In the Productivity Commission report “Shifting the Dial: 5 year productivity review ” released in October 2017, there is a chapter dedicated to Healthier Australians. Extracts from recommendations in this chapter include “collect and divulge data at the hospital Level” and “use My Health Record and other IT platforms to involve people in their choices”. These and other recommendations highlight the importance of innovation in data and digital systems within the broader Australian healthcare system.
To specifically address the need to future-proof the health system and hospitals in particular, Standards Australia published the Digital Hospitals Handbook (SA HB 163:2017) in June 2017. The Handbook is a world first and was an initiative led by the Australian Health Ministers’ Advisory Council (AHMAC) and the National Health CIO Forum (NHCIOF). The Handbook was prepared by Standards Australia technical committee IT-039 using the insights and expertise from a balanced representation of organizations across government, industry, and service provider groups such as the Departments of Health across Australia, Health Informatics Society of Australia, Australian Digital Health Agency, Engineers Australia, and many more.
Conceptually, a digital hospital is one that leverages comprehensive, pervasive IM & ICT to support clinical and administrative workflows as well as safety and quality improvements. Indeed the entire building is designed or adapted to support the new workflows.
The primary aim of a handbook is to design hospitals for technological change from the very beginning. By taking this approach the committee recognized that technology does and will continue to evolve, so interoperability of medical infrastructure becomes one of the underpinning principles.
That interoperability is the ability of one medical facility to share information with another medical facility using the same “language” in real time. This is essential if the benefits of digital hospitals are to be realised and deliver on the important goal of Healthier Australians as identified in the Productivity Commission report.
The committee recognised that hospitals aren’t just physical and technology environments. To make a hospital a successful digital hospital, there must be an acknowledgement and understanding that this extends to culture and workflow design as well as technology and building design.
This is an exciting and thoughtful approach about how to be successful in the modern world. By explicitly addressing culture in the key principles and recommendations, the handbook covers leadership, staffing, risk management and governance as well as communication, engagement and change management. All of these are points of vulnerability when bringing in new ways of working.
A culture that takes a whole-of-business transformation perspective where all disciplines (business, information management, technology, construction and facilities management) work in partnership to deliver outcomes will be the most successful.
Within the hospital there are specific systems and tools that will support the delivery of the digital hospital. These are:
• Care delivery using electronic medical records (EMRs) to ensure data is captured in real time and not relying on scanned documents.
• Patient services using patient management systems to manage patient workflows from admission to appointment scheduling right up to discharge and billing.
• Corporate services using enterprise management systems to support functions like HR, finance, facilities management, and staff rostering.
• Research and teaching responsibilities requiring data and document repositories.
• Smart ICT using the technology architecture of the hospital to track assets and read machine data remotely.
• Smart building elements covering the physical IT infrastructure like cabling, wireless communication systems, and energy supply and management systems.
The impact of the Productivity Commission report could be that all future hospitals are digital hospitals so that we can deliver on the important goal of Healthier Australians. And the Digital Hospitals Handbook provides a framework for hospital designers, administrators, and staff to deliver the sort of patient-centered care that will be needed in the future.