August 9, 2021

With the wireless opportunities in healthcare, one thing that we have certainly seen over the past 18 months for sure, with COVID has been a tremendous response of the industry concerning enabling a lot of wireless modalities, specifically inpatient telehealth opportunities as well as remote patient monitoring. With this shift in Healthcare, there is now potential for CBRS, private networking to greatly improve organizations within this industry.

Below is a transcribed conversation with Eric Abbott, healthcare IT strategist and adjunct professor at Northwestern University, Chris Wixom with Connectivity Wireless, Carla Shaffer with Wesco Anixter, and Steve Wimsatt with CommScope. We hope you enjoy the discussion.

Watch the recorded conversation here

Jump to Speaker Bios

Section 1 – Getting Buy in and Strategic Levers

How would you approach a healthcare organization, particularly for a new technology like CBRS?

Chris: The key is to understand what CBRS is, how it works, how it plays in both a 4G and a 5G world, and start getting into use cases. Typically, we go through a variety of different use cases that even different verticals may use so that you can start the ideation process, to understand what the opportunities are out there. Then, focus on those applications and start to think through the ROIs and the returns that you can get if you drive through with that digital transformation effort. Think of it as a three-step process. 

Steve: In addition to the use cases, you must probe a little bit about where they are having challenges today. Healthcare is a very mobile environment. Everyone is on their feet; they are constantly running around. All your applications are mobile today. It is a challenging environment, certainly for Wi-Fi, to provide all the coverage and capacity. Most healthcare operators would recognize that some of their solutions do not work as well as they would like. Their coverage does not work, or they have dead spots. CBRS, when they understand the advantages of running an LTE network versus a Wi-Fi, they can see how this is net new capacity. It is a better performance. It supports some of the same use cases much better than other alternatives.  

Carla: With this new tool we have with CBRS, it is looking at what are your plans at an executive level? Being the CIO, COO, what are your priorities in the next one, three, and five years out? How can you apply this tool with everything else that you have in your toolbox? It is an exciting time because there are things that we have just been limited to in the past, which can bring various parts and pieces together. It is a great time to look at those priorities and understand them. It is a technical piece, so working with a good partner that can help you apply that to your business goals, can benefit your company.  

Are any other levels within the organization that can launch something like this? What other conversations would you have at the healthcare system to build consensus?

Chris: The key is to understand what CBRS is, how it works, how it plays in both a 4G and a 5G world, and start getting into use cases. Typically, we go through a variety of different use cases that even different verticals may use so that you can start the ideation process, to understand what the opportunities are out there. Then, focus on those applications and start to think through the ROIs and the returns that you can get if you drive through with that digital transformation effort. Think of it as a three-step process. 

Steve: In addition to the use cases, you must probe a little bit about where they are having challenges today. Healthcare is a very mobile environment. Everyone is on their feet; they are constantly running around. All your applications are mobile today. It is a challenging environment, certainly for Wi-Fi, to provide all the coverage and capacity. Most healthcare operators would recognize that some of their solutions do not work as well as they would like. Their coverage does not work, or they have dead spots. CBRS, when they understand the advantages of running an LTE network versus a Wi-Fi, they can see how this is net new capacity. It is a better performance. It supports some of the same use cases much better than other alternatives.  

Carla: With this new tool we have with CBRS, it is looking at what are your plans at an executive level? Being the CIO, COO, what are your priorities in the next one, three, and five years out? How can you apply this tool with everything else that you have in your toolbox? It is an exciting time because there are things that we have just been limited to in the past, which can bring various parts and pieces together. It is a great time to look at those priorities and understand them. It is a technical piece, so working with a good partner that can help you apply that to your business goals, can benefit your company.  

Section 2 -Use Cases

Describe some use cases that we see today?

Chris: There are two parts to this. The first part is four areas. There’s patient impact and the experience that you can have for your patients coming into the facility, there’s driving efficiencies for your facility’s organization, there’s driving support for your clinicians and staff, and then there are the remote applications and driving telemedicine and those types of things. First, divide it into those four areas. The second thing is the applications will change over time. Right now, what we are seeing is mostly facilities driving operational efficiencies. The reason for that is most of what we are seeing is the applications are not actually around handset connectivity, they are around driving those kinds of operational efficiencies around IoT and other types of applications. As roaming and other types of capabilities come to play, then you are going to see it play more in the handset connectivity on that side of it. But right now, we are driving a lot of operational efficiencies for healthcare organizations.  

Eric: It looks like the operational efficiencies would be a high priority, which makes sense from a margin improvement perspective. Clinical effectiveness is something that has been mentioned. Then, the patient experience, which today is more broadly referred to as consumer experiences. We see several use cases there.  

Are there any cases that can be applied in healthcare organizations?

Carla: One of the immediate ones that drive efficiencies and profitability are the two-way radios for the security and facilities teams at a healthcare organization. Today, most of those are under a licensed network from the FCC that they must pay, for an ongoing licensing. This is something that they can now bring in-house and has not only the same quality of the two-way radio communication but no longer having to pay the ongoing license fee. You now own that license, but you do not have to pay for it. It is a much more profitable setup for the customer to own that portion for themselves. Then, they can use it for other types of applications. That is just one piece where today that license that they get only works for two-way radios. They cannot apply it to anything else. 

Another important thing is the capacity of these networks. The Wi-Fi network is so burdened already within a healthcare organization, not only from all the devices that are on internally, but then when a patient comes, and they come with visitors. You have a lot of types of people joining these Wi-Fi networks with multiple devices, whether they are YouTubing, they are streaming, they are Facebooking. They are looking at a lot of things that suck a tremendous amount of bandwidth from the network. You want to be able to prioritize the video streaming that the surgeon must do. You want to make sure that that is secure. 

CBRS is based on a platform that is incredibly secure from a virtual and cyber perspective. There are a lot of diverse ways to apply it and then offset some of the network and challenges that you have today, to boost up those things for other types of applications. 

Steve: One that we have seen in every trial that we have done, every POC, has been the Carts on Wheels. It is operational and it does not depend on a handset. You can put in a little LT router, $200 or $300 device, and suddenly, the laptops that you have on carts roll from room to room, they have rock-solid high-speed connectivity. They never lose a connection. That is proven to be a wonderful way to demonstrate the capability of CBRS, private wireless, and an interesting benefit of when you not only show that application works much better, but you can offload a lot of traffic from the Wi-Fi network. All your other applications start to work a little bit better as well. That is one that a lot of healthcare facilities should be looking at. 

Are there any location services use cases?

Steve: For location-based services, CBRS opens the door to some new applications, again, because it can provide fresh capacity, great coverage. You can do things from a Patient Manager’s perspective, in a nursing home or certain parts of the hospital. You put on a little Bluetooth tag, and you can track that using CBRS. You can also use CBRS, to help provide better location-based services in place of some of the technologies they use today. RTLS is Wi-Fi-based. It is the triangulation of the Wi-Fi network. It is a widely used technology, but with CBRS you have that great connection everywhere. You can just put a little tag on there that detects its location and broadcasts that back. There are a lot more location-based use cases that can be rolled out.  

What are the security advantages of CBRS?

Eric: The points brought up are important, because currently, healthcare systems grapple with the rise in the number of internet of medical things, devices, the number of patients, and mobile data communications. One thing that was mentioned was video calling. As well as the operational efficiencies piece. Cybersecurity has been brought up as sort of an undertone area of interest for healthcare organizations for obvious reasons, HIPAA compliance as well as the safety and security of patients and staff. 

CBRS private networking brings a defense-in-depth approach as it relates to being able to provide a very secure, highly flexible, adaptable platform for these different engagement points. Whether it be a patient, a visitor, or someone else. It certainly adds that extra context to the organization in addition to the use cases that have been mentioned.  

Chris: A strong aspect of CBRS is that you do not have an IP address. You cannot be hacked because it is a trusted connection between the device and the network. It is just inherently much more secure number one. Number two, because it is a private network, you now have control over the 4G- 5G network that you are deploying in your healthcare organization. You can create these secure envelopes where you can now control what people are doing on your network and what applications are active on your network. For HIPAA compliance, you can control what is and does not transgress over the network for what clinicians or nurses are doing. There is a huge advantage from a security perspective just on that side, too. 

Eric: Brought up was HIPAA personally identifiable information, this is what they call PII, the PHI, the protected health information, and PCI for financial transactions. As healthcare pivots to a more real-time environment, certainly what was mentioned is going to appeal to a CSO or a CTO at a healthcare organization.  

Section 3 – Objectives & Key Results

When speaking to high-level executives, what are some benchmarks that you would bring forward to demonstrate that value beyond the expected intrinsic functionality?

Eric: Certainly, being able to show greater improvement in patient satisfaction or HCAHPS scores is something that has a direct correlation to system revenues. A second one is going to be patient safety, by being able to have more timely communications as well as a better context of exchange of information. The third is staff satisfaction. One of the quadruple aim measures by being able to have physicians, nurses, surgeons, clinicians, and so forth is to be able to communicate more effectively. 

This is something that is going to create a much more effective working environment. Their ability to do their jobs more easily. Whenever you do something like that, you make it a low friction environment. You tend to build better satisfaction. The measures that are associated with those improvements, by implementing a CBRS private network, the organization can expect to see a certain percentage in improvement. For instance, in a particular type of modality; and then be able to scale from there. It could be even pragmatic, operationally being able to consolidate, disparate communication systems.  

Sharing data in a much more organized and orchestrated manner with the private Wi-Fi network is used for certain medical transactions as well as the private 4G-5G network that CBRS could enable. This certainly has a lot of advantages especially around benchmarking. 

What are your thoughts on devices that rely on Wi-Fi?

Steve: In a mobile environment, in a challenging RF environment, for example, hospitals; they are difficult with thick walls, lots of electronics, etc. As a vision, a lot of those applications should move over to private wireless. Everything will work better. Not having your call drop is going to go a long way toward improving satisfaction. 

From a device perspective, it is just not realistic. You are not going to get all those use cases on CBRS, private wireless, 4G, or 5G in the near term. That said, there are certainly some applications that you can move to right away. The simplest one, honestly, is the Carts on Wheels. You have the laptops there and they are connected now over Wi-Fi. Add a $200 router, put it on the cart, and now they are connecting to the CBRS. You can do that right away. Those are high bandwidth use cases. They will help your other Wi-Fi applications. 

The other area where there’s near-term potential is the nurse call or the security, push to talk. There are some dedicated devices out there now. On the nurse call, it is mostly Wi-Fi-based. The security is LMR or UHF licensed radio-based, but you can run those over CBRS using just any sort of a smartphone. Put it over to CBRS and some devices are coming out now that are designed to be working people’s smartphones. You can drop them from six feet, and they will never break. They have big buttons. You can use a touch screen even with your gloves on. You get a nice phone that does nurse calls, can be pushed to talk, whatever you want to do. Some of those use cases can move over very quickly as well also. When you get into patient monitoring, some of those things are long lifespan equipment. That would just take a little bit longer to get onto the CBRS. 

Carla: It is important to make sure that we are enabling the new methods that surgeons and doctors use to communicate real-time with their colleagues around the world, with the number one guys that can help in these critical, demanding situations. At the same time, and this goes certainly all back to the kind of video and internet access, the customer experience. 

Let’s face it, when you are going to the doctor’s office it is not the most enjoyable situation. The more you can make it a pleasant experience for everyone, not just your individual, the parent, the person that is there, the child as well. The more you can enable them, the more you can provide a network and connectivity that allows them to take their minds off for a minute, why they are there, especially on their own devices that they brought. That does make a significant difference. 

It can also help address some of the points, those metrics that were just mentioned, and then just really figuring out, okay, what should we put on this network? It will evolve. This is an evolution. This is, what do we do now, what do we do 12 months from now, and down the line.  

Eric: One of the things that have been brought forward is the experiential aspect and distraction therapy, which is a good example of what you just mentioned is something, especially for pediatric units, very appealing. That point is spot on about using the patient’s device. Having a network you can support that because it is a very variable environment. It is not a nice clean environment where you know exactly who is walking through that door and when.  

Do you need a specific license for CBRS private networks?

Chris: With CBRS there is 150 megahertz. 80 megahertz of those 150 megahertz is free. It is called the GAA or generally available spectrum. You do need to have certain capabilities to look into other areas like the SAS and other things to function. But no, you do not need a specific license, this is a free spectrum that you get. In the commercial real estate world, they call it the billion-dollar gift that the government has finally given out to building owners throughout the United States. 

If you look at how much Verizon and some of the others paid for the other piece of the spectrum, it was in the billions of dollars. This is an incredible gift. Try and take advantage of it. Do not be worried or concerned about this new technology and shy away from it. Go big. Go big in smart ways and take advantage of it. 

Steve: One thing is the channels, 80 megahertz of GAA spectrum. You are a hospital. You have thick walls. Certainly, everything you do indoors, you are protected. You are not going to have any trouble using that spectrum. No one else is going to step on it. It is a gift. Take advantage of it. 

Are there any important key takeaways?

Carla: Be a leader right now. This is the time to decide to be a leader in this industry with this technology.  

Chris: Our industry is going through an incredible amount of change, increased spectrum, 5G, Wi-Fi 6, new business models, and novel applications that were touched upon in this conversation. The focus of this conversation was CBRS, but there is a huge amount of opportunity out there. Again, go big in smart ways and avoid the missteps by taking incremental steps and pilot some of these technologies with a variety of different applications that we talked about. If you have questions or want to find out more, reach out to one of us and hopefully, we can help take you through the process. 

Speaker Bios

Eric Abbott: Healthcare Advisor

A Senior Technology Executive in healthcare and mobility domains, Eric has directed and led large complex global initiatives to drive value, creation, and growth to achieve meaningful outcomes. He is also an adjunct faculty instructor at Northwestern University teaching Consumer Digital Health and serves as a healthcare subject matter expert advisor for Connectivity Wireless. 

Carla Shaffer: VP of Wireless at Wesco Anixter

Wesco Anixter holds customers’ hands through the entire process and ecosystem. Licensed frequency and unlicensed frequencies cause a lot of complexities, and they are there as subject matter experts to support their customers, whether they are the healthcare enterprise or the contractor that works with them, to make sure all avenues are covered and bring their projects to fruition. 

Chris Wixom: Chief Revenue Officer at Connectivity Wireless

Connectivity is a managed services provider. What does that mean? All things connectivity: 4G, 5G, Wi-Fi, private networks, and public safety. They, indeed, are all things wireless connectivity for the healthcare industry. They pride themselves on the amount of experience that they have. They have completed over 2,700 projects and are currently involved with ~60 healthcare organizations. Connectivity does everything from A to Z, truly turn-key. From consulting to design, all the way through to project management installation. In addition to this, they provide monitoring and maintenance on the final day to help evolve the system over time.  

Steve Wimsatt: Senior Director of Strategic Alliances at CommScope

Commscope is a large manufacturer with a complete portfolio of connectivity solutions – everything from structured cabling and fiber, through networking, through licensed wireless Wi-Fi, and now CBRS private wireless. Within the CBRS private wireless space, they have a complete solution of access points. They have our cloud-based core network. They are a SAS provider and have a complete solution of private wireless that we sell to a variety of enterprise vertical markets, including healthcare.