© 2006 Hewlett-Packard Development Company, L.P.The information contained herein is subject to change without notice
The Digital Hospital at The Digital Hospital at St. Olavs HospitalSt. Olavs HospitalKen WattProgram Manager – Digital Hospital Europe Middle East & AfricaHewlett-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
What is a Digital Hospital?
−Relies on technology as an integral and fundamental part of its business strategy
−Enables the organization to leverage it’s 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 Phone Systems (PBX)
DECT/Pagers
Access Control
Intercom
CCTV
AGV (Robotics)
Lighting control
Blinds
Air condition
Facilities Control
Medical Devices
Paper
Data Networks
Wireless LAN
WiFi
Client PC
Hospital Applications
EPR PACS HIS LAB etc
Patient Entertainment
Everything over IP – IP Everywhere
Infrastructure IP ConvergencePatient terminal
LAN/WLAN
IP converterESPA 4.4.4
MDA/PDA
PC Mobile phones(SMS)
IP wirelessphones
OPC, SMTP, SMNP
I/O signalconverter
Digital PenPatient monitoringmedical equipment
WiFi tags
Facilitycontrol
MiddlewarePACSEPREHCLaboratory etc.
Nurses’portal
GSM
Nurse call
PagerIP phones
The Digital Hospital – Putting it Together:Integration Technology
Portal
Middleware Platform
Digital Hospital Roadmap
Enhance Infrastructu
re• IP LAN• Wireless &
mobility• Security
InnovatePilot & rollout e.g• Messaging & alerts• Location based
services• Asset tracking• RFID
Integrate• Enhance integration of
applications and services• Seamless communications
& alerts• Align applications with
business processes
Service evolution/ New InfrastructureNetwork enhancement
Physical integration
Change Management
Logical integration
Ecosystemintegration
• IP Telephony
• Wireless
• Patient bedside terminal/portal
• Patient monitoring
• Better quality of care
• Reduced number of errors
• Improved productivity and decreased cost
• Converged IP network for voice, data and video
• Reinvention and redesign of care processes
• Organizational virtualization
• Ecosystem partner integration
Current state:
Inefficient manualprocesses
Future state:
Technology enabled efficient processes
Integration Platform
Patient Bedside Terminal & Portal
Messaging & Alerts - Nurse call - Medical team assembly - Hospital orderly - Event driven alerts
Network & communication infrastructure
Location and identification services - WiFi - RFID
Creating the Digital Hospital – The Applications Layer - Solutions .....
Device integration - Patient monitoring - Infusion pumps
Case Study: St Olav’s Hospital
St Olavs Challenges & VisionBuilding 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 Europe’s/World’s most modern hospital (the hospital of the future ....)
• Located in Trondheim - Norway’s 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
• An opportunity to re-structure to enable a holistic view of the patient
• Opted for a campus-style layout
− 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.
St Olavs Challenges & VisionCont ....
500 patient and staffInterviewed: 2,500
requirements/requests
“...Based on teamwork working in an integrated environment, with medical expertise, and nursing care focused on the patient.“
ICT – The Core Enabler at St. Olavs
MobilityFlexibilitySecurity
Availability
Everything over IP – IP Everywhere
System integration, digital infrastructure
Communications and Cisco Clinical Suite Solutions Suite
Integration Platform
Patient Bedside Terminal & Portal
Messaging & Alerts - Nurse call - Medical team assembly - Hospital orderly - Event driven alerts
Network & communication infrastructure
Location and identification services - WiFi - RFID
Device integration - Patient monitoring - Infusion pumps
• 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)
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
Medical Equipment Integration
IP Gateway
Conversion and display of data in real time (archived for historical/research & decision Support)
Patient MonitoringAccess to device and its data via web browser
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
Location-based servicesIdentification and location tracking
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
Staff required
0 4 8 12 16 20 24 Hrs
5
4
3
2
1
Shift
Work load
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 patient’s 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 ......
• 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 Entertainment
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 ...