All levels of Australian government are trying to find a solution to the spiralling cost of health services, writes ALAN TIMMINS from O’Donnell Griffin Data, but there is an emerging technological approach that could provide great savings through efficiency – the digital hospital.
Dr David J Brailer, IT expert and former National Health Information Technology co-ordinator for the US Government, has estimated information technology could lead to a six percent cut in US health spending each year. In Australia this would equate to $3.4 billion of the $56.9 billion health bill for 2010-2011.
Individual hospitals are estimated to save 20 percent of their budgets by implementing fully digital services. In the latest Federal Budget the Federal Government gave $480 million to develop e-health – a central national database of individual e-health records. By commencing the network for personally controlled electronic health records – even on a voluntary basis – the Federal Government is acknowledging the importance of a centralised database to allow for better and more efficient provision of health services.
A digital hospital requires integrated technology as part of its day-to-day operations to deliver health services to patients, health providers and hospital administration from a single platform. These operations run from a single technological platform that synthesises both clinical and non-clinical procedures and measures performance. Such a ‘digital hospital infrastructure’ is known as DHI.
Under this DHI model all clinical data is accessible instantaneously to all health professionals who have access to it through devices carried by clinical and non-clinical staff, with levels of access rationed according to roles. These emerging digital hospitals are operating with centralised digital records to enable medical teams to share patient information quickly and securely, enhancing diagnosis and treatment times.
Information collected electronically at the bedside – e.g. blood pressure, pulse rates, oxygen levels, medication requirements and nursing entries – are available to be viewed anywhere across the hospital. These are all recorded or uploaded automatically. Historical data is also collected and stored so there is a full patient history available at the necessary point of clinical support.
In addition, electronic touch screens can be used for patient entertainment and communication. In nurse care, a nurse inputs data that automatically updates the patient’s record. Medications are monitored by bar codes.
BUDGETARY INFORMATION
The technology also supports a hospital’s administration by providing vital budgetary information such as energy usage, availability of services and other mission-critical data to ensure the facility operates at optimum capacity and maintains costs control.
At the economic edge of this revolution, hospital managers are realising the need to overhaul their approach to IT systems and they will need to look initially at increasing budgets to produce this change. Payback periods are predicted to radically shorten as these systems produce huge efficiency improvements in the overall system.
There are numerous DHI projects underway overseas and under construction in Australia. Two prominent examples overseas, both in Norway, are St Olav’s in Trondheim and Oslo’s Akershus University Hospital. St Olav’s, a major university and research hospital, began a new hospital construction in 2002 and upgraded existing IT systems and buildings using a DHI approach in 2005 (see www.hospitalmanagement.net). It includes an end-to-end IP network, which allows staff to access information at any time in any position within the hospital using a range of devices such as PDAs and IP wireless phones.
According to Hewlett-Packard (HP), it used network appliances from leading system integrator companies and middleware from Norway-based Cardiac to build its highly distributed network. Under the HP process nurses receive patient calls via an IP phone. If there is no response within seconds, the request automatically routes to another nurse until someone responds. An intelligent locating system tracks physicians and specialists throughout the hospital so they can be found at a moment’s notice in an emergency. Patient terminals developed by Cardiac can deliver hospital services, nurse calling, internet, entertainment and telephone service right to the patient’s bedside, while also providing clinicians with secure access to electronic patient records.
Most critically, in approaching these digital infrastructure replacements for all new DHI projects, the design consultants must liaise closely with both clinical and operational executives and practitioners to ensure that the projected needs and developments in these sectors are accommodated within the roll-out plan. Hospitals need to be both technologically and clinically progressive in their planning. Doctors and IT professionals have to be seen to collaborate to produce total solutions.
As was acknowledged in a 2010 article by HP lead industry technologist, Jared Walker, “[Healthcare] organisations must begin viewing technology strategically and [embrace] the opportunity it brings for change.”
While we are still waiting for the first fully digital hospital to be built in Australia, much of the technology is available locally. Mechanical, electrical and communications providers such as the Norfolk Group, with brands such as Diverse Data CommunicationsO’’Donnell Griffin Data (formerly Diverse)’, O’Donnell Griffin and Haden, have the technical capabilities and resources already to provide many of these solutions today.
Tangible benefits of the digital hospital include:
- cost-saving benefits: less equipment is needed and the entire technology runs off a single, large system
- there is less complex installation and engineering required, as it involves one common system requiring less maintenance, and
- improved equipment and improved environmental monitoring, which in turn means energy and emissions measurements and savings are tangible.
Non-tangible benefits of the digital hospital include:
- time savings, which increase productivity gains in clinical services
- improved operations and standard procedures for better response
- more information, available to a larger number of staff
- simpler management of staff
- digital links to out services, with better, consistent management of remote areas
- common data repository
- consistent response across all incidents
- superior auditing and compliance
- superior capture of historical information, which assists in decision-making in clinical and non-clinical situations, and
- cost-competitive installation, compared to traditional systems.
Alan Timmins is general manager of O’Donnell Griffin Data, formerly known as Diverse Data Communications. It is a subsidiary of the Norfolk Group and a leading data and communications specialist brand.
