August 23, 2021
With the world becoming more reliant on connected technologies, there is always need a for smarter, more robust wireless infrastructure. Infrastructure plays a critical role in every industry and can affect an organization’s ability to perform optimally. One industry we see most impacted by the best (and worst) of planned infrastructure is healthcare.
Below is a transcribed conversation featuring Connectivity Wireless’ Chris Wixom and JMA’s Melissa Ashurst sharing insight into the latest wireless healthcare hot topics like the impact of 5G, CBRS and the impact these technologies have on healthcare, and key strategies and tips for planning successful wireless infrastructure in this day and age.
We hope you enjoy the discussion.
Hi, I’m Chris Wixom and I lead the venue sales team for Connectivity Wireless. I am here today with Melissa Ashurst to talk about the future of connectivity in healthcare. This conversation will be broken down into three parts:
- The marketplace from a connectivity perspective and how things like 5G, private networking, new spectrum and the business models too, are changing.
- The implications for healthcare given this changing market, and how that enables applications and how healthcare is provided.
- The diverse ways to fund these solutions, depending on what one is looking for and how they would pay for these systems
Section 1 – Overview of the Current Marketplace
Chris: Starting with the marketplace. The amount of innovation and advancements that are happening has never been quite where it is. There is a combination of 4G and 5G. An incredible increase in the amount of spectrum that is available. New applications and new business models are coming from that. Also, the data analytics and what you can do with the data is just incredible
With all of this comes responsibility, responsibility to make sure that it is deployed in a secure environment. Thus security, particularly with CBRS, is becoming important. Starting with technology changes first. Everybody is talking about 5G, but nobody really understands what it really means, except for having a 5G bar notation on your phone.
What is 5G and what are the implications for Healthcare?
Melissa: At AT&T, the conversation about 5G started four years ago. There’s so much confusion around 5G and what it means. For the normal customer, it is not going to be this massive change. When we look at 5G, we really see low latency and things that are more associated with IoT than the traditional applications that we use on our cell phones.
There is also the confusion of what 5G is and what 5G millimeter wave is. While you may be connecting to IoT devices with 5G, you may be performing heart surgery on a hologram with glasses on, in a learning environment tied to healthcare with a 5G millimeter wave. It is exciting to think about all the devices and applications that someday will be utilizing 5G and 5G millimeter wave in healthcare.
Chris: 5G can be completely different depending on what you are talking about. To that point, on IoT, it is all about going from a hundred thousand devices per square kilometer to what, millions. So, that has nothing to do with speed or capacity. It is just the number of devices that one can get on the system versus millimeter wave, which is a combination of low latency and the massive amount of capacity and speed that you get, versus others who might just be really interested in the enhanced security that comes along with 5G. It can be quite different things for different people, depending on what they are looking for.
When talking about 5G the first thing you need to do is split the spectrum discussion from technology. If you think about a lot of what we are getting from 5G, from a capacity and throughput perspective, it is all about the spectrum. A lot is happening with the spectrum now, where I would say we are going from a dirt road of today to a superhighway of tomorrow.
In all the billions of dollars that the carriers have spent over the years for spectrum, they had about 650 megahertz of spectrum. Verizon alone has about 115 megahertz. It is a limited amount of spectrum. From my perspective, it really is like trying to drive on a dirt road. Where we have a new mid-band spectrum coming out. In addition to that, there are 280 megahertz coming out with this C-Band auction that just happened. Just to give you an idea of how much the carriers spent on this C-Band auction, it was, I believe $80 billion. Is that right?
Melissa: Yes and now the government cannot wait to open more.
Chris: Between CBRS and C-Band, there is a lot more spectrum that is available. If you go on the high end with a millimeter wave, you are talking about a 5x increase in the amount of spectrum. Take the technology and put it aside for a minute. We are more than doubling or tripling the amount of spectrum that we have available. With that, you really are going from a dirt road to a superhighway for data, as you are putting data across the network.
Melissa: Having a traditional cell phone now, I see it as a covered wagon. Then I see IRT and VR, I feel like I am in Tron or something.
What is CBRS?
Melissa: CBRS is 150 megahertz of spectrum in three-dot five, that has been traditionally used by the Navy for repositioning their ships. It has been highly underutilized as a whole. When the US government started analyzing what was going on in the US versus some of the Asian countries as to 5G adoption and advancement, it really came down to that you have very few carriers that are supporting the advancement of this technology. They use the three-dot five spectrum as an opportunity for the average enterprise customer, ISP or WISP. Others go out and play with this, own their own network, and drive innovation in the United States around IoT and 5G.
They separated some of that spectrum, so you have three tiers. The first tier is the Navy for those repositioning. Then you have a second tier that is called Priority Access License. This is an auction that took place last summer. That allowed people to purchase blocks of spectrum up to 70 megahertz in a market to utilize for whatever they want. When we say a market, we are talking about a county. It is not like the footprint the carriers have, which allows more people to participate with the spectrum.
The remainder of that spectrum is general access. Anybody can use it and that is where we are seeing the most activity. You have people who have started to understand CBRS and understand that they want to lay their stake in the ground and control as much of that spectrum as they can before others catch on to the advancements taking place.
Chris: A friend of mine described CBRS as a $4 billion gift that the US government gave to enterprises, healthcare being one of them. They can take advantage of it because it is a free spectrum that the carriers would normally have to pay for. It is LTE-based or 5G NR-based technology, so you get all the reliability, security, and throughput that comes along with it. We see a lot of people moving mission-critical applications off other, wireline or wireless, technologies onto this.
What are some examples of CBRS that JMA Wireless is working on?
Melissa: Right now, hospitals are coming off an extremely hard year, as to be expected. They are evaluating some lessons learned on their ability to adapt their network in critical times. We are seeing anything from temporary deployments to utilizing CBRS to support tents and parking garages. As well as hospitals looking at how they can leverage this technology to retrofit existing facilities with recent technologies.
When you think about all the regulations in place about open ceilings/walls and patient rooms, being able to eliminate all of that by having the connectivity enabled by a highly secure CBRS network can save thousands of dollars. It can ensure that those patient rooms stay live and active. It is exciting, but it does not stop.
We must ask ourselves, how we can utilize this network to offload some of the telemetry devices we have to leave on the Wi-Fi? There are other hospital applications that we are seeing issues with, and we would like to get that off our Wi-Fi and onto something more secure, and something more reliable. So, it is an exciting time to be talking with hospitals because there is such a broad amount of use cases that exist and are just developing every day.
Section 2 – The Impact of New Technology
How do the enhancements in connectivity, capacity, and reliability transform the way that patients experience or how clinicians do their job in a healthcare setting?
1.) Impact on Patients
Chris: Starting on the patient side, I have a fitting example of this. One of the guys that I work with was talking about how he went in for back surgery last week, and he was in the basement. Without the connectivity solution, there would be no connection from the outside world. His surgeon decided at the last minute to look at his MRI. After looking at the MRI on his tablet, he decided that instead of going in from the back of the neck, he would come in from the front. So, at the last minute, he decided to change the process by which he was going to perform the surgery; all because of the connection he could get in the basement. This would not be available at all without a good wireless system. That kind of impact is amazing.
Melissa: It is exciting to think about. It makes you think about being a patient over the past year and what that means. A year ago, if I wanted to see my doctor, I went to the doctor’s office and I saw my doctor. We have seen this complete transformation in how we as patients interact with our physicians. Being able to ensure that there’s good connectivity, not only in the hospital or the clinic. Doctors being able to have that interaction on telehealth. On a larger scale, we can see how hospitals partner with communities, counties, and cities. All to ensure that there’s connectivity for their patients in their homes.
This past year as patients we have had a completely different experience than normal. With all this recent technology coming out on the market; we have no idea what our experience is going to be two years from now.
Chris: We tend to think about connectivity within the hospital, but it goes out into the community at large. Video streaming is imperative to have that intimate relationship with your healthcare provider. You cannot have that without connectivity.
We should also talk about patient comfort. This can occur in so many ways. Some of the hospitals that we are working with are allowing patients to control their environment. That is something I admire. To me, that is anything from temperature control to automated shades. Even connecting to the outside world. Imagine giving birth and not being able to share that experience with your loved ones.
Melissa: Some of the happiest days of my life were in a hospital meeting new family members. I have also been in a hospital sick and by myself. In this case, my loved ones could not be with me because they were working or had three kids to take care of. Then I was there when we lost somebody. Every single one of those times that I have been in the hospital has been a very emotional thing for me. That comfort, ensuring there is not only warmth but lighting and everything else. Sometimes the most comforting thing we can have is a connection to the outside world. That is what these technologies enable. It allows you to have a positive experience and share that with your family. When you need somebody to be there and support you, you can have that. That is an incredible gift.
Chris: To be able to do that with streaming video and zoom calls and those types of things require a lot of bandwidth. When you are in the hospital, it is nice to be able to have control over your own devices. This allows you to entertain and keep yourself busy while healing. Watching a video or doing other things on your tablets and phones requires connectivity too.
2) Impact on Clinical Support
Chris: I know many of our hospitals talk about how important it is to provide good connectivity for their doctors and staff.
Melissa: That is how they make their money. Ensuring that you have the best surgeons and the best physicians at your facility. Thus allowing people to come in and get their elective surgeries done at your facility. There will be new end-user devices and applications coming onto the market. Then it will be important that these facilities invest in the infrastructure to support the clinicians.
It can be like something from a dual SIM. Where they authenticate onto that private network when they enter the hospital. Only certain hospital authorized applications are running on that private network. Any sensitive HIPAA information is being stored only on those applications. When the physician leaves the facility, they no longer are at risk of someone getting access to something they should not. It is such an important thing.
Chris: You can use it for things like motion sensors and predictive fall monitoring. Being able to look after somebody, knowing that they must get up and go to the bathroom. Yet, they should not be up and about, and being able to track that activity. There are all sorts of applications like that on the clinical support side. From that down to just the simple hand washing. Hand washing is such a critical item. How does one do compliance monitoring around that? How do you drive that kind of behavior, where you are reducing the risk of the transfer of germs?
Melissa: My kids need to have this so that they can have happy birthday sung automatically twice as they are washing their hands.
3.) Impact on Facilities
Chris: The amount of assets that get lost in a hospital on an annual basis is incredible. And/or how they are used; so that they are lost forever or stolen. Or even lost for a day or two. With these systems and the ability to do location-based services with asset management and tracking, the number of implications from an efficiency perspective is wild.
Melissa: Some of those assets can even be patients. It is amazing when you hear stories about patients getting lost or put in the wrong rooms. So for facilities, everything in a hospital needs to be tracked. From your pharmaceuticals to your medical devices. CBRS and 5G give us that pathway to truly untethering hospitals. Ensuring that they can track where those devices are going, but then also using those devices on the same network.
Chris: For those of you that are looking at building automation systems, it is incredible what you can do with wireless connectivity and the sensors that connect to the network. Where you can sense where people are and turn on and off HVAC systems based on that traffic. There are many studies out there and real-life examples where you can decrease the cost per square foot of somewhere. This can be around 50 cents per square foot per year. It is incredible the amount of savings driving to a green environment, just on that one alone.
I saw a Deloitte analysis and it may have stated that IoMT may grow to about $52 billion by 2022. That is 3.5x more growth in the number of devices that you have on the network. So you need a robust network to think through these types of things. This will allow you to grow with the increasing need for different devices connecting to it.
Melissa: That is very valid, especially in hospitals when you look at it. Most of those Wi-Fi systems are already overtaxed. You must start looking at what your priorities are. What are your security requirements? Then figure out a true strategy for how you ensure that you are keeping up with the times. Remember to take advantage of some of these incredible ways to automate your building and reduce your operating costs.
Section 3 – Key Strategies & Tips
Is funding available for these systems?
Melissa: You’ll see that in a lot of broadband funding that is coming out, they are designated for healthcare. Again, that goes back to how different our patient interactions are now. The ability to support that and patients who are pulling up outside of hospitals to get COVID tests or vaccines. How can someone pull all of that together without having ubiquitous coverage? That is the purpose of a lot of this funding.
In many communities, we see hospitals partnering to ensure that all patients have access. They are pooling that government money to ensure that there is coverage for all. Constituents and patients that may live within that community. It is inspiring to see that out of something tragic in our history, we are seeing this convergence of the public sector and private sector in caring for communities.
Next Steps & How to Connect
“If you have any questions or want to reach out, please do so. We would love to try and help with anything you are trying to tackle. Whether it be on the connectivity, wireless, and/or funding side. As well as how you can get funding for these systems”.
Melissa Ashurst: VP of Emerging Markets at JMA Wireless
JMA is a US-based manufacturer located in Syracuse, New York. They have been around for about 60 years and are best known for their connectors and DAS products. They have an amazing software-based product that has just come out on the market. This product is revolutionizing the way people connect to CBRS. They are looking at how they can implement that with some of the US-based carriers.
Chris Wixom: Chief Revenue Officer at Connectivity Wireless
Connectivity Wireless is a managed service provider. They specialize in providing all things wireless. This consists of 4G, 5G, Wi-Fi, and private networking with CBRS. They are in ~ 2,700 buildings across the country, so just about every vertical one can think of. Currently, they are doing quite a bit in healthcare. They are in ~60 hospitals. From Nationwide Children’s hospital, the CDC to a variety of university hospitals nationwide.