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Peter Mcmahon digital by design
Peter Mcmahon digital by design
Peter Mcmahon digital by design
Peter Mcmahon digital by design
Peter Mcmahon digital by design
Peter Mcmahon digital by design
Peter Mcmahon digital by design
Peter Mcmahon digital by design
Peter Mcmahon digital by design
Peter Mcmahon digital by design
Peter Mcmahon digital by design
Peter Mcmahon digital by design
Peter Mcmahon digital by design
Peter Mcmahon digital by design
Peter Mcmahon digital by design
Peter Mcmahon digital by design
Peter Mcmahon digital by design
Peter Mcmahon digital by design
Peter Mcmahon digital by design
Peter Mcmahon digital by design
Peter Mcmahon digital by design
Peter Mcmahon digital by design
Peter Mcmahon digital by design
Peter Mcmahon digital by design
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Peter Mcmahon digital by design

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  • 1. © Copyright 2012 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. DigitalbyDefaultor DigitalbyDesign Peter McMahon
  • 2. © Copyright 2012 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice.2 HP Confidential Hospitals face substantial challenges Increasing healthcare costs Improving quality of patient care Low productivity, stagnant even declining Regulatory imperatives Clinical staff shortages
  • 3. © Copyright 2012 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice.3 HP Confidential Where do we need to improve? 20-40% 2 WHO’s estimate of all health spending wasted through inefficiencies in the system 19.3% 1 The average proportion of time a nurse spends on direct patient care during the active nursing part of a shift 5.4% 3 Average annual increase in recurrent health expenditure in Australia 1 A 36-HospitalTime and MotionStudy: How Do Medical-SurgicalNurses Spend Their Time? Permanente Journal, Summer 2008 2 World Health Report (2010), BackgroundPaper 28, data sourced from WHO National Health Accounts 2009 3 The Australian Institute of Health and Welfare 2010: Health expenditure Australia 2008-09. Health and welfare expenditure series no. 42. • Improve productivity • Reduce inefficiency • Spend the $ wiselywitha view to sustainability
  • 4. © Copyright 2012 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice.4 HP Confidential Considerations in new facility Limited funding and focus needs to cover: • The building itself – with considerations for a 70 year + lifespan • Patient experience and flow • Clinical department considerations • Changing demographics and long term sustainability • Integration of research and teaching organisations • New equipment – F&F, biomedical, communications, building systems, patient interactive, end user devices • Pharmacy, lab, imaging, outpatients, ED, ambulatory … Oh, and your Information & Communications Technology (ICT)
  • 5. © Copyright 2012 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice.5 HP Confidential What you will invest in – by default… PAS CIS LAB RAD
  • 6. © Copyright 2012 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice.6 HP Confidential But wait, there’s more… PAS CIS LAB RAD Pharma CathLab NICU Onc Dietary Dept CISs AIS BYOD Nav
  • 7. © Copyright 2012 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice.7 HP Confidential So it seems you will have a “digital hospital” Your investment in clinical and operational technology means that the hospital will be “digital” whether you plan it that way or not; whether you allocate funding to “digital hospital” or not. So, will you be digital by default? Or digital by design?
  • 8. © Copyright 2012 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice.8 HP Confidential Without a plan, there will be piecemeal integration Technology“Hairball”Integration “Hairball” Costly to establish Costly to maintain Compromises agility
  • 9. © Copyright 2012 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice.9 HP Confidential Digital Hospital – by Default User access complexities, multiple/shared sign-ons and barriers to mobility for clinicians Inefficient use of infrastructure tools and technologies due to broad range of underpinning technologies Stretched ICT staff without critical support skills. Clinical staff performing ICT support functions. Disparate and incompatible applications & technologies with resulting integration challenges Constant pressure on budgets to do more with less, reduce ICT costs Unclear TCO/value of ICT services to the business Inadequate executive oversight of ICT investments Departmentally driven investment undermines need for enterprise wide interoperability Redundancies in a diverse application & technology portfolio
  • 10. © Copyright 2012 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice.10 HP Confidential What’s the solution? Devolve responsibility? • Let departments make their own decisions using their own budgets, after all they are the experts… Take control and dictate? • The only way to get an environment that is secure and works is to centralise it all… Or create an ARCHITECTURE (an enterprise architecture) that allows the digital environments within the hospital to integrate and to support the clinical and operational processes?
  • 11. © Copyright 2012 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice.11 HP Confidential Digital Hospital – by design To achieve this integrated and underpinning information fabric, you need a combination of architecture and technology.
  • 12. © Copyright 2012 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice.12 HP Confidential What is Possible Today
  • 13. © Copyright 2012 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice.13 HP Confidential HP’s Digital Hospital Maturity Model IT Domains Facilities Medical Communications Level 5 Adaptive Level 4 Managed Level 3 Co-ordinated Level 2 Connected Level 1 Initial Level 6 Optimised Speed Innovation to Practice, Improve Operational Efficiencies, Improve Quality of Care • Primitive building and security systems • Dependence on human surveillance • Building and security systems integrated • Single card based facility access • Tasks communicated electronically to mobile decides • RTLS location awareness • Closed loop task mgmt with escalation • Role-based two factor authentication • Demand based delivery of services • Bulk reconfiguration of security privileges in near real time • TBD • Stand alone modalities • Wholly paper Patient Record • Post-care updating of basic EMR • Modalities accessed and viewed separately to patient record • Ability to view some aspects of EMR from a central point • Modality/ Lab/Rad outputs attached to EMR • Full EMR update at point of care • Some clinical decision support • Modality/Lab/ Rad/ Meds fully integrated • Fully integrated EMR across facility • Support for personalised medicine • TBD • Dependent on wired telecomms • Manual routing of all requests • Combination of wired and wireless comms • Some requests rules based • Ubiquitous wireless • Comms routed and escalated automatically • Presence managed • Comms routed to nearest available • Device independent • TBD • Tribal • Opportunistic • Budget driven • Departmental • Rationalised • Virtualised • Facility-centric • Multi-Year Plan • Semantically interoperable • Care Community Oriented • TBD
  • 14. © Copyright 2012 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice.14 HP Confidential IT Domains Facilities Medical Communications Level 5 Adaptive Level 4 Managed Level 3 Co-ordinated Level 2 Connected Level 1 Initial Level 6 Optimised Speed Innovation to Practice, Improve Operational Efficiencies, Improve Quality of Care • Primitive building and security systems • Dependence on human surveillance • Building and security systems integrated • Single card based facility access • Tasks communicated electronically to mobile decides • RTLS location awareness • Closed loop task mgmt with escalation • Role-based two factor authentication • Demand based delivery of services • Bulk reconfiguration of security privileges in near real time • TBD • Stand alone modalities • Wholly paper Patient Record • Post-care updating of basic EMR • Modalities accessed and viewed separately to patient record • Ability to view some aspects of EMR from a central point • Modality/ Lab/Rad outputs attached to EMR • Full EMR update at point of care • Some clinical decision support • Modality/Lab/ Rad/ Meds fully integrated • Fully integrated EMR across facility • Support for personalised medicine • TBD • Dependent on wired telecomms • Manual routing of all requests • Combination of wired and wireless comms • Some requests rules based • Ubiquitous wireless • Comms routed and escalated automatically • Presence managed • Comms routed to nearest available • Device independent • TBD • Tribal • Opportunistic • Budget driven • Departmental • Rationalised • Virtualised • Facility-centric • Multi-Year Plan • Semantically interoperable • Care Community Oriented • TBD HP’s Digital Hospital Maturity Model Closed loop task mgmt with escalation Role-based two factor authentication Full EMR update at point of care Some clinical decision support Modality/Lab/ Rad/ Meds fully integrated Presence managed Comms routed to nearest available Virtualised Facility-centric Multi-Year Plan
  • 15. © Copyright 2012 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice.15 HP Confidential You need to recognise the real (hidden?) investment in ICT PAS CIS LAB RAD Pharma CathLab NICU Onc Dietary Dept CISs AIS BYOD Nav
  • 16. © Copyright 2012 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice.16 HP Confidential And DESIGN a sustainable approach to integration Pharma CathLab NICU Onc PAS CIS LAB RAD Dietary Dept CISs AIS Nav BYOD
  • 17. © Copyright 2012 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice.17 HP Confidential Creating a sustainable architecture and maximising ROI Integration Engine Staff Scheduling Staff Scheduling PayrollPayroll Materials Mgmt Materials Mgmt FinanceFinance EPR/EMREPR/EMR HIS/PASHIS/PAS PACS/RISPACS/RIS LISLIS MaternityMaternity OR Scheduling OR Scheduling Building Automation System Mechanical Lighting Hydraulic ChuteSystem Electrical Escalator Caroussel Vertical Transp- AGV Pneumatic Tube Building Automation SystemBuilding Automation System MechanicalMechanical LightingLighting HydraulicHydraulic ChuteSystemChuteSystem ElectricalElectrical EscalatorEscalator CarousselCaroussel Vertical Transp- Vertical Transp- AGVAGV Pneumatic Tube Pneumatic Tube Hospital/Clinical Information SystemHospital/Clinical Information System Active Directory VideoConfVideoConf VoIP Telephony VoIP Telephony Audit Repository Wayfinding& Signage Wayfinding& Signage KioskSoftwareKioskSoftware BedsideTerminalsBedsideTerminals PA-SystemPA-System BACNet, OPC, WS TAP,ESPA4.4.4 HL7/WS WS WS WS LDAP Dashboard/ NurseStation Dashboard/ NurseStation Unified CommunicationUnified Communication Video/Audio Video/Audio FireAlarmSystemFireAlarmSystem SecuritySecurity NurseCallNurseCall E-mailE-mail IMIM IVPumpsIVPumps MonitorsMonitors Power Systems Power Systems ……..…….. Medical Device Middleware Medical Device Middleware LocationSystemLocationSystem External OrganizationsExternal Organizations Staff Sup. Service NurseClinician Patient • Take work out of the system • Intelligent workflows • Actionable alerts • Value adaptability and standards
  • 18. © Copyright 2012 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice.18 HP Confidential The HP digital hospital solution and approach reduces costs Integrated environment Systems used more efficiently and effectively More timely and accurate information Service oriented architecture environment
  • 19. © Copyright 2012 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice.19 HP Confidential Akershus University Hospital, Norway The hospital • Serving an aging population of 450,000 • Obsolete and failing facilities replaced The decision • Build the most modern university hospital in Europe, fully equipped with the latest digital technologies The results • 50% reduction in adverse events • 20% shorter length of stay • 20% increase in activity covered by only a 2.7% increase in staff
  • 20. © Copyright 2012 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice.20 HP Confidential Example of integration between a StateCo & ProjectCo Integration Engine: A Model to Consider • Integration of State Health ICT systems is a StateCo responsibility via a Health Information Broker (HIB) • Integration of ProjectCo systems is a ProjectCo responsibility via the HP Integration Engine (IE) • Orchestration and Choreography between StateCo and ProjectCo is achieved and simplified via interfaces between the IE and HIB ProjectCo Systems StateCo SystemsIdentity and Access Management IPPABX Real Time Location System Security Audio Visual Systems Facility Service Management Catering Building Management Systems Nurse Call Wayfinding Logistics, AGV, Pneumatic tube Identity and Access Mangement Patient Administration System Pharmacy Pathology Radiology Help Desk Supply Chain Linen Supply IntegrationEngine HealthInformationBroker EHR/EMR Other Clinical Systems Orchestration Choreography Events Reference Data Metrics Correlations Asset Management Asset Management ProjectCo Processes StateCo Processes
  • 21. © Copyright 2012 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice.21 HP Confidential ICT: a small cost centre • The bulk of costs are salaries (66%) • Goods supplies 14% • ICT is a small part • ICT is the KEY to making personnel more efficient, data more accessible and reducing overall TCO Pay cents to save dollars Source: Australian Institute of Health and Welfare, Recurrent expenditure, public hospitals, 2009–10 ICT: a component of Administrative expenses
  • 22. © Copyright 2012 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice.22 HP Confidential
  • 23. © Copyright 2012 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice.23 HP Confidential Conclusion When planning a hospital, the quality of the interactions between different stakeholders, care providers and areas of the hospital as they support the patient journey will be one of the determinants of outcomes and efficiencies. ICT has a role to play in the quality of those interactions. So, a planned “Digital Hospital” is one of the opportunities to increase productivity and improve outcomes in the health system, and it’s a proven way to drive efficiency and save money. This won’t happen by default. The journey has to consider all aspects of the hospital – not just medical or communications, facilities or ICT; it’s the interaction of the various domains that releases the real value. Nothing happens in isolation… So, when you are planning your hospital, understand that you will be a digital hospital but that the choice – “digital by design” or “digital by default” is yours.
  • 24. © Copyright 2012 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice. Thankyou. Questions? pmcmahon@hp.com

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