Anatomy of a Smart Hospital: Innovations in Patient Care
Aug 25, 2023
Brian Eastwood is a freelance writer with more than 15 years of experience covering healthcare IT, healthcare delivery, enterprise IT, consumer technology, IT leadership and higher education.
There’s a perception by some that the healthcare industry lags when it comes to technology, but in fact, there’s a longstanding tradition of innovation in the industry. Hospital-based telemedicine dates to the 1950s, the first electronic health record system emerged in the 1970s and robot-assisted surgery debuted in the 1980s.
Today, technology previously imagined in science fiction is increasingly common in hospitals, whether it’s predictive analytics for clinical decision support or ambient artificial intelligence to process clinical notes. Hospital rooms also are adopting applications found in modern homes, such as voice-controlled lighting and multipurpose video screens.
How are these smart hospitals growing and reimagining patient care? Houston Methodist, for example, already has an impressive ranking on Newsweek’s World’s Best Smart Hospitals 2023 list, but the health system’s leadership hopes that its new hospital will push it even further up the list.
A 5G network will blanket the 105-acre suburban campus of Houston Methodist Cypress Hospital. Each patient room will be part of two wired networks: a front end for Epic, PeopleSoft and other business apps, and a back end for mounted cameras and other medical devices.
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Due to open in early 2025, the new hospital is poised to change the way clinical staff care for patients. What won’t be new: up to 95 percent of the technology in place. From virtual care to wayfinding and integrated voice response in the call center, the technology to run the new smart hospital is in use or soon to be piloted at the health system’s other eight campuses.
“We think of Cypress as the landing point, not the departure point,” says Murat Uralkan, director of innovation at Houston Methodist Center for Innovation. “We know that we want to lead medicine with innovation. Cypress gives us a unique opportunity to implement everything we’re working on in one place without retrofitting an existing facility.”
Houston Methodist’s new hospital represents a growing trend in healthcare: bringing together previously disparate innovations and enabling technology to support the patient journey from beginning to end, inside and outside hospital walls.
One major challenge to building smart hospitals has been a piecemeal approach to implementation. Technology that works for one business unit might not work for another, let alone an entire organization.
Three things signal a change, however. One is a growing willingness to integrate innovation with operational, clinical and IT decision-makers rather than treating innovation as its own department. “Innovation is everyone’s responsibility; it’s not just a few people,” Uralkan says.
The second is a significant decrease in the cost of storage and computing power. Just five years ago, it would take months to find the servers that could fulfill a request to process a few terabytes’ worth of data, says Sameer Sethi, senior vice president and chief data and analytics officer at New Jersey-based Hackensack Meridian Health.
Now, he says, “Our CTO just swipes his credit card. We can scale up innovation very quickly.”
The third shift pushing smart hospitals forward is focusing less on what a product can do and more on what problems need to be solved; this was exemplified by the COVID-19 pandemic response in healthcare.
Through a cloud infrastructure partnership with Google, Hackensack Meridian Health was able to deploy more than 3,000 Chromebooks running Citrix in a matter of days to support remote work in March 2020.
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“The problem in healthcare is that you have to pivot very quickly. Analog and paper and even on-premises data centers never allowed us to pivot that quickly,” says Mark Eimer, senior vice president, associate CIO and CTO at Hackensack Meridian Health.
Both Hackensack Meridian Health and Houston Methodist first implemented and then expanded virtual nursing pilots amid the pandemic as well. Health system leaders saw nurses slammed with administrative work during admissions and discharge. Amid a significant nursing shortage projected to hit 450,000 as soon as 2025, Eimer says, it was imperative to limit burnout.
Virtual nursing, with staff working remotely and dialing into patient rooms for admission or discharge interviews or observation, quickly proved popular.
“Within two weeks, the units piloting the program said, ‘Don’t take this away,’” Houston Methodist Cypress Hospital CEO Trent Fulin says. “Word spread, and it started to snowball. Everyone started to see the value of the technology.”
Hackensack Meridian Health further coupled virtual nursing with medical-grade wearable devices to support real-time vital sign monitoring. This eliminated the need for frequent rounding, allowing nurses to focus on value-added tasks, Eimer says.
It also augmented clinical insight: “Collecting the data in real time and digitizing it quickly helps drive our evidence-based reporting,” he adds.
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Even if organizations can quickly roll out initiatives such as virtual nursing, enterprisewide mobile device deployment or real-time monitoring, it typically takes years to build the infrastructure that makes a smart hospital possible.
“I look at it through the lens of a developer building a neighborhood. First, you lay the pipes and the plumbing. Then, each lot gets the utilities,” says Jim Francis, CTO and vice president of IT at Houston Methodist. “That gets overlooked. People want to do virtual health, but a lot has to occur before you can do that. There’s a lot of infrastructure to support video and audio. You need a power source for those devices. You need to get the data back to the data center.”
Dr. Michael Roebuck, chief medical informatics officer at Hurley Medical Center, points to the Flint, Mich.-based hospital’s Epic implementation in 2010 as a starting point for its smart hospital journey. From then on, hospital leadership had a “shared vision” of leaning on technology investments to advance quality, safety and efficiency.
“When you talk about building workflows that leverage technology and enable those outcomes and you take a step forward every day, at some point, you become a smart hospital,” he says.
Jim Francis CTO and Vice President of IT, Houston Methodist
For Roebuck, the future of the smart hospital is one where technology helps clinicians interpret the billions of data points now available from remote monitoring devices.
“In our neonatal ICU, we get pulse oximetry readings every five seconds. That’s a lot of noise, but within those thousands of readings, there might be a signal that separates one patient from another,” he says. “That will be when we realize the benefits. How do we find the 10 data points that matter and deliver them to clinicians?”
Hackensack Meridian Health is looking even further ahead. Its smart facility, the Helena Theurer Pavilion, is used for surgery and intensive care. Outside its medical center campus, the health system plans to build dozens of health and wellness centers, with services varying based on what the demographic data determines a community needs.
“We want to make sure we’re enriching, enhancing and reaching out to our communities,” Eimer says.
Meanwhile, Houston Methodist is eagerly anticipating its coming state-of-the-art facility. “But we’re not waiting to do everything there,” Fulin says. “We’ve been talking for several years about how to use the latest technology. Now, we’re finally putting the pieces in place, and each hospital in our system is actively participating in this work.”
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