Hospitals, nursing homes and healthcare facilities are transitioning to digital. This renovation is necessary to maintain and upgrade data, surveillance and security, often with convergence of all low-voltage systems on one cable infrastructure. According to a January 2009 article in the Washington Business Journal, software systems and IT services for healthcare are continuing to rise, even though overall technology acquisition was down in 2008. That trend is expected to continue.
To balance technology upgrades with patient comfort, hospitals employ contractors and installers who understand the technology and can install it without disruption. Those knowledgeable in both low-voltage wiring and the healthcare environment are a small group and heavily in demand.
Most expansion and retrofits happen in active hospitals. Patients are there 24 hours a day, maybe even on the other side of the wall where electricians are drilling. Since there is no down time, healthcare facilities require that their own staff members and contractors can work together to ensure the work is done without compromising health, comfort or safety.
Union Memorial Hospital near Baltimore employs a construction supervisor to oversee the upgrades, maintenance and expansion work at the 154-year-old hospital’s complex of buildings, totaling 1.2 million square feet with 300 beds. Before any new project, the construction supervisor sits down with a team of infection control personnel and the contractors who will be doing the work.
“We need to be very sensitive to patients’ needs in that area,” said Neil McDonald, Union Memorial operations vice president.
For some areas of the facility, work can be done outside clinical hours, limiting the disruption, which takes coordination with vendors, he said. But much of the work needs to be done in the hospital, and before that work begins, an infection control plan—including erecting plastic partitions or temporary walls to control dust—is needed, McDonald said.
For that reason, McDonald said he would be reluctant to work with a vendor without healthcare experience.
Southwestern (SW) Electrical Co. Inc., Wichita, Kan., has been doing low-voltage work in hospital settings for a dozen or more years.
“Hospitals are constantly upgrading,” said Dick Drake, SW Electric vice president. He added that contractors are present at many hospitals on a daily basis.
“It’s not hard for us anymore; the most important thing is to take into consideration the needs of patients who go there,” Drake said.
The company typically receives a request for the installation of new cable drops (usually Cat 6 or 5e or fiber) for data connections; these require very fast turnaround—typically 72 hours to get the work done.
“We may get 20 to 30 work orders like it a week,” he said.
Many hospitals have multiple campuses, so there may be several crews working at the same time.
The work can mean data or surveillance installations, but the low-voltage demands are expanding. For example, biomedical equipment often needs to be upgraded or installed with higher capabilities and integration, which require wiring equipment back to a server, Drake said.
Hospitals usually strategize their construction upgrades, bringing in low-voltage contractors when they renovate or expand a floor or wing.
When opportunities allow contractors to work without disrupting operations, the heavy work gets done. Instead of adding connections to bring new low-voltage functions to a server, for example, it is easier to replace old cable with fiber or another low-voltage cable.
“What drives their security needs is often the geographic location. We want to ensure our patients feel they are coming to a safe environment,” said Union Memorial’s McDonald.
The hospital had been using time-lapse VCRs but has now allocated $500,000 for a new surveillance system with intentions of spending another $300,000 over the next two years. Union Memorial is switching the 125 cameras from analog to digital. While the older cameras work, replacing parts for analog systems is getting harder, McDonald said, and the new technology is intriguing. He liked the idea of intelligent cameras that detect unusual behavior, then tilt, pan, zoom and send an alert to a remote location.
“We’re seeing, throughout the city, everyone is moving toward digital technology. There’s so much more capability with the newer stuff,” he said.
McDonald is facing the same dilemma as many other healthcare facility directors: how much to invest in now because technology evolves so quickly. He relies on his integrator to advise him and to ensure the installed technology will work for the hospital’s needs.
“I felt I didn’t want to spend a half-million dollars on a system and then not have it perform as I expected,” he said. “It’s very important that the people I work with understand and can advise us on the technology,”
McDonald expects the hospital to continue budgeting for security upgrades after the immediate work is complete.
“There has been a dramatic increase over the years in security concerns,” he said. “We’re still a primarily female-dominated system, and unless [female employees] feel this is a comfortable, safe place to work, they won’t be coming.”
Low-voltage technology has a short lifespan in the healthcare world, which leads to more expansions and reinstalls. According to Chicago healthcare communications company Jeron Electronic Systems’ director of marketing, Miles Cochran, IT infrastructure technology has a lifetime of three to four years, while wireless phones and nurse call systems can last closer to a decade. However, as more hospitals begin integrating their technologies onto one backbone, the life spans are shorter.
Wireless networks will become more prolific in the healthcare environment in 2009, Cochran predicts, based on each facility’s analysis of how the technology could affect workflow and lessen the effects of nursing staff shortages. Hospitals are integrating systems, allowing remote information retrieval from locations around the campus.
Whether it is all being installed at once or incrementally, Cochran said all installations start with the infrastructure.
“The LAN gives you access, and you can add the wireless aspect as you go along,” he said, adding that the amount of renovation depends on whether the hospital chose a vendor for what other technology would be compatible. “It all goes back to the backbone and how the technology interfaces,” he said.
The new technologies that draw hospitals to more security renovations are many and varied. Night-vision technology is one popular trend that Bosch Security Systems, Fairport, N.Y., is banking on. Bosch recently acquired Extreme CCTV, which makes an infrared video system for use in hospitals, sleep labs and mental health facilities. The idea is to capture footage in low light, which would allow facilities to better track their residents at night and make it possible to lower the lights in stairwells or unoccupied hallway areas where lighting (and energy consumption) currently has to be kept high to allow camera recording.
The infrared camera responds to a wavelength beyond the visible light spectrum, so it is invisible to the human eye. Cameras can record in a dark room without disturbing the room’s occupants.
“It’s being used in mental institutions and hospitals for safety and security,” said Willem Ryan, product marketing manager at Bosch. “One of the good things about active infrared is you can simply add the small illuminators to almost any camera, although they need a black and white mode.”
Those cameras can be either analog or digital. The ease of upgrading is one reason the technology is being well received, Ryan said.
“Most healthcare facilities already have cameras in place […] and with this system, the principles of surveillance don’t change,” he said. He added that users can take comfort in the fact that while technology changes, the principals of video, namely lighting, do not. “The fact is, they shouldn’t be limited to good images during the day.” With the ability to shoot in low light, companies can enhance their energy-savings initiatives.
The systems also are being installed in front of emergency entrances, providing cameras with the ability to capture a license plate as a car arrives and leaves the facility. That way, if someone drops off a patient, especially a victim or participant in a crime, the car can be traced if necessary.
Wireless devices include nurse call systems integrated into a hospital’s universal communication system. Ascom Wireless Solutions Inc., Research Triangle Park, N.C., for example, offers an advanced nurse call system integration system. IBM Enterprise Mobility Services provides doctors and nursing staff with wireless communications and real-time access to patient records anywhere on the facility premises. Vocera Communications System, San Jose, Calif., is selling a wireless platform with hands-free, voice communication throughout an 802.11b/g networked building or campus.
Ultimately, hospitals need more than security systems, they need faster data transmission and integration of equipment and systems. This means removing Cat 3 or 4 cable and installing Cat 5e, 6 or fiber. Increasingly, healthcare facilities look for one contractor to provide it all—design, installation and support. While integration companies and manufacturers are moving into this realm, so are many electrical contractors.
SWEDBERG is a freelance writer based in western Washington. She can be reached at firstname.lastname@example.org.