less is more? (or how to make the most of our new hospitals) nanna skovgaard head of division
TRANSCRIPT
Agenda
1. Background – why and what we build
2. Demands on ICT for the new hospitals
3. Demands for connected care
4. Goals from government perspecitive
5. Initiatives
6. In what sence could less be more?
Hospital structure - Fit for e-health?
Nybyggeri i det danske sygehusvæsen
0
200000
400000
600000
800000
1000000
1200000
1400000
1900-09
1910-19
1920-29
1930-39
1940-49
1950-59
1960-69
1970-79
1980-89
1990-99
2000-06
År
antal nyopførte kvm
Activity aims towards year 2020 (from 2007)
• Out patient treatment up with 50 percent
• Number of beds down with 20 percent
• Bed days down from approx. 5 days to approx. 3 days
Building a hospital structure for the future
• In the next 15 years, 7 billion US-$ will be invested in 16 main hospitals
according to a national strategic plan covering all Denmark
• From 40 to 20 main hospitals –specialization and centralization
• Common emergency wards and single bed rooms
• The largest capital investment in the history of Denmark – since
medieval church construction
• A unique chance for a coordinated boost of patient treatment and
technology in the health care sector – and strong demands for more
connected care and telemedicine – given reduced number of beds etc.
National standards and strains• Demands on efficiency gains of 6-8 percent on activity
• Strong focus on budget control – overruns not accepted
• Approx. 20 pct. of construction costs is reserved for IT, medico-
technical devices and apparatus etc.
• This high share to ensure that the hospitals are new – also when
doors open in 10 years
» We will gain a unique experience when it comes to building robust buildings, new solutions and green profile
Demands on hospital ICT and equipment
• If treatment to the same level is to be given faster, it takes new
ways of organizing treatment and supporting it by ICT etc.
• If demands on capacity is rising - so are demands for timely delivery
of resources and flows – less slack
• It takes well functioning and integrated EPR’s, mobile solutions, CBI
• Focus on clinical and service logistics to optimize man power and
equipment – RFID, emergency boards etc.
• Merge of equipment, medical devices, ICT – work end-to-end
• How to develop, purchase – and combine with existing gear?
To keep people out – can ICT help us?
• If we build more efficient – and more distant - hospitals
• We also need efficient surroundings – to keep people at home
• New ways of working between patients, local nurses, GPs, hospital
doctors – telemedicine is key here
• Infrastructure, devices in place, logistics, new concepts on service -
organization, clear tasks etc.
• Digital communication between sectors – and clear clinical
guidelines and clinical path ways to enhance seamless treatment of
patients cross sectors – cross diagnosis and geography.
• Also we will probably se more hospital treatment at home –
changing demands on devices and ICT.
Structural challenge and ambitions* The more we want to do with data, the more mutual dependencies we face* Strong need for commitment on information, tasks, competences, work flows - end to end* Systematic reliability and systematic semantic - digital communication cross sectors
Government goals – ICT and hospitals
• The new hospitals must achieve targets on treatment, implement
common emergency wards - and keep building budgets
• Use opportunity to develop new solutions to shared challenges -
how to work with ICT in buildings, logistics, design etc.
• Share experiences and strategic decisions – develop business
cases and chose new solutions on larger scale.
• Establish the new hospitals as knobs in structure for connected
care – demands on ICT and agreements “our of the building”
• Demands on efficiency gains of 6-8 pct. – can you help them out?
• Wider benefits – growth – international cooperation and exports.
Government initiatives
• Demands for transparency on shared experiences and results of
cooperation between regions - and private companies
• Network to share “best results and solutions” and present abroad
• Work with national standards on ICT, equipment etc. – to make
procurement of new gear cheap, reliable and connected
• Further develop National action plan on telemedicine – and test bed
to facilitate uptake of new solutions
• Further develop health.dk – as a shared site for citizens data
So – in what sence could less be more?
1. Reduce number of hospitals – to gain specialization and
concentration
2. Reduce number of in beds and in bed-time
3. Reduce the number of ways we do things – do it right once
4. Work with standards and models for procurement of equipment
and ICT to make sure it functions end-to-end and is cost
effective
5. Not least: With data and right timing – we need to do less to
achieve more in treatment of patients.