New FCC requirements may mean replacing telemetry equipment
Wireless equipment has designated frequencies — Is yours outdated?
The good news: The Federal Communications Commission (FCC) has designated sections of the radio spectrum for use by telemetry equipment, which means you’re less likely to have an incident such as the one that occurred in Dallas. In February 1998, a Dallas television station was testing its digital television signal. Electromagnetic interference caused low-powered heart monitors at Baylor University Medical Center and Methodist Medical Center to be knocked out of operation. Fortunately, no patients were harmed. Now, television stations are required to notify nearby health care facilities when they are testing digital television signals.
The bad news: You might have to buy new telemetry equipment, which could cost hundreds of thousands of dollars, depending on the size and specialty of your facility. Also, the new FCC designation does not address electromagnetic interference from cellular phones and other wireless technology. (For more on how cellular phone interference can be addressed in your facility, see next month’s issue of Same-Day Surgery.)
In a July 17 Federal Register notice, the FCC announced the establishment of a Wireless Medical Telemetry Service (WMTS) as of Oct. 16, 2000. (See specific bands, listed above.) Same-day surgery managers now have a portion of the radio spectrum designated for use by wireless medical monitoring equipment so that it can operate with protection from outside electromagnetic interference. This equipment includes wireless heart, blood pressure, and respiratory monitors.
"What we’re trying to do is get patients out of harm’s way by getting equipment out of harm’s way," says Mary Beth Savary-Taylor, director of executive branch relations for the American Hospital Association (AHA) in Washington, DC. Savary-Taylor served on the AHA/American Society for Healthcare Engineering Task Force for Wireless Medical Telemetry Systems, which worked with the FCC on the Federal Register notice.
This designated spectrum might mean providers will have to invest in new equipment, which could cost a large hospital from about $200,000 to as much as $1 million, if the hospital specializes in areas such as cardiology, says Joseph P. McClain, PhD, FASHE, FACCE, director of clinical engineering at Walter Reed Army Medical Center in Washington, DC. McClain also served on the task force.
Walter Reed already was scheduled to replace its entire physiological monitoring system before the FCC developed the designated spectrum. How-ever, the cost would have been about $200,000 to replace the telemetry equipment if only that equipment had needed updating, he estimates.
The problem is that old equipment might not operate in the designated spectrum. However, you may be able to have your current equipment modified or upgraded, McClain says. Contact your original equipment manufacturers to determine if they have "rebuild kits," which would allow you to use the same systems, he advises.
Savary-Taylor adds, "You want to operate in the dedicated spectrum and be safest for patients." A flood of new equipment that operates in the new spectrum is expected to be on the market in the next two years , she says.
Many same-day surgery managers currently use equipment that operates in one of the following spectrums: 174-216 MHz (television channels 7-13); 470-668 MHz (TV channels 14-46), or 450-470 MHz, which is for the private land mobile radio service (PLMRS). The PLMRS is used by two-way radios, including those in taxicabs and trucks.
According to a 1998 study that McClain conducted for the American Society of Healthcare Engineering/AHA, 61% of medical telemetry is operating in the PLMRS bands. The other 39% is operating in the digital TV range, which is where the Dallas hospital’s equipment was operating, Savary-Taylor says.
Digital television is filling up many channels, McClain warns. "The possibility of degradation of [medical monitoring] equipment or interference is greater than with analog TV signals."
Also, there has been a freeze on additional licenses in the PLMRS bands, but that freeze is going to be lifted in three years, Savary-Taylor warns.
McClain adds, "You’ll have more interference with trucks using radios, or taxicabs, coming close to the facility."
With so many wireless devices, it’s becoming difficult to find a "clean" frequency to monitor your patients on, he says.
Contact your manufacture to determine if your patients are in immediate harm’s way, Savary-Taylor suggests.
"To minimize interference to your wireless medical telemetry devices, work with the manufacturer of your equipment to assess the immediate and long-term risks of disruption," wrote Rick Pollack, executive vice president of the AHA, in an Aug. 1 Regulatory Advisory to AHA members. If you or your manufacturer determine that your equipment is not at risk of electromagnetic interference, you might not need to make any immediate changes, he adds.
Determine when you will move your equipment to the dedicated spectrum, Savary-Taylor suggests.
The FCC has built in a grandfather clause for health care providers to operate their equipment as secondary, unlicensed users. But that clause doesn’t take away any risk, McClain says. "And there’s no recourse if you encounter risk."
Although you aren’t required to change at this time, it is advisable to change your equipment so that it can operate within the designated spectrum, McClain advises. In two years, manufacturers will no longer sell equipment that operated in bands outside the designated spectrum, he says.
Most providers are going to want to move within three years, before the freeze is lifted on PLMRS licenses, Savary-Taylor advises. But providers in rural areas might not need to move, if they have little electromagnetic interference from television stations and PLMRS. "The bottom line is patient safety."
Executive Summary
The Federal Communications Commission (FCC) has designated the following sections of the radio spectrum for use by telemetry equipment: 608-614 MHz (TV channel 37) band, 1395-1400 MHz band, and 1429-1432 MHz band. The designation, which is referred to as the Wireless Medical Telemetry Service, is official Oct. 16, 2000.
- To avoid electromagnetic interference, your current monitoring equipment might need to be upgraded or replaced. The cost could be hundreds of thousands of dollars or more.
- Unless you’re in a rural area that isn’t likely to experience electromagnetic interference, your facility probably will want to switch to the designated bands in the next three years. In three years, the FCC will lift a freeze on new licenses for two-way radios used by taxicabs and trucks.
Sources and resources
For more information, contact:
- Joseph P. McClain, PhD, FASHE, FACCE, Director of Clinical Engineering, Walter
Reed Army Medical Center, P.O. Box 59215, Washington, DC 20012. Telephone: (202) 782-3048. Fax: (202) 782-8158. E-mail:
[email protected].
- Mary Beth Savary-Taylor, Director of Executive Branch Relations, American Hospital Association, 325 Seventh St. N.W., Suite 700, Washington, DC 20004. Telephone: (202) 638-1100. Fax: (202) 626-2254. E-mail: [email protected].
The Federal Register is available at many public and academic libraries. The document also is available on-line at www.access.gpo.gov/index.html. To order a copy of the July 17, 2000, Federal Register, send your request to: New Orders, Superintendent of Documents, P.O. Box 371954, Pittsburgh, PA 15250-7954. Specify the date of the issue requested and enclose a check or money order for $8 payable to the Superintendent of Documents, or enclose your Visa or MasterCard number and expiration date. Credit card orders also can be placed by calling the order desk at (202) 512-1800 or by faxing to (202) 512-2250.
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