Case Study

Wireless Environment Supports Swedish Healthcare

Uppsala University Hospital has become one of ’s oldest and most respected institutions by not resting on its laurels, embracing information and communications technologies wherever possible to improve service quality. The university was able to build on the success of its secure, reliable and integrated Cisco Medical-Grade Network infrastructure to take advantage of wireless data and video across the campus and prepare for IP telephony. With high availability, faster services and increased access to data, the university has created a state-of-the-art environment for clinicians and researchers alike, providing information where and when staff need it.

Executive Summary Business Challenges

Customer Name Sweden’s health and medical services are organised into a nationwide programme that • University Hospital, Sweden gives each person access and the right to the best available care. As one of the fastest growing counties in Sweden, Uppsala County aims to deliver the highest quality Industry healthcare it can to the people it serves – one third of the Swedish population. Its • Healthcare 1,400-bed Hospital, Sweden’s (and Scandinavia’s) oldest, is one of Business Challenges the country’s most complete regional hospitals and its 50 clinics serve two million • Improve effectiveness of overall health chain people in central Sweden. With a strong reputation for science and learning, the • Improve quality of patient care University Hospital also conducts a wide range of research and education programmes.

• Help clinicians perform duties more efficiently Although its first department was established as early as 1708, the hospital does not

• Maintain secure environment rest on its laurels. Quite the contrary. It is characteristic of the hospital to always look for new innovative solutions. It makes the best use of new technology, new scientific Solution findings and new ways of working in order to solve medical problems and to • Based on a Cisco Medical-Grade Network infrastructure, one of Sweden’s largest continuously improve the way it takes care of its patients. wireless networks is supporting a suite of applications, such as electronic patient For example, an ageing population requiring more specialised care is placing an records, to improve healthcare delivery. increasing strain on resources at a time when healthcare costs are being scrutinised Clinicians and researchers alike are benefiting from increased access to a state- more closely than ever before. Studies have also shown that 25 to 30 per cent of of-the-art environment which provides healthcare staff time is spent on searching and handling information. By integrating information where and when staff need it wireless technologies, Uppsala’s Cisco Medical-Grade Network infrastructure does this Business Results more efficiently and effectively to improve patient care, provide greater security and • Patient administration and clinical increase access to data, so that caregivers can dispense the highest quality healthcare information delivered electronically, county-wide possible, when and where it is required.

• Costly paper-based processes removed

• Layered security keeps sensitive patient data confidential “Cisco was the only supplier that could offer us components that matched our requirements for cost efficiency and security.”

Britt Ehrs Project Manager Computer Journal Project Uppsala County Solution In the Swedish medical care system, patients visit their GP at local primary centres. A patient administration system makes a record of each consultation and follow-up. Eventually, the whole treatment process produces a paper ‘journal’ which medical staff refer to during the various stages of the care process.

Uppsala County has decided to update this entire process to make it more efficient, aiming to replace such paper-based systems – known to be inefficient, costly, and error-prone – with electronic patient records. Many healthcare organisations have already introduced electronic systems, or are planning to do so, in order to provide better quality information and communication at the point of care.

Electronic patient records are highly confidential. A number of clinicians might require access to them at different stages of the “We even hope that the rapid progress being made with this patient’s treatment. They can store a variety of file formats, technological development will also make it possible for including text, images, and video. Network access must doctors and nurses to dictate information with automatic therefore be flexible – covering remote and wireless options – transcription, rather than typing it in,” says Britt Ehrs, Project high speed, and extremely secure. Manager for Uppsala County’s Computer Journal Project.

To meet this need, one of Sweden’s largest wireless networks is The hospital’s new Cisco wireless network brings true mobility being built at Uppsala University Hospital, using Cisco Aironet to the existing Cisco Medical-Grade Network infrastructure. It technology to support patient administration and journal makes the journal accessible whenever and wherever it is handling so that more comprehensive versions of a patient’s needed. For instance, during patient meetings information from journal can be called up electronically, wherever that patient is the journal can be projected on the wall so that everyone in the being treated. nursing team sees the same graphs and data in the front of them as they discuss specific treatments. Staff will be able to examine a patient’s X-rays, ECG and other results, simply by logging into the system. Old paper-based Uppsala University Hospital is experimenting with remote journals will be scanned and stored in the same system. access to the journal system using small, handheld computers. External drug information will also be available alongside These devices are currently being used to read medicine lists journal notes, dictated and stored digitally as sound files. and to register patient data such as body temperature, pulse and blood pressure.

Effective security is also critical to the new system, which is now protected in several ways. Firewalls, antivirus software “It would not have been possible and encryption defend against external threats, such as viruses, worms and Trojans. to fully replace paper-based “An independent third party has tested our system security,” journals without wireless says Mats Arbman, Uppsala University Hospital’s Computer technology. Thanks to this Engineer. “They were not able to break into it.”

technology we are able to capture A computer-based journal is much more secure than its paper- information at the spot where based equivalent, the content of which cannot be replaced or nursing is done, without involving read by someone who is not authorised to see it. The new any intermediate paper notes.” system logs the identity of each person who reads the journal and records which staff are able to access it further as part of

Mats Arbman the patient’s follow-up care process. For example, laboratory Computer Engineer results and more general information is readily available to staff Uppsala University Hospital although more sensitive, say psychiatric data, or the journal records of a celebrity or politician, are heavily protected. Business Results According to Uppsala University Hospital’s Mats Arbman, the “From the start, Cisco has fully co- decision to use Cisco equipment for the journal project was never operated in this project by in doubt: “Cisco was the only supplier that could offer us supporting us and Uppsala to build a components that matched our requirements for cost efficiency and security. Our entire computer infrastructure is based on solution which fulfils our goals. Cisco Cisco equipment. It would have been wrong not to continue with also delivered products on time. This Cisco, when its products had worked so well for us in the past.” proved to be a critical success Wireless technology also provides staff with the option of factor in a project of this scale.” working wherever and whenever they need to, accessing information where and when it is convenient. The new paperless Gustav Boström patient’s journal can also constantly be updated and accessible Managing Director SYSteam Nät throughout the whole care process – all the way to the patient’s bed – by using mobile devices attached to wireless networks.

“It would not have been possible to fully replace paper-based When emergencies are admitted to hospital, all relevant journals without wireless technology,” says Britt Ehrs. “Thanks information regarding the patient is immediately available. The to this technology we are able to capture information at the nursing team can see which sort of medication the patients are spot where nursing is done, without involving any intermediate taking and how sensitive they are to a certain medicine. paper notes.” For a university hospital with such a respected research pedigree, But Uppsala’s Cisco Medical-Grade Network approach not Uppsala teams also have a lot to gain from using computer-based only intelligently distributes information to improve worker journals, with fast access providing a window on to a much efficiency and patient care, it is also resilient and responsive to larger world of potentially valuable clinical data. For example, a support a 24x7 environment that holds lives in the balance. few keystrokes can identify individuals – say, 50 smoking women with high blood pressure – for particular studies. Later in 2006, when the journal system is fully implemented, healthcare in Uppsala County will be able to rely on uniform In the future patients themselves might also be able to securely administrative routines, which satisfy high levels of quality and access their own journal through the Internet. Uppsala’s security. Although security threats are being reviewed continually, wireless network may also support a transition to IP telephony, the new electronic journal – supported by wireless technology – which will allow voice calls to be made at a fraction of the cost should also improve patient security in several ways. of conventional telephony. Technology Blueprint The County’s new journal system software is based on Boström. “Cisco also delivered products on time. This proved Cambio Healthcare Systems’ Cosmic (Compliant Open to be a critical success factor in a project of this scale.” Solutions for Modern Integrated Care) software suite of eight SYSteam Nät installed 500 Cisco Aironet 1100 Series access service modules which cover all parts of a healthcare points on the hospital’s campus. These are connected to 30 organisation: resource planning, everyday administration, Cisco 3560 Series Switches, which not only transmit data but clinical care support (case notes, medication, referrals and also deliver power to the access points. tests), incident reporting, statistics and occupational medicine. “Cisco Aironet 1100s were chosen because they were the first Also based in Uppsala, systems integrator SYSteam Nät access point to support 802.11g, at that time a new standard tested, delivered and implemented the University Hospital’s which enables communication at the rate of 54 Mbps,” says new wireless infrastructure. The quality of its work won Gustav Boström. SYSteam the Cisco Mobility Partner of the Year title. The switches are connected to Cisco Secure Access Control “From the start, Cisco has fully co-operated in this project by Server (ACS), which centralises security management. supporting us and Uppsala to build a solution which fulfils our goals,” says SYSteam Nät’s Managing Director, Gustav

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