Healthcare Wireless and Device Connectivity

FCC and Channel 37

Have not responded to this as of yet; as wanted to listen to all the back and forth between all the parties providing input. One word…”interesting”!

As one, I have been in the medical telemetry space for over thirty years and I have designed many large antenna systems for both UHF and VHF for large healthcare systems. Thus you could say… have the field experience of not only design; but lugging around a spectrum analyzer and making this all work.

Working for a company that developed VHF receivers and transmitters; I vividly remember how WMTS came onto the horizon in the late 90’s. Also was I was in the throws of when Wi-Fi came out in 1999 and I transitioned to a company that helped develop the Wi-Fi Alliance. Wi-Fi can onto the scene in 1999, simply because 802.11b was approved. As a side, 802.11 was there years before. In addition I worked with many medical device companies to incorporate WLAN into their applications from 1999 till a few years later.
So in some essence know both sides.

When the issue of HDTV interference came into being, healthcare systems spent millions and millions of dollars to shift to WMTS out of UHF and VHF. The whole notion sold to the “end user” and the industry was that this was a “quote protected spectrum”. That was in the late 90’s. However; nothing really changed in terms of the actual design of the diversity antenna system or transmitter/receiver… still decades old..in my opinion. Companies simply shifted frequencies.

Moving forward to 2015, WLAN has been proven to work for patient monitoring, infusion pumps, and pretty much any type of healthcare application today. In fact there are very sophisticated real time spectrum analyzers built into today’s modern WLAN controllers and access points to monitor any potential interference and identify it.

This not present with WMTS. Fifteen years of progress and billions of $$ have been spent in the WLAN space. The little known technology of 802.11 in 1998 and 1999 has become a "household" word of WiFi today.

Question…. how much continued R&D has been spent in the WMTS space in the past fifteen years?

Spectrum is spectrum, it is precious and the FCC does control this. No doubt sooner or later Channel 37 would come under pressure.

See attached articles and white paper.

802.11af, also called Super Wi-Fi or White-Fi, employs unused TV spectrum at frequencies between 54MHz and 790MHz, over very long ranges (possibly several miles).

According to a study, there will be nearly 26 - 30 billion devices on the Internet of Things by 2020. ABI Research estimates that more than 30 billion devices will be wirelessly connected to the Internet of Things (Internet of Everything) by 2020.

Download Wp_medical-grade_life-critical_wireless_networks_stevebaker-3

Download 150728-statement-oversight-fedcom

Download DOC-334757A1

Download ExApril_24_2014

Download FCC to allow unlicensed devices on same band as patient monitors - Modern Healthcare

Download OTI-PK-comments-TVWS-Part15_02252015

Download Product_data_sheet0900aecd807033c3

The Wireless Patient Monitoring Architecture for 2014

I have been expressing professional views and why the value of 802.11a/b/g/n for patient monitoring since 2000…it is now 2013. Ironically…now the pervasive WLAN is going full main stream with all the infusion device companies as well as patient monitoring companies adopting the use of this infrastructure. See attached a video link of my latest filming to provide an unbiased validation of why 802.11a/b/g/n and the compare and contrast with WMTS.

http://www.youtube.com/watch?v=Rr8btSBKWPo&list=PLCEB337222DC73C29&index=11

Related articles

A WLAN Radio is Not a WLAN Radio and the WiFi Alliance

Wireless Patient Monitoring - Is WiFi Safe and Reliable?

The HTML link below will allow for registration

Download 131011_Draeger_sponsor_email

The debate is over. From 1999 (when 802.11b got approved….the extended set of 802.11) Integra Systems, Inc., has worked in multiple vertical markets designing mission critical (Department of Defense) and life critical networks.

In 2005, we worked with a major patient monitoring company and designed the first ever “converged” data, voice, video, and real time patient monitoring network. Many in the industry that were strong advocates of WMTS…said it just could not work.

The opinion it seems was not technical; but a business decision to keep moving forward.

It is now 2013 and every infusion device company is using 802.11 for their smart pumps, as well as Sp02 monitoring companies and “every” patient monitoring company (the leading ones), for patient transport monitoring.

The question…then remains why then is WMTS still being sold? One word describes this….interesting.

I think as a CEO of a healthcare system I may want to leverage my current investment in my infrastructure so I could use my savings in capital expenditures to support the EMR for meaningful use; versus spending dollars on proprietary architecture.

Folks also are it seems all over the map in terms of well “we need to have 802.11a” or we “cannot have WiFi” for wireless enabled medical devices. At the end of the day, an application that even is life critical such as patient monitoring; uses a very small amount of bandwidth and can be managed correctly with the right enterprise QoS mechanisms. What is important from the get go is to have the right radio design, the correct roaming algorithms, and right design of the infrastructure and environment to support the application requirements.

Look forward to the upcoming web based event video conference that Integra Systems, Inc. will be presenting next week surrounding all of the aforementioned.

In addition, we will be a moderator and presenter at the upcoming fifth annual Medical Device and Connectivity Conference & Exhibition – November 21-22 in Washington, D.C., as well presenting and moderating at the UBM Wireless Medical Device Conference, December 3-5, San Jose, CA. All presentations and discussions will be surrounding the best practices for testing, design, and deployment.

Please go to www.ixiacom.com the world’s leading networking test and instrument company and download the recently authored “white paper” by Integra Systems, Inc. about the best practices of design, testing, and deployment for a life critical wired and/or wireless medical device application.

WMTS versus 802.11,…Really Again! Add now the spin of 802.11g versus 802.11a

It is 2013 and I still cannot I believe still hear this argument for WMTS. My head hurts. In 2000 we were on the presentation circuit when Welch Allyn came out with their FHSS MicroPaq. In 2005 Integra Systems, Inc. was the thought leader behind the architecture of Draeger OneNet…the first shared WLAN infrastructure for patient monitoring. Moving forward in 2013, this has been deployed on a global basis and it is safe, reliable, and cost effective. In fact if you go to www.cisco.com you can download the complete technical architecture for the design and implementation in a shared enterprise environment with other healthcare applications. As more and more hospitals want house-wide coverage and more and more telemety and patient monitoring channels, the channel spacing at 608-614MHz simple does not allow this, hence the need to use 1.4GHz, of which means two separate systems. Oh yes, does healthcare have the $$ to throw away at a costly and dedicated WMTS infrastructure when they could now use this for their needed EMR implementation to meet meaningful use?
802.11a/b/g is not “safe” versus dedicated spectrum of WMTS. This argument has no validity. Last year Integra Systems, Inc. was involved in a forensic investigation where a WMTS system was experiencing repeated drop out of “minutes” over a two year period. Had to haul in a spectrum analyzer and figure things out. So it is a myth that this is protected….it is RF! This also caused a huge liability problem for the institution. We were called in because the manufacture could not figure out was going on for two years!
Now I hear, well 802.11a is better than 802.11g? Who is saying this? Yes there are only three non-overlapping channels in 802.11b/g at 2.4Ghz versus 802.11a with more non-overlapping channels, but that is not the point. It about proper network design! Integra Systems, Inc. last year designed a 802.11g voice network for a classified Department of Defense that had to work with 100% reliability…all the time. You know what…it worked just fine. Let me also say that patient monitoring takes up a very small amount of bandwidth, so no way is it going to be a bandwidth hog.
802.11ac acceptance the end of 2013 puts an end that 5.0GHz is the place to be not 2.4GHz. This where the high bandwidth applications will reside as this will pretty much offer GigaEthernet speeds. So the premise of a dedicated patient monitoring network for 802.11a..well that is where it is going to get real crowded, real fast.
So, this is jest of it. WMTS will be history. A WLAN enterprise patient monitoring network is simply another application that through proper network design will work in a reliable fashion. It has been proven out since 2005…it now 2013. Some food for thought, most folks do not know the majority of financial transactions that occur daily on Wall Street are through an enterprise WLAN. Guess if good enough for security and quality of service for billions of $$, guess just fine for healthcare.

Couple of good reads: Co-authored paper by author and Dr. Baker...2008, published in IEEE. Writing a paper with a rocket scientist..was a definite challenge. It also on Aruba Networks web site.

Everything you wanted to know about 802.11ac...by Cisco. Good when you want to go to sleep at night.

Download Wp_Medical-grade_Life-critical_Wireless_Networks_SteveBaker

Download White_paper_c11-713103

Integra Systems, Inc. presentation to NYC AAMI Chapter - WMTS and the WLAN

On December 04, Integra Systems, Inc. presented a wireless seminar on the content of WMTS; the move forward... and the WLAN and the value add for medical device connectivity in 2012 and beyond. This was sponsored on the behalf of www.draeger.com. Content can be provided upon request.

WMTS Channel 37 Web Event Regarding Recent Potential Changes

Never expected this turn out, but from over 400 registered, we had 240 plus on line and over 70 comments/questions. Definitely a very hot topic. Once cleaned up I will provide the PDF of the presentation on this blog and links to other sites. Thanks for Draeger to their support of this event of which OneNet via somewhat my pioneering effort in 2005 has become the reality of the patient monitoring networked environment.

Issues surrounding Channel 37 WMTS Potential Re-Allocation Web Event.

On the 23rd of July I am conducting a web based event surrouding the potential issues of Channel 37 reallocation on WMTS that will be sponsored by www.draeger.com

http://www.ashe.org/resources/ashenews/2012/advocacy_alert_12061212.html

Fallacy of WMTS and WMTS on a DAS

I got an interesting call this week from a major healthcare system (not to be identified). Question was...are their Quality of Service Requirements or latency issues for WMTS? Well, no. However I probed further and found out what the real issue was.

Apparently one of the installed (not to be named..but lets' say real large companies) WMTS in 608-614Mhz was actually having delays of up to 4-8 seconds from the transmitter to central station waveform display. (Very clinically unacceptable), every few hours. My read is it probably had to do with "drop-out". (The companies (manufacturing this)...apparently threw up their hands!)

So how do you trouble shoot this?...send people out and use a spectrum analyzer and then step by step look through all aspects of the coaxial antenna system. How do I know this...because been there and done that years ago. The point of this, (if the companies..which we know about), actually used WiFi; it would at least be a different story. You could remotely troubleshoot, but also ensure enterprise grade Quality of Service...and the IEEE standards.

Now moving on the issue of WMTS on DAS. Well looking at my crystal ball and what I know, the big companies that we know all have skunk work projects to figure out probably to exchange the 608-614Mhz and 1.4GHz radio with WLAN (probably 802.11n..as silicon gets smaller and more efficient. So this is where it gets interesting. One company is promoting how great it is to combine WMTS with a DAS, (at 1.4GHz). Another quote is obtained from a competitive WMTS company (at 1.4GHz). Discrete WMTS at 1.4GHz Combining it with a DAS cost $900,000.00 (more)..yes more. Oh yes how would you like an antenna element spaced every 15 feet down the hallway!

WMTS and the Reality of Bandwidth for Medical Telemetry

The article that Steven D. Baker and I wrote for IEEE Titled “Medical Grade Mission Critical Wireless Networks” covers a lot ground.  However, I did want to touch on one area.  Back in the 80’s (dates me), when it was still the days of VHF and UHF (yes even go back to analog and the transition to digital and non-fade oscilloscopes), hospitals rarely had over a 100 channels.  Now the game is to provide ambulatory (telemetry), patient monitoring house wide, especially with the innovations in displays, battery life, and better overall system designs.  This means often large institutions may want over 240 channels.  Telemetry with these innovations is often the monitor of choice. The issue is with WMTS at 608-614MHz, you have 6MHz of bandwidth.  Since the modulation is GMSK (Gaussian Minimum Shift Keying), the channel spacing is 25KHz. So doing the math, 25KHz into 6MHz, gives you 240, that is without any guard bands. As described in this paper “However the widest band in the WMTS spans only 6MHz. As a result, spread spectrum systems that use this band render useless nearby second-generation systems that are transmitting in the 608-614MHz band.  Other companies use the 1.4GHz WMTS bands but they suffer from a small BW (one with a 5-MHz BW, another with a 3-MHz BW,) and a prohibition of all but medical telemetry data.” Large hospitals, especially those in dense metropolitan areas continue to struggle with limitations of their WMTS systems due to restricted BW.  This is further complicated by documented cases where WMTS bandwidth had to be further restricted in some cases to only 2.5MHz, or where legal broadcast stations have cause interference, there again, causing restrictions on the bandwidth. Having less than 120 (25KHz into 120) usable telemetry channels simply is not adequate for a lot of large integrated house-wide telemetry deployments.  The M300 (Telemetry) from Draeger Medical since it uses 802.11b/g network components changes the game.  The M300 is intended to support up to 999 beds (channels) in a single network.  All the more reason for standards based networking technologies leaving WMTS in the dust.