Monday, July 22, 2024

Case Study: W-LAN Eases Burden For Nursing Home Caregivers

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Lowering costs, increasing productivity and improving service are the goals of most new technology deployments. Rice Management, Inc. says it has met those goals with its new wireless local area networks (WLANs).

Rice is a 1,000-employee nursing home management firm based in Appleton, Wisc. Until recently, nurses in its 12 facilities would visit patients in their rooms to deliver care and then, at some later time, return to their desks and add information to the patients’ medical charts.

“Charting at the (nurse’s) desk after the care is given ties up your nursing staff because they’re not giving care,” says Ron Van Dyck, Rice Management’s controller.

Now, nurses wheel carts with WLAN-equipped laptops into patients’ rooms and do their charting on the spot when the care is given. “It’s easier and more accurate to chart while the care is actually taking place and it frees up nurses to do what they do best,” Van Dyck says.

Each of the laptops includes a 3Com AirConnect 802.11 PC Card network adapter, according to Van Dyck. In broad terms, charting information entered into the laptop is sent, via the WLAN within each nursing home, to a server in the home office. There, a director of quality assurance monitors the charts to ensure the quality of care given to patients.

Van Dyck says the benefits have been significant to the company, its nurses and its patients.

Added Accuracy

Besides simplifying and speeding the charting process and freeing up nurses to do more nursing, Van Dyck says the wireless LANs give Rice Management a competitive leg up. “If the nurses are providing more care and if you’re giving quality care and people are happy, the residents will come to you instead of to the next nursing home down the street,” Van Dyck notes.

The added accuracy of charting when care is given also is a crucial benefit, he says. That’s because auditors from the state periodically examine nursing homes, poring over charts to make sure that appropriate care is being provided to patients.

Perhaps most important, the system will make the company’s bottom line healthier, according to Van Dyke. In fact, he said the savings are so clear and the payback is so fast that he said the company won’t bother to do a return-on-investment study.

“We estimate that the staff savings are about $40,000 per year per facility,” he says. Specifically, the company can eliminate the equivalent of a half-time medical records technician and a half-time nurse in each home. They probably won’t lay off any employees because of the system, instead handling the added efficiencies via normal staff attrition.

He notes that deploying the WLANs is a work in progress – at this writing, only about half of the company’s 12 homes are wireless, he said. The rest will be deployed by spring of 2002.

Tim McNicoll, a consultant for Rice’s integrator, Heartland Business Systems in nearby Little Chute, Wisconsin, said that the deployment has been trouble-free so far. Besides 802.11b adapters in each laptop, his company installed AirConnect access points in the hallways. Those access points, in turn, connect to a hub, which connects via a Cisco 2600 series router to the frame relay network.

He said that between 10 to 20 laptops and two to eight access points have been deployed in each nursing home, depending on the size of the facility. Each laptop is a Citrix client, enabling the laptop to directly access the charting software running on the Windows NT 4.0 server in headquarters. McNicoll said that the server will soon be upgraded to Windows 2000.

The cost for the entire project will be about $300,000, McNicoll says. Given Van Dyck’s assertion that the company will save $40,000 a year in each of its 12 nursing homes, the payback on cash outlay is less than a year.

As cost-effective as the WLAN is, however, Rice Management’s headquarters remains networked using standard Ethernet wiring.

Security Concerns

“Wireless gives us more flexibility in the nursing homes but sometimes it’s more expensive,” McNicoll says. “The decision to deploy (WLANs) depends on the building and the type of work. We still treat wireless as an extension of the wired network.”

The only area of lingering concern, Van Dyck says, is the privacy and security of the system. These are paramount issues in health care organizations, particularly with the new federal privacy regulations that are being phased in during the next few years.

Currently, the charting software manages access control to the charts, requiring a password, according to Van DyckWhile the data is sent to headquarters via a secure frame relay network, 802.11b WLAN technology that has been the subject of serious security concerns.

As a result, the security of the system is an ongoing issue that will to receive a lot of attention from the company in the future, Van Dyck said.

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