to familiar notepads, but none are yet appropriate for deployment.

"We looked at Fujitsu and ViewSonic slates, but the battery is gone in two hours," recalls OSU’s Thomas. "When the battery died, you had to reload the drivers for the device because everything is in memory."

St. Vincent’s is testing 20 tablets from different manufacturers. Whatever tablets Stettheimer selects, he will not store data on them, even if he takes advantage of their processing power to offload work from the servers. That’s already the policy for PDAs: no data stored on the devices. Instead, he uses XML on the handhelds to query the EMR system for information that is read-only on the device screen.

Ongoing Experimentation

Wireless technology is still new and evolving, so hospital wireless systems—just like their EMR systems—will evolve for years, and hospitals will choose different paths for their deployments.