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A private WLAN with an ACS. A workstation running the Linux operating system functioned as a Network Address Translation (NAT) server. The private LAN was linked with the Internet through a switched hub or router. The AP was configured to use ACS for AAA services for the EAP-enabled wireless devices over the WLAN. A Windows 2000 Server running Active Directory was used to mimic a NAS to negotiate with ACS through the RADIUS protocol.
Source publication
Wireless local area networks (WLANs) are considered the next generation of clinical data network. They open the possibility for capturing clinical data in a prehospital setting (e.g., a patient's home) using various devices, such as personal digital assistants, laptops, digital electrocardiogram (EKG) machines, and even cellular phones, and transmi...
Citations
... Davis et al 6 and Briggs et al, 7 examining RFID-tracked blood products, postulated that this technology might help to reduce the morbidity and mortality associated with transfusion reactions. Other studies have also examined the role of RFID in tracking pathology specimens, 4 the safe administration of inpatient medication, 8 improving safety and productivity in the perioperative environment, 9 developing anti-elopement and anti-abduction programs, 1 creating wireless electronic health record systems for mass casualty incidents, 10 obtaining outpatient clinical data for prehospital admissions, 11 and surveillance in a residential care setting. 12 Nevertheless, information about the feasibility of using mobile technologies for monitoring inpatient localization and clinical workflows is sparse. ...
Background:
Patient localization can improve workflow in outpatient settings, which might lead to lower costs. The existing wireless local area network (WLAN) architecture in many hospitals opens up the possibility of adopting real-time patient tracking systems for capturing and processing position data; once captured, these data can be linked with clinical patient data.
Objective:
To analyze the effect of a WLAN-based real-time patient localization system for tracking outpatients in our level I trauma center.
Methods:
Outpatients from April to August 2009 were included in the study, which was performed in two different stages. In phase I, patient tracking was performed with the real-time location system, but acquired data were not displayed to the personnel. In phase II tracking, the acquired data were automatically collected and displayed. Total treatment time was the primary outcome parameter. Statistical analysis was performed using multiple linear regression, with the significance level set at 0.05. Covariates included sex, age, type of encounter, prioritization, treatment team, number of residents, and radiographic imaging.
Results/discussion:
1045 patients were included in our study (540 in phase I and 505 in phase 2). An overall improvement of efficiency, as determined by a significantly decreased total treatment time (23.7%) from phase I to phase II, was noted. Additionally, significantly lower treatment times were noted for phase II patients even when other factors were considered (increased numbers of residents, the addition of imaging diagnostics, and comparison among various localization zones).
Conclusions:
WLAN-based real-time patient localization systems can reduce process inefficiencies associated with manual patient identification and tracking.
... Solutions to secure access include requiring verification by virtual private network access for both receiving and sending devices, using an access control server, Wired Equivalent Privacy (WEP) security protocol wireless network encryption, and other security requirements used in hospital settings. 35,[44][45][46][47] Wi-Fi Protected Access (WPA and WPA2) encryption also should be considered when deciding how to protect patient data. WPA and WPA2 offer several advantages over WEP. ...
OBJECTIVE: The goal of this paper is to identify strategies for connectivity that will optimize point-of-care testing (POCT) organized as small-world networks in disaster settings. METHODS: We evaluated connectivity failures during the 2010 Haiti Earthquake, applied small-world network concepts, and reviewed literature for point-of-care (POC) connectivity systems. RESULTS: Medical teams responding to the Haiti Earthquake faced connectivity failures that affected patient outcomes. Deploying robust wireless connectivity systems can enhance the efficiency of the disaster response by improving health care delivery, medical documentation, logistics, response coordination, communication, and telemedicine. Virtual POC connectivity education and training programs can enhance readiness of disaster responders. CONCLUSIONS: The admirable humanitarian efforts of more than 4000 organizations substantially impacted the lives of earthquake victims in Haiti. However, the lack of connectivity and small-world network strategies, combined with communication failures, during early stages of the relief effort must be addressed for future disaster preparedness.
... The certificate authority issues digital certificates to client computers, server computers, and the CA itself. An additional Remote Access Server (RAS) is implemented to allow remote access [6]. A connection between clients and the database was created through a method for client-database connection (Open Database Connectivity, ODBC). ...
Organizations that have limited resources need to conduct clinical studies in a cost-effective, but secure way. Clinical data residing in various individual databases need to be easily accessed and secured. Although widely available, digital certification, encryption, and secure web server, have not been implemented as widely, partly due to a lack of understanding of needs and concerns over issues such as cost and difficulty in implementation.
The objective of this study was to test the possibility of centralizing various databases and to demonstrate ways of offering an alternative to a large-scale comprehensive and costly commercial product, especially for simple phase I and II trials, with reasonable convenience and security.
We report a working procedure to transform and develop a standalone Access database into a secure Web-based secure information system.
For data collection and reporting purposes, we centralized several individual databases; developed, and tested a web-based secure server using self-issued digital certificates.
The system lacks audit trails. The cost of development and maintenance may hinder its wide application.
The clinical trial databases scattered in various departments of an institution could be centralized into a web-enabled secure information system. The limitations such as the lack of a calendar and audit trail can be partially addressed with additional programming. The centralized Web system may provide an alternative to a comprehensive clinical trial management system.
... We adopted an agent software strategy (Baujard, Baujard, Aurel, Boyer, & Appel, 1998;Boyer et al., 1997;Chen, Soong, Grimes, & Orthner, 2004;Gao & Wang, 2004) to search various informa- tion sources automatically. The objective was not to develop new agents but to use available ones for searching and retrieving with minimum human intervention. ...
Our earlier study (Chen, Orthner, & Sell, 2005) showed that it is possible to record the searching strategy, to search and retrieve literature information automatically, and to visualize the retrieved information through a Web interface. The objective of this study was to update the current sys-tem into a prototype of the Literature and Information Tracking System to search, retrieve and visualize information in a guided and customized manner. The implementation of the system showed that users could update their account information and searching strategies including top-ics, online sources, etc., over Web interfaces. The guided approaches for optimized terms usage enhanced the recall, precision, and efficiency. The web-based system may become an efficient tool for both bench scientists and clinicians for their daily information retrieval and visualization. The implemented digital certification kept both convenient access and the highest possible level of security for the retrieved information. The system has great potential to serve a large number of concurrent users.
... The major concerns have been the cost and security. [1][2][3] Once the office is digitally transformed, then comes the question of user access (to whom, where, and how). Traditionally dental offices have personal computers (PC) in fixed locations, usually at the reception/chart room. ...
Wireless networking is not new to contemporary dental offices around the country. Wireless routers and network cards have made access to patient records within the office handy and, thereby, saving valuable chair side time and increasing productivity. As is the case with any rapidly developing technology, wireless technology also changes with the same rate. Unless, the users of the wireless networking understand the implications of these changes and keep themselves updated periodically, the office network will become obsolete very quickly. This update of the emerging security protocols and pertaining to ratified wireless 802.11 standards will be timely for the contemporary dentist whose office is wirelessly networked. This article brings the practicing dentist up-to-date on the newer versions and standards in wireless networking that are changing at a fast pace. The introduction of newer 802.11 standards like super G, Super AG, Multiple Input Multiple Output (MIMO), and pre-n are changing the pace of adaptation of this technology. Like any other rapidly transforming technology, information pertaining to wireless networking should be a priority for the contemporary dentist, an eventual end-user in order to be a well-informed and techno-savvy consumer.
Citation
Mupparapu M. Contemporary, Emerging, and Ratified Wireless Security Standards: An Update for the Networked Dental Office. J Contemp Dent Pract 2006 February;(7)1:174-185.
... However, the rapid expansion of the telecommunications industry offers many opportunities for applications to health. Wireless local area networks (LAN) are already with us and offer the opportunity to create clinical data networks that can be used in hospitals and in the pre-hospital setting (Chen et al 2004). Web-based systems can be used via PC web browser or appropriately configured mobile phones to facilitate chronic disease management, e.g. ...
... We have not detected any electromagnetic interference (EMI) between our WLAN AP's and medical devices, cell phones or pagers. Although the power transmitted by our AP's is significant (100mW), the operating frequency of 2.4GHz falls outside that employed by most medical devices and is unlikely to interfere with them unless the AP is in very close proximity 11 . ...
Background:
The newly mandated eighty hour work week for anesthesia residents demands that they make efficient use of their time to accomplish their educational, clinical, and administrative objectives. We set out to help residents with these tasks by developing a point of care handheld computer (HC) system that gives them access to the hospital network and the Internet through a secure, wireless local area network (WLAN) from most perioperative locations.
Methods:
Different hardware and software platforms were investigated to meet the capability of the specification above. Five anesthesia residents were asked to evaluate the platform selected through a simple ten-question survey.
Results:
The PocketPC operating system and Dell Axim HC with third party encryption and Web browsing software was the best performing platform. Residents unanimously agreed that the system improved their daily workflow efficiency and compliance with administrative requirements. No electromagnetic interference was noted between the HC or WLAN and medical equipment, cell phones or pagers. One resident saw the Web browsing capability as a potential distraction from patient care.
Conclusion:
This system appears to be a valuable tool for resident education, although more rigorous study of its effect on resident vigilance and the safety of patient data are needed.
... The wireless component included several wireless LANs (WLAN) with Access Point (AP) was centrally controlled by an Access Control Server (ACS, Cisco Company) for Authentication, Authorization and Accounting (AAA). All wireless clients had Extensible Authentication Protocol (EAP)-enabled as described before [1]. The scheduling software agent called Schedule Wizards was installed and programmed to use the stored user preference such as words, websites, and journals in the database to search the various information sources automatically. ...
... The wireless LAN managed wireless clients from a centralized ACS as reported before [1] and shown in the Figure 1. We chose to include the wireless component due to the increasing popularity of the technology. ...
... The security concerns for accessing retrieved information through both wired and wireless network still prevent the healthcare organization from deploying them. One of the approaches to minimize the vulnerability is to control the remote and/or wireless clients' access through RADIUS and EAP-enabled AP management [1]. Another approach is to use digital certificate and secure web servers [19,20]. ...
The rapid growth of online publications such as the Medline and other sources raises the questions how to get the relevant information efficiently. It is important, for a bench scientist, e.g., to monitor related publications constantly. It is also important, for a clinician, e.g., to access the patient records anywhere and anytime. Although time-consuming, this kind of searching procedure is usually similar and simple. Likely, it involves a search engine and a visualization interface. Different words or combination reflects different research topics. The objective of this study is to automate this tedious procedure by recording those words/terms in a database and online sources, and use the information for an automated search and retrieval. The retrieved information will be available anytime and anywhere through a secure web server.
We developed such a database that stored searching terms, journals and et al., and implement a piece of software for searching the medical subject heading-indexed sources such as the Medline and other online sources automatically. The returned information were stored locally, as is, on a server and visible through a Web-based interface. The search was performed daily or otherwise scheduled and the users logon to the website anytime without typing any words. The system has potentials to retrieve similarly from non-medical subject heading-indexed literature or a privileged information source such as a clinical information system. The issues such as security, presentation and visualization of the retrieved information were thus addressed. One of the presentation issues such as wireless access was also experimented. A user survey showed that the personalized online searches saved time and increased and relevancy. Handheld devices could also be used to access the stored information but less satisfactory.
The Web-searching software or similar system has potential to be an efficient tool for both bench scientists and clinicians for their daily information needs.
... vices in a limited area to communicate among each other without physical cabling. The data transmission rate of wireless LAN is superior to PAN / BAN (e.g. 54 Mbps 1 for IEEE 802.11g vs. 3.0 Mbps for Bluetooth 2.0) (Wikipedia, 2006). In medical settings, transmission of complex data formats such as x-ray images or ECG in a wireless LAN is feasible. Chen et al. (2004) developed a wireless LAN prototype in a pre-hospital environment. The system allowed paramedic personnel to send patients' data (e.g. demographics and ECG) using personal data assistants (PDA) and laptops from the patients' homes to ambulances parked outside. Data was then re-transmitted to the emergency rooms prior to patients' arrival ...
ICS 614 Fall 2006 1. Background Telemedicine is defined as the "use of computers and telecommunications equipment to provide health care over long distances" (Larkin, 1997). It is applied to all facets of health care such as dermatology, radiology, surgery, etc. Early developments of telemedicine can be traced back to the National Aeronautics and Space Administration (NASA) in the 1960's where physiological parameters of space-bound astronauts were monitored remotely by physicians on Earth (Pitrone, 2000). Since then, technologists have continuously attempted to apply the latest technologies in the computer industry to the health care system. The emergence of mobile wireless devices in the 1980's and 1990's was no exception. In its simplest application, physicians nowadays carry mobile phones, pagers, and BlackBerry's to keep in touch with throughout the day. Additionally, there are many research projects that use mobile wireless devices in more complex telemedicine applications. Disaster response, physiological state monitoring, and wound care management are a few examples. 2. Introduction It is the intent of this literature review to study the use of mobile wireless devices in telemedicine in a holistic manner. First, the various technologies related to mobile wireless devices will be examined using a number of existing research projects. Secondly, some of the economic issues will be addressed since many health care providers scrutinize the use of costly technologies in telemedicine because of a lack of reimbursement for the majority of its applications. Lastly, this review will illustrate some of the social implications including patient information confidentiality, system usability, care provider acceptance and adoption, and licensure. 3. Method A comprehensive search was performed in the electronic databases of the PubMed Central (PMC) 1 and the Telemedicine Information Exchange (TIE) 2 . Search was limited to results that were in the English language and those that contained entire articles. Three search queries were used in this review: "telemedicine and cellular", "telemedicine and mobile", and "telemedicine and wireless".
Technology of wireless local area network (WLAN) has rapidly developed, and it has been more and more extensively applied. With the establishment of IEEE802.11 WLAN standard, WLAN gradually enters campus and plays an increasingly important role. This paper analyzes the requirements of Campus WLAN and puts forward the implementation plan. The scheme was designed and discussed in the aspects of network structure, business deployment, management mode and security of network. This paper prefers the techniques of two-way authentication, dynamic WEP key and session WEP key between client and authentication based on WLAN authentication to ensure the security of network. At the same time, according to the security requirements, it can be further improved by setting up authentication service and configuring other monitoring means.
