When is a Hospital Digital?

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Adele Lawrence
8 years ago
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1 When is a Hospital Digital? Fiona Stuart August 2012

2 Overview The digital hospital is not a destination, but a journey. The journey delivers better patient outcomes, streamlined workflows, greater productivity and efficiency, and increased patient and staff satisfaction. Healing is enhanced. Investments must be made with consideration to the overall goals of the hospital and surrounding care network. It s not black and white not digital or notdigital ; there are shades of grey from minimally digital to fully optimised 2

increased patient and staff satisfaction. Healing is enhanced.

3 Why Digital Hospital 19% The average proportion of time a nurse spends on direct patient care during the active nursing part of a shift 20-40% WHO s estimate of all health spending wasted through inefficiencies in the system 5.2% Average annual increase in recurrent expenditure on public hospitals in Australia To improve the situation, we can must either improve the productivity of the resources, or substitute them. Health statistics sourced from the World Health Organisation and the Australian Institute of Health and Welfare highlighting the inefficiencies of traditional hospitals and continual rises in health care costs. 3

2% Average annual increase in recurrent expenditure on public hospitals in Australia To improve the situation, we can must either improve the productivity of

4 Productivity improvements 4

5 Akershus University Hospital, Norway The hospital Serving an aging population of 450,000 Obsolete and failing facilities replaced The decision Build the most modern university hospital in Europe, fully equipped with the latest digital technologies The results 50% reduction in adverse events 20% shorter length of stay 20% increase in activity covered by only a 2.7% increase in staff 5

in Europe, fully equipped with the latest digital technologies The results 50% reduction in

6 Purpose of the Digital Hospital Maturity Model A guide to the characteristics of Digital Hospital The art of the possible A starting point for discussions about investment options An opportunity to get clinicians and administrators on the same page about technology investments A framework to allow self-evaluation To identify strengths and weaknesses Objective assessment tool To create the baseline and identify areas for improvement To assess how digital the hospital should optimally be A starting point for discussions with vendors The foundation for your transformational journey 6

to allow self-evaluation To identify strengths and weaknesses Objective assessment tool To create the baseline and identify areas for improvement

7 HIMSS EMR ADOPTION MODEL EMRAM as a proxy for Digital Hospital Maturity? Need to consider other aspects of hospital operations and infrastructure that can impact the effectiveness of EMR initiatives 7 From: Nothing happens in isolation

8 Healthcare technology convergence Pervasive technology integration enabling a real-time information environment and intelligent/automated workflow care orchestration Facilities Medical Communications Information Technology integration 8

and intelligent/automated workflow care orchestration

9 HP s Digital Hospital Maturity Model Facilities Medical Level 1 Initial Primitive building and security systems Dependence on human surveillance Stand alone modalities Wholly paper Patient Record Level 2 Connected Building and security systems integrated Single card based facility access Post-care updating of basic EMR Modalities accessed and viewed separately to patient record Level 3 Coordinated Tasks communicated electronically to mobile decides RTLS location awareness Ability to view some aspects of EMR from a central point Modality/ Lab/Rad outputs attached to EMR Level 4 Managed Closed loop task mgmt with escalation Role-based two factor authentication Full EMR update at point of care Some clinical decision support Modality/Lab/ Rad/ Meds fully integrated Level 5 Adaptive Demand based delivery of services Bulk reconfiguration of security privileges in near real time Fully integrated EMR across facility Support for personalised medicine Level 6 Optimised Communications Dependent on wired telecomms Manual routing of all requests Combination of wired and wireless comms Some requests rules based Ubiquitous wireless Comms routed and escalated automatically Presence managed Comms routed to nearest available Device independent IT Domains Tribal Opportunistic Budget driven Departmental Rationalised Virtualised Facility-centric Multi-Year Plan Semantically interoperable Care Community Oriented Speed Innovation to Practice, Improve Operational Efficiencies, Improve Quality of Care 9

Coordinated Tasks communicated electronically to mobile decides RTLS location awareness Ability to view some aspects of EMR from a central point Modality/ Lab/Rad outputs attached to EMR Level 4

10 HP s Digital Hospital Maturity Model Facilities Medical Communications IT Domains Level 1 Initial Primitive building and security systems Dependence on human surveillance Stand alone modalities Wholly paper Patient Record Dependent on wired telecomms Manual routing of all requests Tribal Opportunistic Level 2 Connected Building and security systems integrated Single card based facility access Post-care updating of basic EMR Modalities accessed and viewed separately to patient record Combination of wired and wireless comms Some requests rules based Budget driven Departmental Level 3 Coordinated Tasks communicated electronically to mobile decides RTLS location awareness Ability to view some aspects of EMR from a central point Modality/ Lab/Rad outputs attached to EMR Ubiquitous wireless Comms routed and escalated automatically Rationalised Level 4 Managed Closed loop task mgmt with escalation Role-based two factor authentication Full EMR update at point of care Some clinical decision support Modality/Lab/ Rad/ Meds fully integrated Presence managed Comms routed to nearest available Virtualised Facility-centric Multi-Year Plan Level 5 Adaptive Demand based delivery of services Bulk reconfiguration of security privileges in near real time Level 6 Optimised Closed Full EMR update loop task at mgmt point of with care Fully integrated EMR Presence across facility Virtualised Support for managed escalation personalised medicine Some clinical decision Facility-centric support Comms routed to Role-based two factor Modality/Lab/ Multi-Year Plan Rad/ authentication Meds fully integrated Device independent nearest available Semantically interoperable Care Community Oriented Speed Innovation to Practice, Improve Operational Efficiencies, Improve Quality of Care 10

access Post-care updating of basic EMR Modalities accessed and viewed separately to patient record Combination of wired and wireless comms Some requests rules based Budget driven Departmental Level 3

11 How well do we really understand the end game? 30 years ago, 70% of today s inpatients would have been in ICU. * 30 years ago, 70% of today s ICU patients would have been dead. * Can we really predict tomorrow s innovations? The key to sustainability is adaptability to change. * Clayton Christensen: The Innovators Prescription p

* 30 years ago, 70% of today s ICU patients would have been dead.

12 What lies ahead? 12

13 What lies ahead? 13

14 Conclusion Digital Hospital is one of the opportunities to increase productivity and improve outcomes in the health system, and it s a proven way to drive efficiency and save money. To undertake the digital hospital journey, you will need a guide a plan. The journey has to consider all aspects of the hospital not just medical or communications, facilities or IT; it s the interaction of the various domains that releases the real value. Nothing happens in isolation Consider partnering with organisations that have the experience of transforming the hospital environment. 14

The journey has to consider all aspects of the hospital not just medical or communications, facilities or IT; it s the interaction of the

15 Thank you

THE EMR ADOPTION MODEL: RELATIONSHIPS BETWEEN IT ADOPTION, PATIENT SAFETY AND PERFORMANCE

Subtitle THE EMR ADOPTION MODEL: RELATIONSHIPS BETWEEN IT ADOPTION, PATIENT SAFETY AND PERFORMANCE PRESENTED BY: UWE BUDDRUS, MANAGING DIRECTOR HIMSS ANALYTICS EUROPE HIMSS HIMSS PARALLEL Analytics SESSION