Why Wi-Fi should be free in hospitals

Free Wi-Fi access to the internet and greater use of electronic ways to monitor convalescence could help patients recover quicker, according to Gary Hotine, informatics director at the South Devon NHS Foundation Trust.
In a world first, Hotine pioneered free public access for patients and staff at the Torbay hospital and associated community hospitals.

Hotine – connectivity for patients is a ‘no-brainer’.

Speaking on TechQT, Hotine said although the clinicians at South Devon have not explicitly provided evidence of the benefits of patient connectivity, they regard it as a “no-brainer”, he says.
Hotine says it’s “common sense” that if people are in touch with people who care about them, they will be less anxious about going to hospital and this will speed up recovery and/or provide more comfort while they are in hospital.
“Just recently we had a terminally ill patient in our cancer ward who was being blocked from getting into a bingo site. (South Devon’s policy is that providing access to gambling sites is inappropriate in a state-owned service.) She contacted our service desk; we asked the ward if they had any objection, which, under the circumstances, they didn’t, so we were able to unblock it fairly quickly. So you can’t just leave people hanging; you have to provide a level of support.”
John Popham, a campaigner for free Wi-Fi in hospitals, said he’d seen an early stage dementia patient speaking about how having an iPhone has transformed his life. Although it had a number of apps to help him, the most important thing for him was the stored numbers of people he could call if he was unsure or in trouble.

We wanted to use something people were already familiar with when they came to hospital.

Popham also reported on a patient who was recovering from stem cell surgery and had to live in an isolation pod for six weeks. The hospital gave him a laptop and an outside link for the time. According to the supervising doctor, the laptop did the patient more good than all the drugs they gave him. “Those are the kind of stories we need to be telling,” he said.
Hotine put in Wi-Fi two years ago because South Devon asked themselves what they would like if they were patients.
“We go to a lot of meetings in hotels, and it’s extremely irritating if the hotel doesn’t have Wi-Fi, and only slightly less irritating if they make you jump through hoops to authenticate, or you disconnect suddenly,” he says.
“We wanted to use something people were already familiar with when they came to hospital. The opportunity arose to put Wi-Fi into hospitals about four years ago. I asked my technical teams to see if we couldn’t use the same infrastructure to provide a publicly accessible, secure and robust Wi-Fi infrastructure.
“They found a way, and we did penetration tests to make sure that there could be no unauthorised access to the hospital and patient records systems, which of course would be a major concern.

From 2Mbps to 30Mbps
“Then we bought some capacity from the company that provides the junior doctors’ residence with Wi-Fi with I think a 2Mbps pipe originally. The idea was that we’d let the patients and public use it, and if it filled up and slowed down, we’d monitor it. To justify an increase we could show the trust board that it was having a beneficial effect on our patient community.
“We’re currently up to 30Mbps of bandwidth. The bearer circuit we’re on will allow us to go up to 100Mbps, but the present demand is satisfied by 30Mbps.
“The busiest period is 10am when we have about 1,500 connections, and the quietest period is 4am to 5am when we have about 220, mostly patients connecting to iPlayer and email.”
A significant percentage of the 1,500 are staff who are using their private devices to access the internet during breaks.
Staff at hospitals in neighbouring towns have been nagging their managers for similar access, and Hotine has been taking calls for information on how he’s done it.

Popham – hospitalisation is an isolating event

Popham says hospitalisation, especially for long term patients, is a very isolating experience, both for patients and visitors. The equipment now in hospitals to access the internet is out of date, he says.
“Being able to access the outside world would be helpful in the recovery process because being able to speak to others is therapeutic.
“Making telephone calls on those units costs about 39p/min. If you’re online you can use Skype or Hangouts and talk to anybody for free for as long as you want.
“Even if you are on 3G or 4G, half the time you can’t connect because the wards are in a basement or the walls are steel and glass and the signal can’t get out.”
Popham’s campaign is growing – he has about 400 members on Facebook, and he claims it’s becoming accepted that public access Wi-Fi should be available free in hospitals. “I reckon there’s about 25% of hospitals now that have it; that’s a big increase on what it was four or five years ago, but still not enough.”

Marginal cost
Hotine says provided a hospital already has a 24×7 IT service desk, the extra cost of providing public access Wi-Fi is the marginal cost of receiving a telephone call from the public. In the year since the system was in place he counts four or five logged incidents. “You can’t really measure the cost of that, in our experience,” he says.
Hotine notes that the £10,000/y he pays for the South Devon’s 30Mbps bandwidth seems a lot more than what people pay for their home broadband. But it’s the service level agreement, which includes the managed service, the walled garden, the site blocking and uptime requirements that pushes up the price. “Typically at home when there’s an outage you are in the lap of the gods as to when service is restored,” he says.

Being able to speak to others is therapeutic.

The Wi-Fi system supports Torbay Hospital with 400-500 beds plus another couple of hundred beds in community hospitals. The main hospital has about 1,500 access points, which Hotine expects to rise to about 2,500.
He notes that the existing patient entertainment system is rare in hospitals with fewer than 200 beds, but few community hospitals have that many. Closing the gap was key to the design of the Wi-Fi system.
Hotine said the trust has an active ‘league of friends’. He is considering asking them if they’d like to support building up a library of access devices, such as laptops or iPads, for patients’ use.
He hasn’t done it yet because the advent of mobile phones in hospitals has hurt the revenues of the firm that supplies the trust’s patient entertainment system and services.

An offer refused

Hotine notes that patient turnover has been rising in Torbay hospital, but the community hospitals take patients who need long term care. Remembering to collect devices that the patient has rented is likely to be low on the list of priorities once the clinical decision to discharge a patient has been taken, so an efficient collection service is a must, he says.
“We’ve made (the company) an offer asking them if they’d like to offer a paid-for service whereby they would supply the access devices. They haven’t been very keen, so we’re probably getting to the point where we will ask the Torbay league of friends. They’ve got a small army of volunteers who could get around the wards to handle the logistics.”
Hotine and Popham also spoke about the use of tech to monitor and diagnose patients remotely.
South Devon uses data provided by Patients Know Best, a private firm run by UK-trained doctors. Data privacy is governed by the patients’ contractual relationship with PKB. This allows the patients to give their data to South Devon without the trust having to abide by the duty of care restrictions that would apply if it were the primary data collector. Doing it this way has been “quite liberating and allowed us to make the progress we have,” Hotine says.
To hear the full discussion go to TechQT.