Wireless products overview: comments from vendors.

Wireless communication technology is just starting to make inroads in the long-term care field. More convenient than cellular, and less disruptive of medical equipment, it has been marketed in recent years in the acute hospital environment to free up nurses and others from overhead pagers and plugged-in phones. Now, as the patient population of long-term care facilities becomes more clinically intense, major manufacturers are starting to focus their sights on this new market. What are the benefits and other "selling points" you are likely to hear about? Nursing Homes Magazine asked representatives of four major vendors to respond to some basic questions:

What types of facility would most benefit?

Craig Bixler, Product Development Manager, Dukane

PRODUCT: ProCare 6000, ProCare 2600 (in beta testing)

"A facility would have to be a fairly decent size to offset the base costs of $30-40,000. The often quoted price of $800-1,000 per handset assumes a certain number of handsets to gain the full advantages of having a more mobile staff."

Tom Ohlsson, Director of Marketing, SpectraLink

PRODUCT: Pocket Communications System 

"I would recommend a minimum size of 120 beds because of the size advantage. This would also probably be more appropriate for a skilled care or subacute setting than a convalescent setting. This would be a natural offshoot of the hospital setting, where we have some 450 installations so far. Not only do you have the advantage of rapid two-way communication between physicians and nurses - physicians are sometimes amazed to find themselves contacting the right nurse on the first call-back - but you have a more quiet, homelike atmosphere without the constant overhead paging."

Shannon Ryan, Senior Manager, Enterprise Mobility, Nortel (Northern Telecom)

PRODUCT: Companion Wireless Communications System for Business

"Our system covers everything from 5,000 square feet to millions of square feet, but in general it is useful in areas where there is a large number of people moving about over a wide area. Within the nursing home, for example, nursing and housekeeping staff would be prime candidates for carrying these devices, which are small enough to be carried in a pants pocket or jacket pocket."

Ray Zacharkevics, Marketing Specialist, Panasonic

PRODUCT: BusinessLink

"There is no minimum size, practically speaking, and the maximum for a BusinessLink installation would be about 250 handsets. In general, this system comes in handy when people want to be freed up from their desks and be able to move about a facility as needed. We have also found, in our hospital installations, that staff makes these phones available to bedbound patients who want to call their physicians or call home. It opens up new communications possibilities for these patients."

Installation problems?

Bixler:

"This is not nearly as invasive as, say, wiring a new alarm system in every room. Installers are occupying a hallway for a short period of time. One consideration is the type of base station you think you need. There are two-voice, which are cheaper, and eight-voice, which reduces chances of blocking and busy signals. That would be important for functions requiring rapid response. Two-voice base stations can be 'stacked' next to each other to avoid blocking problems but you lose their cost advantages; you may save money with them at first but end up paying in the long run."

Ohlsson:

"After we go through the blueprints of a facility and determine the makeup of the floors and walls, we attach the base stations, each about the size of a paperback book, to the ceilings. Each base station covers about 15,000 square feet, so a 60,000 square foot facility would require four base stations. We wire these to the phone wiring closet and spend time training two nursing shifts. That is about the extent of it."

Ryan:

"We have installed these in hundreds of health care facilities, and it is nothing more elaborate than connecting the wiring in the phone wiring closet (PBX, Centrex or key system) to small ceiling-mounted 'base stations'. The cost of installation depends on the number of handsets and area to be covered."

Zacharkevics:

"After a site survey, it's a matter of hooking up with the facility's PBX and connecting it to the base stations, which look like small doorbells and are relatively invisible. There is not a great deal involved."

Options Available?

Bixler:

"These devices are capable of anything that phones can tie into. You can have two-way communication with residents if they are intelligible enough and their hearing is good enough. Depending on whether you have the information system that can handle this, you can message important pieces of patient information to the handset to better inform the caregiver about the patient he or she will be seeing. There are also voice mail capabilities. E-mail and faxes, as a practical matter, will work best with PDAs (Personal Data Assistants), those small wireless notebooks that staff can carry or keep in patients' rooms. That technology isn't quite here yet."

Ohlsson:

"We integrate PBX calling features with the handsets so that the calling number is displayed on the alphanumeric screen. Also, with today's computer technology using our newly-announced Open Application Interface, simple pieces of patient information could be displayed as well. The nurse, for example, could call up the values for the patient's last-measured temperature, pulse rate and blood pressure. Features such as these will become more common in about a year."

Ryan:

"In health care the most requested option is integration with the nurse call system, so that calls ringing at the nursing station will ring simultaneously on a given handset being carried by a staff member on the floor. This eliminates the noise and delay associated with overhead paging systems. Connection with our Meridian 1 Communications System provides such features as call forward, call transfer, conferencing and voice mail. On the Companion system other possible options include messaging to pick up brief faxes, e-mail and patient information using our scroll-through, two-line, 16-character feature on the alphanumeric display incorporated on the handset."

Zacharkevics:

"We have paging, including a vibrator mode which eliminates missing a call because the ring wasn't heard. Our alpha-numeric display allows for short messaging and a scrollable feature will be released soon. There are also possibilities for call forwarding, call waiting, conferencing and voice mail."

Interference concerns?

Bixler:

"This is a legitimate concern, but the low power of these devices offers a definite advantage. Some vendors have conducted extensive testing and the results should be asked for. There can be concern with devices used outside the base station network kicking into higher power, so external calling in should be watched. There really should not be a problem inside the facility."

Ohlsson:

"These are very low-powered devices, using less than 100 milliwatts, compared with 1 watt for some external cellular devices. There could be some older medical equipment - for example, infusion pumps or ventilators made in the late 1970s or early 1980s - that could be susceptible to interference from these higher-power cellular devices. The micro-processors used back then were relatively crude and were not designed with radio-interference concerns in mind. All of our equipment has been ECRI-tested and shown no problems, which we attribute to our low-power radio output."

Ryan:

"A great deal of testing has been done with Companion in the health care environment, and no interference problems have been found with the items tested."

Zacharkevics:

"Because of the relatively low power of these devices, there has been no interference with medical equipment."

Results to report?

Bixler:

"We have not marketed as yet directly to long-term care, but we are beta-testing the ProCare 2600, which is designed for long-term care settings. It will offer lower-cost base stations and be able to handle units as large as 80 beds, compared with the typical 5- to 25-bed acute care units."

Ohlsson:

"Beverly Health and Rehabilitation Center's Spokane, Washington facility eliminated minute-by-minute overhead paging handling over 300 calls a day, drastically reduced physician-nurse wait times for calls and provided patients with pocket phone access to family and friends using this system. This is a 120-bed facility occupying 60,000 square feet. Good Samaritan Center in Sioux Falls, South Dakota - a 141-bed skilled nursing facility - experienced similar benefits. Also, because the 13 handsets have been made available to not only nurses, but Activities, PT and OT, Environmental Services and Social Services, these personnel have been freed up to work with residents while taking important calls. Requests for admissions, for example, are forwarded directly to those with the answers about bed availability, without the delays of call holding and calling back."

Ryan:

"In one managed care facility, nurses reported saving a mile a day in walking distance. Porters who move patients about reported saving 20-30 minutes per shift. Overhead paging was reduced by as much as 75% in this facility."

Zacharkevics:

"Though we have not marketed as yet in long-term care, we are looking very closely at that field. In the hospital environment, we have had nurses reporting saving from two to three hours a week from time spent answering pages, leaving and receiving voice mail, and so forth. There is also considerably more peace and quiet without the overhead pagers."