Unique Challenges of Cabling for Medical Facilities

The healthcare industry has been late in adopting technology. Only a few years ago, many medical facilities relied on paper files for record management, analog phone systems and outdated cabling infrastructure. Due to strong government regulation and compliance standards, healthcare is finally being transformed by technology.

Hospitals and doctors’ offices can become advanced communication hubs and patient data centers. However, it requires an investment in physical cabling upgrades, scaling cabling infrastructure to meet new demands, lower risk and improve security and performance.

Challenge: Cabling Standards Must be Compliant

The healthcare industry is governed by multiple laws and standards that seek to protect data and carry severe consequences for violations. New requirements are updated frequently as new security breaches and technologies experience vulnerabilities. For example:

• HIPAA, or Health Insurance Portability and Accountability Act, first encouraged healthcare providers to migrate paper records to digital format.
• HITECH Act, or Health Information Technology for Economic and Clinical Health Act, reinforced HIPPA and provided incentives for healthcare providers to upgrade IT systems.
• The ANSI/TIA-1179 Healthcare Infrastructure Standard was enacted in 2010 and provides guidance for structured cabling in a healthcare facility. Due to a unique environment (labs, patient rooms and waiting areas) and laws that aim to protect data, the ANSI/TIA-1179 standard should be followed by all medical organizations. The 1179 standard is a comprehensive standard that starts with cabling design. For example, a minimum of two diverse pathways from the entrance facility to an equipment room provides greater reliability of data. It also separates critical applications such as life support paging from less critical, non-emergency voice calls. Failure to follow 1179 standards by an IT department or telecom installer can result in lawsuits, warranty cancellations and more serious outcomes.
• Infection Control Requirements (ICRs) are another significant difference between a medical office and a commercial office. ICR prevents the spread of disease by requiring safeguards such as enclosed cabling pathways. Exposed copper cable, while preferred in some businesses, is not an option for a hospital.

Challenge: Uptime and Reliability are Critical

Emergency rooms, 911 dispatch and outpatient care facilities require the highest level of uptime. When a network is down during peak demand, lives can be affected and lost. Not only is reliability mission critical, there are diverse systems and software that rely on a strong IP connection for a medical facility:

• Nurse and doctor paging
• Vital signs monitoring
• Medicine inventory systems
• Surveillance camera networks
• Building automation systems
• Visitor records management
• Patient records management

Medical facilities are not only transmitting a variety of data internally, but many systems require high bandwidth. Doctors are collaborating more, as the field of healthcare continues to specialize and information becomes easier to share.

However, a single X-Ray, CT Scan or MRI file can be up to 20GB. On a 100 Mbps internet connection, a file of this size could take longer than 1 hour to upload.  On a 1 Gbps internet connection, it would still take over five minutes to upload the file. When doctors need a second opinion and quickly, a faster internet connection can make a difference in a patient’s outcome. Choosing proper cabling enables a stronger connection and performance.

Many hospitals are now part of a sprawling campus with multiple buildings and research facilities. Buildings in a campus should be connected with OS2 single mode fiber. Intra-building backbones may be connected with OS2 single mode or, at least, OM3 multimode fiber. For other backbone cabling needs, category 6A, or higher, can be installed. These recommendations are made with the goal of preventing the need for infrastructure upgrades in the future.

Category 5e is the minimum standard for existing horizontal cabling in a medical facility. However, it may be necessary to upgrade the cabling to accommodate current applications for higher speed and Power over Ethernet (PoE) devices. Category 6A, or higher, is recommended for new installations.

Challenge: Privacy and Security

Medical facilities must not only guarantee the easy flow of information and collaboration, but protect networks from cyber-attacks. Patient medical records are the most sensitive data in a hospital network.

The ANSI/TIA-1179 standard recommends separate pathways based on applications and services supported. Structured cabling for a server room storing patient records, should be color coded and support only that work-area. This also helps with compliance and matches performance needs to cabling, which can lower the cost of a retrofit.

Separate cabling infrastructure further prevents unauthorized access internally. A growing trend in security breaches is an inside hack which can be intentional or caused by a computer virus. Phishing scams and computer viruses are getting smarter and fooling employees into sharing sensitive data.

Structured cabling installed to follow the 1179 standard provides safeguards and limits exposure of a hospital network to patient records.

Another trend affecting the security of the healthcare industry is hospital mergers and acquisitions. In 2016, a record 102 deals were announced and for first quarter 2017, there was an eight percent increase in M&A deals.

Frequently, rural hospitals with limited technology infrastructure are joining national hospital networks to cut costs and improve service. Inadvertently, mergers can expose insecure networks to millions of patient records.

Conclusion

The challenges to upgrading cabling infrastructure for a health facility can be solved by hiring an experienced telecommunications contractor. Ask if the ANSI/TIA-1179 standard will be followed and whether a vendor is a partner certified with cabling vendors. Case studies and references on new installations and retrofits in a medical environment should be provided in a scope of work.