© 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 ...