Forget instant image processing. Forget real-time patient monitoring. Forget remote surgery. Chicago-based Rush University Medical Center is embarking on a major installation of 5G with one driving force in mind, at least initially: getting rid of all those wires.
"If you found out how much a LAN drop was in Chicago for a hospital, you'd die. It's highway robbery. So we're trying to get away from a wired infrastructure to a modern wireless infrastructure," explained Jeremy Marut, the hospital's chief enterprise architect.
In the next few months, Rush is planning to begin rolling out a 5G network in conjunction with AT&T in one of the buildings on its campus, Marut said. The building was constructed almost a hundred years ago, and has the wiring to prove it.
"It looks like an old AT&T telephone closet where operators are changing wires. It is crazy," Marut said. "We can save a ton of money on having to upgrade an aging infrastructure. You can't even lift the ceiling tiles to run any more cable. So if you have to run more cables it would be just a multi-, multi-million dollar project."
The solution? 5G.
"We are going into this with the RIO [return on investment] with the expectation that we're going to be able to eliminate the wiring and traditional infrastructure. That was a huge driver [for Rush's deal with AT&T for 5G], aside from even the experiences and the connected hospital," he said.
And what exactly is the savings? "We're talking in the millions [of dollars], in the absolute millions. Especially in the old, old building," Marut said.
One of the first steps, he said, will be for AT&T to install a millimeter-wave antenna within the hospital's atrium, where it will connect hospital PCs and devices using a 5G hotspot. "Those are the first things that are going to happen probably in the next 6-9 months," Marut said, explaining it will allow both the hospital and AT&T to test the use of millimeter-wave transmissions in a healthcare scenario. “And then we're going to take that to start tweaking it with the engineers at AT&T."
Importantly, Rush's 5G ambitions aren't just about retrofitting an older building with newer technology. Marut said the hospital is also in the midst of kicking off the construction of a "massive" 11-story outpatient building. "That building is going to be a building of the future, or hospital of the future," he said.
"We have the opportunity right now, because we're in drawings and submitting them to the builders, we can build out a massive 5G infrastructure," Marut explained, "in the hopes that we will be connecting all devices through wireless."
Not surprisingly, the Rush medical center is already outfitted with a wide range of wireless technologies, from LTE across all carriers via a major distributed antenna system deployment to plenty of WiFi. But Dr. Shafiq Rab, Rush's SVP and chief information officer, wasn't satisfied with that.
It all comes down to the "speed and latency," Marut said. "There will be 10 gig wireless connectivity [with 5G]. You can’t get that" with WiFi.
Rush's Rab met with Maria Lensing, AT&T's healthcare chief, to look into what 5G could do. The two came to an agreement to essentially trial AT&T's 5G technology at Rush (the companies didn't disclose the terms of the agreement).
And though replacing wires with wireless is a big initial push for the technology, it's really just the first step.
"5G will give us the speed, the low latency as well as the ability to connect many more devices. So we're talking scales being connected, we're talking blood pressure cuffs being connected, it's just going to be a connected hospital," Marut said. "We want to be able to provide that density, and we believe riding on the 5G wave, that's going to provide it for us."
Specifically, for Rush's new 11-story outpatient building, Marut is planning for a completely digital experience, where patients would be able to navigate their entire visit through an app, from alerts at home to scheduling visits to navigating the hospital to meeting with doctors. And all kinds of wireless services would be available for physicians, from remote imaging to remote radiology diagnosis.
Marut said Rush's two overriding goals are to provide "hospital at home" and "connected care," leveraging all the services available at the intersection of healthcare and technology.
Investing in edge and cloud
Another noteworthy part of Rush's overall technology efforts involves digitizing the hospital's systems and services and putting them into the cloud, but making sure they're available quickly. That's the reasoning behind the hospital's edge computing efforts, wherein an instance of AT&T's core network will be hosted in Rush's on-site data center. This kind of edge computing paradigm essentially eliminates the latency involved in sending requests for information stored in a faraway data center.
“That brings the internet essentially to the edge of our data center," Marut said.
The first step, though, is for Rush to digitize health records and move all of the hospital's various apps and services into the cloud. “We have hundreds, over 300-400 applications in the hospital. So it takes some time," Marut said.
The end result though of this process will be increased speed and reliability: "We're bringing the internet right to our wall," he said.
Further, Rush's 5G network will straddle the line between a public and a private network. Marut explained that the hospital's deployment will allocate a portion of the network for patients and visitors, but will retain another portion exclusively for the use of Rush's physicians and staff. That design is noteworthy considering wireless players across the spectrum are increasingly looking at the opportunities around private enterprise wireless networks.
A final question for Marut is one that everyday consumers will be increasingly asking in 2019: What about 5G devices? "That's one of the challenges we have right now. We're waiting with bated breath," he said.
However, Marut said that Rush is "a huge Apple shop," as many of the hospital's physicians and staff use iPhones and iPads. That could create problems, Marut acknowledged, considering Apple is widely expected to skip 5G this year and instead release its first 5G phone in the fall of 2020. In the meantime, Marut said, Rush plans to get Android 5G devices up and running shortly.
The 5G enterprise opportunity
Rush's interest in 5G is particularly important because a wide variety of top players in the wireless industry have pointed to the enterprise opportunity in 5G as perhaps more important than the consumer opportunity. (See The 5G Enterprise Conversation.)
That's a noteworthy position, considering 4G LTE rose to prominence on the back of consumers' widespread embrace of smartphones like the iPhone. Such phones, coupled with speedy wireless networks, created opportunities like ride-sharing through services like Uber and mobile payments through services like Apple Pay. Such developments raise the obvious question: What will 5G be used for?
"The early opportunities are going to be in enterprise," AT&T's John Donovan, head of the company's 5G business, explained at an investor event late last year. "We're seeing a lot of demand from enterprise customers for blurring the line between what has historically been a wide area network, mobile, with a local area network, which has traditionally been wired.”
Verizon executives have made similar statements. For example, last year Verizon's Ronan Dunne counted off seven specific enterprise segments where Verizon plans to target its 5G efforts: retail, healthcare, gaming, stock trading, smart cities, stadium experiences and precision manufacturing.
As those in the industry have explained, each of these sectors might use 5G differently. For example, Disney is testing 5G with Verizon for cloud-based production workflows, live volumetric video and delivery of movies to theaters, while AT&T is testing how 5G could impact manufacturing via an "Innovation Zone" in Austin, Texas, with partner Samsung.
But, as a number of analysts have pointed out, the enterprise sector doesn't move nearly as quickly as the consumer sector. As Rush's Marut said, the hospital is moving forward with services that likely won't be available to patients for years to come, simply based on the complexities of the technologies involved, the regulations around healthcare services, an the massive legacy architecture inherited from decades of analog systems.
Thus, the ultimate question for operators is whether they will be able to reap benefits from 5G quickly enough to satiate investors while ensuring long-term opportunities remain intact.