1. © 2006 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice The Digital Hospital at St. Olavs Hospital Ken Watt Program Manager – Digital Hospital Europe Middle East & Africa Hewlett-Packard Company

2. © 2006 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice > Definition of the Digital Hospital > St. Olavs - Background - Business vision - What implemented - Benefits

3. What is a Digital Hospital? Relies on technology as an integral and fundamental part of its business strategy Enables the organization to leverage its potential for delivering higher quality care in increasingly efficient ways through the use of IT and process redesign. Goes beyond advanced clinical systems and includes additional integration between IT, medical, communication and building technologies to create a real-time hospital information environment Source: PWC

4. The Infrastructure of a Typical Hospital today Nurse CallPhone Systems (PBX) DECT/Pagers Access Control Intercom CCTV AGV (Robotics) Lighting control Blinds Air condition Facilities Control Medical Devices Paper Data Networks Wireless LAN WiFi Client PC Hospital Applications EPR PACS HIS LAB etc Patient Entertainment

5. Everything over IP – IP Everywhere Infrastructure IP Convergence Patient terminal LAN/WLAN IP converter ESPA 4.4.4 MDA/ PDA PC Mobile phones (SMS) IP wireless phones OPC, SMTP, SMNP I/O signal converter Digital PenPatient monitoring medical equipment WiFi tags Facility control Middleware PACS EPR EHC Laboratory etc. Nurses portal GSM Nurse call Pager IP phones

6. The Digital Hospital – Putting it Together: Integration Technology Portal Middleware Platform

7. Digital Hospital Roadmap Enhance Infrastructure IP LAN Wireless & mobility Security Innovate Pilot & rollout e.g Messaging & alerts Location based services Asset tracking RFID Integrate Enhance integration of applications and services Seamless communications & alerts Align applications with business processes Service evolution / New Infrastructure Network enhancement Physical integration Change Management Logical integration Ecosystem integration IP Telephony Wireless Patient bedside terminal/portal Patient monitoring Better quality of care Reduced number of errors Improved productivity and decreased cost Converged IP network for voice, data and video Reinvention and redesign of care processes Organizational virtualization Ecosystem partner integration Current state: Inefficient manual processes Future state: Technology enabled efficient processes

8. Integration Platform Patient Bedside Terminal & Portal Messaging & Alerts - Nurse call - Medical team assembly - Hospital orderly - Event driven alerts Network & communication infrastructure Location and identification services - WiFi - RFID Creating the Digital Hospital – The Applications Layer - Solutions..... Device integration - Patient monitoring - Infusion pumps

9. Case Study: St Olavs Hospital

10. St Olavs Challenges & Vision Building a state-of-the art hospital to deliver patient centric services Hospital was too costly to operate, with annual rising costs Opportunity to build a hospital that will provide outstanding quality of care Objective to deliver patient centric services Transition from one large structure to 11 separate centres Opportunity to integrate clinical and teaching/research areas (key objective). Opportunity to integrate University employees seamlessly Opportunity to exploit ICT to deliver information to the right persons at the right time at the point of care Opportunity to align business outcomes/process re-design with IT requirements Become Europes/Worlds most modern hospital (the hospital of the future....) Located in Trondheim - Norways largest hospital Premises: Main Acute Services Unit (75%) & University Hospital (25%) Managed by the Regional Health Authority of Mid-Norway 950 beds 8,000 Staff (+1,250 students) 413,000 patient treatments per year Provides services & specialties for other hospitals in the region

11. An opportunity to re-structure to enable a holistic view of the patient Opted for a campus-style layout 11 interconnected buildings instead of one big infrastructure Major changes in organisation, support, and building architecture design (influenced by staff & patients) to: Deliver patient centred services and treatment Vs. traditional approach of patients moved between departments/centralised facilities. ICT support to provide the right information to the right person at the right time at the point of care Adoption of the Planetree model: All-round care and treatment in collaboration with the patient and families A nursing process that minimises the number of health workers a patient has to deal with An informed and involved patient: knowledge of their condition should contribute to diagnosis, treatment, and follow-up. St Olavs Challenges & Vision Cont.... 500 patient and staff Interviewed: 2,500 requirements/requests...Based on teamwork working in an integrated environment, with medical expertise, and nursing care focused on the patient.

12. ICT – The Core Enabler at St. Olavs Mobility Flexibility Security Availability Everything over IP – IP Everywhere System integration, digital infrastructure Communications and Cisco Clinical Suite Solutions Suite Integration Platform Patient Bedside Terminal & Portal Messaging & Alerts - Nurse call - Medical team assembly - Hospital orderly - Event driven alerts Network & communication infrastructure Location and identification services - WiFi - RFID Device integration - Patient monitoring - Infusion pumps

13. All devices with I/O signal can be connected to the network and provide real-time data Analysis of measurement and device data Devices can me monitored remotely (HP OpenView) Medical equipment: Provides real-time clinical data Accessed via web browser (& real time EPR update) Can be integrated to Centralised alerts solutions (Wired or Wireless) Protected by RFID/WiFi tags Medical Equipment Integration IP Gateway

14. Conversion and display of data in real time (archived for historical/research & decision Support) Patient Monitoring Access to device and its data via web browser

15. Benefits Trauma Team assembly Medical Emergency alarm and locating nearest clinician Monitoring of high-risk patients Device alarms and theft protection WiFi/RFID asset monitoring and identification Activity control and process monitoring Location-based services Identification and location tracking

16. IMATIS Nurse Call Nurse Station - visualization of ward/bed area Role based – individual and teams Emergency alarms, locates nearest Clinician/Nurse Better staff utilisation (Nurse to patient dialogue anywhere) Dynamic distribution by peaks Staff required 0 4 8 12 16 20 24 Hrs 5432154321 Shift Work load

17. Lab requests and results Requests raised/Results displayed via mobile devices (PDA, Tablets, Laptops, CCOWS) Signatures stored in audit database

18. Patient Terminal – Multiple Role Meets patients need for entertainment, communication, and access to own or other hospital information A secure and efficient way for clinicians & nursing staff to use the same terminal to access core clinical systems (i.e. EPR or IMATIS Patient Chart). Patient and family involvement in diagnosis & treatment......

19. TV and Radio over IP Video Internet/ E-mail Telephone (VoIP) Information (e.g. hospital & treatment...) Room Lighting control Nurse Call Real time Access to Catering Services Games - Xbox Professional application use through smartcard Patient Entertainment

20. Patient Chart Displays critical patient information: - Vital Signs - Administered Medication - Treatment History - Lab results & examinations history

21. Electronic Patient Record Complete Electronic Patient Record based on European standards. (CEN ENV 13606-1) EPR can be: fully integrated or accessed via Citrix Session to existing EPR System

22. Expected results at St. Olavs Improved patient care through real time access to data at the point of care Reduced Length of Stay (LOS) Staff productivity increased through improved collaboration (objective: achieve productivity gain of 26.1% by 2015) Achieve measurable reduction in staff workloads Reduce operating and waste costs by 22M Euros. Converged network to improve TCO and reduced network operating costs

23. Thank you...