The Digital Hospital at St. Olavs Hospital

1. The Digital Hospital at St. Olavs Hospital Ken Watt Program Manager – Digital Hospital Europe Middle East & Africa Hewlett-Packard Company

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

3. 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

4. Data Networks Patient Entertainment Nurse Call Access Control Intercom CCTV AGV (Robotics) Phone Systems (PBX) DECT/Pagers Paper Medical Devices Wireless LAN WiFi Client PC Hospital Applications EPR PACS HIS LAB etc Lighting control Blinds Air condition Facilities Control The Infrastructure of a Typical Hospital today

5. 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. I/O signalconverter IP converter ESPA 4.4.4 WiFi tags Nurse call Patient monitoring medical equipment Facilitycontrol Digital Pen Everything over IP – IP Everywhere

6. The Digital Hospital – Putting it Together:Integration Technology Portal Middleware Platform

7. Digital Hospital Roadmap Future state: Technology enabled efficient processes • Integrate • Enhance integration of applications and services • Seamless communications & alerts • Align applications with business processes • Better quality of care • Reduced number of errors • Improved productivity and decreased cost • Innovate • Pilot & rollout e.g • Messaging & alerts • Location based services • Asset tracking • RFID Current state: Inefficient manualprocesses • Patient bedside terminal/portal • Patient monitoring • Organizational virtualization • Ecosystem partner integration • Enhance • Infrastructure • IP LAN • Wireless & mobility • Security • IP Telephony • Wireless • Reinvention and redesign of care processes • Converged IP network for voice, data and video Ecosystem integration Physical integration Logical integration Service evolution Network enhancement Change Management / New Infrastructure

8. 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

9. Case Study: St Olav’s Hospital

10. 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 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 ....)

11. St Olavs Challenges & VisionCont .... “...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 • 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. 500 patient and staff Interviewed: 2,500 requirements/requests

12. Patient Bedside Terminal & Portal System integration, digital infrastructure Messaging & Alerts - Nurse call - Medical team assembly - Hospital orderly - Event driven alerts Communications and Cisco Clinical Suite Location and identification services - WiFi - RFID Everything over IP – IP Everywhere Solutions Suite Device integration - Patient monitoring - Infusion pumps Integration Platform Network & communication infrastructure ICT – The Core Enabler at St. Olavs Mobility Flexibility Security Availability

13. 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

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

15. Location-based servicesIdentification 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

16. Staff required 5 4 3 2 1 Shift Work load 0 4 8 12 16 20 24 Hrs 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

17. Lab requests and results Requests raised/Results displayed via mobile devices (PDA, Tablets, Laptops, CCOWS) Signatures stored in audit database

18. 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 ......

19. 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

20. Patient Chart • Displays critical patient information: - Vital Signs - Administered Medication - Treatment History - Lab results & examinations history

21. 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

22. 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

23. Thank you ...