Smart Hospital, Resilient Organization
By Benjamin Kanter, MD, FCCP, Chief Medical Information Officer, Vocera
Health Information Technology Can Enable Organizational Resilience
Clinical and operational systems in hospitals push out notifications about patient care events: a patient is deteriorating; a patient is about to fall; a patient has pressed the nurse call button.
For care teams to respond effectively to notifications from multiple different systems, the hospital’s digital infrastructure must be able to rapidly convert data from these sources into actionable information. This is a key component of a smart hospital.
Clinical and operational friction adversely affect care quality and patient safety. Clinical friction includes things like delays in knowing about clinical events like abnormal lab results or sepsis risk alerts, or delays in responding to nurse call. Operational friction includes things like an unexpected staff shortage or problems with getting rooms cleaned.
The ability to respond rapidly to events and thereby minimize operational and clinical friction characterizes hospitals that successfully navigate crises, and is a major factor in what makes an organization resilient.
A smart hospital leverages its digital infrastructure to continuously derive insight and value from its systems and rapidly address operational and clinical challenges.
Information Must Be Communicated to Be Acted Upon
But deriving insight is not enough. The information must be communicated if it is to be acted upon. This is why a modern clinical communication and collaboration (CC&C) platform is a foundational infrastructure for a smart hospital.
Rapid sharing of organizational knowledge is critically important because most problems that arise during patient care are event-driven and time-dependent. Without a modern CC&C platform, connections in the information chain depend upon fallible staff members, and this fallibility can introduce the opportunity for communication delay or failure. If knowledge sharing is delayed, the consequences can be profound for both the patient and the organization. For example, the length of time taken to rescue patients with unexpected clinical deterioration has been correlated with poorer outcomes, including excess days in the ICU, increased mortality rates, and additional costs.
To Shorten Time to Act and Intervene, Communication Is Essential
Smart hospitals enable caregivers to shorten their time to act and intervene by tightly integrating health information technology systems with a comprehensive communication platform.
Most health information technology systems implemented in hospitals today can send notifications about the status of a patient or the monitoring system itself. Unfortunately, these systems are often siloed, resulting in an excessive number of uncoordinated notifications primarily impacting the patient’s nurse. This can contribute to cognitive overload and burnout.
The Solution: Break Down Silos Through CC&C Interoperability
The solution is a CC&C platform that can receive and analyze data from multiple health information technology systems and orchestrate the necessary actions.
A CC&C platform can determine the relative priorities and distribute work to the right person or teams. Smart hospitals require a solution that can make sense out of chaos and ensure data is converted into information and distributed efficiently.
At the most basic level, a CC&C platform is made up of three elements: inputs, a processing layer, and outputs. Inputs come from clinical and operational systems that send messages and alarm notifications. The Vocera CC&C platform has more than 150 integrations with health information technology systems through the Vocera Engage intelligent workflow engine; those integrations serve as input to the main platform’s processing layer.
The processing layer aggregates data streaming in from the various systems. It breaks down silos so data from independent sources can be merged and processed together using a system of rules. If a rule determines that information needs to be transmitted (for example, a critical lab result, notice of a room cleaning delay, or a sepsis risk alert) the system routes it to the right person or team-based upon the role, responsibility, and availability. The same platform constructs an audit trail and provides analytics and reporting services.
Given data feeds from staff assignment systems, electronic health records, and digital on-call schedules, the Vocera system creates and maintains a real-time care team directory for each patient. It tracks who’s currently working, their role, which patients they’re caring for, and their availability. Maintenance of this up-to-the-moment care team is crucial to the outputs – delivering the right information to the right people and helping to reduce interruption fatigue.
Smart Hospitals Can Improve Safety
An optimal CC&C platform integrates with multiple different hospital systems, processes data, and intelligently distributes information to those who are responsible for acting. As a direct result, hospitals become more efficient and patient outcomes are improved, while communication burdens for physicians and nurses are reduced.
About Benjamin Kanter
Benjamin Kanter, MD, FCCP, MD, FCCP, is the Chief Medical Information Officer at Vocera, where he works closely with clinicians and engineers to co-design the next generation of real-time communication and collaboration solutions for hospitals and health systems. Prior to joining Vocera, Dr. Kanter worked as an industry consultant and thought leader with several innovative healthcare IT companies.
Dr. Kanter earned his medical degree and completed internal medicine training at Northwestern University. He completed post-doctoral studies in both pulmonary disease and critical care medicine at the U.C.S.D. Medical center in California. Dr. Kanter is board certified in internal medicine, pulmonary disease and medical informatics.
