Healthcare and care delivery models are witnessing a rapid change throughout the world. Factors such as increasing cost of care, need to improve access to care, inherent complexity in treatment options, and increasing involvement of patients in the care delivery cycles have spurred hospitals to shift focus from treating episodes to managing overall health of patients. This also enables hospitals and care delivery systems to focus on overall value of care rather than efficiency.
Incorporating ICT technologies to hospitals has given rise to the concept of Smart Hospital. However, Smart Hospitals is more than bringing together connected devices on a high-speed networking infrastructure. Smart Hospitals also help to achieve better clinical outcomes, increase supply chain efficiency and enhance patient experience. This starts with the fundamental objective that every healthcare-delivery institution strives to achieve ‘excellence in healthcare delivery’.
The people at Arthur D. Little, a management and consulting company based in Boston, have developed a framework hospitals can use to explain and better their vision of a Smart Hospital. The framework details out four key areas within the hospitals management and operations that should be considered while developing their own Smart Hospital Agenda:
- Patient services and interfaces: Smart hospitals aim to incorporate more services to maximize patient involvement. This includes digitalizing the appointment in the outpatient section to developing digitalized patient rooms which support audio-video communication systems for virtual, off-schedule interactions between patients and doctors. Digital infrastructure and content management in the patient’s room could provide information related to their condition, procedure, medication and treatment. Kiosks in the outpatient section can quicken patient registration, and billing systems to reduce waiting times, and allow waiting areas to offer more medical services.
- Care processes and orchestration: Wearables, sensors and communication devices are enabling remote patient monitoring and thus revolutionising the way patients interact with their doctors. Smart Hospitals can facilitate multi-specialty, team-based care models across a network of hospitals. Video-streaming capabilities from surgical rooms can enhance training or give the clinician access to external expertise. Integrated patient data and real time changes from sensors in the patient room displayed enable doctors to do ‘virtual’ rounds, improve the frequency of interaction between patients and doctors, and enhance processes and staffing requirements in nursing stations.
- Logistics and support services design: Technology that identifies and reports the location and utilisation of a hospital’s medical and non-medical resources can better orchestrate resources, reducing downtime of critical facilities, synchronising patients’ treatment schedules, and improving inventory management. Hospitals that use RFID and Wireless LAN technology to track consumables are minimising waste and realising major cost savings. Optimizing the movement of clinical and non-clinical equipment throughout the hospital would not only enhance overall efficiency, but also ensure access to well-maintained equipment.
- Organisation and capability design: To fully leverage digital capabilities in the hospital setting, there needs to be adequate focus on people management and training. Both clinician and non-clinical staff need the training and skills to successfully implement new technology. A strong governance model that brings together clinical and technical staff into cross functional collaboration remains one of the most critical enablers in ensuring technology strategy design and adoption in a provider institution.
In developing their vision of a Smart Hospital across these four domains, hospitals need to identify the impact on their MedTech Infrastructure, Facility Design, IT Infrastructure & Operations and the overall Information Management approach. Only when a hospital focuses on all of these domains, can it truly identify and detail a vision that will allow it to become smart.
Karolinska University Hospital (Stockholm, Sweden) has developed and tried out a concept in which Parkinson’s patients follow treatment programs from their homes. The concept has been implemented and is used in daily work. During video consultations the patient is asked to perform specific exercises, and the neurologist is able to monitor the movements and tremors via HD. This enables the neurologist to diagnose the status of the patient and, if necessary, recommend a change in the medicine dosage remotely.
Ng Teng Fong Hospital in Singapore has adopted several unique, patient-centric attributes in its design-physical infrastructure, workflows and use of technology. The hospital is among the first to combine registration and triage to reduce waiting times before treatment. Furthermore, the queue number provided to the patient at the time of arrival is the registration number for the patient’s whole treatment, thereby significantly reducing the waiting time. Enabling these concepts through smart introduction of ICT capabilities has resulted in the hospital developing a patient friendly healing environment.
More than simply introducing automation and connected devices, a smart hospital strategy rethinks care processes, management systems, and even physical facilities to deliver the best form of care. This blueprint equips hospital managers with the tools to successfully meet cost and patient care objectives and allow for the hospitals to adapt to a fast-changing landscape of healthcare.
Author: Parvathi Nair