Understanding smart hospitals and why most aren’t there yet

Here’s what executives need to know now about embarking on the journey by implementing applications to build a smart network of solutions.

By Siddharth (Sid) Shah

October 23, 2017, 09:14 AM

Link to Original Article

Hospitals globally are under tremendous pressure today and are facing factors such as reimbursement and cost pressures, while serving an increasingly aging population suffering from chronic diseases. Hospitals are seeking ways to improve their productivity and efficiency, in order to reduce operational costs and therefore, improve margins. While hospitals are busy doing this, the patient is evolving to be a consumer, whose needs and preferences need to be addressed to achieve optimal ‘customer satisfaction’, a notion hitherto alien to the healthcare industry (for the most part). 

Naturally, hospitals envision digital technologies as a solution. But singular, siloed implementations don’t necessarily serve the purpose. Digitization trends have a high impact on hospitals, and indeed digital hospitals are also emerging. But does that result in a true, ‘smart hospital’? In our opinion: not really. This is how Frost & Sullivan defines Smart Hospitals. 

Our definition
“Smart hospitals are those that optimize, redesign or build new clinical processes, management systems and potentially even infrastructure, enabled by underlying digitized networking infrastructure of interconnected assets, to provide a valuable service or insight which was not possible or available earlier, to achieve better patient care, experience and operational efficiency.” The critical component for smart hospitals is the ability to provide a valuable service of insight, which was simply not possible or available earlier. This is what makes a hospital a step further from being just digital, making it truly smart. Simply digitizing, or making the hospital paperless (although a great achievement) is not sufficient. We see current implementations of digital solutions in hospitals as steps in their journey to become smart. From exploratory implementations to an intermediate stage, to finally becoming smart where hospitals have complete alignment of clinical processes and management systems. 

Conceptualizing smart hospitals
The smart hospital framework involves three essential layers – data, insight and access. Data is being collected even today, although not necessarily from all systems in a hospital, but is not integrated together to derive ‘smart’ insight, which can be done by feeding it into analytics or machine learning software. This insight must be accessible to the user – a doctor, a nurse, facilities personnel or any other stakeholder, through an interface including a desktop or a smartphone or similar handheld device, to empower them to make critical decisions faster, improving their efficiency.

There are three areas that any smart hospital addresses – operations, clinical tasks and patient centricity. Operational efficiency can be achieved by employing building automation systems and smart asset maintenance and management solutions, along with improving internal logistics of mobile assets, pharmaceutical, medical device, supplies and consumables inventory as well as control over people flow (staff, patients and visitors). Not only do these solutions reduce operational costs such as energy requirements, but also reduce the need for capital expenditures on mobile assets for example, by improving utilization rates of existing equipment. Patient flow bottlenecks, when addressed, improve efficiency, allowing more patients to be ‘processed’ through the system, allowing for more revenue opportunities at lower costs.

Clinical excellence revolves around solutions for nurses and doctors to improve their work efficiency, and also solutions designed for various departments, especially the emergency, surgery and radiology areas. Clinical excellence also encompasses improving patient outcomes by ensuring patient engagement and monitoring. A smart hospital needs to look beyond its walls with a population health view to get patients discharged quicker while ensuring they recover well, without being required to be readmitted. Remote monitoring tools can help smart hospitals achieve this goal.  

Apart from the above initiatives, which also serve to improve the patient experience, other non-clinical aspects can also help in better patient satisfaction. Consider the smart patient room, which allows voice-based interactive devices such as Amazon Echo with Alexa or tablets, to call nurses or dim the lights. Hospital design features such as large open spaces and gardens to alleviate patient fears associated with hospitals or customized environments for children, can also aid in the healing process and ensure faster recovery.

Hospitals that are already smart The current hotspots for smart hospitals are Canada, Finland, South Korea, Dubai, Singapore and Australia. Not all of the hospitals currently truly qualify as smart hospitals as they don’t necessarily address all of the prerequisites of smart hospitals. Yet, some of the advanced hospitals which are closer to the journey of becoming smart include the Humber River Valley Hospital (Canada), Nuffield Health Bristol Hospital (UK), Farrer Park Hospital (Singapore), Seoul National University Bundang Hospital (South Korea) and the Royal Adelaide Hospital (Australia). 

Some of the features of the Humber River Valley Hospital in Canada include it being North America’s first fully-digital hospital (with online appointment schedule, digital check-in, electronic path lab tests ordering and results), GE Healthcare Managed Equipment Services, a RIVA Chemotherapy Robot, Automated Pharmacy Systems (3/4th hospital supply chain automated) and a Patient Flow Command Center (currently in progress).

Similarly, at the Farrer Park hospital in Singapore, doctors have electronic tablets and/or phones linked to hospital systems, the hospital design combines nature and art with 700 paintings and 15 gardens, patients have access to telemedicine consulting services, there are fiber optic connections throughout hospital with 650 WiFi access points, and the focus is on medical tourism with a combined healthcare-hospitality approach to include an international desk, hotel and spa in the same complex, and a shared kitchen with 5-star hotel. 

As can be imagined, different hospitals in different regions have taken varying approaches to becoming smart, but are highly advanced compared to their peers. Although we do not imagine a significant number of hospitals to become smart in the coming few years, we do expect a majority of existing hospitals to begin the journey by implementing smaller solutions in a piecemeal approach, with integrations happening with each subsequent implementation to ensure building a ‘smart’ network of solutions.