box hill hospital: the trials, tribulations and achievements of a … · information, communication...
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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
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
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
Box Hill Hospital
Maroondah Hospital
Peter James CentreAngliss Hospital
Yarra Ranges Health
Healesville Hospital
7 Major Sites
+ 65
Community
Sites/locations
Wantirna Health
As at June 2015
Revenue: $880M
Staff*: 9,604
Population: 750,003*Includes volunteers
Healesville & District
Hospital
Yarra Valley Community
Health -$8.8 M
-On Track early 2017
Angliss Hospital ICU &
ED Expansion $20 M
-Post Tender Stage
Almost
$520 M in
Capital
Projects
EMR Program
(approx $19+M BHH )
-In Progress
Maroondah Hospital
Breast Cancer Centre
$10 M
-Documentation Stage
Maroondah Hospital
MRI $5.0 M
COMPLETE
Box Hill Hospital $447.5 M
COMPLETE
Maroondah Hospital
PAPU $2.0 M
COMPLETE
Maroondah Hospital
Car Parks
Leverage
Capital
Developments in
your Digital
Transformation
2000 2005 2010 2015
MAJOR CORE
INFRASTRUCTURE
INVESTMENT
& BASE SYSTEMS
FOCUS
INFRASTRUCTURE
REFRESH &
DEPARTMENT
SYSTEMS
FOCUS
SYSTEM
CONNECTIVITY,
ACCESSIBILITY &
MOBILITY
FOCUS
Eastern Health
Great Digital Information
Strategy
2015-2020
DIGITAL
TRANSFORMATION
FOCUS
Planning for the
Digital Transform-
ation Commences
Before new hospital
7
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
Hospital Infrastructure
Information, Comm-
unication & Technology
People, Process & Knowledge
The Box Hill “Digital” Hospital Experience
Traditional
Hospital
Electronic
Hospital
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.”
Digital Hospital
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
• Keeping clinicians by the bedside (Smart technology, vision into rooms,
storage, wireless phones)
• Keeping things simple (consistent
placement of equipment, phone numbering
convention)
• 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
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
17
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!
Most
Victorian
Hospitals
Eastern
Health
Today
Eastern
Health
Aspiration
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 2011Medication, Pathology and Radiology Orders
BHH EMR – Commenced Sep 2015Advanced 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!
27
Automated
Pharmacy
Dispensing2
28
Patient Journey
Board 3
29
EMR Including
PACS Images
4
30
Devices and
Mobility
New Human Scale Trolley running
ONYX All-in-One Battery Powered
Computer
6 year old
Win XP with
IGEL
ONYX
Win XP with
IGEL
5a
31
Devices and
Mobility
Spot Monitors
with
EARLY
WARNING
DETECTION
WITH EMR
WITHOUT
EMR
5b
32
Virtual Desktop
Single Sign On 6
33
7
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
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