Hospital Marries Wireless Not with Thin Clients

Thin client computing coupled with wireless LANs seem to be just what the doctor ordered.

At University Medical Center, Stony Brook, New York, a low-speed wireless LAN links tablet-sized portable terminals with server-based Windows applications.

Respiratory therapists now capture more accurate information faster than ever before, says Michael McPeck, directory of respiratory care and biomedical engineering and the center's wireless guru. This data becomes the basis of faster, more accurate decisions on patient care.

"We wanted to go wireless because the therapists don't work out of an office.

They visit one patient after another," he says.

Previously, therapists visited patients, took notes and then recorded the information later on paper charts at nursing stations.

"You can't help seeing that time is saved because they're not endlessly visiting a nursing station and making pen notations on the patient's chart," McPeck says.

Two years ago - before ratification of the IEEE 802.11 wireless Ethernet standard - McPeck selected wireless LAN equipment as well as the handheld tablets from Symbol Technologies, located in nearby Holtsville. The 802.11b standard, with a bandwidth of 11M bit/sec, was approved last fall. The center's IT staff is planning an upgrade in the future.

For the 504-bed hospital, part of the State University of New York at Stony Brook, McPeck did most of the installation and deployment himself.

"It's not as simple as just plugging in a few wires. But it's certainly not as complex as people might believe," he says. Today, as a growing number of users and departments start to use the technology, the center's IT department has embraced it enthusiastically.

"Others see you using wireless, and very suddenly, they see the benefits and advantages that could take place in their line of work," McPeck says.

The 1M-bit/sec speed of the current wireless link serves the hospital well.

"That's the data transfer rate between the mobile client and the Access Point [the interface between the wireless and wired nets]," he says. "The radio speed is only for the clients, not for the backbone."

Interference with the hospital's radio-based heart monitors and other equipment has not been a problem. "Sometimes, when I have visitors in to see the wireless LAN, I take them to our telemetry unit, where we monitor hearts with radio telemetry," McPeck says. "I show them the monitors with their antennae peacefully coexisting next to our Access Point antennae."

The Symbol wireless LAN was to be the connection medium. McPeck decided to use a portable Windows-based terminal - a thin client - to access applications on an NT server, via the Citrix Systems Inc.'s software.

"The handheld computers didn't have the horsepower to run Windows applications locally," he says. "Worst of all, they would have had a spinning PCMIA hard drive, which would have been expensive, delicate, hot-running and power-draining."

The Symbol tablet terminal that McPeck selected has an Intel 486-MHz processor with MS DOS. McPeck added a card with 4M bytes of RAM and loaded into it TCP/IP software and the Citrix ICA client to access the server-based applications.

The Citrix software makes administration a snap. McPeck loads new or upgraded software on the one server, and all the users have immediate access. The respiratory therapy department has 10 tablets deployed.

The software also lets an administrator troubleshoot problems by "shadowing" a user's session - the administrator can see from his desktop PC exactly what appears on the user's screen.

Besides upgrading to a faster wireless LAN topology, McPeck is looking to client devices that are lighter and less cumbersome than the tablets.

"The terminal still weighs about three pounds. So, for a mobile worker on their feet for eight hours, it gets pretty heavy," he says.

McPeck is looking at handhelds running the PalmOS operating system. They're much lighter and smaller than the tablets, but one drawback is the lack of software that lets the Palm act as a thin client to server-based applications.

"I think there's a screaming need for thinner applications that can work with PalmOS-based devices and the Palm database structures," McPeck says.

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