‍Stanford Health Care has always incorporated the latest technologies into their healthcare facilities and practices. For the new Stanford Adult Hospital, an IP speaker system was proposed as the next cutting-edge unified communications solution for public address systems. Stanford Health Care engaged TEECOM to review the design for constructibility and cost, and we determined that this IP-based solution would cost around $3 million once all cabling home runs, enlarged conduits, enlarged pathways and penetrations through rated wall, and their enterprise standard PoE network equipment was factored in — about $2 million over budget.

In addition to the inflated costs, the paging system did not easily accommodate a few sought-after requirements, including ambient noise sensor integration, communication with Stanford Health Care's newly adopted mass communication platform, and the ability to monitor the paging system’s health.

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Finding a Better Unified Communications Solution

TEECOM’s problem-solving curiosity was engaged; we were determined to find a better solution. The new mass notification platform Stanford adopted for their telephone system was called InformaCast. InformaCast is a giant piece of software and Stanford had an unlimited license to expand use of it. A key feature of InformaCast is that it allows every phone in the hospital to be used as a paging loudspeaker. We understood that the key to a successful overhead paging system was going to be seamless integration with the InformaCast platform.

Ben Shemuel and I approached the local manufacturer’s representative, John Hood with The Farm, and discussed this design challenge. Not surprisingly, he had been thinking about the same type of design involving InformaCast. He and I approached QSC, the audio manufacturer, and asked if they could make it work at a reasonable cost. The solution we were able to create is a hybrid digital-analog topology, using the strengths of each technology to deliver all the functionality required at a fraction of the cost. Its basic topology goes something like this:

• A person dials 911 (on campus) or calls the Call Center;
• The Call Center’s call management software records an audio file and sends the audio to an intermediary platform which, in turn, converts formats and sends the now real-time audio stream to the InformaCast platform;
• Depending on the type of page, InformaCast distributes the audio to the appropriate zone using the Cisco phones as well as the QSC Q-Sys platform;
• The QSC accepts this audio stream, processes (normal EQ and compression) and adjusts the output level based on the ambient noise sensors location throughout the hospital (oh yeah, did I forget to mention there are over 300 microphones monitoring the ambient noise level in each zone and increasing paging signal level as needed to ensure the volume of a page is at least 10dBA above ambient noise level at the listener’s ears? Well, that’s in there too);
• Within the QSC platform redundancies are created for processors and amplifiers;
• The signal is then routed over Q-LAN to the appropriate amplifier and then output to traditional 70V daisy-chained loudspeakers.

Okay, maybe that was not the shortest description, but I bet you liked it! The important part is: It works — crucially, without having to network each individual speaker.

Leading Toward a Common Goal

This system has been retroactively implemented in the existing Stanford Adult Lucile Packard Hospitals as well as planned for the New Adult and New Lucile Packard Children’s Hospital. It’s a great example of creative teamwork and coordination with a myriad of stakeholders and departments across all Stanford’s branches, including Stanford Health Care IT, Stanford Health Care Administration, Stanford University IT, Stanford University Project Management, the Stanford Health Care Call Center, the LPCH Unified Communications Team, LPCH Facilities, the LPCH network team, TEECOM, and QSC. Together we were able to work towards a common goal and create a solution that did not exist before this project. I have to give a big shoutout to QSC and the infamous Joe Peavey, who wrote custom software to ensure seamless integration between InformaCast and Q-Sys. TEECOM drove the process and design and the project implementation was a partnership with all those entities listed above.

The final solution was 30% the cost of the original design, at under $1 million. Aside from the cost savings, we were able to deliver a fully scalable solution that was based on the hospital’s workflow and operating criteria. We worked closely with the overhead paging service owners to iterate possible scenarios, evaluate what worked and didn’t with the existing system, and determine what future needs might be. We made sure the overhead paging solution met Stanford’s quiet hospital criteria, which recognizes that noise has an impact on recovery times and patient satisfaction — a component that the original, more expensive design also lacked.This is the kind of problem-solving we love to do at TEECOM. It’s the best use of engineering: a top-down, cost-effective solution that offers value to everyone.