Rethinking Innovation in Hospitals

Transcription

1 Rethinking Innovation in Hospitals The Mackenzie Health Experience Altaf Stationwala, President and CEO, Mackenzie Health February 6, 2018

2 Canadian Health System Publicly funded health care financed through taxation Federal government establishes the criteria for health insurance plans (national level) Covers medically necessary hospital and doctors services Drug coverage is starting to evolve Provinces have the most responsibility for delivering health and social services Administration of health insurance plans Health services provided by doctors and other health professionals Negotiation of fee schedules with health professionals Planning and funding of care in hospitals and other health facilities Planning and implementation of health promotion and public health initiatives 2

3 Ontario Health System 14 million people live in the province of Ontario with over 6 million in the Greater Toronto Area The Ministry of Health oversees funding for health services across Ontario. Ontario is divided into 14 Local Health Integration Networks (LHINs) which are responsible for planning, integrating and funding local health care. Each LHIN consists of Sub-Regions which are smaller geographic planning regions to focus on addressing local patient needs. Hospitals are funded through Health System Funding Reform (HSFR) which links funding to volume and quality of care. 3

4 Mackenzie Health: Quick Facts Serve over half a million residents across Western York Region PEOPLE SITES 450+ Physicians 2,600+ Staff 1,000+ Volunteers 2,000+ new staff to be hired for Sites in 2020: Richmond Hill and Vaughan SERVICES Hospital Beds MRHH: 515 MVH: ,500 Emergency and Urgent Care Visits 243,441 Outpatient 19,376 Admissions 9,359 Surgeries 200,938+ Diagnostic Exams 2,305 Births 4

5 Key Timelines What s next Received Approval to build new hospital Developed Strategic Plan Start of Established Lean Mi 2 Innovation journey Institute Product/ Concept Testing in Innovation Unit Advanced Clinical Managed ICAT Services Transformation (MISP) Managed Equipment (MESP) Innovation for Support Services Building Blocks for a Smart, Two Site Model 5

6 Innovation and smart systems are key enablers to achieving our strategic plan POWERED BY: GREAT PEOPLE INNOVATIVE THINKING SMART SYSTEMS 6

7 A Problem and a Unique Opportunity In the hospital, people, processes and technology all have an important role to play in delivering quality care. We found MOST things don t talk to each other Clinical, business and building systems were operating in separate silos. This presented a unique opportunity for taking an integrated approach. 7

8 Building Smart Hospital Infrastructure Traditional Approach Smart Hospital Approach Business Building Clinical Business Clinical 8

9 Developing the building blocks to implement a smart hospital vision 9

10 Mackenzie Innovation Institute (Mi 2 ) Fostering Partnerships Developing strategic partnerships with healthcare innovators Developing Solutions Collaborating with clients to develop solutions that improve quality care Providing expertise in disruptive innovation Source for implementation and evaluation of disruptive innovations 10

11 Investment in Technology Infrastructure First in Canada Hospital modular data centre as used by large technology giants Full adoption of Epic as our EMR platform is key to realizing the Smart Hospital vision Secured medical grade platform networked for unified communications Serving needs of today and scaling up to a two-site model

12 Innovation Unit: A Sandbox for Scalable Innovation Ideate, develop, iterate, implement and test solutions before wider scale roll out Smart Badges (RTLS) Hand Hygiene Tracking Data Centre Smart Infusion Pumps Mobile Phones Smart Beds 12

13 Managed Equipment Services (MES): Philips Strategic partnership of $300M over 18 years. Access to advanced technology, equipment, and infrastructure for medical equipment Philips to provide full suite of services including procurement, installation, maintenance, training and on-site technical support for all equipment in the agreement MES Objectives Address pitfalls in not having cut sheets early enough Ensure quality across both sites Kick start long-term renewal for major equipment Two site model provides scale to make deal possible 13

14 Managed ICAT Services (MIS): Compugen Provides infrastructure and services for the devices, network, security and technology management of the new hospital. An integrated smart layer enables unified messaging across systems. Enables integration of cuttingedge healthcare technologies and connectivity both, inside and outside of the hospital walls. SMART Layer Objectives Ensure quality across both sites Establish flexibility and integration Guarantee long term arrangement 14

15 Advanced Clinical Transformation enabled by Epic Fully integrated EMR that has transformed delivery of patient care Embedded within operations to enhance care workflows Ability to document at bed-side Patients can easily access medical record through web-based platform Shift from EMRAM Stage 3 to 6 to leverage technology as an enabler 15

16 Bringing together the building blocks for a Smart Hospital 16

17 Smart workflow in action: Code Blue Fully integrated smart technology systems and devices speak to exchange information Bring Elevator to the Team s Location Hold Narcotic Infusion Notify Critical Care Response Ream Display Patient Summary on Electronic Screen Modify Bed Position For illustrative purposes only. Turn Off Room Alarms When Team Arrives 17

18 Managing change: patient centred design is the basis of our transformational model Innovation in healthcare has a significant patient and provider impact Mobilizing stakeholders for change is critical for success Voice of the Patient Engagement Patient Family Advisors Governance Ensure accountability Manage risks Clinical Ownership Active clinical involvement Embedded in operations Project Support Teams Project management Technical expertise 18

19 Key success factors for sustainability Use of Lean techniques and Back to Basics approach to engage end users in developing solutions to improve workflows Innovation embedded into operations with a patient centered focus Ongoing plan and support resources to test, evaluate and optimize leveraging feedback from end users Workflows have changed and incentives have not. Strategic Issues: Determining at what point we should make changes Important to align change with practice 19

20 Next Steps: Epic Optimization + Smart Workflows Epic as a Platform Opportunity for system leadership Opportunities for innovation: Mobile Healthcare in the Home Predictive Analytics Integration with Value- Added Service Providers Building Smart Workflows Integration with Building, Business and Clinical Management Systems Code Blue Triage Alerting Bed Allocation Decision Support Laboratory + More 20

21 Integrated Healthcare Delivery Model Smart within our hospitals And across our communities 21