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Summary
Summary
Focusing on its recent proliferation in hospital systems, Wi-Fi Enabled Healthcare explains how Wi-Fi is transforming clinical work flows and infusing new life into the types of mobile devices being implemented in hospitals. Drawing on first-hand experiences from one of the largest healthcare systems in the United States, it covers the key areas associated with wireless network design, security, and support.
Reporting on cutting-edge developments and emerging standards in Wi-Fi technologies, the book explores security implications for each device type. It covers real-time location services and emerging trends in cloud-based wireless architecture. It also outlines several options and design consideration for employee wireless coverage, voice over wireless (including smart phones), mobile medical devices, and wireless guest services.
This book presents authoritative insight into the challenges that exist in adding Wi-Fi within a healthcare setting. It explores several solutions in each space along with design considerations and pros and cons. It also supplies an in-depth look at voice over wireless, mobile medical devices, and wireless guest services.
The authors provide readers with the technical knowhow required to ensure their systems provide the reliable, end-to-end communications necessary to surmount today's challenges and capitalize on new opportunities. The shared experience and lessons learned provide essential guidance for large and small healthcare organizations in the United States and around the world.
This book is an ideal reference for network design engineers and high-level hospital executives that are thinking about adding or improving upon Wi-Fi in their hospitals or hospital systems.
Author Notes
Ali Youssef is a Senior Network Architect specializing in mobility (CWNE #133) and digital health with over 18 years of design, strategy and operations experience. His passions include mHealth, patient engagement, patient experience, medical device design, and how IOT and mobile devices are transforming healthcare and improving clinical outcomes. Ali led the design, implementation, and ongoing support of one of the largest wireless networks in healthcare in North America. He speaks regularly at industry events like HIMSS, AAMI, CWNP, CTIA, IHP, and MDM&M, is an active member of the AAMI Wireless Strategy Task Force, and the chair for wireless technology for the Intelligent Hospital Association. He has authored several articles on topics ranging from network design to mobile medical device design, and a book entitled "Wi-Fi Enabled Healthcare."
Bob Zemke CPHIMS, CISSP is the Healthcare Solutions Manager at Extreme Networks and a member of the Association of Medical Instrumentation Wireless Strategy Task Force (WSTF). Bob has degrees in Telecommunications Management from Western Michigan University and a Master's degree in telecommunications and network management from Syracuse University's prestigious iSchool. An IT professional with a broad span of experience in healthcare, Bob has been practicing and consulting in healthcare IT for over 15 years of experience in network design, deployment and management for hospital organizations globally. You can reach Bob on twitter @bobzemke
Doug McDonald CPHIMS, CWSP is the Wireless Network Manager for Henry Ford Health System in Rochester Hills, Michigan. He is responsible for over 7 million square feet of hospital grade wireless Infrastructure. He holds a Bachelor's degree in Information Technology and Services Management from Michigan State University and is currently pursuing an Executive MBA at Oakland University. Doug has fifteen years of experience as an IT professional. A member on the mHIMSS task force and coauthor of the mHIMSS roadmap, he holds a number of certifications including CPHIMS, CWNA, CWSP, CWDP, and ITILV3. You can reach Doug on twitter @DougRMcDonald
Jon Linton CWNE #89 is a Senior Wireless Architect at Henry Ford Health System. He holds a BS in Management from Kettering University and is one of the first 100 Certified Wireless Experts in the CWNP organization. Jon also holds the ITILV3 certification. He has been active in publishing articles, presenting webinars and writing blog posts on all things Wi-Fi. You can reach Jon on twitter @wifisamuri
Aaron Earle CRISC, CISSP, CISA, CISM, CCNP, MCP, A+, Net+, and Security + has been securing computer and network systems for over a decade. In this time he has accumulated thirty five certifications and two corporations. Aaron Earle has been involved with System Auditing, Vulnerability Assessment, Security Architecture, and Corporate Policy Writing. Aaron is an avid speaker and instructor for many security organizations worldwide. He has taught for prestigious security organizations such as Computer Security Institute (CSI) and Information Systems Security Association (ISSA). Aaron has also instructed personnel from almost every United States three or four letter government agency including NSA, FBI, and DOD. Aaron Earle's talent has taken him around the world informing, educating, and safeguarding governments and companies alike. You can reach Aaron at aaronearle@aeecorp.com
Table of Contents
Foreword | p. xiii |
Preface | p. xvii |
Chapter 1 Brief History of Wi-Fi | p. 1 |
History and Current Growth and Proliferation of Wi-Fi in Hospitals | p. 3 |
Regulatory Bodies | p. 10 |
Federal Communications Commission | p. 11 |
Institute of Electrical and Electronics Engineers | p. 11 |
Wi-Fi Alliance | p. 14 |
Core Programs | p. 15 |
Optional Programs | p. 15 |
International Organization for Standardization | p. 17 |
Wi-Fi Impacts on Clinical Workflow | p. 17 |
mHealth | p. 21 |
Endnotes | p. 22 |
Chapter 2 Wireless Architecture Considerations | p. 23 |
About Wi-Fi Networks | p. 23 |
The MAC Layer | p. 24 |
Vendor-Specific Solutions | p. 25 |
Autonomous Architecture | p. 26 |
Controller-Based Architectures | p. 27 |
Distributed Architecture | p. 30 |
Medical Devices | p. 38 |
Medical Imaging | p. 39 |
Wireless on Wheels | p. 41 |
Tablets and Smart Phones | p. 43 |
Bonjour | p. 44 |
Chapter 3 Site Survey Process | p. 47 |
Wireless Site Survey Process | p. 47 |
Preparation | p. 47 |
The Statement of Work | p. 48 |
Facility Blueprints | p. 49 |
Pre-Survey Walkthrough | p. 49 |
Design Considerations | p. 50 |
High-Capacity Design | p. 51 |
Channel Planning | p. 52 |
Multifloor Designs | p. 53 |
Aesthetics | p. 54 |
Augmenting Existing Designs | p. 55 |
Upgrading Access Point Hardware | p. 55 |
Cabling | p. 56 |
Network Infrastructure | p. 56 |
Network Ports | p. 57 |
Power Availability | p. 57 |
Network Bandwidth | p. 58 |
IP Address Availability | p. 58 |
Survey Equipment | p. 58 |
Form Factor | p. 60 |
Site Survey Design Software | p. 61 |
Spectrum Analyzer | p. 62 |
Survey Types | p. 62 |
Predictive Survey | p. 63 |
Passive Survey | p. 63 |
Active Survey | p. 64 |
Survey Techniques | p. 64 |
Site Survey Report | p. 65 |
Post-Validation Survey | p. 66 |
Chapter 4 Wireless Security Wi-Fi | p. 67 |
About Information Security and Wireless Networking | p. 67 |
Confidentiality | p. 67 |
Availability | p. 67 |
Integrity | p. 68 |
Wireless Security Risks and Threats | p. 68 |
Denial of Service | p. 68 |
Malicious Code | p. 69 |
Social Engineering | p. 70 |
Signal Analysis | p. 70 |
Spoofing | p. 71 |
Rogue Access Points | p. 71 |
Wireless Hacking and Hackers | p. 72 |
Motives of Wireless Hackers | p. 73 |
War Driving | p. 73 |
Tracking War Drivers | p. 75 |
The Hacking Process | p. 75 |
Information Gathering | p. 76 |
Enumeration | p. 78 |
Compromise | p. 79 |
Expanding Privileges and Accessibility | p. 79 |
Cleaning Up the Trails | p. 81 |
Service Set Identifier | p. 82 |
Shared Key Authentication | p. 84 |
Open Key Authentication | p. 85 |
Wired Equivalent Privacy Standard | p. 86 |
802.1x | p. 87 |
Authentication Server | p. 88 |
Authenticator | p. 88 |
Supplicant | p. 89 |
Extensive Authentication Protocol over Local Area Network (EAPOL) | p. 89 |
Remote Authentication Dial-In User Service (RADIUS) | p. 90 |
Extensible Authentication Protocol | p. 93 |
EAP-MD5 | p. 95 |
EAP-TLS | p. 95 |
EAP-TTLS | p. 96 |
LEAP | p. 96 |
PEAP | p. 96 |
EAP-FAST | p. 97 |
Wi-Fi Protected Access | p. 97 |
802.11i | p. 99 |
Robust Secure Network (RSN) | p. 101 |
Transition Secure Network (TSN) | p. 104 |
Temporal Key Integrity Protocol | p. 104 |
TKIP MIC | p. 106 |
Advance Encryption Standard | p. 107 |
802-lli System Overview | p. 108 |
Wi-Fi Protected Access | p. 110 |
Rogue Access Points Detection | p. 110 |
Wireless Security Tools | p. 111 |
Scanning Tools | p. 112 |
Sniffing Tools | p. 113 |
Hybrid Tools | p. 114 |
Cracking Tools | p. 114 |
Access Point Attacking Tools | p. 114 |
Wireless Security Policy Areas | p. 115 |
Pas sword Policy | p. 116 |
Access Policy | p. 118 |
Rogue Access Point Policy | p. 118 |
Guest Access Policy | p. 119 |
Remote WLAN Access Policy | p. 120 |
Physical Security | p. 121 |
Wireless Monitoring and Security Incident Response | p. 122 |
HIPAA and Wi-Fi | p. 122 |
Chapter 5 Wireless Guest Services | p. 129 |
Sponsored, Open Access, and Self-Enrollment | p. 130 |
Sponsored Guest Access | p. 130 |
Self-Enrollment Guest Access | p. 131 |
Open Access | p. 132 |
Captive Portal Page Types | p. 132 |
No Registration Splash Page | p. 133 |
Self-Registration | p. 134 |
Manual Registration | p. 134 |
Sponsored Registration | p. 135 |
Supporting Infrastructure | p. 136 |
Revenue Generation | p. 136 |
Bring Your Own Device (BYOD) | p. 137 |
SCEP | p. 143 |
Endnotes | p. 143 |
Chapter 6 Mobile Medical Devices | p. 145 |
Functional Testing | p. 153 |
Network Testing | p. 154 |
Failover and Redundancy Test | p. 154 |
Mobile X-Ray Machines | p. 155 |
Medication Dispensing Systems | p. 157 |
IV Pumps | p. 158 |
Electrocardiogram Carts | p. 160 |
Ultrasound Devices | p. 161 |
Blood Gas Analyzers | p. 163 |
Hemodialysis Machines | p. 163 |
mHealth | p. 165 |
Chapter 7 Voice over Wi-Fi | p. 167 |
Why VoWi-Fi? | p. 167 |
The Challenges of VoWi-Fi | p. 168 |
Quality of Service Fundamentals | p. 172 |
Evolution of QoS | p. 172 |
The Journey of a Voice Packet | p. 173 |
What Happens at Phone One | p. 174 |
What Happens at the Access Point | p. 176 |
What Happens at Switch One | p. 177 |
What Happens at the Router | p. 177 |
Differentiated Services | p. 177 |
802.1Q. | p. 180 |
Anatomy of VoIP | p. 181 |
The Anatomy of Codecs | p. 183 |
Proprietary Protocols | p. 188 |
Wireless Arbitration | p. 190 |
Troubleshooting VoWi-Fi | p. 194 |
Roaming | p. 199 |
Chapter 8 Real-Time Location Services | p. 203 |
RTLS Technologies | p. 204 |
ZigBee | p. 204 |
Wi-Fi | p. 204 |
Infrared | p. 205 |
Ultrasound | p. 205 |
How RTLS Works | p. 205 |
Architecture | p. 207 |
ISO/IEC Standards | p. 208 |
Different Types of Transmitters | p. 208 |
Applications | p. 208 |
Asset Management | p. 208 |
Equipment Rentals | p. 209 |
Shrinkage | p. 210 |
Condition Monitoring | p. 210 |
Patient and Clinician Safety | p. 210 |
Infection Control | p. 211 |
Workflow | p. 212 |
RTLS Issues | p. 212 |
Privacy Concerns | p. 212 |
Challenges with Accuracy | p. 212 |
Maintenance and Costs | p. 213 |
Chapter 9 The Wireless Project Management Process | p. 215 |
Refining the Scope | p. 217 |
Scheduling and Developing Milestones | p. 217 |
Developing a Budget | p. 218 |
Quality Assurance | p. 218 |
Communication Strategy | p. 219 |
Risk Management | p. 219 |
Change Management | p. 220 |
Closure Criteria | p. 220 |
1 Identify Key Stakeholders and Set up a Kickoff Meeting | p. 221 |
2 Perform an RFI and RFP to Choose a Wireless Vendor | p. 221 |
3 Survey Network Closets for Port Capacity and POE Availability | p. 222 |
4 Perform Predictive and Onsite Wireless Survey | p. 222 |
5 Develop Detailed Physical and Logical Architecture | p. 224 |
6 Develop a Survey Report and Create a Cabling Bid Package | p. 225 |
7 Order Hardware and Consider Lead Times on the Project Plan | p. 226 |
8 Identify Third-Party Training Requirements | p. 226 |
9 Stage Hardware | p. 226 |
10 Oversee Installation and Turn-up of Wireless Network Using a Standard Change Management Process | p. 227 |
11 Ensure that All Hardware Is Set up on the Enterprise Monitoring System | p. 229 |
12 Validate Channel and Power Plan | p. 229 |
13 Conduct Post-Implementation Survey and Make Modifications as Needed | p. 229 |
14 Perform UAT (Unit Acceptance Testing) Using Various Form Factors of End-User Devices | p. 229 |
15 Send a Series of Communications Outlining Offerings with Instructions | p. 230 |
16 Develop Helpdesk Knowledge Base for Common Troubleshooting | p. 230 |
17 Create a Runbook | p. 230 |
18 Handoff Support to Ongoing Operations Team | p. 231 |
19 Ensure that a Process is in Place for Onboarding and Certifying Wireless Devices | p. 231 |
Chapter 10 Support Considerations and Lifecycle | p. 233 |
Tool Set | p. 233 |
Protocol Analyzer | p. 233 |
Voice Analyzer | p. 234 |
Spectrum Analyzer | p. 235 |
Site Survey Software | p. 235 |
Performance Software | p. 236 |
Packet Capturing | p. 238 |
Wireless Intrusion Prevention Systems (WIPS) | p. 239 |
Wireless Network Management | p. 240 |
Staffing Considerations | p. 240 |
Vendor Neutral Training | p. 242 |
Software Tool Training | p. 243 |
Wireless Manufacturer Training | p. 243 |
Wireless Runbook | p. 244 |
Policies | p. 244 |
Acceptable Use | p. 244 |
Disaster Recovery | p. 244 |
Procedures | p. 245 |
Architecture | p. 245 |
Systems Lifecycle | p. 246 |
Routine Maintenance | p. 246 |
Technical Support | p. 246 |
Tier 1 p. 247 | |
Tier 2 p. 247 | |
Tier 3 p. 248 | |
Tier 4 p. 248 | |
Infrastructure Code Upgrade | p. 249 |
End-User Device Considerations | p. 249 |
Lifecycle and Drivers for System Upgrades | p. 250 |
Infrastructure Lifecycle | p. 250 |
Client Device Lifecycle | p. 251 |
Chapter 11 Emerging Trends and Technologies | p. 253 |
Demand for More Bandwidth and Denser Deployments | p. 254 |
Device Density | p. 254 |
Evolution of the Electronic Medical Record | p. 254 |
Mobile Voice and Video | p. 255 |
Guest Access | p. 255 |
Patient Engagement with Social Media | p. 256 |
Device Consolidation | p. 257 |
Shrinking Herds of Carts on Wheels (CoWs) and Workstations on Wheels (WoWs) | p. 259 |
Key Emerging Technologies | p. 259 |
IEEE 802.11ac | p. 260 |
Infrastructure | p. 260 |
Client Devices | p. 260 |
Design and Planning | p. 261 |
Policy Management and Software Defined Networking (SDN) | p. 261 |
The Rise of the Smart Phone | p. 262 |
Application Performance and Security | p. 262 |
IPv6 | p. 263 |
802.11u/Hotspot 2.0/Passpoint | p. 264 |
mHealth | p. 265 |
Index | p. 267 |