One of the questions when implementing an EHR is whether to install a local (wired) network within the practice or whether to go wireless. In many cases, with the implementation of an EHR, the result is a combination of both options with wired access points in examination rooms, administrative areas, and for document scanning purposes. However, this decision is highly dependent on the type of EHR that you select, the size of your clinic, and whether your style of practice is better suited to carrying a mobile laptop or tablet with you between encounters vs. logging into a fixed-station computer in each area of the practice.
What should you consider when selecting between local and wireless networks?
Local Networks — Pros
- Speed: With the advent of Gigabit routers, the speed of data transfer is significantly faster than wireless and not sensitive to dead spots within the practice as sometimes is encountered with wireless. Good for locations in which a lot of data is being accessed, e.g. diagnostic images or the scanning of large files.
- Cost: Relatively inexpensive to initially install and very low maintenance cost thereafter. The average cost for each network drop (outlet) is approximately $100; however, if a full office is being set up, this cost can be negotiated down. Wiring does not need to be replaced. As a result, long-term maintenance of the wiring is zero. However, switches and routers may need to be upgraded over time.
- Network security: The network must be protected by a firewall and should be set up by a professional networking expert who can ensure that the correct ports are switched on and other security features enabled. Once this is done, the network is generally well protected, particularly if it is not directly connected to the Internet.
- Stability: Local networks are very stable and, once correctly configured, are workhorses that do not cause many problems or require much maintenance. They are generally more stable than wireless networks, although wireless is improving all the time.
Local Networks — Cons
- Mobility: Once the network drops are installed, there is limited ability to move to a different location without setting up additional switches and running cables. This is relevant if you change the layout of your medical office or examination rooms and want to move computers around.
- Server: In very small networks, it is possible to set up a local network without a server (peer-to-peer). However, once there are more than five computers in use, it is advisable to install a high powered and high capacity server. The server stores and centralizes information across a medical office. In medical offices, due to the amount of data being moved and the need for centralized storage for documents, you should have a server. This requires ongoing maintenance and greater cost, as you will need to purchase software licenses, anti-virus software, etc. for the server and pay a qualified individual to maintain the server on your behalf.
Wireless Networks — Pros
- Ease of installation: Wireless networks have become commonplace with Wireless N being the current standard. While it is easy to purchase a wireless router, connect it to the Internet, and install in either a home or office setting, it is best to have a network professional install and configure the wireless router in your practice. You want to ensure that you have high security enabled and that there is sufficient wireless coverage throughout all areas within the practice.
- Cost: Depending on how many wireless repeaters (signal amplifiers) you have installed, the cost of hardware is generally low, although you are strongly recommended to use the services of a wireless network expert in the selection and configuration of a wireless router. Commercial routers are generally more expensive, but are more stable and offer better security controls. A $99 router from Best Buy is not advisable.
- Mobility: The ability to access information anywhere in your practice and not be limited to fixed stations offers significant advantages, in particular within your examination rooms where you may want to use a wireless tablet or laptop and carry it with you from room to room.
Wireless Networks — Cons
- Security: Wireless networks are more difficult to secure than wired local networks. As a result, they are more vulnerable to attack by unauthorized users. If improperly secured, an individual could access the network from a location near the practice using scanning software to identify available networks. All of your clinical and sensitive information could be exposed in this situation.
- Installation difficulties: Because wireless networks are so commonly used, you may find that other wireless networks set up in your medical building interfere with your wireless signal. There are a limited number of channels and if the incorrect channel is used, you may end up with inconsistent network connections or no network connectivity at all.
- Wireless transmission speeds: Wireless networks generally do not have the transmission throughput of wired local networks, as they are limited to the maximum speed of the wireless network in a specific area of the practice. As a result, many larger practices will use both a wired network as the core backbone and a wireless access in specific areas.
Whatever you select, ensure that you get professional help in selecting and implementing your network. It may seem easy and inexpensive to do it yourself; however, responding to a security breach is going to be far more expensive than simply setting up the network correctly right from the start.