Smart, connected hospital framework

Hospital IT leaders have made massive investments over the past two decades installing digital systems, while receiving too little value in return. To deliver value, digital technologies need to be connected and integrated within the clinical ecosystem. Siloed technologies create workflow complexity for frontline care teams, who must focus more on dealing with the tools than on the work of patient care. If the problem remains unchecked, complications will negatively affect patient safety and outcomes.

Indeed, too many hospitals have invested too much money and effort installing digital systems and received too little value in return. Why? Because to derive optimal value from these data sources, a hospital needs to be “smart.” And digital technology alone isn’t what makes a hospital smart.

What makes a hospital smart is the ability to rapidly derive insight and value from data sources which, in turn, enables nurses and physicians to respond quickly and appropriately. The ROI is this ability to shorten the time to recognize and react to issues. Smart hospitals leverage data in near-real time, and to do it, they need digital technologies to be connected – that is, integrated within the clinical ecosystem through an intelligent clinical communication and collaboration platform.

Integrated systems for communication and collaboration form the bedrock of the smart, connected hospital. They break down data silos, accelerate the conversion of data into information, and rapidly communicate new events to the most appropriate and available team members.

The agility with which hospitals derive insight and value from data sources contributes to organizational resiliency. A resilient organization rapidly adapts in response to challenges, be they pandemics, staffing shortages, or other internal or external stressors.

We devised a smart, connected hospital framework to help IT leaders visualize how to make the most of investments in an EHR infrastructure and clinical and operational systems while improving the care team experience, patient safety, and other outcomes.

1. Input layer (the foundation)
2. Aggregation and intelligent processing layer
3. Experience layer
4. Analytics layer

The input layer features data interoperability between healthcare IT systems such as the EHR, patient monitoring equipment, smart beds, and medical devices. Data interoperability creates the foundation for connectedness. It significantly reduces the human workload required to interpret output from disparate, siloed systems and enables a clinician to execute a care plan along a continuous care pathway. For example, when results from a hospital’s lab information system are integrated with cardiac monitoring, a physician can more easily understand that a patient’s new onset atrial fibrillation is due to an abnormally low potassium level.

A broad need exists for clinicians to receive accurate, relevant information on which they can act, helping to reduce alarm fatigue and cognitive burden and strengthen patient safety. Intelligent middleware enables routing, escalation, and prioritization of communications and alarm notifications at scale, and delivers it with associated context about the patient, event, and care team. This layer builds upon the data interoperability of the input layer. As an example, the Vocera® Engage intelligent workflow engine uses standards such as Health Level 7 (HL7) to break down data siloes and prepare data for analysis.

In the experience layer, people receive information from multiple systems that has been aggregated and intelligently processed. A goal of workflow interoperability is to avoid creating siloed context and disconnected repositories of information. To achieve it, IT and clinical leaders need a deep understanding of the connection points among physician, nursing, and cross-team workflows – especially during transitions of care. As one example, most hospitals require a physician to directly communicate to a nurse when a new stat medication order has been placed. This is an intersection of a physician medication ordering workflow with a nurse’s medication administration workflow. An intelligent clinical communication and collaboration platform automatically notifies the nurse when the stat order has been placed, reducing the communication burden for both parties.

Analytics help IT leaders measure clinical and economic outcomes and gauge the value they’re receiving from digital technology investments. Continuous process improvement is a cornerstone in the development of a smart institution.

Wherever you are on your journey from digital to smart, I invite you to connect with me to have a conversation about ideas, solutions, and possibilities. Click here for more information.