The Impending Hospital Wi-Fi Collapse

BlackBerry’s collapse is one of the greatest business learning opportunities of the past few years. It’s peppered with invaluable lessons.

This is perhaps the best analysis I’ve seen yet. As I was reading it, a particular quote struck me: "’How did they get AT&T to allow access to the full desktop web?’ Mr. Lazaridis recalled in the interview at his Waterloo office. ‘It’s going to collapse the network.’ And in fact, some time later it did."

Although I can’t find them, I recall seeing graphs quantifying that statement in 2010. I’ve provided a mockup that effectively shows the same thing. Note that the orange line is actual data and the black line is an approximation that I drew in.

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The key mistake that telecom executives made was that they failed to foresee the explosion in growth of data due to iOS and Android. Through 2007, smartphones had eschewed the desktop web because they didn’t have the processing power to drive modern apps. Telecom executives assumed that the mobile apps would continue to emulate BlackBerry’s stripped down mobile web of the pre-2007 era.

The telecom executives were wrong. iPhones and Android powered a new generation of apps that were exponentially more data-hungry than their BlackBerry predecessors. This explains why the general public complained about AT&T during the early years of the iPhone. The AT&T network literally collapsed under the weight of the iPhone. This also explains why our cell phone bills continue to skyrocket: the telecoms are investing in far more infrastructure to support data growth than they had originally planned five years ago.

I foresee the exact same thing happening on hospital Wi-Fi networks, if it’s not happening already. CIOs are forecasting intra-hospital data requirements based on last year’s usage models, not next year’s apps. Most wireless communications in hospitals today are asynchronous: EHRs, CPOE, asset management tracking, pagers, mobile texting, etc. But we’re on the cusp of a major wave of real-time, synchronous communications in hospitals.

Apps that push real-time data to mobile devices are growing rapidly. AirStrip, iSirona, and Capsule Tech are piping raw data to wireless devices in real time. Vocera and Voalte are piping copious volumes of VoIP data over Wi-Fi networks. Telemedicine is exploding (although many of the telemedicine carts are wired and the rest have onboard routers to compensate for weak Wi-Fi infrastructure in hospitals). ORs, which demand stutter-free 3D HD video, tend to operate on their own wired networks that are independent from the rest of the hospital’s wired infrastructure.

Telemedicine is growing rapidly, with estimates between 18-22 percent year-over-year growth for the next few years. Telemedicine is going to require massive investments in Wi-Fi infrastructure as midlevels continue provide an increasing percentage of total patient care relative to physicians.

Moreover, we’re on the dawn of the WebRTC era (a secure protocol for real-time audio / video / image / text based communications on the web), an era that will be characterized by the commoditization of all forms of IP-based communication. Commoditization will lead to a massive wave of innovation and adoption of real-time communications apps.

These communications apps will be better, cheaper, faster, and ultimately more ubiquitous. But they will share the same Achilles’ heel: they will depend on and be bounded by the ability of mobile devices to seamlessly connect to and push data over Wi-Fi networks.

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Kyle Samani is a healthcare technology entrepreneur who is passionate about healthcare and technology startups.

  • Tom from Raleigh

    Also, consider patients and families will want reliable, wireless access. Under healthcare reform, a percentage of revenue is tied to patient experience.

  • In June 2010 the NHIN Direct project held a watershed meeting early in the software sprint to identify the transport protocol that the entire effort would ride on. There were about 100 people present in the meeting, with 4 proposed protocols, only one of which would go forward. The first protocol to be voted down (with only 4 supporters) was XMPP, a synchroous, real-time protocol. I was one of the 4 votes for XMPP. As an aside, not that it matters, XMPP is embedded (and unutilized) in the CONNECT software stack. Anyway, at the 2010 Direct meeting after two more votes the final transport protocol selected for Direct was SMTP, an asynchronous batch process protocol. As I did in 2010, today I still think the future of health care data transport is synchronous and real time. And, more to the point made by Mr. Samamni in “The Impending Hospital Wi-Fi Collapse,” I believe the 2010 vote for asynchronous email is part of the reason why Direct has struggled to gain traction. Because underneath the hood at the data integration level Direct can never hit the target of real time synchronous health care work flows.

  • Hospital Wi-Fi has three different use cases: life critical med devices, mission critical enterprise apps such as VoIP, COW, RTLS, and customer/patient/guest access. The blog is focused on mission critical and patient access and rightly highlights data growth. However, for life critical devices, we need a reliable network. For this use case data load is not even moderate. With Gigabit Wi-Fi, hospitals would be able to meet the data load, in my view. However, I doubt they would be able to meet reliability required for medical devices.

  • kylesamani

    Will

    Excellent insight. I had no idea on the political backwaters.

    I suspect that decision was made for 2 reasons:

    1) asynchronous protocols have less overhead, and thus folks were more inclined to support them, particularly when Wi-Fi wasn’t as good

    2) folks fundamentally believed in asynchronous communications, not synchronous

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