Box Hill Hospital: The Trials, Tribulations and Achievements of a Digital Hospital HIC - Digital Hospital Design Melbourne Convention & Exhibition Centre 25 July 2016 Zoltan Kokai B.Bus (Accounting)/ B.Comp (Info. Systems) MBA AIMM HISA Executive Director, Corporate Projects & Sustainability Eastern Health Members of Eastern Health: Angliss Hospital, Box Hill Hospital, Healesville & District Hospital, Maroondah Hospital, Peter James Centre, Turning Point Alcohol & Drug Centre, Wantirna Health, Yarra Ranges Health and Yarra Valley CH
Eastern Health Digital Hospital Definition Box Hill Hospital Redevelopment overview Digital Hospital Achievements and Challenges Applicability to existing hospitals Top 7 ideas you might consider
Healesville Hospital Box Hill Hospital Peter James Centre As at June 2015 *Includes volunteers Yarra Ranges Health Maroondah Hospital Revenue: $880M Staff*: 9,604 Population: 750,003 Wantirna Health Angliss Hospital 7 Major Sites + 65 Community Sites/locations
Box Hill Hospital $447.5 M COMPLETE EMR Program (approx $19+M BHH ) -In Progress Maroondah Hospital PAPU $2.0 M COMPLETE Leverage Almost Capital Developments $520 M in in your Capital Digital Transformation Projects Maroondah Hospital Breast Cancer Centre $10 M -Documentation Stage Maroondah Hospital Car Parks Healesville & District Hospital Yarra Valley Community Health -$8.8 M -On Track early 2017 Maroondah Hospital MRI $5.0 M COMPLETE Angliss Hospital ICU & ED Expansion $20 M -Post Tender Stage
MAJOR CORE INFRASTRUCTURE INVESTMENT & BASE SYSTEMS FOCUS SYSTEM CONNECTIVITY, ACCESSIBILITY & MOBILITY FOCUS DIGITAL TRANSFORMATION FOCUS INFRASTRUCTURE REFRESH & DEPARTMENT SYSTEMS FOCUS Planning for the Digital Transformation Commences Before new hospital Eastern Health Great Digital Information Strategy 2015-2020 2000 2005 2010 2015
The digital hospital is defined as a framework of hardware, software, partner point solutions, and consulting services that lay the foundation for the digital transformation of healthcare service delivery. Duffy and Holland, Health Industry Insights Mar 1, 2009 7
The Box Hill Digital Hospital Experience Traditional Hospital Hospital Infrastructure Electronic Hospital People, Process & Knowledge Digital Hospital Information, Communication & Technology Virtual Hospital
Digital Hospital The convergence of building infrastructure, information, communication and technology with integrated applications, an electronic medical record and clinical processes to enable delivery of superior patient outcomes through enhanced knowledge.
Box Hill Hospital Digital Hospital Planning Box Hill Hospital ICT Priorities Medication Dispensing Automation Fault Tolerant Data Centre, Server and Comms. Infrastructure Building System/ICT Integration Unified Messaging Barcode Technology Patient Entertainment System/Clinical Terminal Core EMR/Device Integration
Slide 13 As the major referral centre for people living in the eastern region of Melbourne, the redeveloped Box Hill Hospital is a contemporary facility, attracting the finest staff to deliver best-practice models of care. Eastern Health and the Department s vision was to create a technologically advanced healthcare facility
Wayfinding Technologies to Support Patient/Visitor communication/ movement (supported via a Business Service Centre) Room Booking Technologies
Eight generic wards (levels 5-9) each with similar layout Ward clerk station is easily located upon ward entry Security swipe access for ward entry after-hours 50 per cent of the patient rooms are single bedrooms Keeping clinicians by the bedside (Smart technology, vision into rooms, storage, wireless phones) Keeping things simple (consistent placement of equipment, phone numbering convention)
Wifi access PES/ Clinical Terminal -Integrated to Pat. Admin Sys -Meal orders -Messages to patients -View Only Patient Info from EMR Standardised & Integrated Nurse Call All new latest technology Hill-Rom beds supporting patient safety, mobilisation and skin care
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Patient Room and Operating Theatre Integrated Nurse Call and Communication -Excellent Technology -Operating Theatre communication very useful -Patient handset to Wifi Nurse Phone Fantastic -Interoperability of call buttons with existing workflow systems can be an issue
Complex Communication Integration may cause Issues between devices if not configured correctly
Integration of Legacy Technologies -Don t integrate pagers! -Clean up your communications directory -Have a strategy for managing legacy Fire Systems and Hospital Public Address/Emergency Management systems Just because you can doesn t mean you should!
Eastern Health Aspiration Eastern Health Today Most Victorian Hospitals
Release 1a Commenced Oct 2008 Patient Demographics Recording Allergies, Diagnosis, Problems, Alerts Integrated Results (Pathology and Medical Imaging inc PACS) Electronic Discharge Summaries Release 1b Commenced Aug 2009 Discharge and Outpatient Prescriptions including drug and allergy interaction checking Release 2 Commenced Aug 2011 Medication, Pathology and Radiology Orders BHH EMR Commenced Sep 2015 Advanced Clinical Documentation, Core Department Systems (ED, Surgery/Anaesthetics, ICU), Device Integration, Complex Medications
Staged Implementation along the EMR Maturity Model Means: -Pathology, Radiology, Medication Orders will be electronic HOWEVER -Clinical Notes can be on paper -Potential increased risk of hybrid records -Electronic Medication Management challenging
Data Centre, Redundant Comms. 1 Does not need to be owned!
2 Automated Pharmacy Dispensing 27
Patient Journey Board 3 28
EMR Including PACS Images 4 29
Devices and Mobility ONYX Win XP with IGEL 5a 6 year old Win XP with IGEL New Human Scale Trolley running ONYX All-in-One Battery Powered Computer 30
Devices and Mobility Spot Monitors with EARLY WARNING DETECTION WITHOUT EMR 5b WITH EMR 31
Virtual Desktop Single Sign On 6 32
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Digital Hospitals no longer a thing of the future Learnings Applicable to existing hospitals: 1. Fault Tolerant Data Centres and Communications 2. Automated Medication Dispensing 3. Patient Journey Board 4. Progressive implementation of an EMR inc PACS 5a) Mobility and Devices (WOWS, ipads, Surface Pros) 5b) Clinical Device Integration (Early Warning Monitors) 6. Virtual Desktop, Single Sign-On, Tap On Tap Off, Roaming 7. Room Booking Systems