[Ed. Dr. McMenamin was a practicing emergency physician before turning his sights to the practice of law. He is currently a partner at McGuireWoods LLP specializing in health-related litigation.]
By: Joe McMenamin, JD, MD
In 2010, the Federal Communication Commission (FCC) issued its first national broadband plan, which included a proposal for a “medical body area network” (MBAN).
Specific frequencies would be assigned for medical wireless monitoring. In May, 2012, FCC issued proposed rules for these MBAN systems, providing a platform for wirelessly networking patient sensors.
After initially raising concerns about radio interference, the Aerospace and Flight Test Radio Coordinating Counsel (AFTRCC) appears now to be collaborating with health institutions to allow spectrum allocation for MBANs, an important and positive development.
In fact, the FCC has scheduled for tomorrow (May 24) an open commission meeting at which time more details of the proposed rule making will likely be made public.
The miniaturization of wireless technology has paved the way to replacing existing monitoring devices with wireless equivalents. Wireless computer networks, Bluetooth devices, cell phones, cordless phones, and other new technologies allow wireless monitoring of a variety of patient-specific physiologic parameters, including vital signs, blood glucose levels, EKGs, EEGs, and pulse oximetry.
Originally, the AFTRCC, representing companies such as Raetheon, Boeing and Cessna, among others, opposed FCC’s proposal. The frequencies proposed for the MBAN network (2360-2400 MHz) are currently used for aeronautical mobile telemetry, for federal radio location tasks, and by amateur radio operators. Fearing interference, AFTRCC argued that aircraft and aeronautic equipment manufacturers need the radio bands to dispatch telemetry information during aircraft testing.
Later, though, AFTRCC began to collaborate with health care professionals and institutions to develop measures that would help manage any interference that could result from sharing a wireless spectrum. Eventually, health care professionals and aeronautics industry association members asked FCC to approve their plan to set aside bandwidth for MBAN. Representatives of AFTRCC met with members of FCC’s Office of Engineering and Technology to present joint health care and aeronautics industry modifications to the FCC’s proposed rules.
Fortunately, the great majority of hospitals are not situated near aeronautical mobile telemetry operations. The interference problem is largely confined to those that are so located. As currently envisioned, such hospitals are to develop a plan to notify aeronautical mobile telemetry (“AMT”) operations of MBAN use and to follow a procedure to prevent disruption of aeronautical traffic. Under the proposal, electronic keys would limit access to the spectrum.
Patients will enjoy greater mobility when wires can be dispensed with. Immobilized patients are at higher risk for emboli, wasting, bed sores, pneumonias, and other problems. Since cables must be sterilized after use by one patient and before use by another, a wireless approach may decrease the risk of cross-infection.
MBAN technology presents opportunities for cost savings as well. Earlier intervention is often cheaper, more effective intervention. Wireless monitoring requires fewer staff than more conventional approaches. Sometimes, patients are admitted to ICUs not so much for specialized nursing care as because they need monitoring. If the same monitoring could be carried out in less costly settings, the savings could be appreciable. While as presently envisioned wireless monitoring is intended for hospital use, these devices could also help protect soldiers in combat, and eventually the technology may become suitable for home use.
Although details need to be worked out, the potential for benefit from deploying this technology appears to be substantial.