By Arnold Kim

Hospitals and healthcare facilities are high on the list of industries that stand to benefit from 5G networks because of the mission-critical and data-intensive nature of nearly every part of the experience. Consider the improvement faster speeds and low latency 5G can bring to telehealth capabilities, real-time patient tracking, electrical record management access, remote surgery, and general patient-care. Hospitals are rarely seen as early adopters of cutting-edge technology, but that is the case at the most innovative healthcare brands.

However, most hospitals around the country, particularly in rural areas, still struggle with modernization through cellular networks. This is usually because of the belief that WiFi is good enough, and confusion about how impactful it is to hospital operations coupled with budgeting concerns. The following is a typical path and process for investing in the right cellular connectivity.

It Starts With Poor Cell Service

The need for cellular connectivity typically begins with mounting frustration from patients, doctors, and administrative staff around the inability to make phone calls or send text messages inside the facility. Most hospitals have WiFi for private use (some offer patients connectivity) but that is often not enough to provide ubiquitous connectivity, particularly for larger facilities, because it is only usable within range of a router. Unlike cellular, WiFi also adds an extra step requiring users to find the network on their device and connect. While this may seem trivial, it can be frustrating in a fast-paced healthcare environment. Consider on-the-go doctors that can’t get access to patient files in the lounge or must send a quick email in the hallway on the way to see the next patient.

How Does Installing Wireless Networks Work?

Once management recognizes the need for better cellular connectivity, there are three models typically involved in deploying in-building wireless networks. First is the carrier-funded model, where a mobile network operator (MNO) like AT&T, T-Mobile, or Verizon pays to install the in-building wireless equipment like distributed antenna systems (DAS) or repeaters because it benefits them to have better coverage in that region. This model is rare today, and is typically reserved for major venues in densely populated areas. If you’re not in a Super Bowl city, chances are it’s off the table.

The second is the hospital-funded model, where the institution pays the full cost of the DAS or repeater as well as for installation and upgrade costs.

Last is the neutral-host funding model, in which a third party pays the upfront cost for the DAS, installation and ongoing maintenance and leases the in-building infrastructure to the carriers on behalf of the hospital. One benefit of this model for the healthcare institution is that the neutral-host tends to support multiple mobile carriers so that users can receive great cellular signal regardless of whether they are AT&T, T-Mobile, or Verizon. Also, the hospital does not have to bear the expense and ongoing maintenance of the system, and the carriers are able to design a system to their specifications. This can be done in the hospital-funded model as well, but it will increase cost.

Regardless of the funding model type, a radio frequency (RF) engineer and systems integrator (SI) will be responsible for designing and installing the equipment. It isn’t simple to pull RF from the macro network (i.e., outside the facility) and bring it indoors. There are plenty of natural and man-made obstacles that are disruptive to RF. This is especially true in hospitals, where structural elements like dense walls, concrete, and metal material can impede cellular reception. An RF engineer must design the custom RF environment through RF planning software like IBWave to ensure remotes and antennas of a DAS are placed in the right location for maximum connectivity and minimal interference.

Value-Added Feature Stage

Once the hospital has made their in-building cellular infrastructure investment through one of the three aforementioned funding models and got their foot in the door, they often consider new features enabled by the network like connected nurse carts, in-hospital GPS, better entertainment options for patients and other technologies offered by the mobile carriers or other independent software companies. Carriers are partnering with companies to bring these applications to hospitals. Cellular is important for patient-facing applications, in particular, because the need to sign-in on WiFi is a barrier to entry for mainstream adoption.

“Most hospitals’ DAS projects begin by fixing the fundamental problems with their cellular connectivity. However, once the new network is deployed, hospital administration realizes the quality of life benefits to staff and patients, such as the ability to add new healthcare and public safety wireless features only available through cellular in-building connectivity,” says Greg Najjar, sales director for DAS & small cells at neutral-host operator SBA Communications, who has worked with numerous hospitals on in-building wireless installations.” Often, when hospital administration sees the impact of this enhanced connectivity and understands the process of installing wireless solutions, they bring it to their hospitals in other locations.”

But it’s important hospitals ask the right questions about 5G to align their expectations with reality, as the nationwide rollout is still in progress. Najjar continued: “Hospitals should understand that there is a big difference between ‘5G-capable’ and ‘5G-ready’. The former means you have LTE right now, but the DAS solution has the ability to upgrade to a 5G spectrum once the carrier turns it on in the region.”

This is generally the optimal path to most hospital modernization when it comes to deploying in-building cellular networks. Wireless needs change frequently, so it’s important to ensure the DAS or repeater equipment can support all the different frequency bands for 4G/LTE and 5G across all major carriers to avoid a costly rip-and-replace exercise when the time comes to upgrade the solution or add more carrier bands to the in-building network.

Arnold Kim is the chief operating officer at ADRF, tasked with handling the day-to-day operations for the company. He has 20 years of experience covering the telecommunications industry. Prior to joining ADRF, he worked at Bear Stearns, Evercore Partners, J.P. Morgan, and Salomon Smith Barney. His former clients include ARINC, EarthLink, Frontier Communications, Global Crossing, MRV Communications, Motorola, Sorrento Networks, SK Telecom, Teleglobe, and WaveSplitter Technologies. He earned his MBA in Finance and Economics and his BA in English and Economics, both from Columbia University. Questions and comments can be directed to 24×7 Magazine chief editor Keri Forsythe-Stephens at