Members of Eastern Health: Angliss Hospital, Box Hill Hospital, Healesville & District Hospital, Maroondah Hospital,

Peter James Centre, Turning Point Alcohol & Drug Centre, Wantirna Health, Yarra Ranges Health and Yarra Valley CH

Box Hill Hospital: The Trials, Tribulations and Achievements of a

Digital Hospital

HIC - Digital Hospital Design

Melbourne Convention & Exhibition Centre

25 July 2016

Zoltan Kokai B.Bus (Accounting)/ B.Comp (Info. Systems) MBA AIMM HISA

Executive Director, Corporate Projects & Sustainability

Eastern Health

Eastern Health

Digital Hospital Definition

Box Hill Hospital Redevelopment overview

Digital Hospital Achievements and Challenges

Applicability to existing hospitals

Top 7 ideas you might consider

Box Hill Hospital

Maroondah Hospital

Peter James CentreAngliss Hospital

Yarra Ranges Health

Healesville Hospital

7 Major Sites

+ 65

Community

Sites/locations

Wantirna Health

As at June 2015

Revenue: $880M

Staff*: 9,604

Population: 750,003*Includes volunteers

Healesville & District

Hospital

Yarra Valley Community

Health -$8.8 M

-On Track early 2017

Angliss Hospital ICU &

ED Expansion $20 M

-Post Tender Stage

Almost

$520 M in

Capital

Projects

EMR Program

(approx $19+M BHH )

-In Progress

Maroondah Hospital

Breast Cancer Centre

$10 M

-Documentation Stage

Maroondah Hospital

MRI $5.0 M

COMPLETE

Box Hill Hospital $447.5 M

COMPLETE

Maroondah Hospital

PAPU $2.0 M

COMPLETE

Maroondah Hospital

Car Parks

Leverage

Capital

Developments in

your Digital

Transformation

2000 2005 2010 2015

MAJOR CORE

INFRASTRUCTURE

INVESTMENT

& BASE SYSTEMS

FOCUS

INFRASTRUCTURE

REFRESH &

DEPARTMENT

SYSTEMS

FOCUS

SYSTEM

CONNECTIVITY,

ACCESSIBILITY &

MOBILITY

FOCUS

Eastern Health

Great Digital Information

Strategy

2015-2020

DIGITAL

TRANSFORMATION

FOCUS

Planning for the

Digital Transform-

ation Commences

Before new hospital

7

The digital hospital is defined as a

framework of hardware, software, partner

point solutions, and consulting services that

lay the foundation for the digital

transformation of healthcare service delivery.

Duffy and Holland, Health Industry Insights

Mar 1, 2009

Hospital Infrastructure

Information, Comm-

unication & Technology

People, Process & Knowledge

The Box Hill “Digital” Hospital Experience

Traditional

Hospital

Electronic

Hospital

Virtual

Hospital

Digital

Hospital

“The convergence of building infrastructure, information, communication and technology with integrated applications, an electronic medical record and clinical processes to

enable delivery of superior patient outcomes through enhanced knowledge.”

Digital Hospital

Box Hill Hospital – Digital Hospital Planning

Box Hill Hospital ICT Priorities

• Medication Dispensing Automation

• Fault Tolerant Data Centre, Server and Comms. Infrastructure

• Building System/ICT Integration

• Unified Messaging

• Barcode Technology

• Patient Entertainment System/Clinical Terminal

• Core EMR/Device Integration

Slide 13

As the major referral centre for people

living in the eastern region of Melbourne,

the redeveloped Box Hill Hospital

is a contemporary facility, attracting the

finest staff to deliver best-practice

models of care.

Eastern Health and the

Department’s

vision was to create a

technologically

advanced

healthcare

facility

• Wayfinding Technologies to Support

Patient/Visitor communication/

movement (supported via a Business

Service Centre)

• Room Booking Technologies

• Keeping clinicians by the bedside (Smart technology, vision into rooms,

storage, wireless phones)

• Keeping things simple (consistent

placement of equipment, phone numbering

convention)

• Eight generic wards (levels 5-9)

each with similar layout

• Ward clerk station is easily located

upon ward entry

• Security swipe access for ward

entry after-hours

• 50 per cent of the patient rooms

are single bedrooms

Wifi access

PES/ Clinical Terminal

-Integrated to Pat. Admin Sys

-Meal orders

-Messages to patients

-View Only Patient Info from

EMR

Standardised

& Integrated

Nurse Call

All new latest

technology Hill-Rom

beds supporting patient

safety, mobilisation and

skin care

17

Patient Room and Operating Theatre

Integrated Nurse Call and Communication

-Excellent Technology

-Operating Theatre communication very useful

-Patient handset to Wifi Nurse Phone Fantastic

-Interoperability of call buttons with existing

workflow systems can be an issue

Complex Communication Integration may cause

Issues between devices if not configured correctly

Integration of Legacy Technologies

-Don’t integrate pagers!

-Clean up your communications directory

-Have a strategy for managing legacy Fire Systems

and Hospital Public Address/Emergency

Management systems

Just because you can

doesn’t mean you should!

Most

Victorian

Hospitals

Eastern

Health

Today

Eastern

Health

Aspiration

Release 1a –Commenced Oct 2008 Patient Demographics

Recording Allergies, Diagnosis, Problems, Alerts

Integrated Results (Pathology and Medical Imaging inc PACS)

Electronic Discharge Summaries

Release 1b –Commenced Aug 2009 Discharge and Outpatient Prescriptions

including drug and allergy interaction checking

Release 2 –Commenced Aug 2011Medication, Pathology and Radiology Orders

BHH EMR – Commenced Sep 2015Advanced Clinical Documentation, Core Department Systems (ED,

Surgery/Anaesthetics, ICU), Device Integration, Complex Medications

Staged Implementation along the

EMR Maturity Model Means:

-Pathology, Radiology, Medication

Orders will be electronic HOWEVER

-Clinical Notes can be on paper

-Potential increased risk of hybrid

records

-Electronic Medication Management

challenging

Data Centre,

Redundant

Comms.1

Does not need to be owned!

27

Automated

Pharmacy

Dispensing2

28

Patient Journey

Board 3

29

EMR Including

PACS Images

4

30

Devices and

Mobility

New Human Scale Trolley running

ONYX All-in-One Battery Powered

Computer

6 year old

Win XP with

IGEL

ONYX

Win XP with

IGEL

5a

31

Devices and

Mobility

Spot Monitors

with

EARLY

WARNING

DETECTION

WITH EMR

WITHOUT

EMR

5b

32

Virtual Desktop

Single Sign On 6

33

7

Digital Hospitals no longer a thing of the future

Learnings Applicable to existing hospitals:

1. Fault Tolerant Data Centres and Communications

2. Automated Medication Dispensing

3. Patient Journey Board

4. Progressive implementation of an EMR inc PACS

5a) Mobility and Devices (WOWS, iPads, Surface Pros)

5b) Clinical Device Integration (Early Warning Monitors)

6. Virtual Desktop, Single Sign-On, Tap On Tap Off, Roaming

7. Room Booking Systems