John Cinicolo: Reliable Wireless Service in Hospitals - Needs and Challenges

December 18, 2023

Building owners struggle with the challenges of having reliable mobile service within their properties which is a result of mobile networks being primarily designed for outdoor coverage. Since the people that work or reside within those properties are served across all mobile service providers, the indoor issues are usually seen across all of them. This challenge is exemplified when we consider a typical hospital facility where it’s common to experience poor mobile signal performance that results in the inability to consistently use your mobile device within that facility. Whether you are a hospital staff member or doctor, a patient, or a visitor, the ability to make/receive calls or texts, or access information from your mobile device, is important.

To understand the specific challenges of a hospital facility, we first look at the layout and construction of a typical hospital and how that affects indoor mobile signal performance. These venues are generally built with a large and wide lower level, or pedestal. Macro mobile signal levels from the outdoor towers quickly decrease as users move towards the interior of these large hospital floors for several reasons. This is primarily due to the number of walls that the outdoor mobile signal must pass through to reach the interior areas of the hospital. Also, the construction of those walls includes various hospital infrastructure and mechanical systems, as well as X-ray and diagnostic area walls with special properties, that significantly attenuate mobile signals. Additionally, below-grade floors are common with little to no mobile signal coverage in those areas. The upper levels of the hospital can also be impacted by the same wall density and construction issues, as well as energy efficient low-E glass and building materials that significantly attenuate outdoor mobile signals. Considering all these factors, the resulting poor mobile signal levels are not uncommon as you move throughout the hospital.

The connectivity requirements of the various groups inside the hospital are also important in defining the best solution for immediate and future needs. Staff, and especially doctors, depend on constant communication with their practice as they work within the hospital. For example, a doctor may be waiting for important patient updates from their office that can be delayed due to poor mobile service in the areas of the hospital where they are working. Patients and visitors similarly depend on their mobile devices to keep in touch with family members to provide updates or for basic needs. And since this issue applies to all mobile service providers a solution must meet the requirements of each of them. In addition, we can’t forget the First Responders who are regular visitors at hospitals, especially in and around emergency departments, who depend on specialized communications services like FirstNet that need to be factored into the requirements.

The common solution is an indoor mobile system that brings both dedicated quality mobile coverage and capacity to the users inside the facility across all mobile service providers. This is accomplished with a Neutral Host DAS, or Distributed Antenna System. The traditional DAS solution commonly seen in these environments uses passive antennas throughout the facility. This solution brings an RF signal from various distribution points closer to the mobile users. These traditional solutions have limitations for capacity and future capabilities, while newer solutions leverage fiber optic architectures and active small cell antenna points that offer many advantages over those traditional coax designs including the ability to more easily scale and upgrade to future needs. These new architectures also benefit from standard IT installation resources and methods which can reduce installation costs.

Finally, connecting these DAS solutions to each mobile service provider network is a critical step towards delivering the needed signal quality and capacity, and requires close coordination with each of them. There are several current and potential future options to complete the mobile service provider connections to the inbuilding mobile solution that can further simplify and accelerate those connections. This end-to-end approach is needed to solve the challenges for the building owner and mobile service providers to ensure quality standards and performance criteria are met.

The neutral host DAS infrastructure solves the initial problem of providing seamless mobile coverage and capacity for users inside the facility. Doctors and staff no longer struggle to make calls or receive critical information related to their patients and practices. Patients and visitors similarly are connected to their families and have access to important information. And the addition of FirstNet services on this infrastructure provides First Responders with the critical connectivity they need as well. But let’s look at the evolution of mobile technology and its further benefits.

Healthcare applications for telemedicine are emerging that depend on secure systems, data throughput capacity, and low latency. For example, the ability for doctors to perform or assist remotely for surgery depends on highly reliable and secure connectivity with the bandwidth, capacity, and low latency to perform these tasks. 5G mobile technology can solve these problems through various options in addition to the basic neutral host infrastructure. With the advanced architectures of today’s fiber-based systems the addition of those features is simplified. For example, 5G mmWave technology delivers very high capacity and low latency connectivity which is critical for real-time applications such as augmented reality and remote surgery. For other applications tied to the Internet of Things (IoT), capacity and low latency are generally not as important, but the number of connected devices grows significantly, so connectivity to IoT devices can be accomplished on the same neutral host solution or a private network layer with an RF capacity expansion of the existing infrastructure. IoT applications are often used by the facility to optimize their operational activities and reduce costs, such as energy management, staff coordination, medical asset/medication tracking, and many other automated processes.

Overall, hospital environments can showcase the diversity of mobile applications for the various types of users over a common infrastructure that can be layered or sliced to address each of their needs. These capabilities are supported by the current and future 5G technology improvements and can be delivered on today’s indoor DAS solutions with minimal changes to that existing infrastructure. As private and public neutral host networks evolve and converge, the infrastructure deployed in hospitals can scale to deliver the quality and capacity needed to support the growing list of applications.

You can also read this article in The Fast Mode.

John Cinicolo leads Tillman Digital Cities’ Technical Operations function including solution architecture, technology strategy, program execution and technical services. He has over 35 years of experience building mobile technology business around the world in leadership roles with network infrastructure provides and entrepreneurial startups. He holds a Bachelors of Engineering in Electrical and Computer Engineering from Concordia University in Montreal, Canada.

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