Unique Cabling Challenges in Healthcare
TIA-1179 Addresses Cabling
The Telecommunications Industry Association, which develops standards for the information and communications technology industry, released TIA-1179 Healthcare Facility Telecommunications Infrastructure Standard. TIA-1179 specifies requirements for telecommunications infrastructure for healthcare facilities (e.g. hospitals, clinics) and is intended to support a wide range of clinical and non-clinical systems (RFID, BAS, nurse call, security, access control, pharmaceutical inventory, etc.), particularly those which utilize or can utilize IP-based infrastructure. It specifies cabling, cabling topologies, and cabling distances. Additionally, pathways and spaces (e.g. sizing and location), and ancillary requirements are addressed.
Ratified in August 2010, the TIA-1179 Standard is the culmination of work that took place within the TIA TR-42 Engineering Committee. It is an example of the newer generation of standards from the TIA that address cabling infrastructure within specific areas or environments. While the TIA-568 series of standards effectively addresses cabling in traditional premises environments, the connectivity needs of healthcare facilities are far more complex than commercial buildings.
Pathways and spaces
The standard recommends a minimum of two diverse pathways from the entrance facility to the equipment room. Doing so allows the user to segregate more-traditional network-type applications such as voice and data from other critical applications that are more specific to healthcare, such as imaging and diagnostic communications. Additionally, this type of pathway redundancy is crucial because in these healthcare environments, the network supports not only data or information flow, but often it quite literally supports the life and health of hospital patients.
The TIA-1179 standard also recommends larger equipment rooms and telecommunications rooms (TRs) with a minimum of 130 square feet. The standard recommendation allows for 100 percent growth when planning these spaces. That may initially sound excessive, but a significant consideration behind this recommendation is to prevent future disruption of rooms, hallways and other areas within a hospital. Hand-in-hand with this consideration is the standard guideline that the cabling-system pathways should not compromise the facility's operation.
Select the highest bandwidth cabling
Many new hospitals can have more than two dozen different low-voltage systems and these facilities are being cabled today to support the eventual transition of these systems to IP.
The new TIA healthcare infrastructure standard recommends a minimum of Category 6 copper cabling for horizontal runs (Category 6A for new builds), as well as 50-micron multimode fiber-optic cabling for high-bandwidth transmissions such as computed tomography (CT) scans and magnetic resonance imaging (MRI) exams. For backbones, the standard recommends multimode and singlemode fiber-optic cabling and should be redundant.
One of TIA-1179's recommendations is to segregate cables based on the applications or services they are supporting. One practical way to accomplish this is to color-code cables and connectors so they can be identified easily. While the TIA-1179 standard recommends color-coding cable, the standard does not specifically designate certain colors for services or applications.
Some other best-practice recommendations likely to apply in healthcare facilities include considering multi-fiber cable, preferably pre-terminated, in high-density work areas. These cable constructions will be cost-effective, reliable and the least disruptive in sensitive environments. Also, cables installed in hospitals will be subject to high levels of electromagnetic interference (EMI), temperature swings from area to area, and the possibility of contact with chemicals and other gases. These considerations may affect the choice of cables and may affect the manner in which those cables are installed and the environment includes adhering to strictly regulated Infection Control Regulations (ICR).
Redefining the work area
In particular, with regard to healthcare applications, the new standard recognizes that the meaning of the term "work area" must take on a broader scope as the work area is located in a multitude of application-specific areas and spaces within the healthcare facility. Very much in contrast to the work area of a commercial office building, in which a communications outlet might service a computer, phone, printer and perhaps another user-administered device, a work area in a healthcare facility can take many forms. TIA-1179 addresses this by defining 11 work-area classifications: Patient Services, Surgery/Procedure/Operating Rooms, Emergency, Ambulatory Care, Women's Health, Diagnostic and Treatment, Caregiver, Service/Support, Facilities, Operations, and Critical Care.
Each of those 11 classifications is further broken down into subgroups, and in total there are 75 work-area types defined in the standard. Each of these 11 work-area classifications and the subgroup work areas within them is characterized in the standard as a low-, medium- or high-density work area. The standard calls for 2 to 6 outlets, or ports, in a low-density work area; 6 to 12 outlets in medium-density work areas; and more than 14 outlets in high-density work areas.
The TIA-1179 standard recommends the use of multi-user telecommunications outlet assemblies (MUTOAs) to provide the flexibility of adding up to 24 additional outlets to a work area but does not recommend the use of consolidation points (CPs) to add outlets to a work area.
Keeping in mind the density of outlets, bandwidth requirements and mission-critical nature of communications within healthcare facilities, it is recommended to design cabling systems to support the longest possible lifecycle.