we explore the digital hospital

Industry Focus: Digital Hospitals

Evening at the hospital—after a long day at work, visitors arrive to see their loved ones just as most hospital personnel are returning home.

You, like the bulk of visitors, don’t know this place very well. You may have been once or twice for something minor, but you haven’t set foot in the rest of the institution.

And now, you’re alone in the hospital’s wide hallway. You turn to the left and begin walking, unsure if you’re headed in the right direction, because the front desk was empty when you entered, and you have only signs and arrows to guide you. Your footsteps echo off the white walls. Your ears begin to ring.

Then, glowing in the distance, you see it: a map. You quicken your pace, searching for the red YOU ARE HERE mark on the maze-like image. You sigh in frustration. You have wasted precious visiting time going the wrong way.

This wouldn’t have happened in a Digital Hospital, where Bluetooth location-sensing technology would have guided you right where you needed to go.

What Is A Digital Hospital?

New to the world of medicine, Digital Hospitals have nonetheless garnered enough attention for a standardized rating scale to have been put in place. Ranging from zero to seven, the scale rates the degree to which a Digital Hospital has increased efficiency, both within and outside of the institution. Below is a shortened version of the scale, as published in the International Journal of Health Science Research and Policy:

Stage 0
  • No part of the institution is included in the digital environment, including clinical support units (pharmacy, lab, radiology).
Stage 1
  • Clinical support units (pharmacy, lab, radiology) are included in the digital environment.
Stage 2
  • Digital environment includes a clinical data repository (CDR). Physicians can view medical information and results internally.
  • The CDR can receive medical image documents. If applicable, information exchange is enabled between hospitals.
Stage 3
  • Clinical documents, electronic medication management records, order entry, and tracking systems are integrated with the CDS.
  • Physicians located outside the radiology department can access medical images and image archives.
Stage 4
  • Any licensed clinician can add a nurse to a computerized physician order entry (CPOE) system.
Stage 5
  • Physicians outside the institution can access medical images via a secure, intra-institutional system.
Stage 6
  • At least one in-patient clinic has an integrated documentation system.
  • A closed-loop system manages medications; the hospital uses a coded drug system.
  • Automated ID and delivery technologies comply with the “5 Rights”:
    • Right patient
    • Right drug
    • Right dose
    • Right route
    • Right time
Stage 7
  • Total digitization: no use of paper documents.
  • The institution stores and analyses data to increase healthcare quality and ensure patient safety.
  • All data is standardized and accessible to all hospital personnel.
  • A closed-loop system manages all healthcare materials.

Today, lower-stage Digital Hospitals are common, usually the central institution of a city or community. In this article, we focus especially on the higher-stage Digital Hospitals and the technologies they use.

we explain the stages of digitization of a hospital

Touring the Digital Hospital

Digital Hospitals are large institutions, which typically house several technologies that work in combination. Nonetheless, some of these programs are more prevalent in certain areas of the Digital Hospital. CB Insights has broken them into the following categories:

  • Supply management
  • Diagnostics
  • Communication
  • Electronic medical record (EMR) and practice management
  • Surgery
  • Referrals
  • Care coordination
  • Patient experience
  • Infection control
  • Readmissions and emergency department (ED) admissions
  • Hospital navigation
  • Medication management
  • Patient monitoring
  • Radiology

Although we could break these down for you into minute sections (and we will do this at a later point in time), for now, we would rather give you the big picture by showing you what goes on behind the scenes, in the examination room and at home.

Behind the Scenes of a Digital Hospital

Hospitals are public places: their guests, patients, and employees enter from the outside. However, to manage the constant influx of people and resources, they must dedicate part of that public space to private matters, such as logistics and asset management. Also, to provide for recipients of more invasive medical care, they must construct sophisticated private care spaces.

Until recently, humans took charge of these behind-the-scenes aspects. Relying on employee attention to detail and organisational capacities, hospitals and patients alike lose time and money to misdiagnoses, excessive supply use, and unnecessary medical procedures.

Digital Hospitals aim to reduce waste, beginning with the back-of-house processes. To implement effective, consistent solutions, institutions forego human help and rely instead upon self-driving robots, like Aethon’s TUG. Coded to understand hospital layouts and patient needs, they deliver meals, prescriptions, and even surgical supplies.

Programmed to track use and waste, self-driving robots adapt to reduce errors and improve hospital function. For example, if surgeons use a certain number of materials to perform a common operation, like an appendectomy, then the robot will provide materials in that amount—no more, no less—for future operations. Overall, by using technology to keep supplies in-check, Digital Hospitals reduce costs and increase patient satisfaction.

Standardized procedural methods are also a controlling factor in supply use. When all hospital staff operates in the same manner, they conserve more resources.

Digital Hospitals extend this philosophy to the operating theatre with apps like TouchSurgery. With the goal of transforming surgery into a “conveyor-belt” system, TouchSurgery uses simulation to teach surgical procedures according to a prescribed model. Keeping real life in mind, however, the app recognizes steps where surgeons will most likely encounter an adverse event, and pauses to allow for critical decision-making. In this way, TouchSurgery (and apps like it) helps Digital Hospitals streamline surgery while also helping residents to develop intellectually.

we analyze what goes on behind the scenes of a digital hospital

Moving beyond the app, streamlined surgical methods have already seen real-world success. In India, the Bangalore-based Narayana Hrudayalaya hospital has standardized heart, eye, cancer, and trauma procedures to expedite patient recovery and cut prices from thousands to hundreds of pounds. Planning to have 30,000 beds by the end of 2017, the hospital delivers heart services for approximately $800 (£622.60) per procedure, in contrast to the UK’s current average heart surgery cost of £7,000 to £10,000.

In all, Digital Hospitals are more than they appear. Looking at the back end, we gain a better insight into their impact on healthcare institutions and communities.

Between Patient & Specialist

Obviously, Digital Hospitals don’t lag on implementing new technology. With apps that meet security guidelines and privacy policies, Digital Hospitals have upgraded admissions departments as well as examination rooms.

When a patient comes to the hospital, traditional practice calls for a scramble to gather that patient’s information from their primary care physician and relay it to the current care practitioner. Unfortunately, such protocols often take longer than the consultation allows.

Tracking apps like PositionHealth and Cureatr alleviate this problem substantially. Using location-sensing technology, PositionHealth alerts physicians when their patients return to the hospital, allowing them to directly contact other professionals about treatment specifics. Similarly, Cureatr alerts primary care specialists about patient transfers, and provides actionable alerts for primary physicians to guide other professionals down the best path of care. In all, tracking applications take the hassle and miscommunication out of healthcare.

In Digital Hospitals, tracking technology often forms part of a larger, internally-integrated system. Two European Digital Hospitals have used these systems to go beyond patient tracking, determining patient needs and shortening recovery time with robot-like precision.

Spain’s Marina Salud Hospital, for instance, uses the Cerner Millennium system, which catalogues all electronic health records (EHRs) and makes them instantly accessible to hospital personnel. In the Netherlands, the Nijmegen Hospital uses a similar system called Epic EHR. Using real-time tracking like its competitors, the system integrates all patient vital signs and IV pumps, and monitors for fast, convenient verification.

Many Digital Hospitals have “improve patient experience” etched into their mission statements. Introducing location-sensing technology and easily-transferrable records is making this a reality.

we introduce you to the future of hospitals

For Autonomous Patients

As outlined above, nearly all stage 6 and stage 7 Digital Hospitals have secure, inter-institutional networks to facilitate data sharing. To compete, many Digital Hospitals have also developed virtual private networks (VPNs) that allow patients and professionals to access healthcare information, contact one another, and even order treatment from remote locations.

Such technology even functions in the inpatient setting. Toronto’s Humber River Hospital uses real-time tracking devices on patients and guests to automate prescription delivery, food services, and blood sample delivery. Also, in the United States, patients in New York’s Sloan Kettering surgery recovery centre rarely see their specialists: equipped with private messengers and personal iPads, they complete regular surveys that customize their recovery plans. Nonetheless, if they need a physician, expert help remains a mere message away.

As patient satisfaction is critical to the success of Digital Hospitals, it goes without saying that some programmes focus on experience, rather than on care alone. Practitioners, for instance, rely on NarrativeDx to receive more detailed accounts of their patients’ experiences, from hospital stays to routine appointments, to detect patterns and address pitfalls in their own practice. Institutions themselves, on the other hand, deploy robots like Gozio Health’s Magellan to receive customized information about their institution and to make their tracking devices more precise.

When it comes to care, Digital Hospitals focus on their guests as well as their patients and staff. By ensuring easy navigation for visitors as well as attentive care for those who need it, they create a space that satisfies all users.

Pros and Cons of Technological Transition

Tech in a Time of Tight Budgets

Technological advances aside, healthcare resources remain in limited supply as the number of aging and chronically-diseased individuals rises worldwide. Strapped for cash, around 75% of hospital executives plan to cut costs, as of 2017.

This news does not bode well for countries like France, Czechia, and Denmark, which provided between 35% and 45% of all healthcare in hospitals in 2013. Even areas with more healthcare centres are likely to suffer, because networks will be pressed to stretch budget resources to their limit.

Decreased hospital funding will also affect countries with limited access to medical technology, such as CT, MRI, and PET scanners. With the exception of Malta, all EU countries reported less than 0.3 PET scanners per 100,000 people in 2014. The same report revealed that widespread funding losses would affect even highly-developed countries, like the UK. Having reported less than one CT scanner per 100,000 inhabitants in 2014 and a decrease in overall operating theatres, even the United Kingdom wouldn’t have the supply to satisfy demand.

Indeed, these numbers grow more surprising when compared to healthcare technology consumption. France and Hungary, for instance, showed the most frequent CT scanner use, performing more than 11,000 scans per scanning unit in 2014. The same two countries also performed the most MRI scans per unit—Hungary tracking an impressive 11,000 and France following closely behind with 9,000. Other numbers, though, tell us we shouldn’t gape at these statistics: over 72% of healthcare consumers believe technology is important to their healthcare.

we analyze the pros and cons of technological transition

Silver Lining (Efficiency Increases, Lower Budget Requirements)

By all other reports, healthcare professionals are no different than consumers: 83% of doctors, for instance, use some sort of mobile technology in their profession. As CB Insights predicts that Digital Health will see record year levels of adoption in 2017, this number is only set to rise.

Healthcare’s affinity toward technology has primed the transition toward widespread Digital Healthcare institutions which, through increased efficiency, aim to address budget cuts. Turkey’s Tire Public Hospital, for instance, has increased efficiency by 35% since opening in 2016. Outside the EU, Abu Dhabi’s digitized Cleveland Clinic is expected to grow about 15% annually and bring more medical tourists to the region. Both cases, when paired with the technologies outlined in the previous section, illustrate how Digital Hospitals intend to use these innovations to save money and generate new revenue.

The world is growing, and healthcare budgets haven’t yet caught up. Thankfully, Digital Hospitals understand the cost-saving benefit of their innovations, and continue to create environments tailored toward what COCIR board member Hans Vandewyngaerde calls “a future where resources are under pressure, chronic diseases are on the rise and we are asked to do less with more”.

Working in a Digital Hospital

In terms of healthcare, Digital Hospitals are rather new. Because of their popularity, however, educational institutions have adopted programmes with Digital Hospital functions in mind. According to HIMSS, some Digital Hospital-focused specialisations across the EU are:

  • Health innovation
  • Nursing informatics
  • eHealth
  • Health management

Even if you don’t specialise in one of the above (or something similar), working in a Digital Hospital requires Digital Health literacy, as well as the following skills:

  • Flexibility
  • Patience
  • Data interpretation
  • Attention to detail
  • Ability to work in a fast-paced environment
  • Familiarity with privacy and security policy

we present a list of skills necessary in digital hospitals

Career Profiles

Marketing Coordinator

In Digital Hospitals—particularly institutions with specialities like psychiatry or rehabilitation—marketing coordinators develop relationships with clients as well as outside parties to advertise the hospital’s mission. Digital Hospital marketing coordinators must display adequate soft skills when interacting with patients, and have detailed insight to the hospital’s function. In summary, marketing coordinators are:

  • Relatable to outside markets and aware of community needs
  • Friendly to clients, as well as hospital personnel
  • Effective communicators

Informatics Specialist

Informatics specialists will resemble IT workers, but have specialised training in healthcare technology. They are able to install institution-specific networks that comply with privacy guidelines, as well as repair institution-specific technology. More specialised than other IT workers, informatics specialists are:

  • Aware of patient privacy guidelines and EHR security measures
  • Able to understand the relationships between their institution’s network and other institutional networks
  • Willing to help hospital staff, patients, and guests with technological concerns

eHealth Technology Instructor

As traditional hospitals transition to more digital formats, eHealth technology instructors help fill the knowledge gap between young healthcare professionals and their older, less tech-savvy counterparts. Instructors in eHealth technology not only have extensive knowledge of Digital Healthcare technology and their institution’s technological infrastructure, but also the ability to explain both in layman’s terms. Furthermore, they must be:

  • Available for questions from personnel in training
  • Aware of generational and institutional differences in healthcare technology knowledge and abilities
  • Able to generate lesson plans that address the needs of both learners and healthcare institutions

Outlook On The Future of Digital Hospitals

The future of the hospital is digital, and things will only progress from here. Subscribe to our newsletter, visit our Facebook page or follow us on Twitter to stay updated on the future of Digital Hospitals, and to find opportunities in the field.

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Theresa Kern

Business Development at beta|careers
Theresa is a management student and team member of the 2017 class at beta|careers.

Her responsibilities include growing and nurturing our digital health platforms and, occasionally, taking care of bus tickets for the team. In her free time, she can be found on horseback out in the woods.
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