From COW to iPad to Google Glass

 

So far, my posts have been focused more on the software side of ICT in hospitals, such as EHR, CPOE, and CDS. This time, however, I will focus more on the hardware side of it.

When doing a more research about the concept of connected hospital explained in my previous post, I came across this video about Toronto General Hospital.

 

The video was produced in 2010 and shows how the best practices looked like at that time: installing a battery-powered PC into nurse’s medication carts (dubbed “MedCart”) to replace a traditional paper based instruction, and using a Wireless Devices on Wheels (WDoW) so physicians have a constant EHR and CPOE access. Of course, these efforts chiefly aimed to ensure portability and mobility of information access which increase not only the hospital operational efficiency, but also the quality of patient care.

 

But these hardware technologies became a little bit outdated two years later, when people saw Apple’s iPad (and arguably any tablet devices) as a genuine disruptive technology which will replace the MedCart, WDoW and other Computer on Wheel (COW) technologies. Why would a physician pushing a cart with a big computer on it when he / she can access the same information through an iPad? The iPad's battery life is also good for 10 hours, perfect for a hospital environment. As comparison, a typical COW has a battery life of 4 hours (although some of them are lasting for 12 hours). When the nurses or physicians need to change the battery in the middle of the shift, it is of course seen as counterproductive. A research shows that 62% of US physicians use a tablet device, in which iPad is the dominant platform, for professional purposes in 2012. To give you a better illustration on how iPad changes the hospital operation, Healthcare Australia (HCA) has the following video:

 

So these are the past and present of ICT in hospitals. How about the future?

Now, the hospitals and other application developers are visioning the implementation of wearable technologies, such as Google Glass, to support health care service. As of now, at least four startups are focused on Google Glass application for healthcare. So how will exactly Google Glass improve hospitals operations? Please, compare the previous videos with the one below.

As you can see, Google Glass is envisioned to be connected with EHR, enable remote collaborations between physicians and hospital staff, help monitoring the patients’ vital status anytime and anywhere, and facilitate tele-consultation with specialists. All these can be achieved instantly in a real time basis. Furthermore, unlike using iPad and other tablet devices, using a wearable technology like Google Glass means that the physicians and other health care providers do not need to get their hand off the patient while accessing important information. The efficiency in the hospital operation has never been better.

That's it for now!

The Connected Hospital

My posts to date explain how EHR stored the data recorded by the physicians and other health providers, and how this data can be shared easily to other stakeholders. Clearly, EHR is the key example that illustrates how ICT can help a hospital to achieve a state called the connected hospital - a vision of a fully integrated hospital where wireless technology allows care givers and patients to roam throughout the hospital while providing accurate and timely monitoring. A lot of hospitals see this vision as the “promised land” of ICT integration. UCSF shares its vision of connected hospital in an amazing video here.

This video shows that ICT can do more than ensuring accurate patient records and enabling real time data analysis through EHR. In this post, I will elaborate two of many instances that UCSF mentioned.

Patient Survey

So a hospital has implemented the EHR system, in the hope of increasing patient satisfaction. However, how does it know that the patients are indeed satisfied? In my previous post about best practices, I shared how important it is to have an ICT optimization team in order to identify and implement improvement opportunities. Patients are evergreen source of innovative ideas if hospitals listen to what they say and probe for more. Furthermore, patients can also be the best source for identifying unsolved problems. Therefore, a patient survey is an important source of data set that a hospital should collect and analyze.

Evaluating a paper based survey, however, is very time and labor consuming. This fact makes hospitals limit the sample size and questions to a manageable amount. As a result, hospitals tend to miss a lot of information. ICT helps to solve this problem and enables e-Survey, as shown in this video.

Example of e-Survey Utilized in Hospital Setting

Brockton Hospital in Massachusetts has implemented this method. When about to leave the hospital, each patient is given an iPad so he / she can fill out a survey about his / her experience in the hospital. This e-survey allows a real time feedback and alerts the hospital management team whenever a patient rates the service as poor. This means the hospital supervisors can provide quick coaching and guidance to their staff as soon as possible.

Preventive Health Care

When we use our Nike+ FuelBand, we can extract data about our movements, activity levels, and calories burned. When we use Sleep Cycle application, we can monitor our sleep phase easily. When we use Diabetes Buddy application, we can track our blood sugar level actively.

What do these imply?

Just like what Dr. Bokser said in the UCSF video: “We are capturing data from the places we never imagined”. Having this data would help the hospitals and physicians to be more proactive on patient health and promote preventive medications. Cloud computing helps hospitals to bring this idea into a reality.

Example of Preventive Health Care Interface

Letting the physicians in the hospitals to track these data and diagnose the symptoms actively mean the hospitals would know something is going on even before the patients know about it. This will help the hospitals to control patient condition before it is getting worse. Controlling in the early stage means not only patients can be cured easier, but also hospitals can prevent a costly treatment. Therefore, don’t be surprised when someday the hospital suddenly calls you and tells you to see a physician / specialist as soon as possible.

That’s it for now! Stay tuned for the next post!