April 6, 2022
Table of contents
Technology Research Analyst
In his first interaction with the protagonist of the hit show Scrubs, the cold-hearted and cynical chief physician Bob Kelso candidly says "Dr. Dorian, do you not realize that you're nothing but a large pair of scrubs to me? The only reason I carry this chart around is so I can pretend to remember your damn names!". He also points out that uninsured patients should be kicked out of the hospital, failing miserably to keep the Hippocratic oath that every doctor is supposed to make at the beginning of their career.
If you are wondering what a smart hospital should be like, well, it's basically a 180-degree turn from the aforementioned scenario. Paper documentation to coordinate human resources? Poor communication between management and staff? Patient neglect? These are vestiges of a past where decision-makers in the healthcare industry were reluctant to embrace technological innovations and, even when they did, were not necessarily able to blend and harmonize such tools with standard clinical processes.
However, things are changing rapidly under the pressure of several socio-economic dynamics, which was effectively pointed out by McKinsey in its 2019 Finding the future of care provision report:
One of the most promising solutions to better address these trends (not to mention the effects of the global pandemic) implies the gradual shift from conventional to smart hospitals. Let's better define their nature and find out what's under their hood, both from a technological and operational point of view.
Even the most traditional hospitals are extremely intricate organizations based on a sprawling network of people, processes, and assets. Improving and balancing this triad of elements to make such structures “smarter” may sound like a challenging task, given their complexity but also the stakes. After all, failures in most organizations or companies usually only result in the loss of capital or jobs, while inefficiency in a hospital is a matter of life or death.
Fortunately, technology comes to our aid, providing us with a wide range of tools to enhance every single aspect of the clinical workflow and patient care. Smart hospitals represent the holistic (perhaps even the ultimate) embodiment of such tools, encompassing AI, process automation, VR, healthcare data governance and analytics, the internet of things (IoT), and all related high-tech solutions driving digital transformation in the healthcare sector.
At this point, you may say that this sector is no stranger to investing in hospital management applications and medical device software development, and you would be right. Indeed, the adoption of digital technologies in healthcare for management and operational purposes has undergone a steady growth, further catalyzed by the COVID-19 pandemic, as reported by Deloitte in its 2020 Digital Transformation: Shaping the Future of European Healthcare study.
The real novelty in smart hospitals, however, is the integration of the aforementioned solutions into a coherent and synergistic technological ecosystem, which requires healthcare institutions to configure these facilities according to specific design cornerstones:
Summing up, configuring a smart hospital implies remarkable efforts both in organizational and technological terms. Is the game worth the candle? Well, assessing the intangible benefits ensured by this hospital model (such as patient wellness) can be challenging, but from a practical perspective, we may mention that full-scale healthcare digitalization could easily contribute to national health budget savings of over 10%, based on McKinsey's assessments.
So, it's definitely worth exploring such opportunities, and according to statistics, many investors seem to agree. Juniper Research, for example, reported that the smart hospital market was valued at $29 billion in 2021 and may grow to $59 billion by 2026, with the US and China leading this trend.
The study also identifies the lack of pre-existing digital infrastructures and tools (including EHRs), poor interoperability between devices and platforms, and relevant investment requirements as the major obstacles to smart hospital adoption. In other words, ambitious moonshots without a solid foundation may lead to complete failure.
Since we just talked about investments, let's take a look at the key technologies healthcare institutions will need to invest in when shifting from old-school facilities to smart hospitals, along with some real-life examples of their actual deployment on the ground.
We'll start this overview with artificial intelligence, which is arguably the most transformative technology for healthcare, according to Deloitte.
But really, there is no surprise, since AI is a boundless realm, vaster than doctor Kelso's misanthropy and encompassing or directly affecting a broad range of sub-branches and related disciplines. Therefore, its applications are as numerous as they are impactful. Here are some of the major ones in a smart hospital scenario.
RPA (robotic process automation) bots might be less chatty than the aforementioned robots. However, they have still proved extremely useful in a smart hospital setting, as they can be programmed to replicate (or even learn by themselves, when powered by AI) human interactions with software applications and therefore replace or assist the clinical staff in a broad range of time-consuming clerical duties. The applications of RPA in healthcare include patient appointment scheduling, medical records updating, self-service triage, claims management, and more.
Max Healthcare, a major clinical network in North India, deployed this technology in its 14 hospitals to speed up claims processing and data reconciliation, leading to 50% reduction in turnaround time. Their RPA solution can gather data from emails and PDF files, turn it into CSV format, and enter it into their databases.
We mentioned the role of machine learning in fueling cognitive technologies that allow medical devices to see, hear and speak (almost) like humans. But this powerful branch of AI also has a lot to offer in terms of healthcare analytics.
Smart hospitals rely on machine learning algorithms, specifically on their pattern recognition and anomaly detection capabilities, to constantly oversee both patients' health conditions and medical equipment's operation, identify risk factors, and prescribe fully personalized therapies or targeted interventions. The medical datasets required to fuel such algorithms can come from several sources, including EHRs previously stored in the hospital databases, lab tests, PGHD (patient-generated health data), and health wearables.
An example of data analytics in a clinical scenario comes from Saratoga Hospital in New York, which implemented a predictive analytics solution to monitor patients’ vital signs and identify those whose conditions are deteriorating. Since its adoption in 2015, this system has reduced patient transfers to intensive care units by 63%.
Considering that, as described above, two cornerstones of smart hospitals are their data-centric approach to medical care and the "sparse" nature of their clinical workflows, the importance of a technology like the Internet of things shouldn't come as a surprise. While data analytics systems are the brain that processes healthcare data, IoT devices represent the hands collecting data on the ground (typically paired with cloud computing for data storage and sharing).
Health wearables equipped with sensors, GPS asthma inhalers, video conferencing tools, or even smartphones with mobile health apps can easily collect clinical data and patient feedback, allowing smart hospitals to provide 24/7 patient monitoring and consulting both within their facilities and outside their standard geographic reach (the so-called telemedicine). In this regard, the Johns Hopkins Hospital at Home, Baltimore, developed an advanced telehealth program designed for elderly patients at risk for nosocomial infections, ensuring better clinical outcomes and cost savings of up to 30% over standard hospital care.
IoT-based telemedicine, however, can also be applied for psychological support. Built by Itransition's team, a remote patient monitoring suite allows expert nurses to communicate with sexual assault victims living in rural areas and perform forensic examination via high-resolution smartphone cameras.
Moving from IoT for patients to IoT for technical equipment, it's worth mentioning that this technology has also been implemented in several smart facilities (for example, at OLVG hospital in Amsterdam) to streamline asset management with Real-Time Location Systems (RTLS). These solutions allow the clinical staff to keep track of medical devices via radio frequency identification after placing location-aware tags on such items, remarkably reducing equipment search time.
The last smart hospital tech trend in our brief round-up is arguably the most picturesque as well, namely augmented and virtual reality. From a physician's perspective, AR and VR can be exceptional tools to enhance medical training with highly interactive case-based simulations. Not to mention the opportunities opened up by AR-guided surgery in the operating room, where smart glasses can overlay 2D or 3D projections over the patient body to better focus on their anatomy without having to pay attention to different monitors.
On the patient side, instead, AR and VR represent effective training solutions to exercise in immersive virtual scenarios during rehabilitation. Furthermore, they proved to be a valuable source of distraction to relieve chronic pains, as shown by a 2019 study conducted at Cedars-Sinai Medical Center in Los Angeles.
We live in a world where pinning the word "smart" on anything sounds easy and trendy. But if there is something out there that deserves this title, it's smart hospitals for sure. By embracing the full spectrum of technologies that modernity has gifted us, this innovative model has been able to provide flexible, data-driven medical care, streamline clinical workflows, relieve medical personnel's workload, and enhance the patient experience or, let us be slightly hyperbolic, reaffirm the centrality of humans over treatments and assets.
However, smart hospitals are something more than a mere collection of technologies with high-sounding names, and reimagining healthcare from the ground up may require a radical redesign of several clinical functions, along with proper upskilling initiatives and the creation of solid partnerships with other institutions to exchange data and expertise. In short, smart hospitals can be truly smart in so far as we wisely adopt all those best practices to harmonize the aforementioned triad of staff, clinical processes, and tools.
Even so, this will probably never lead to Dr. Kelso being a nice guy (at least for seven seasons). But he may decide to replace that terribly vintage clipboard with a fancy tablet.
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