Better patient experiences at smart hospitals

The emergence of new technologies has changed consumer expectations. Healthcare services are increasingly being delivered in a convenient, comfortable, and near-normal setting to help patients improve their health.

As a result, a paradigm shift occurred in how care is provided, and we are likely to see the shift accelerate in the years to come. In the context of this, hospitals, historically the center of healthcare delivery, have been forced or are seeking to redefine themselves.

Cities worldwide are being redeveloped to take advantage of the latest technology to become smarter. A smart hospital is typically included in these cities. New technologies are incorporated into the design and operation of these hospitals in order to improve customer experience, outcomes, and costs. These technologies will improve care within the smart hospital, as well as connecting the hospital to a wider healthcare delivery ecosystem, where hospitals play a lesser but still important role.

Smart hospitals are sometimes being built in cities with less technological sophistication, outpacing their towns’ general infrastructure development. Although most hospitals only recently began to use these technologies, they are rapidly catching up. In order to meet the challenges ahead, hospitals must incorporate these into their care delivery processes.

As of now, smart hospitals make very good business sense. The use of digital technologies in healthcare delivery can significantly reduce healthcare expenditures in most OECD1 countries by more than ten percent. Digital health solutions have attracted investors’ attention – venture capital funding for these solutions grew exponentially over the past seven years from over US $1 billion to over US $8 billion.

Investors and operators of hospitals need to be aware of the implications and imperatives of this trend. To be fit for the future, greenfield hospitals should be designed in a way that makes them nimble, futuristic, and adaptable for the next 20 to 30 years. Remaining unchanged is not an option for existing hospitals. It is necessary to phase in new technologies, rethink how they work with other healthcare providers, and outsource activities to others who are better able to do so. Analyzing the factors driving the development of smart hospitals, defining future-ready smart hospital characteristics, and discussing the implications for hospital investors and operators, we hope to shed light on what is driving the development of smart hospitals. Smart hospitals have been widely adopted to date, as shown in the sidebar.

Trends driving smart hospitals

Smart hospitals are being shaped by five important trends worldwide:

Manage health instead of treating diseases.

Over the past few years, health management has moved from disease treatment to wellness, healthy living, and disease prevention. Health care demand is rising due to longer lifespans and healthier lives (and insurers are losing money in some cases because of this). Globally, many countries are moving toward health management. As an example, the Singapore government has established a health promotion agency that encourages citizens to live a healthy lifestyle through the dissemination of evidence-based information and disease prevention programs at schools, at work, and at home. A healthy diet, regular exercise, and preventive screening all help reduce the likelihood that any diseases will develop (or progress) and that hospitalization will become necessary. As part of the overall patient care pathway, the Board also places greater emphasis on nonhospital segments that help residents avoid and avoid hospitalization.

Quest for clinical outcomes and quality.

Healthcare is full of diagnoses and treatment errors, no matter how shocking it sounds. As a result, about ten percent of deaths are associated with erroneous diagnoses in the U.S. More than one-third of orthopedic surgeons will conduct a wrong-site surgery at least once during their careers. Developing countries may have even higher misdiagnosis rates as well, according to reports.

It has been estimated that even in developed countries, at least seven out of 100 hospitalized patients contract a hospital-acquired infection each year. Every year, more than $210 billion are wasted on “unnecessary services” in the US alone. These statistics show that hospitals as the major site of care delivery need fundamental reform to improve the quality of care. AI and robotics can significantly improve the precision of treatment and reduce the likelihood of errors.

 

Where smart hospitals stand today

Health services are being ” tailored” (outpatient settings are becoming more common).

In the past, hospitals were regarded as one-stop shops that provided everything to everyone. The role of hospitals is increasingly being shared by multiple other facilities (i.e., primary care providers, clinics, pharmacies, rehabilitation centers). Some leading U.S. retail companies, for example, offer a variety of routine medical testing and treatments through retail clinics. The government of China is now shifting its focus to primary care by building a family physician network and creating community clinics, as its medical resources have traditionally been concentrated in tertiary hospitals.

As outpatient care becomes more common, new technologies become a key component, since they make it possible for different entities to communicate better and improve the quality of care.

 

Patients are becoming more informed.

As patients become more informed and empowered, healthcare decisions are being made with greater ease around the world. As education and literacy levels rise in some countries, this change is fuelled by a more connected society that increasingly uses digital devices and the internet. Many healthcare providers see this as an opportunity to be more patient-centric. Patients no longer expect passively to be treated, but instead, expect to be informed and actively involved when it comes to making their own decision. The patient and the provider often make decisions together about hospitalization. Hospitalization is an option that patients can choose if they can afford it and if they would prefer alternative treatments. With new technologies, such as online consultations and multidisciplinary teams, hospitals are becoming more patient-centric.

Accountability and value are now at the forefront.

In most countries, healthcare costs have been increasing. US healthcare spending has exceeded 17 percent of GDP each year for the past decade. The cost of healthcare has been increasing year over year, even in a country like China, where six percent of its GDP is spent on healthcare, and this has led to problems for many provinces and cities.

Payer-provider risk sharing has been tested in a range of health systems as part of a reform methodology that prioritizes value. The United States has created episodes of care; China is implementing diagnosis-related group (DRG) schemes nationwide. We found that digital interventions that support connected electronic health records (EHRs), hospital automation, and care coordination can enhance payment reforms and provide considerable savings. Furthermore, in developing markets versus mature markets, there is probably greater potential for value creation because digital devices could allow hospitals in developing countries to leap ahead of older methods of providing care.

Smart hospitals have a distinctive look and feel

Healthcare delivery is not the sole responsibility of smart hospitals; instead, they offer a narrower range of highly valued services within a broader ecosystem of entities, many of which aren’t affiliated with it. Patients may receive preventive healthcare and healthcare management programs in clinics, gyms, or even at home. Additionally, ambulatory centers provide minor medical procedures. Independent centers provide diagnostic services (imaging and lab work). In addition to major surgeries, intensive care, management of severe trauma, and treatment for other severe, acute conditions, hospitals do not provide other types of care.

 

Smart hospitals are characterized by five features:

The smart hospital ecosystem is digitally connected.

 

 

A smart hospital is part of a broader ecosystem of providers, payers, and healthcare data platforms. It is essential that all entities share patient data (as permitted by law and while protecting patient privacy) in order to provide efficient and convenient health care for patients.

An ecosystem like this would look something like this:

• A primary care provider or independent service center collects personal health records. In any information system, these records are the foundation. Personal health records are updated with information from hospital EHR systems.
• Hospitals and other stakeholders can share data in real-time through the information system. Furthermore, health data can be used to integrate with payer data (claims and payments) and government/technology data relating to health behaviors (data on government programs and businesses).
• The standard, structure, and rules for the collection, storage, transmission, use of data, in addition to the principles of data connectivity, must be agreed upon by all entities (including hospitals). Data must be used appropriately and kept secure to protect the privacy of patients.
• Interactive equipment (e.g., wearables) is used within hospitals to collect, track, and transmit real-time data by patients and the staff engaged in clinical care. Mobile devices enable clinical staff to access the data more efficiently as well, allowing them to perform clinical operations with greater efficiency. Australian Adventist Hospital, for example, has evolved into a digital hospital complete with e-prescribing software, virtualized data centers that collect and centralized patient information, and a mobile app that allows clinical staff to view information within seconds.
• It is at smart hospitals’ discretion whether to integrate data, store it, and make it available to others (to the extent permissible by law). As data aggregators, governmental agencies or payers in other systems enable smart hospitals to track patients’ lifetime care across all settings of care. For hospitals to be able to manage inpatient care and oversee post-discharge interventions, connectivity is fundamental.

Automation is a major factor in smart hospitals.

Labor has traditionally been a significant part of hospital care. By using a variety of devices, smart hospitals are able to improve their operations and automate workflows, thereby improving efficiency and accuracy in hospital care. Here are a few examples:

• Radio frequency identification Devices (RFID), bar codes, and other sensors are employed to improve internal asset management and track people and materials in real-time.
• As a result of automation, staff can devote more time to direct patient care throughout their day. Automation is used to improve efficiency, both in the front-office and back-office.
• Managing patient records online, allocating capacity electronically, and tracking the services provided by the hospital online improve efficiency.

 

Hospitals across the globe have already experienced the benefits of automation. Hospitals in Canada use robotics and digital technology to improve patient care, enhance laboratory and pharmacy services, and automate nearly 80% of back office functions, including laundry and food delivery. A positive impact on productivity and quality of care was achieved as a result.

Patient-centric hospitals provide better patient experiences.

In order to increase patient satisfaction, new healthcare technologies are being introduced. As a matter of fact, smart technologies have the potential to enhance the patient experience before, during, and after hospitalization. Here are some examples:

• Wearables and remote-sensing devices can be used by patients to monitor their blood pressure before treatment. In the event that something is unusual, the devices will send the patient an automated warning. The patient can then upload their blood pressure data and communicate with online staff about appointments.
• In addition to an ID card, fingerprints, and facial recognition can be used to establish the patient’s identity when he or she arrives at the hospital. Patient records are automatically populated with notes on the type of insurance the patient has, and the system welcomes the patient. Upon entering the system, the patient is given instruction on how to proceed, what tests will be done, and how to follow instructions. The results are delivered to the patient automatically following the completion of the exams.
• A cloud platform can aggregate all of the patient’s data after treatment is completed, enabling a report to be produced on the current treatment. A mobile device can be used by a patient at any time to access the results. Besides sending notification about upcoming services, insurance, and medication adherence, the device can also send reminders about medication adherence.
• A telehealth platform is also used to monitor the progress of the patient’s recovery and provide any necessary consultations.

 

A number of digital apps at Cleveland Clinic Abu Dhabi (CCAD) are used to enhance the patient experience at the clinic. The apps can be used by patients to communicate with their doctors and finish all admission procedures before their admission. In hospitals, patients can use smart pads to access detailed clinical information, order meals, and access treatment plans. At discharge, CCAD sends drug prescriptions directly to patients’ pharmacies and allows them to check their hospital bills and confirm their discharge times by using mobile apps.

 

Analytics and big data are driving smart hospitals.

It is not always possible for hospitals to harness the full potential of analytics on their own. It would be beneficial to them if they had access to the clinical data gathered by other entities in the health ecosystem. To protect patient privacy, the collection of data must be based on both the legal requirements as well as the privacy protections. As a result, hospitals are able to make significant improvements in treatment quality and operational efficiency when they are able to access data via digital connections easily. They can use analytics to quickly diagnose diseases, identify and manage risk early, and maximize the use of key facilities. Among the applications are:

• With deep neural networks and image analysis, deep learning can help diagnose a variety of diseases with an accuracy rate that is comparable to human physicians.
•  In China, for instance, Sir Run Run Shaw Hospital, the largest hospital to be accredited by the Joint Commission International, began using artificial intelligence to diagnose liver disease in 2012. Chinese and American researchers recently demonstrated that deep learning techniques can be used to process large amounts of EHR data and achieve an accuracy rate comparable to that of doctors who have been in practice for a long time.
• Clinical records are used for big data analytics to help patients who require early intervention and care. Behavioral, medical, and claims data can be used to build predictive models for identifying high-risk patients for readmission to hospital or chronic disease progression, both in developed and developing markets. Then, preventive programs or interventions tailored to target patient segments can be designed. It is common for developing markets to lack high-quality data; however, we have learned that programs can be designed better when they are designed based on data from just a few years of claims information.
• Furthermore, big data analytics can help improve operating room schedules by integrating a variety of variables from hospital records (such as the time required for various procedures and the time it takes to transport patients). Consequently, idle time between procedures can be reduced.

Interdisciplinary, holistic hospitals are at the forefront of healthcare innovation.

Intelligent hospitals are not IT projects, even though advanced IT technologies are needed. As such, it is a holistic, deep-rooted process involving all members of the health care team, including physicians, nurses, and managers.

The ability to detect potential problems quickly-and identify, design, pilot, and deploy solutions as quickly as possible-also depends on open collaboration. Continuing to improve clinical processes, quality of care, and patient experience while keeping costs under control are all the things that can be achieved through this approach.

One of the best examples of a system-wide effort is provided by Intermountain Healthcare, an integrated system in the US with a track record of continuous quality improvement. Local and regional clinical teams evaluate and develop new care programs, conduct analyses, identify and manage prevention challenges in priority disease areas, and evaluate effectiveness once the programs are implemented. A physician, nurse, statistician, data manager, and staff in medical informatics, finance, and other areas all take part. A rigorous development process and the involvement of diverse experts ensures that care delivery is rationalized, optimized, and improved.

Investing in and operating hospitals: implications

Health systems with smart ecosystems need sophisticated IT systems capable of allowing entities to share information in order to function. Private organizations have succeeded in creating similar systems. However, government assistance is required in many cases.

Governing bodies

Regional governments are already responsible for designing healthcare systems in many developing markets and investing heavily in hospitals.

Governments can take advantage of their administrative power to support a smart, decentralized healthcare system in these cases. Governments in regional areas should consider taking the following steps:

• Plan the overall strategy. Implementation of policy guidance that favors decentralization instead of building massive, comprehensive hospitals could be done by a government that wishes to take a more nuanced approach to develop smart healthcare ecosystems. The system could then be overseen while all stakeholders are given the opportunity to participate. The government can encourage cooperation between all stakeholders by allowing them to leverage their strengths.
• Develop a platform for integrating networks. Bringing an IT system online may require government involvement in some countries. Building the system requires more than just appropriate resources. Network connectivity isn’t enough – the providers need the ability to share data, which means operational and data standards must be established. Additionally, government involvement may ensure the creation of data centers that are capable of integrating and storing all of the patient’s information with appropriate controls to ensure confidentiality and correct use. As a consequence of these developments, some cities and regions might be able to build their own health system; in these circumstances, the government could make sure that new technologies are integrated in the health data infrastructure (typically, this type of integration is complicated and expensive in existing health systems).
• Support mechanisms should be in place. To ensure effective information dissemination and alignment of stakeholders as part of a decentralized smart healthcare ecosystem, there are support mechanisms that are needed. Incentives (for instance, nonfinancial incentives) might be offered by payers to encourage patients to try innovative digital care tools or disease management programs.

Operating hospitals

The hospital operators (whether in the public or private sectors) play a crucial role in ensuring that a smart hospital functions effectively, although regional governments are often deeply involved in the initial creation of a smart healthcare ecosystem. Especially true for existing hospitals whose operators are facing significant staff challenges. To ensure transformation success, these operators need to think strategically, communicate to their staff that vision, and help the staff develop the capabilities they need.

Operators of hospitals are encouraged to take the following steps:

• Develop an ecosystem for smart healthcare. By contributing to the ecosystem, hospital operators can take advantage of a wider range of options to position their facilities within the ecosystem. An operator should identify diagnosis and treatment services that other entities do not offer, and determine how the hospital can efficiently deliver these services with the highest level of quality rather than trying to provide all services.
• The future of smart hospitals will not be about the goal of becoming smart, but rather how to differentiate themselves and innovate. Instead of blind investments centered on hardware upgrades, sustainable smart hospitals should have a clear vision, roadmaps, and executed processes that make their vision a reality (e.g., becoming the nation’s premier cardiology center).
• Foster a culture of innovation. Additionally, hospitals must continue to innovate so as to improve their patient outcomes in addition to incorporating innovative technologies. Hospitals can only go so far with sophisticated hardware and software. Operators of hospitals can consider taking these steps:
  • Embrace collaborations with universities, research institutes, and innovative technology companies that will encourage the staff to innovate and improve the quality of care.
  • Create a similar collaboration with government agencies, opinion leaders, and industry unions to encourage the staff to think about healthcare delivery in a broader context.
  • To develop the capabilities needed to ensure that the best outcomes are achieved, invest extensively in hospital staff in order to deepen their knowledge of what smart hospitals and smart ecosystems can do. When change management is as important as the changes themselves, the best results are often achieved. Both clinic and nonclinical staff need to be addressed in terms of their minds and cultures.

Ultimately, the hospitals of the future will look much different from the ones of today. Healthcare interventions will no longer be provided by hospitals primarily as a central point of care (or in some countries, only via smart hospitals). An agile, efficient system will connect smart hospitals to a broader ecosystem of providers to deliver additional care services. A patient’s experience will be more integrated and patient outcomes will be better in a smart hospital where the clinical staff is digitally enabled.