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Nortel 920-336 : BCM50 Rls.3.0 and BCM200/400 Rls.4.0 Installation, Configuration Exam

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Test Name : BCM50 Rls.3.0 and BCM200/400 Rls.4.0 Installation, Configuration
Vendor Name : Nortel
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Use of mobile and wireless technology Jumps in Hospitals | 920-336 Study Guide and Latest Questions

Dec. 7, 2006 | know-how replace: although adoption of digital health records (EHR) and other clinical IT is still fairly anemic, as a minimum one element of health-IT has taken gigantic steps ahead in the final few years: the use of mobile and wireless technology the place selections are proliferating.

"This basically is the third generation of wireless in healthcare," says Neil Martin, M.D., chief of neurosurgery at the David Geffen college of medication at the tuition of California, l. a.. medical doctors and other healthcare gurus have advanced from pagers to primary cellphones and now to records-enabled "smartphones."

remember personal digital assistants (PDAs) with docks or infrared beams for synching? that's soooo Y2K. Even Wi-Fi playing cards for computer computers have began to appear dated.

"we now have considered evolution from cradle synching," says Mireille Gotsis, a Redmond, Wash.-based mostly healthcare business supervisor for Cingular instant (Atlanta). Physicians have been buying and selling of their old, disconnected PDAs for contemporary PDA smartphones with mobile integration and developed-in Wi-Fi and Bluetooth instant performance to be used within the clinical atmosphere.

"Now all and sundry is looking on the brilliant, new gadgets that deliver those built-in capabilities," Gotsis says. "You are trying to attain the doctor or the clinician anyplace they are."

And practitioners wish to be reached. "As a neurosurgeon, i'm in all places the health center," Martin says. "I wager i am the highest quality mobile knowledgeable." And he needs greater than vmail.  Martin needs entry to photos when consulting on patients in important care.

An MRI or CT scan considered on a PDA or smartphone may additionally now not be diagnostic-nice for a radiologist, but for a neurosurgeon or different expert assisting to deal with lifestyles-threatening emergencies, the resolution is just first-class, in accordance with Martin. He says that a smartphone monitor just occurs to be concerning the size of 1 square of a 12-picture MRI film, which is good sufficient for him.

"We're no longer hunting for tiny things when we're known as about changes to patients in intensive care," Martin says. "The situation is not: Will you leave out some tiny particulars? The problem is: can you access the tips in case you get called from the ER? there is obtained to be a true-time way to get the information."

together with his all-in-one mobile equipment, Martin can look at EKG wave kinds from afar, now not simply lab experiences, permitting him to alert the working room that a patient is on the manner. "It shortens the determination cycle," Martin says.

"It eliminates useless journeys to the medical institution," he says. In congested southern California traffic, it really is a vital plus.

because the hardware has advanced, so has the community infrastructure at the back of it. It has been viable for years to connect a cellphone to a pc modem and get dial-up information superhighway access from very nearly anyplace, but anybody who has cable or DSL web provider at home is aware of how painfully gradual a fifty six-kilobit-per-2nd (kbps) dial-up connection can be.

Three years ago, it used to take 30 seconds to transfer an image over cellular airwaves. via subsequent yr, Martin expects obtain time to cut back to a mere three seconds, thanks to a new technology of wireless broadband expertise. "Now the technology that they anticipated years in the past is feasible," says Martin, who also is chief clinical officer and co-founder of global Care Quest, a cell healthcare application developer in Aliso Viejo, Calif.

He says that the networks of Verizon instant and sprint Nextel had been upgraded enormously, in line with a data-transmission protocol known as Evolution facts Optimized (EVDO).

Late ultimate month, dash upgraded its broadband network via debuting EVDO Revision A within the San Diego enviornment, and the business introduced plans to add 20 additional markets with the aid of 12 months's conclusion and to have the fast information change accessible nationwide by way of the third quarter of 2007.

Revision A of the expertise raises obtain speed a bit of, to about 450-800 kbps, but speeds up upload pace to 300-four hundred kbps, roughly six instances sooner than the old latitude. top obtain pace might "burst" as excessive as three.1 megabits per 2nd and uploads to 1.eight Mbps, in accordance with Verizon and know-how partner Nortel. Verizon has not stated when it intends to flow to Revision A.

"it really is going to deliver us DSL speed over a mobile community," Martin raves.

For its part, Cingular has excessive-pace records networks in fifty two metropolitan areas the use of a protocol called accepted cell cell device/excessive velocity Downlink Packet entry (UMTS/HSDPA). These networks convey sustained obtain speeds of four hundred-700 kbps, with bursts topping 1 Mbps.

something as speedy as home DSL actually cannot compete with a well-developed hospital community, however pace is relative. in the hospital, physicians would stop the use of wireless gadgets if it took a several seconds to drag up an image. "if you are sitting in a restaurant a half-hour from the health facility, taking 10 seconds does not seem so bad," Martin says.

One problem is easing the transition between vast-enviornment networks like cellular broadband and local-area networks such as a Wi-Fi sizzling spot, Gotsis says. She mentions a Seattle-based business referred to as NetMotion instant that has developed a mobile virtual inner most network (VPN) exceptionally for healthcare and public-safeguard utilization to clean the handoff between instant WAN and LAN environments.

earlier this yr, Cingular launched office attain a product that connects instant contraptions to latest PBX telephone programs, enabling a mobile phone to work like simply one more internal mobile extension. "we've seen reasonably just a little of pastime there," Gotsis says.

quickly, cellular statistics networks can be capable of detect a person's presence on a VPN. If a person is busy updating records, that grownup is not instantly attainable for an extra appointment. "This truly helps with the scheduling of a homecare nurse," Gotsis says.

Cingular is also testing a web-based mostly technology known as IP Media Subsystem (IMS),  as a way to allow the simultaneous transmission of voice and facts; for instance, a person in a health center may ship pictures and check results to a far flung, consulting healthcare professional. If the medical professional has a close-by computer with Bluetooth connectivity, the cellphone could feature as a modem while the medical professional is talking.

region-by-location introduction of here is planned beginning in 2007, Gotsis says.

Laying the groundwork for such future innovations, the institution of Chicago Hospitals put in a finished instant infrastructure, protecting about 95 % of its campus -- including the hallways, stairwells and elevators in its older buildings -- on varied frequencies.

Even phone alerts are now as strong deep interior growing older constructions as they are within the institution's gleaming, new little ones's medical institution. "We also discovered that their pagers and radios work flawlessly," says vice president and chief suggestions officer Eric Yablonka.

"Mobility within the building is essential," Yablonka explains. The health center has replaced its old paging system with wireless IP phones for those on the flow. The flooring are quieter and clinician response is faster. "And the nurses adore it," Yablonka adds.

Campus protection is instant-enabled, and some different constructing capabilities corresponding to lights and HVAC may go instant if management wanted to make the change, Yablonka says. The infrastructure is comfortable and effective adequate that Yablonka is comfy presenting instant internet access to sufferers and company on a segmented a part of the network that does not compete with vital sanatorium systems.

"here's a disruptive, enabling technology," he says. during this case, disruptive is a positive in that it challenges historic, inefficient techniques of doing issues.

that is precisely the approach it's going to be, suggests Intel senior healthcare strategist Ron Ribitzky, M.D. "Mobility by means of itself isn't a panacea for the birth of statistics," Ribitzky talked about in a contemporary Webcast geared up with the aid of ambulatory electronic scientific facts (EMR) vendor Allscripts. Mobility simply enables birth.

"If they do not take note the business proposition, it's going to now not work," Ribitzky says. what is the desired outcome of IT funding? It can be economic, it may be scientific great development, or it could be workflow optimization to allow effects measurement.

In his view, mobility has three add-ons: tagging, moving, and connecting. Tagging is the capacity to identify and account for what is relocating, Ribitzky says. "the key factor is to allow americans to connect with the facts from anyplace they're."

For Albert Einstein Healthcare network, part of Jefferson fitness device in Philadelphia, the aim of IT was more correct charge trap and more desirable communique between more than two dozen websites.

each of the 60 clinicians contains a Hewlett-Packard iPaq PDA loaded with an Allscripts e-prescribing module and linked to an IDX scheduling gadget. built-in instant connectivity allows for charge capture on the element of care.

The observe created "exploding units" that open up custom templates and populate varied information fields as a health care provider clicks on a specific procedure or order. "we are an awful lot less prone to leave out [charges for] procedures that are being executed," explains clinical director Julie Massey, M.D.

The prescribing element connects in precise time to payer formularies, offers interplay indicators, and may be taught physician "favorites" to keep time sooner or later. The system also offers practitioners movements clinical reminders for selected forms of patient visits.

Massey reviews that physicians in the beginning were reluctant to take over cost catch from office personnel, and it commonly takes a few months for brand new docs to application their favorite medicines into the device. "once they get over that learning hump, physicians adore it," Massey claims. They now not must fill out paper stumble upon slips, and the expenses are submitted electronically so claims are cleaner.

and there's an extra facet improvement of the cell contraptions. "Our children, in specific, simply love us carrying around their iPaqs," says Massey, a pediatrician.

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