Digital Transformation: Reimagining the Hospital Experience

Last Christmas, I found myself in the emergency room and unexpectedly laid up in a hospital bed for the better part of a week. Fortunately for me, this is not a common occurrence. But it did provide a front-row seat to the entire patient experience and allowed me time to reflect on the many digital transformation opportunities to enhance it. It also gave me an appreciation for the great work done by nurses and doctors to bring me back to health.

No Shortage of Screen Time

Throughout my stay, there were six “screens” in use either by myself or the hospital staff:

• A computer with a barcode reader attached used by most visitors to my room to view or add information to my electronic health record (EHR)
• The requisite broadcast/cable TV in the corner controlled by the wired combination nurse call/remote control that constantly got lost in the bed
• The IV infusion pump
• The EKG, blood oxygen, and blood pressure monitor
• My cell phone’s six-inch screen with paired earbuds
• My Care Board (a whiteboard hanging on the wall with my information on it)

Why am I calling the whiteboard a screen? Because it was the most useful one of the six, despite often being inaccurate or hard to read. It held valuable information for visitors and me — the day and date, my name, my wife’s name and phone number, current nurse, primary and consulting doctors, nurse’s assistant (CNA) name and extension. It also indicated whether I could leave my bed or room on my own, what I could eat, my pain goal and plan, and other notes about medications or test samples needed.

Updating this information seemed to be an important ritual during CNA shift changes and with each new attending doctor who would introduce themselves to me. The quality of these exchanges was a lot better during the day. At night it would coincide with vitals being collected and entered by hand into my EHR, the scanning of barcodes on my wrist, and while administering medications.

The TV in the corner got turned on once to remind me how insufferable broadcast/cable TV with commercials is. I immediately switched it off in favor of watching movies on my cell phone. Because the medication I was on really messed with my sleep schedule, there was a LOT of movie watching done on that tiny screen.

I was also able to access my EHR records online. I would bring them up on the small screen to review them and learn more about their meaning. Often this happened before the doctor even came by to discuss the results. As you can see from the screenshot, it was a constant challenge to keep my phone charged while using it from my bed.

When I wanted something to eat, I looked up my options in a hard copy menu and picked up the hard-wired phone to call room service. They were responsible for knowing and enforcing my dietary restrictions, even though the system didn’t always reflect changes. Those delays matter when you haven’t eaten solid food in over a week!

Alarms sounded at all hours of the day. They would continue until I pushed a separate button to call a nurse to fix it. I was on IV fluids the entire time, and the bag would empty and set off an alarm every few hours — the other common one related to problems with the automated blood pressure cuff or pulse oximeter.

The simplest of things can be stressful when you’re sick. The constant flow of alarms and interruptions combined with the tedium of always waiting for the next thing can feel overwhelming.

Throughout this entire experience, one question kept coming to mind.

Why?

When you’re in the hospital, you have a lot of time to think. I found myself wondering a lot of things:

• Why am I sitting in a room with six screens and using the smallest one most of the time?
• Why is it easier to get food delivered to my home than to my hospital room?
• Why is it so hard to find outlets to charge things?
• Why are there three ways to reach my CNA, and which one am I supposed to use?
• Why do I have to hit a nurse call button and talk to someone at the nurse’s desk just to get a cup of water and then wait to see if they show up?
• Why does my identity need to be confirmed by handheld barcode scanning multiple times a day with every new provider?
• Why do alarms sounding in my room not get the attention of someone to address the problem? And why are false alarms so common?
• Why is the information on my whiteboard often missing, incomplete, or wrong?
• Why does the average hotel room costing $100–$200 per night have a better user experience than a hospital room that costs thousands of dollars a day?
• And, of course, the most important question: why is hospital food so bad?

Having said all this, I understand there are many systemic reasons why changes are hard to implement in a hospital, and I express my gratitude to the fantastic people who took care of me. Life-critical systems are FDA-regulated, costly, and slow to adopt, quickly falling behind consumer expectations.

Hospital-grade equipment is built for longevity. It still fulfills its primary purpose long after connectivity innovations and integrations with other equipment become commonplace. However, upgrading the software or hardware is remarkably expensive and time-consuming due to regulatory requirements. As such, “swivel chair” integration remains the most popular form.

Just Imagine If…

By now, it’s probably pretty clear what this engineer’s mind started to imagine. What if:

• Once plugged into my bed, my cell phone automatically charged and connected to Wi-Fi. It served as the hub for everything in the room related to my comfort and convenience, as it does with every rental car that supports Apple CarPlay.
• The instruments that collect vitals automatically updated my health record.
• When conditions triggered an alarm, no sounds occurred in the room. Instead, it automatically notified relevant staff.
• The TV mounted in the corner was a smart device. I could see my digital care board, cast movies or shows from my phone, or even peruse a menu of diet-safe food options and place an order.
• The digital care board had the same contact information but was also interactive. I could contact the current CNA or message the on-call doctor with questions about my care.
• My digital care board always displayed my next care activity. It also included my next scheduled medication and current prescribed dosage.
• Whenever someone enters the room, an RFID chip in their badge identifies them and keeps a running record of what happened throughout the day.
• I used voice-activated devices to turn lights on and off, let people know I was sleeping, or even call the CNA. I could tell them what I needed using voice-to-text to translate it into a text message delivered to their device.

These ideas are not only commonplace, but they’re also quite affordable in the consumer marketplace. As our homes and lives become surrounded by automation and smart devices that integrate, we become accustomed to this experience. We expect it wherever we go in the world, including the hospital.

It’s easy to understand why the priorities of reliability and safety trump all other concerns in a life-critical environment like a hospital. But this also explains why digital transformation of the hospital patient experience is falling so far behind.

Original post found here.

Authored by Craig Knighton:

Happiness for Craig is building successful products with collaborative teams. For him, there is magic to be found at the intersection of business and technology. Craig helps clients nurture new ideas, often in healthcare, and to plan scalable mobile and SaaS architectures. He aims to determine how organizations can successfully implement new technologies like artificial intelligence and cloud architectures.

An electrical engineer with an MBA and a 25-year career as a software developer, clients — from startups to enterprises — look to Craig for his technical and strategic expertise. His previous titles include VP of Engineering, VP of Engineering and Technical Operations, VP of Development at Gearworks, LiquidSpace, and Spok, respectively.

Long interested in improving patient experiences through the thoughtful application of software, Craig is actively involved in founding a non-profit charitable organization that will deliver technology solutions that facilitate better services for children with special health needs. In the past Craig volunteered in the emergency department at Coon Rapids Mercy Hospital.

When he isn’t helping businesses build innovative solutions, Craig enjoys his view of the Mississippi River or taking his Harley Davidson for a ride.