Before the Drywall: Technology Decisions That Make or Break a New Medical Facility

In Brief

• Cabling, pathways, telecommunications rooms and power for network equipment are building decisions, not IT purchases. They belong in design development, and they become expensive to change once walls are closed and ceilings are in.
• Healthcare spaces have different requirements than ordinary offices. The TIA-1179 healthcare infrastructure standard calls for denser outlets in clinical areas, diverse pathways, room for growth and, in its current revisions, Category 6A cabling.
• The most common rework in medical build-outs comes from details that seemed minor at design time: a missing data drop at a nurse station, an access point mounted above an imaging room, an ISP circuit ordered too late, or a telecommunications room with no dedicated cooling.

The Short Answer

A new medical office needs its network cabling designed alongside its architectural and electrical drawings, not after them. Bring a technology designer into the project during design development, document every data, wireless, camera and access-control location on the drawings, size the telecommunications room for growth, and order the internet circuit months before move-in. Waiting until finish-out usually means opening walls, re-pulling cable or accepting a network that never works as intended.

Why Timing Matters More Than Equipment

On a construction schedule, technology tends to appear late. Switches, computers and phones are delivered near the end, so the network feels like a final-stage item. But the physical infrastructure those devices depend on is installed during rough-in, weeks or months earlier, alongside electrical and mechanical work.

Once inspectors sign off on the above-ceiling and in-wall work and the drywall goes up, every change becomes a change order. Adding a cable to a finished wall means cutting, patching, painting and, in occupied clinical space, coordinating around patients. Moving an access point after ceilings are installed can mean relocating other trades' work. These costs are entirely avoidable with earlier decisions.

The sections below follow the order in which those decisions need to be made.

Phase 1: Design Development

Map Every Outlet to a Clinical Use

Work room by room with the clinical team. A typical exam room may need data for a workstation, a wall-mounted display, a phone, a vitals monitor and possibly an ultrasound or ECG cart. A nurse station may serve several workstations, label printers, a phone system and a monitor. Procedure rooms and imaging rooms have their own needs.

TIA-1179, the telecommunications infrastructure standard for healthcare facilities, includes recommended outlet densities by work-area type precisely because clinical spaces outgrow office-style assumptions. Planning to those recommendations, then adjusting with the clinical team, is far cheaper than discovering a shortage after opening.

Choose the Cable Category Deliberately

Category 6 cable supports 1 Gb/s to every outlet and 10 Gb/s over shorter distances. Category 6A supports 10 Gb/s across the full 100-meter channel and handles the heat generated by high-power Power over Ethernet better in large bundles. The TIA-1179-A revision specified Category 6A as the minimum for horizontal and backbone cabling in healthcare facilities, and the standard was revised again as TIA-1179-B in 2023.

For wireless access points, cameras and any location likely to carry PoE devices, Category 6A is the conservative choice. Some projects use Category 6 for basic workstation drops to manage cost. That is a reasonable trade-off if it is a documented decision rather than a default.

Plan the Backbone

In a single-floor clinic, one telecommunications room may serve the whole suite. In larger or multi-story buildings, intermediate rooms connect back to the main equipment room through a fiber backbone. Specify enough fiber strands for future growth and consider diverse routes, so a single damaged pathway does not isolate part of the building. TIA-1179 recommends at least two diverse pathways from the entrance facility to the equipment room.

Phase 2: Construction Documents

Size and Locate the Telecommunications Room

The telecommunications room is where projects most often cut corners. It is easy to assign the network to a leftover closet near the restrooms. A closet that works on paper can fail in operation.

A workable room has:

• Space for current racks plus room to grow (the original TIA-1179 recommended allowing for 100 percent growth)
• Dedicated cooling that runs when the building HVAC is in setback mode overnight and on weekends
• Dedicated electrical circuits, sized for network equipment and a UPS
• No water lines overhead and no shared use as storage or janitorial space
• Controlled access, ideally on the same access-control system as other sensitive rooms
• A grounding and bonding connection installed by the electrical contractor

Specify Power for the Network

Network switches powering phones, access points and cameras draw substantial current. Plan a UPS sized to keep core network equipment running through short outages and long enough for an orderly shutdown in longer ones. Coordinate with the electrical engineer if the building has a generator, so network and critical clinical circuits are on the right panels.

Integrate Cameras and Access Control

Security cameras and card readers are usually networked devices, and most cameras are powered over Ethernet. Show their locations on the same drawings as data outlets, agree on who furnishes and installs each component, and route them to network ports in the telecommunications room. Door hardware, electric strikes and fire alarm interfaces require early coordination between the door hardware supplier, the electrical contractor and the access-control installer. When those trades plan separately, doors end up with hardware that cannot be wired the way the system needs.

Phase 3: Rough-In and Inspection

This is the last inexpensive moment to change anything.

• Walk every room against the drawings before ceilings are closed. Confirm boxes are at the right height for wall-mounted displays and workstation arms.
• Confirm pull strings or spare conduit to locations likely to change, such as reception and future procedure rooms.
• Verify wireless access point locations against a predictive wireless design. Access points need to be positioned for capacity and roaming, not just coverage. Rooms with lead shielding for imaging will block signal and need their own consideration.
• Confirm that cable pathways, supports and firestopping meet code and the specification. Cables lying directly on ceiling tiles are a common deficiency.
• Photograph open walls and ceilings. Those photos are valuable long after the project closes.

Phase 4: The Internet Handoff

The internet circuit is the single most common reason a new medical office opens without working systems. Carrier lead times for new fiber service vary widely and can stretch far longer than owners expect when construction work is required in the right-of-way.

Order primary service as soon as the address and suite number are fixed. Confirm where the carrier will terminate the circuit, typically a demarcation point in the main equipment room or a building utility room. If the demarcation is elsewhere in a multi-tenant building, plan the extension cabling to your suite. Consider a second carrier or a cellular backup from the start, because both are easier to accommodate before walls close than after.

Phase 5: Medical Equipment and Commissioning

Medical device vendors frequently have specific network requirements, such as static IP addresses, particular ports or isolated networks. Collect these requirements early from every vendor delivering connected equipment. Plan a separate network segment for medical devices so they can be protected and monitored without disrupting clinical workflows.

Before opening, require:

• Certification test results for every cable run, not just a statement that testing occurred
• Labeling that matches documentation, following a consistent scheme such as TIA-606
• As-built drawings showing every outlet, access point, camera and pathway
• A post-installation wireless survey under realistic conditions

Frequently Asked Questions

Should a new medical office use Cat6 or Cat6A cabling?

Cat6A is the safer choice for most healthcare facilities, especially for wireless access points, cameras and other PoE devices. Cat6 can be acceptable for basic workstation drops if the decision is deliberate and documented.

When should the IT or low-voltage designer join the project?

During design development, before construction documents are finalized. At that stage outlet locations, room sizes and power can be changed on paper.

How far in advance should we order internet service?

As early as possible once the address is fixed. Treat the circuit as a long-lead item, similar to specialty equipment, and confirm the carrier's installation timeline in writing.

Conclusion

A medical facility can buy new computers in an afternoon. It cannot cheaply move a telecommunications room, add pathways through finished walls or fix a wireless design once ceilings are closed. The difference between a building that supports clinical work for fifteen years and one that requires constant workarounds is often decided in a few meetings early in design. Make those meetings happen, and make sure someone in them is responsible for technology.

Talk to Meem Health

Meem Health works with Central Arkansas healthcare owners, architects and general contractors to plan network infrastructure for new medical facilities and renovations, from outlet mapping and telecommunications room design to wireless planning, medical device networking and move-in. If your project is in design now, it is the right time to call: 501-777-5177.