Session Initiation Protocol

White Paper
Session Initiation Protocol
The blueprint for patient-centric
mobile communication
Including the clinical benefits of SIP integration
with nurse call systems as illustrated by Responder® 5
In any modern hospital
or healthcare setting,
clinical staff need the tools
to be mobile, flexible and
responsive. As primary
care givers, nurses in
particular need to always be
connected to their patients
– no matter where they are
on the ward or elsewhere
on the hospital site.
Hospital technology departments
have responded. The integration
of nurse call systems with
wireless devices is not new. First
such solutions were enabled by
Telelocator Alphanumeric Protocol
(TAP) and relied on a middleware
platform to send nurse call
notifications to wireless devices
such as pagers or wireless phones.
As healthcare providers look
to reduce the total cost of
technology ownership, there is
more prolific use of converged
IP communications technology,
including data, voice and video
on a single network. In line with
this trend, we have seen the
emergence of Session Initiation
Protocol (SIP) – which builds on
the IP communication platform
and introduces a standards-based
approach to IP communications
with various wireless devices.
IP communications and SIP can
dramatically increase workflow
efficiencies and help hospitals
deliver a patient-centric care
model. This includes faster
response times to nurse call
requests, the reduction of noise
levels in the patient care areas and
the ability to provide more detailed
clinical reporting. 02 | Rauland
SIP vs TAP
In this paper we compare TAP vs SIP in
a healthcare setting, discuss the clinical
benefits of integrating nurse call systems
with the SIP telephony standard and
present the technology architecture
which supports patient-centric workflows.
SIP Direct Communication with Responder ® 5 | 03
TAP explained
SIP explained
For a number of years, nurse call
systems have been able to send
event alerts to wireless devices
using TAP and a middleware
platform. The alerts were received
by devices such as pocket
pagers or appropriate wireless
phone systems. These legacy
Telephony API TAP solutions
enabled wireless phones to be
used as display and input devices.
More recently, nurse call systems that implement
the Session Initiating Protocol (SIP) as the telephony
standard are becoming the industry norm. These
solutions allow a SIP compatible wireless device
to communicate directly to a SIP compatible nurse
call station. Since SIP is an industry standard, the
compatibility is native and allows direct, peer-to-peer
communication between the device and nurse call
station – eliminating the need for middleware.
In such a scenario, a nurse phone
ringing is not actually a phone call
at that stage, but rather an alert
(text message) sent to the phone.
If the nurse chooses to respond,
the phone must be directed to dial
the nurse call system, and when
the nurse call system answers,
the phone must then dial the
patient room within the nurse call
system. Although this process
is completed automatically,
Telephony API answer delays
can range from 4 to 15 seconds.
04 | Rauland
In SIP capable solutions, the alert received by
the nurse’s wireless device is actually a voice
call placed from the patient station to the device.
As such, the response time to the patient call is
virtually instantaneous.
Ultimately, the SIP solution involves fewer steps
within the technology to achieve communications
between the two parties. It requires fewer pieces
of equipment to establish the connection and the
connections are made considerably faster than in
legacy TAP-based solutions.
SIP advantages
SIP trunking facilitated by
a dedicated SIP Server is
commonly used to reduce
the nurse call system
footprint that is visible to
the SIP telephone system.
The phone system needs
to only support dial plan
routing, eliminating the
need for visibility to each
individual nurse call room
and bed.
SIP-based nurse call
telephony delivers a
number of important clinical
benefits. To illustrate with
the Responder 5 nurse call
system as an example, SIP
integration will help you to:
1
2
3
4
5
Streamline critical communications
Sometimes in healthcare, every second counts. SIP integration
enables nearly instantaneous connection between the patient
placing the call and the nurse receiving it. Patient needs are met in
a timely fashion which has a positive impact on patient safety, health
outcomes and overall satisfaction, and the seamless connection
saves nursing time.
Provide assurance that every patient call will be answered
The smart call escalation feature ensures each patient call will be
attended to – even if their designated nurse is not available. Nurses
have peace of mind that their patient will receive the care they need
and subsequently patient waiting times are significantly reduced.
Make better clinical decisions
The system provides comprehensive reports which include
information such as answered, acknowledged and ignored calls,
itemised by patient and individual staff member. Equipped with
reliable and accurate data, nurse managers and administrators are
able to make informed decisions to support productivity and
efficiency improvements.
Facilitate clinical collaboration
Great teamwork is powered by great communication. SIP integration
enables messages to be sent to groups or individuals straight from
the PC at the nurses station. This helps to promote better flow of
information and saves time in manual and time consuming follow up
with individual staff members.
Reduce the cost of implementation
Programming of SIP based systems is more intuitive than comparable
TAP based solutions. This represents a saving of up to 50% in labour
cost associated with system set-up. As SIP eliminates the need for
expensive middleware, the associated savings in extra hardware,
software and programming are also significant. Depending on the size
of the site and the complexity of the solution, this saving could be in
the vicinity of $250,000.
SIP Direct Communication with Responder ® 5 | 05
SIP technology
architecture
As Responder ® 5 treats
phones as phones and
response times are
typically immediate,
nurses are empowered
to give a patient instant
assurance that their
request has been heard.
The efficiency of the SIP
technology infrastructure can
be illustrated by the Rauland
Responder 5 nurse call and
hospital communication system.
Responder 5 nurse call system
employs SIP communications
natively to take advantage
of the converged IP space,
including a multitude of wireless
communications devices. These
can include modern enterprise
telephony platforms and
devices such as smart phones
to capture ‘Bring-Your-OwnDevice’ (BYOD) opportunities.
All Responder 5 nurse call beds
/ rooms auto-register with the
SIP Registrar regardless of the
phone system in use. In turn, the
SIP server is able to leverage off
the Responder 5 systems autoregistration of every one of its
audio endpoints – i.e. Patient
Stations, Consoles, Staff Terminals,
etc – and present the entire
nurse call system to the phone
system as a single SIP trunk. This
in turn saves set-up time and
reduces the risk of set-up errors
and system incompatibility.
06 | Rauland
Following is the basic
architecture of a
Responder ® 5 Direct
Connect SIP deployment
– to a wireless SIP
capable device.
Responder® 5 Direct Connect SIP Architecture
ONDER® 5 DATABASE
SERVERS
WIRELESS SIP CAPABLE
PHONES / DEVICES
WIRELESS
ACCESS POINT
SIP TELEPHONY
ENVIRONMENT
RESPONDER® 5 DATABASE
SERVERS
RAULAND DATABASE SERVER
CLUSTER OR SHARED
SQL SERVER
TELEPHONE SYSTEM
SIP SERVER
BREKEKE SIP SERVER
SIP REGISTRAR
ND DATABASE SERVER
USTER OR SHARED
SQL SERVER
RAULAND REPORTING SERVER
CLUSTER OR SHARED SQL
REPORTING SERVICES
ND REPORTING SERVER
TER OR SHARED SQL
PORTING SERVICES
HOSPITAL NETWORK
RAULAND
GATEWAY SERVER
BRC
RESPONDER® 5
SOFTWARE APPLICATIONS
RAULAND
APPLICATION SERVER
RAULAND
MONITORING PLATFORM
RNC
SIP TRUNKING
C
SIP TRUNKING
ETHERNET CONNECTION
NURSECALL NETWORK
ETHERNET CONN
RAULAND JUMP HOST
RESPONDER® 5
SERVERS
RESPONDER® 5
VLAN / SUBNET 1
NURSECALL NETW
SIP Direct Communication with Responder ® 5 | 07
For over 23 years, Rauland
has been supporting better
health outcomes through
integrated communication
solutions for healthcare.
We specialise in nurse
call system deployments
and integration both into
greenfield sites and existing
hospital environments.
The Rauland Responder® 5 nurse
call and hospital communication
system leads the market with its
robust and flexible design and
features the latest developments
in nurse call technology.
Contact us to discuss your current
or future nurse call and hospital
communication requirements,
or to request a demonstration of
the latest nurse call solutions.
T: 1300 142 142
E: sales@rauland.com.au
www.rauland.com.au