Communication service requirements

Information and communication technologies are ubiquitous throughout the NHS, with advances in technologies set to further embed them in every aspect of a health site's day to day operation from patient care to hospital administration and building management. The purpose of this report is not to focus on each particular use case such as wearable monitoring devices or artificial intelligence enabled diagnostics. Rather, it is to consider the short range and long range wireless communication technologies that will be relied upon for the solutions of today and tomorrow.

The main characteristics of the most relevant technologies, Wi-Fi, 4G, 5G, IoT (EnOcean, Lora, LoRaWAN, NB-IoT and LTE-M), RFID and Bluetooth are summarised in the table below and explained in further detail thereafter.

Table 1: Characteristics of wireless networks

Private Wi-Fi networks are generally used for local area networking and providing access to the internet and have been used in the health and care sector for many years. Laptops, tablets and other devices connect to the LAN via a wireless router or access point. Wi-Fi uses the 2.4, 5 and 6 GHz frequencies to transmit data at high speed over short distances. Public Wi-Fi networks are also widely used in the health and care sector. They provide patients and visitors with internet access for contacting family and friends, for accessing health services, and for entertainment. Wi‑Fi is a trademark of the Wi-Fi Alliance, which restricts the use of the term to interoperable products.

At the time of writing, Wi-Fi 7 is the latest specification available for some devices on the market, though it is our understanding that Wi-Fi 4 and 5 are more widely used, with some use of Wi-Fi 6/6E. the latest iterations of the standard provide important benefits over previous versions, such as significantly higher capacity, better coverage, and reduced congestion, resulting in a better user experience.

Illustrative examples of how Wi-Fi technology can be used in a health and care setting include:

• wireless local area networks (LAN): providing health and care practitioners, managers, and administrators with remote access to their organisation’s information and applications including electronic patient records
• real-time patient data and analysis: patient monitors, wearables, and medical devices such as magnetic resonance imaging, computed tomography, and ultrasound machines use Wi-Fi to transmit information

4G is the fourth generation of broadband mobile network technology with standards set by the International Telecommunication Union (ITU) in the IMT-Advanced standard and was launched in the UK in 2012. 4G provided much faster download and upload speeds than 3G and much greater network capacity enabling much more devices to be connected simultaneously. At launch, 4G enabled a broadband-like internet experience on a mobile device for the first time. At the time of writing, there are 4 mobile network operators providing 4G services in the UK, these are EE, O2, Three and Vodafone. 

Illustrative examples of how 4G technology can be used in a health and care setting include:

• audio visual communication: 4G equipped smart phones enable health and care practitioners, managers and administrators to communicate with each other and with patients regardless of their location using audio and video
• electronic patient records (EPR): 4G equipped tablets and laptops enable care workers to download patient records and other information when visiting them at their own homes
• connected and assistive living: 4G equipped devices alert health and care professionals when a patient’s health and wellbeing is at risk

5G is the fifth generation of mobile wireless communication. 5G is not merely an incremental development of 4G, it is a fundamental redesign of the technology with new standards that enable step changes in performance, software-oriented networking and diversification in the MNO/MVNO market. 5G enables 50 times faster download speeds, almost zero latency, 1000 times greater capacity and lower power consumption. 5G enables network slicing where multiple virtual 5G networks can operate on the same physical network infrastructure. Each network slice is an isolated end-to-end network tailored to meet a specific requirement. 5G uses high frequency, high-speed, short range radio waves in addition to the low and medium band frequencies used in previous mobile networks.

5G enables an organisation to design and build its own private 5G network as an alternative to a private Wi-Fi network. This provides access to the performance benefits of 5G and can provide greater coverage using a smaller number of 5G small cells than Wi-Fi access points.

5G technology is not widely used in health and care settings at the time of writing. However, there are many use cases being tested and trialled. Those expected to reach mass adoption the soonest are patient monitoring, connected hospitals, inter or intra-system data sharing and remote surgery.

For more on 4G and 5G see How does mobile coverage work.

Internet of Things (IoT) networks enable physical objects with embedded sensors, processors and software to connect and exchange data with other devices and systems connected to the same network and/or connected to the internet. IoT networks typically enable the communication of small volumes of data over long distances at a slow speed using lower radio frequencies (Lora, LoRaWAN). However, mobile IoT networks use higher frequency ranges and can transmit higher volumes of data at a higher speed – NB-IoT and LTE-M are IoT standards for 4G and 5G.

Illustrative examples of how IoT technology can be used in a health and care setting include:

• asset tracking: IoT devices tagged with sensors are used for tracking the real time location of medical and non-medical equipment such as hospital beds
• building and facilities management: IoT devices connected to a building management system control lighting, heating, ventilation, energy use, security and safety systems

For more info see:

Implementing a Real Time Location Service for medical device tracking

Real Time Location Services (RTLS) guidance

Radio frequency identification (RFID) refers to the method of tracking an object by means of a tag which transmits a radio signal to a reader. The reader emits radio waves and receive signals back from the tag. Active RFID tags are powered by a battery whereas passive RFID tags are powered by the reader. RFID tags can store up to several pages worth of data. Readers are mobile and can be located almost anywhere. RFID communicates at 865–868 MHz over very short distances and does not require a line of sight.

Near-field communication (NFC) is a standards based short-range wireless connectivity technology commonly used by consumers to make contactless financial payments and exchange digital content. NFC has similar use cases to RFID for controlling access, asset tracking and patient tagging.

Illustrative examples of how RFID technology can be used in a health and care setting include:

• baby tagging: babies are RFID tagged to prevent the unauthorised removal of an infant from maternity, neonatal and paediatric wards
• medical records tracking: medical records are RFID tagged to check them in and out of filing and in and out of other locations - this supports real-time case note requests, enquiries and movements

Bluetooth networks are generally used for exchanging data between portable and mobile devices and can be considered as an alternative to a wired connection. Bluetooth uses the 2.402 to 2.48 GHz frequencies to transmit data at low speed over very short distances using little power. Bluetooth is a Personal Area Network (PAN). Bluetooth is a trademark managed by the Bluetooth special interest group, with use of the term restricted to interoperable products.

Illustrative examples of how Bluetooth technology can be used in a health and care setting include:

• blood glucose monitoring and insulin pumps: Bluetooth-enabled blood glucose monitors can be used to wirelessly alter the flow rate of the IV drip, adjusting to a patient’s insulin levels
• smart cards: unique Bluetooth enabled smartcards are assigned to a specific user so they can access the information and computer systems they need to fulfil their role

See An introduction to Real Time Location Systems for more information.

The following table summarises different types of health and care settings and the types of wireless technologies that might be required.

Table 2: Health and care settings and wireless technologies

This table is illustrative, it is not intended to be comprehensive.

Its purpose is to stimulate the reader to consider their own ICT requirements and the implications of this for wireless technologies in their health and care setting.