The Digital Hospital at St.

Olavs Hospital
Ken Watt Program Manager Digital Hospital Europe Middle East & Africa Hewlett-Packard Company

2006 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice

> Definition of the Digital Hospital > St. Olavs - Background - Business vision - What implemented - Benefits

2006 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice

What is a Digital Hospital?

Relies on technology as an integral and fundamental part of its business strategy Enables the organization to leverage its potential for delivering higher quality care in increasingly efficient ways through the use of IT and process redesign. Goes beyond advanced clinical systems and includes additional integration between IT, medical, communication and building technologies to create a real-time hospital information environment

Source: PWC

The Infrastructure of a Typical Hospital today

Nurse Call
Patient Entertainment Access Control

Intercom CCTV AGV (Robotics)

Phone Systems (PBX) DECT/Pagers

Data Networks

Paper

Medical Devices Wireless LAN WiFi Client PC

Hospital Applications
Lighting control Blinds Air condition Facilities Control EPR PACS HIS LAB etc

Infrastructure IP Convergence
Patient terminal IP phones IP wireless phones MDA/ PDA PC Mobile phones (SMS) Pager Nurses portal

GSM

OPC, SMTP, SMNP

LAN/WLAN Middleware PACS EPR EHC Laboratory etc.

IP converter ESPA 4.4.4

I/O signal converter

WiFi tags Nurse call Patient monitoring medical equipment Facility control Digital Pen

Everything over IP IP Everywhere

The Digital Hospital Putting it Together: Integration Technology

Portal

Middleware Platform

Digital Hospital Roadmap

Integrate Innovate
Pilot & rollout e.g Messaging & alerts Location based Patient bedside services Asset tracking terminal/portal RFID Patient monitoring

Future state: Technology enabled efficient processes

Better quality of care Reduced number of errors Improved productivity and decreased cost

Current state: Inefficient manual processes

Enhance integration of applications and services Seamless communications & alerts Align applications with business processes

Enhance Infrastructure

Organizational virtualization Ecosystem partner integration

IP Telephony Wireless

IP LAN Wireless & mobility Security

Reinvention and redesign of care processes

Converged IP network for voice, data and video

Physical integration
Network enhancement / New Infrastructure

Logical integration
Change Management

Ecosystem integration
Service evolution

Creating the Digital Hospital The Applications Layer - Solutions .....

Patient Bedside Terminal & Portal Messaging & Alerts - Nurse call - Medical team assembly - Hospital orderly - Event driven alerts Location and identification services - WiFi - RFID Device integration - Patient monitoring - Infusion pumps Integration Platform Network & communication infrastructure

Case Study: St Olavs Hospital

St Olavs Challenges & Vision

Building a state-of-the art hospital to deliver patient centric services
Hospital was too costly to operate, with annual rising costs Opportunity to build a hospital that will provide outstanding quality of care Objective to deliver patient centric services Transition from one large structure to 11 separate centres Opportunity to integrate clinical and teaching/research areas (key objective). Opportunity to integrate University employees seamlessly Opportunity to exploit ICT to deliver information to the right persons at the right time at the point of care Opportunity to align business outcomes/process re-design with IT requirements Become Europes/Worlds most modern hospital (the hospital of the future ....)
Located in Trondheim - Norways largest hospital Premises: Main Acute Services Unit (75%) & University Hospital (25%) Managed by the Regional Health Authority of Mid-Norway 950 beds 8,000 Staff (+1,250 students) 413,000 patient treatments per year Provides services & specialties for other hospitals in the region

St Olavs Challenges & Vision

Cont ....

...Based on teamwork working in an integrated environment, with medical expertise, and nursing care focused on the patient.

An opportunity to re-structure to enable a holistic view of the patient Opted for a campus-style layout

500 patient and staff Interviewed: 2,500 requirements/requests

11 interconnected buildings instead of one big infrastructure

Major changes in organisation, support, and building architecture design (influenced by staff & patients) to: Deliver patient centred services and treatment Vs. traditional approach of patients moved between departments/centralised facilities.

ICT support to provide the right information to the right person at the right time at the point of care Adoption of the Planetree model:
All-round care and treatment in collaboration with the patient and families A nursing process that minimises the number of health workers a patient has to deal with An informed and involved patient: knowledge of their condition should contribute to diagnosis, treatment, and follow-up.

ICT The Core Enabler at St. Olavs

Patient Bedside Terminal & Portal

Mobility Flexibility Security Availability

Everything over IP IP Everywhere

Messaging & Alerts digital System integration, - Nurse call infrastructure - Medical team assembly

- Hospital orderly - Event driven alerts

Communications Location and identification services and - WiFi - RFID Cisco Clinical Suite
Device integration Solutions - Patient monitoring - Infusion pumps Integration Platform Network & communication infrastructure

Suite

Medical Equipment Integration

Medical equipment:
Provides real-time clinical data Accessed via web browser (& real time EPR update) Can be integrated to Centralised alerts solutions (Wired or Wireless) Protected by RFID/WiFi tags

All devices with I/O signal can be connected to the network and provide real-time data Analysis of measurement and device data

Devices can me monitored remotely (HP OpenView)

IP Gateway

Patient Monitoring
Access to device and its data via web browser
Conversion and display of data in real time (archived for historical/research & decision Support)

Location-based services Identification and location tracking

Benefits

Trauma Team assembly Medical Emergency alarm and locating nearest clinician Monitoring of high-risk patients

Device alarms and theft protection

WiFi/RFID asset monitoring and identification Activity control and process monitoring

IMATIS Nurse Call

Nurse Station - visualization of ward/bed area Role based individual and teams Emergency alarms, locates nearest Clinician/Nurse Better staff utilisation (Nurse to patient dialogue anywhere) Dynamic distribution by peaks

Best OPC Server

Staff required

5 4 3 2 1 0 4 8 12 16 20
Work load
Shift

24 Hrs

Lab requests and results

Requests raised/Results displayed via mobile devices (PDA, Tablets, Laptops, CCOWS)

Signatures stored in audit database

Patient Terminal Multiple Role

Meets patients need for entertainment, communication, and access to own or other hospital information

A secure and efficient way for clinicians & nursing staff to use the same terminal to access core clinical systems (i.e. EPR or IMATIS Patient Chart).

Patient and family involvement in diagnosis & treatment ......

Patient Entertainment

TV and Radio over IP Video Internet/ E-mail Telephone (VoIP) Information (e.g. hospital & treatment ...) Room Lighting control Nurse Call

Real time Access to Catering Services

Games - Xbox

Professional application use through smartcard

Patient Chart

Displays critical patient information: - Vital Signs - Administered Medication - Treatment History - Lab results

& examinations history

Electronic Patient Record

Complete Electronic Patient Record based on European standards. (CEN ENV

13606-1)

EPR can be:

fully integrated or accessed via Citrix Session to existing EPR System

Expected results at St. Olavs

Improved patient care through real time access to data at the point of care Reduced Length of Stay (LOS)

Staff productivity increased through improved collaboration (objective: achieve productivity gain of 26.1% by 2015)
Achieve measurable reduction in staff workloads Reduce operating and waste costs by 22M Euros.
Converged network to improve TCO and reduced network operating costs

Thank you ...