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Call Center/Command


A radical procedure

A radical procedure

Hospital turns to wireless VoIP to save more money, more lives
  • Written by Urgent Communications Administrator
  • 1st June 2007

An increasing number of organizations — primarily in well-defined vertical markets such as health care and education — are deploying voice over IP over Wi-Fi as an alternative to traditional phone service, in order to dramatically reduce the costs associated with traditional PBX systems and to increase employee efficiency.

With large, mobile work forces and many different points of care where doctors and nurses interact with patients, hospitals have great need for real-time communications and information exchange. Many of these hospitals were built long before the need developed for easy-access cabling and wiring closets. And most hospitals ban the use of cellular phones within their facilities because of fears about the devices interfering with medical equipment.

Those were some of the challenges faced by St. John’s Hospital in Springfield, Ill., one of the largest Catholic hospitals in the U.S. with 700 beds, when administrators looked at installing a wireless local area network (WLAN) that could deliver high-quality voice while supporting the mission-critical data services it needed.

St. John’s ended up purchasing a converged voice-and-data WLAN from Meru Networks that enables seamless roaming of voice clients and supports multiple applications that use different security settings. The network is nearly complete and is expected to include 470 access points serving about 400 users. Gretchen Niehaus, IT and telecommunications manager for St. John’s, estimates the first-year return on investment of the new network at more than $2 million.

St. John’s 12-story structure, constructed in 1875, has a complex building topography that makes it difficult to deploy a WLAN.

“We were looking at some serious access points,” said Bill Halpin, St. John’s senior network engineer. “The result would have been co-channel interference, or what is called the honeycomb effect. When you put in more access points, you create more overlapping channels.”

Meru’s architecture, however, puts adjacent access points on the same wireless channel and uses software to sort out the co-channel interference issues. That ability has been a key differentiator for Meru in winning VoIP-over-Wi-Fi contracts, said Christian Gilbey, director of business development for Meru.

St. John’s faced other complex challenges. Nurses were using proprietary Avaya handsets that were reaching the end of their lifecycle, but the staff didn’t want to give them up. In addition, the hospital made an early investment in 802.11b, which supports 11 Mb/s data speeds, to allow its case managers to enter patient information into the hospital’s electronic medical record system. Therefore, the access points on the network had to be multifunctional, accommodating the 802.11a, b, and g bands by transmitting at 11 Mb/s (b) and 54 Mb/s (a and g). Multiple data and voice applications also needed to be combined onto a single network without degrading the quality of service for those using the phones.

For voice communications, St. John’s chose a system developed by Vocera Communications. One hundred Vocera Communication Badges — small Wi-Fi phone/messaging devices — deliver communications among caregivers and other hospital staff. The system has been so well received that plans exist to expand to 300 badges. Some 400 VoIP phones will be deployed as well.

The network already has paid for itself in several ways. In addition to the cost savings achieved by reducing its reliance on traditional telephony services, St. John’s also is benefiting from greater efficiencies created by the new network. For instance, the hospital has been able to streamline turnover of its surgery suites because of improved communications between administrators and staff, shaving 30 minutes off the time needed to get ready for the next procedure. That enables St. John’s to add additional procedures each day, translating into more money for the hospital — and its doctors.

In addition to the voice and case management applications, the hospital also has moved its Surgery Information System to the wireless network. Prior to that, operating room nurses would do pre-operative checks on their patients and then move to another area to transcribe the information into the system. Now carts with laptops can be wheeled right into the patient’s rooms to monitor and record vital information; the data then can be retrieved by doctors and pharmacists using their personal digital assistants (PDAs).

Uses for the WLAN appear endless. In addition to the more than 500 personal PDAs issued thus far, the hospital also is in the process of replacing IV pumps in order to add the ability to transmit vital information, such as the amount of medicine being administered, back to a nurses’ station, where the data is kept up to date. In addition, the hospital is in the process of selecting a vendor to provide radio frequency identification applications — namely the tracking of lost wheelchairs.

Meru’s Gilbey said the inefficiencies in reaching employees and the rising costs associated with mobile phone use are among the factors driving companies to deploy VoIP-over-Wi-Fi. He said such deployments are resonating with the enterprise sector in general, but most organizations prefer to wait for dual-mode phone capability — the ability to seamlessly move between a cell-phone call and a VoIP-over-Wi-Fi call. Enterprise employees generally don’t want to carry both a cell phone and a Wi-Fi phone, he said.

However, according to research and analysis firm the Yankee Group, enterprises face numerous challenges in adopting dual-mode solutions. Although dual-mode, fixed/mobile convergence (FMC), “is a highly disruptive approach to providing businesses with inexpensive, high-data-rate mobile voice and multimedia connectivity,” said Brian Koltyar, research associate with the firm, a variety of obstacles will slow adoption.

Namely, steep infrastructure costs associated with dual-mode FMC and insufficient standardization for dual-mode hardware remain problem areas, Koltyar said. So he doesn’t expect dual-mode FMC to dominate until 2010.

However Osaka Gas in Japan seemingly has debunked the notion that enterprises should wait for dual-mode solutions. Japan’s second-largest utility company embarked on the world’s largest deployment of a wireless office in mid-2005, also using technology from Meru Networks. The rollout was finished in early 2006 with the successful deployment of 6000 wireless IP phones across 49 offices.

“This deployment was closely watched by companies all over the world,” said Kamal Anan, Meru’s vice president of marketing and corporate strategy. “Today, every major corporation is looking at this and thinking of major pilot programs and deployments.”

Osaka Gas imports liquefied natural gas and distributes it to some 6.6 million customers, or about 25% of the total number of customers in Japan. Its service area covers 69 cities and 41 towns. Field workers already used mobile technology to more efficiently conduct tasks such as remote meter reading and pipeline monitoring, but Osaka Gas’ IT executives wanted to gain similar efficiencies in the office environment.

Consequently, the company’s Information & Communication Systems Department (ICSD) launched a companywide “Change our Work Style” initiative in 2005 with the goal of creating the ultimate “address-free” office work environment where employees could not only work on their laptops anywhere on campus but also take phone calls.

“We thought mobilizing technology to our white collar workers would dramatically improve efficiency,” said Hikaru Hirayama, ICSD general manager.

Osaka Gas then sought to deploy a pervasive WLAN infrastructure capable of supporting multiple data and voice applications. The system needed to support a maximum of 10 simultaneous calls to each Wi-Fi access point, meaning that the 11th call would get a busy signal.

Meru beat out vendors such as Aruba, Cisco Systems and NEC/Airespace based on two main factors, Hirayama said. First, Meru’s system was able to support fast call handover enabled by the vendor’s voice service module, which doesn’t require any dependence on proprietary extensions to the client or proprietary signaling from the IP PBX. Second, Meru could control over-the-air upstream traffic without any client-side software. That means the system can restrict the maximum number of simultaneous calls at one access point to control bandwidth and, hence, call quality.

Osaka Gas invested a total of $8 million in the project, but it was able to replace private branch exchanges with session initiation protocol (SIP) servers in its 47 branch offices and avoid the costs associated with wiring offices. To reduce cellular network charges, Osaka Gas has relied on a least cost routing (LCR) function built into its SIP servers.

With the LCR technology, a cellular phone number is converted to an extension number for use within a wireless LAN area; the result is that the corresponding cell phone is considered a fixed-line phone by the wireless carrier when calls are made to another cell phone outside its extension area, to further lower costs.

“We are saving $4 million a year so that means in two years we’ll get a return on our investment,” Hirayama said.

BENEFITS OF VoIP OVER WLAN FOR ST. JOHN’S HOSPITAL

Estimated $2 million cost savings in first year after deployment

Quickly enabled multiple applications, including voice, secure data and guest access using multiple WLANs

Source: St. John’s Hospital

BENEFITS OF VOIP OVER WLAN FOR OSAKA GAS IN JAPAN

Total wireless VoIP solution is expected to save an estimated $4M USD per year

True one-number access, with voice calls running over the corporate wireless LAN indoors, and handing off to NTT DoCoMo’s cellular service when roaming outdoors

Single converged WLAN infrastructure for toll-quality voice and high-density data services

Source: Osaka Gas

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