Paging, Wireless Phones Adapting to Trends in the Healthcare Industry

By Ron Wray Multitone Electronics plc

February 2004

Healthcare, like many other sectors of the economy, is made up of a large number of subdivisions, each with a diverse range of communications needs. However, the core business purpose is delivering medical services to people and, frequently, under critical life threatening circumstances. It’s no wonder that paging and other forms of wireless communications have been a part of the healthcare system for more than 60 years. The first wireless (ultrasonic) paging system was in fact developed (by Multitone) and deployed at St. Thomas hospital in London during the early 1950s. Radio frequency based systems came later (in the late 1950s from Motorola) but still predated many of the now taken-for-granted applications of wireless voice technology. The first true digital pagers were developed for private use (the American Stock Exchange) in the 1970s. multitone pager

Private Paging Lives On

Since then, private wireless on-site paging has evolved to be one of many healthcare applications using RF technology, but it still stands alone as a form of communications where voice and text information is delivered virtually instantaneously with a minimum delay — a factor that is still recognized by hospitals and other patient care facilities around the world as vital to first-rate care.

For this reason alone private paging is undergoing a renaissance — an acknowledgement that despite all the hype over newer technologies, private paging is hard to find an alternative for. That kind of responsiveness is not guaranteed with a public system — particularly in times of emergency and in light of the well publicized economic woes of paging carriers. The face of private paging has changed for other reasons as well — to adapt to the changing needs of the user, to become better integrated with other information systems, to utilize technical advances in the design and manufacture of paging products and last, but not least, to comply with regulatory trends such as spectrum refarming.

Meeting Healthcare Needs

The driving factors behind the communication needs of medium and large healthcare institutions are those same factors that create the trends in private paging technologies i.e., response time improvement, cost containment, greater demands on limited (facility and human) resources and, of course, timely information to maintain life and facilities. However, it is not as simple as "more for less" — such as technology and offshore manufacturing driving down prices. If that were the case, then we'd still be back in the 1950s, functionally speaking.

What's at issue and what is driving paging trends is more about system communication effectiveness, reliability (availability), integration with the information technology (IT) world and allowing hospital staff to operate more efficiently, which translates into better care and keeping costs down. Today’s paging solutions have evolved and matured over a number of years to be exactly what is needed to be absolutely "fit for purpose," which means you get the best return possible on your investment.

Trends Follow Needs

The most powerful feature of private paging, and one which is essential to quick communications, is the delivery of voice messages or voice and text combined. The spoken word is sometimes preferred as more urgent and powerful than any text message under certain circumstances. Cardiac arrest teams in hospitals will not settle for just a tone alert or clearly displayed text. In an emergency, people do not have time to read a message. A spoken message can tell users and team members what has happened and where to go in detail saving valuable time in the process.

The voice feature also best supports the uses of multiple languages that are now increasingly present in our diverse culture. In either case, the ability to store that message (voice or text) can assure redundancy and improve communication effectiveness as well as convenient and useful reference information. With the advent of low-cost memory and digital technology, this feature will lead the trend in new paging receiver designs.

Another trend is the integration and connectivity with other realms of the enterprise IT network. The trend is toward connecting computer-based devices and systems to enable fully automated messaging from life support systems. A simple "pull-cord" alarm approach doesn't suit today's high-tech monitoring and reporting technologies. The same holds true for facility (building) management systems, security and other types of equipment ranging from drug and culture storage to biohazard detection devices.

Today, virtually all such systems have an RS232 communication port and related software to export messaging to external systems. In addition, the modern paging system design will incorporate the facility to activate calls and generate pre-defined text messages from simple contact closures (or openings), a very handy method for rapid deployment of alarm notification for high-security and specially protected work areas. Similarly, all larger healthcare enterprises have a local area network (LAN) computer system. The ability to send a voice or text message from any workstation or server is an important feature that any new private paging infrastructure will support.

Changes in U.S. radio regulations are also dictating new trends. Existing and new networks must be able to operate on channels created by the IC's "refarming" of the private (including government) radio spectrum. Pagers will need to be improved in performance to operate effectively in the new 12.5-kilohertz narrowband channel spacing environment.

Reliability Above All

Above all, a reliable private paging system depends upon a design that is not only comprehensive in function and expandable but one that does not suffer from a single point of failure. One trend is distributed hardware and software systems that do not rely on a central point for continued operation. For example, a one box PC-based solution, which at first blush may appear to do everything that is required, cannot guarantee the same degree of reliability, performance or redundancy that is achievable with a networked element type of architecture. In many cases, the distributed networking approach is preferable for developing a modular approach to potential expansion.

As with all mission critical systems, the solution must be capable of supporting fault tolerant operation. That means an advanced private system must be capable of being automatic hot or cold standby configurable, so that on detection of a fault the system will automatically or manually switch over to a backup system. There is also a trend today for one institution to be the hub and manage other related sites. That requires management from a distance that needs to be reliable and deal in real time for back-up or disaster recovery.

Why Not Wireless Telephones?

Another wireless innovation that has appeared on the healthcare scene in the United States is the wireless telephone system (WTS). Known as DECT in Europe and other parts of the world, the technology already has over 70 million users worldwide. WTS is to business what cordless phones are to residential phone users. Essentially, they are full featured phones capable of being worn on the person and operating within the coverage of a private radio network.

Wireless telephone systems are a new tool to improve business and government operations and customer service. They can have a significant cost and performance impact on the administrative side of healthcare. Everyday, people call a switchboard or direct dial a number and 60 percent are unable to contact the person they want — in operations, support or management. The call is often unanswered, may go to voicemail or a colleague answers the call and leaves a note on the called person's desk or in their voice mail.

WTS systems have proven themselves to be very helpful wireless tools in improving organizational efficiency, response time and convenience for users. In hospitals and other healthcare facilities, WTS phones have greatly enhanced the communications between medical and nursing staff and management and supporting personnel. Because of their portability they promote the mobility of personnel to tend to more tasks while being able to walk and talk and, generally, be more effective in their job.

Based on a spread spectrum wireless platform, the WTS technology available today is relatively easy to apply from an implementation point of view as well as in the operation of the system. Interfacing to existing telephone networks for traditional voice communications can take place through simple analog connections at the extension level to a PBX or they can be connected to LANs and communication with technologies such a VoIP (Voice over Internet Protocol).

Beyond this there is the potential for machine-to-man communications. Several types of WTS systems and handsets are capable of delivering text messages to mobile users. Computer-based devices can generate the text, or the message can be generated by a human on a networked PC. Likewise, WTS handsets can generate control messages to turn equipment on and off, open doors, authorize transactions and a host of other applications that can make modern healthcare facilities more effective in operation, as well as improving safety and security. You can even send a paging call from your WTS to pager-only equipped personnel.

But why do some institutions prefer paging and yet others will adopt WTS as their platform of choice? We believe that it comes down to exactly that – Personal choice! Some users do not like the intrusive nature and immediacy that answering a phone necessitates. This enforces behavioral change on users. With a pager you can decide which is the most immediate need, returning a call or dealing with your current action. This is why modern trends are leaning toward having a phone that acts as a pager, allowing users to make that all-important choice.

Trends Provide Opportunity

While the foregoing is only a brief view of paging and WTS trends and how they will affect the healthcare community, it points out that private wireless innovation offers a great opportunity for user and supplier alike. Like any other new technology or product, it will take education and experience to reap the rewards of better service, greater profits, greater patient safety and security as well as customer and employee satisfaction — a trend that is sought by any growth minded industry.

Author BIO—
Ron Wray is the Director of Marketing for Multitone Electronics plc, an international developer and manufacturer of wireless communications systems and products. For more information, visit