September 05, 2013

The Connected Patient – Wi-Fi Design and Support Strategies

Part 3 of a 4 part series on design considerations for today’s hospital Wi-Fi environment

Moving from the patient facing side of guest Wi-Fi lets talk design strategies and some emerging trends.  First,an alternative to requiring a visitors accept a terms and conditions is to create a scenario where their devices automatically connect to the network when entering the facility.  In theory it makes access simple and reduces possible support challenges of guests.  The Wi-Fi Alliance created HotSpot 2.0 based on the 802.11u standard.  This is very attractive to the mobile carriers looking to offload cellular traffic but think twice before jumping to this approach as there are a couple of downsides when applying in a healthcare environment.

Patient BYOD

  • The hospital loses the opportunities I mentioned above to engage with the patients and visitors.

  • The Wi-Fi and Internet connections in a healthcare facility only have so much bandwidth to share with life critical and mission critical applications taking priority.

  • Assume that EVERY Wi-Fi enabled device including employee owned will be automatically roaming onto the network whether they mean to or not.  This can quickly fill up DHCP scopes and saturate dense areas degrading the experience for all.

I recently witnessed a situation where a hospital reported that the guest network for the corporate office was not working. On examination it was because the guest DHCP scopes were full.  Over 700 “guests” were on the network.  This is an increasingly common trend that can that requires further review of any guest Wi-Fi architecture both in terms of technology and policy.  Here is a sample planning checklist:


  • Have an established guest Wi-Fi policy that prohibits employee use.

  • Have a supporting BYOD policy in place whether it is for or against, it needs to be documented!

  • Educate employees that the purpose of the guest Wi-Fi network is for providing patient service and using the network for personal use does impact their experience.

  • Have legal approve or write the terms and conditions statement for usage.

  • Decide if the service will be offered for free or have a cost.


  • Tunnel the guest Wi-Fi traffic out to the Internet while blocking all access to internal resources.  This will also help keep down employee use.

  • Set bandwidth limits so that one user cannot adversely impact others.

  • Use web filtering.  No one wants to deal with a situation where a guest is going to inappropriate sites in front of others.

  • Decide which protocols will be allowed on the guest network.  Blocking VPN access may quickly lead to escalations from patients and visitors trying to work.

  • Evaluate and decide if it makes sense to offer guest Wi-Fi in ICU areas or if the access points in those areas should be dedicated to hospital operations.

  • Engage with marketing on splash page design and support.

  • If charging for service the billing system needs to be architected.

  • Be sure that the DHCP scopes for guests are large enough to accommodate.  Set monitoring alarms for high water marks and thresholds.  Use shorter DHCP lease times.  It’s amazing how immediately after Christmas guest usage statistics jump.

  • Monitor Internet bandwidth.  Thousands of concurrent guest users can quickly saturate your Internet connections.

  • Leverage a mobile device management solution such as AirWatch or MobileIron for corporate owned mobile devices and employee BYOD programs.

  • Run reports on guest usage.  If a guest is on the network 60 out of 90 days then you are probably in a situation where employees are using the open network to avoid corporate proxies and firewalls.

  • Monitor, Monitor, Monitor!  Monitor for availability, performance, and usage.  Monitoring allows you to keep the system operational and report to leadership on its success.

Lastly there is the challenge of meeting the expectations for increased performance guest Wi-Fi performance.  As patients and visitors turn to video steaming rather than hospital provide television services it has become the primary driver.  We can look to the hospitality business for ideas on how to address but unfortunately there are no easy fixes.  Some current strategies include:

  • Rate limit applications such as Hulu, Netflix, SlingBox, HBO Go, and others however this can backfire with users upset about performance.

  • Move to a tiered service model.  Free provides basic Internet connectivity or the visitor can purchase a premium tier that supports streaming, etc.  Note: Paid for services lead to expectations around support and billing issues.  Consider outsourcing to vendors such as Wandering WiFi to handle billing and support.

  • Bite the bullet and keep increasing bandwidth.  Use usage reports to justify cost increases for additional bandwidth upgrades.

More than likely if it is not already, than in the next couple of years your hospital will become an ISP.  Patients and visitors are expecting the service and how well it performs is a reflection on the hospital.  I once heard a statement “it almost didn’t matter that they saved his life, since his meals were cold the satisfaction survey scored low”.  In the era of the connected customer and social media offering a platform to quickly speak ones mind its important to take the time to design a solution that can live up to this new expectation.  Don’t look at this as a feature that has to be turned on but rather as a strategic service offering the hospital can provide to its patients and visitors.

Bob Zemke is the Healthcare Solutions Manager for Enterasys Networks Please follow him on Twitter and LinkedIn for more thoughts on this and other similar topics.


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