SIMPLIFYING THE PHYSICAL DEPLOYMENT OF WIRELESS TELEMETRY AND RTLS STANDARDS AND BEST PRACTICES While all wireless telemetry and RTLS used within healthcare must meet regulatory requirements such as availability, accuracy, and functionality, these requirements typically pertain to the system. Minimal direction as to the placement of the network edge devices, design recommendations, and installation of the supporting ICT infrastructure is provided. Install- ation should provide full access to the wireless network devices and cabling components for maintenance or upgrades after initial installation for the life cycle of the installed devices. To meet operational requirements, the objective should be to enable authorized access to these components without removing the ceiling tile, thereby simplifying infection control procedures. Additionally, providing a physically secured installation will eliminate tampering with the wireless device and associated cabling reducing downtime. Standards such as the following are routinely updated to address these Issues: NPFA 99, Health Care Facilities Code NFPA 99 has increasingly included ICT infrastructure requirements to minimize risks and hazards to patients, staff, and visitors. Categorization of the specific system or equipment with healthcare functions defines requirements for placement, availability, securing, and operations. ANSI/BICSI 004, Information Communication Technology Systems Design and Implementation Best Practices for Healthcare Institutions and Facilities ANSI/BICSI 004 was developed from an ICT perspective to complement standards such as NFPA 99 and ANSI/TIA-1179. In the next revision, expected in early 2025, has been expanded for all healthcare facilities, and includes new requirements and recommendations for availability/redundancy designs, physical and cyber security, and updates to wireless and building systems that will augment existing information for wireless telemetry and RTLS deployments.
ANSI/TIA-1179, Healthcare Facility Telecommunications Infrastructure Standard ANSI/TIA-1179 specifies the requirements for telecommunications infrastructure (e.g., cabling, cabling topologies, equipment spaces) for healthcare facilities. ANSI/BICSI 008, Wireless Local Area Network (WLAN) Systems Design and Implementation Best Practices ANSI/BICSI 008, while primarily focused on the deployment of Wi-Fi / IEEE 802.11 compliant systems, provides design, implementation, and installation requirements that will assist with both wireless telemetry and RTLS deployments. The standard also contains information on supporting and integrating IEEE 802.15-compliant standards which are used to increase the functionality of telemetry systems
to those parts of an organization that implements mandated infection controls such as hospitals, and medical or biological laboratories. While these documents were developed with differing focus based on participants, most contain a general framework that could impact the installation, inspection, and maintenance activities of ICT, wireless telemetry, and RTLS systems. INFECTION CONTROL AND WIRELESS DEVICE INSTALLATION Depending on the jurisdiction, Infection Control Risk Assessment (ICRA) procedures are a critical requirement for the protection of patients during construction or move, add, change (MAC) work, including ceiling access. Depending on the magnitude or scope of work, ICRA procedures will require the construction of neg- ative air pressure barriers, tents, anterooms, and HEPA filters around the work area, which can add significant costs to the overall project. With ceiling-mounted wireless nodes, access points, and antennas, it is necessary to pull a network cable from above the ceiling space to the device positioned below the ceiling tile on the ceiling’s grid structure.
This process may lead to permanent holes and gaps in the ceiling which are not permitted in many spaces throughout the hospital, particularly and including patient areas (See Figure 3). While openings and voids can be filled to achieve regulatory compliance, there is additional time and related expense with such activities, prior to intro- ducing risk of an additional point of failure from an ineffective seal. The adoption of single-pair Ethernet and the power over digital line (PoDL) protocol within wireless access points and devices will minimize the size of the hole required. However, the availability of these technologies for healthcare environments is not present at the time of publication. Even with such advancement, the installation will also need to address the storage of cable service loops and associated connectivity components, as well as allow for inspection, post-installation service, and maintenance for the life cycle of the installation of the device without lifting the ceiling tile or interfering with other ceiling tiles or systems in the installed location. The goal should be to achieve an installation that eliminates holes of any size for cable egress.
ANTENNAS, ACCESS POINTS AND ENCLOSURES
Antennas and access points are permitted to be mounted in most locations, assuming the ability to comply with all regulatory requirements while maintaining reliable operation in all conditions. The practice derived from experience has narrowed antenna and access point deployment primarily to ceilings. When the designer further specifies, the following factors and considerations are commonly used: • The wireless access point infrastructure’s physical design should consider consistency, compatibility, and ease of operational support while lowering overall cost. • Wireless access point infrastructure design costs should consider both initial installation costs as well as operational costs (e.g., time requirements for inspection, maintenance, and servicing). • Wireless antennas and access points placed within enclosures or otherwise mounted provides physical security and deters tampering • Mounting and installation methods should be selected to comply with programs that minimize risk from infectious and contaminant accumulation and transmission.
FIGURE 3: Examples of ceiling-mounted devices connected to cabling running through gaps between the ceiling tile.
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ICT TODAY
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