Noted that health care practitioners are an aging profession. That the attrition of nursing staff is an issue in North America.
Evolving and changing business models in US health care with billing shifts. Outside of the US, increased privatization of Health Care, Public Private Partnerships, and the movement of risk from the public to the private sector.
Key technology shifts including mobile, cloud, and pervasive or ubiquitous computing, the consumer driving the enterprise, and connectivity.
Parallel drawn between phones and the autonomic user interface and how this can be applied to mobile, pervasive, ubiquitous tools for health care provision.
HP Richter accelerometer is a silicon based device, the most sensitive ever made, at about 1000x more sensitive than competitors products. So sensitive that they can measure in 3 dimensions and measure heart rate as well as breathing simultaneously.
Segue to the concept of the digital hospital. Quote from Peter Drucker, stating "the hospital is all together the most complex human organization ever devised."
The average proportion of a nurses time spent on direct patient care during the active part of a shift is 19%. this is from a 2008 time and motion study in the Permanente Journal across 36 US hospitals. This implies 5 nurses are needed per shift to ensure patients get full time direct patient care.
The theory for a solution is proposed as Care Orchestration, improving clinical and operational efficiency through coordination. Dealing with complexity and interruptions of cognitive and workflow. Resource and process management via event handling, alert management, process flows and identifying bottlenecks, team coordination, and work prioritization.
Noted the importance of convergence in information technologies supporting facilities, medical treatment, and communications. These often operate as three silos of infrastructure, and I would add education and administration as two more potential silos.
The theory is to have pervasive mobile technologies that cross all silos as needed.
Like in many other industries, the economic model is that value is driven by convergence, but this will require significant changes not only to process and organizational governance, but also to the management and governance of data in any state it might be in for compliance.
Video animation provided to illustrate the proposal of how these communications, mobility, and convergence technologies can work together in a use case scenario of transforming the health care world. Using a setof technologies, none of which were brand new, pointed to the fact that it seems simple to just pull this together and automate. There are governance and human care issues that I feel were overlooked in the scenario illustrated of a MVA victim being cared for in an australian hospital.
An illustration was brought up, a functional solution framework indicating how technologies existing today, and where the key integration points are.
Key examples cited are to start by building a converged medical infrastructure, steeped heavily in security for privacy and data governance reasons. Networks and servers and storage are the first points HP addresses, and refers to this as IP convergence points.
Next is client computing infrastructure and the first lift here is proposed as VDI, followed by unified communications and collaboration. This is followed closely in the HP list by messaging & alerts via an integrated alert bus.
From a privacy and data management perspective, patient identification, patient and clinical interactive systems, and asset tracking and management are important for patient care, HCP efficiency, and administrative cost management and risk reduction.
The example keeps being cited of patients pushing a button on a screen to request apple juice or noting pain and requesting meds, to which nurses get an electronic message and pass it on to the appropriate other health care staff whether clinical, pharmaceutical, or administrative support. HP is not acknowledging that the nurses should be going to the patient to assess the validity of the request, or understand if there are mitigating circumstances or health care risks posed by the patients request.
The solution framework map suggested is quite simply, it just has a layer of security separation placed between the converged infrastructure, the integration engine, and the application layer moving upwards, and the underpinning physical access modes.
The discussion moved on to where else besides the hospital is this concept extended into the healthcare community. The mode described is virtual health management, enabling care coordination beyond the hospital and clinic walls.
Key take aways were noted as:
Health care services are in dire need of of paradigm shift in efficient care.
Applying tech in innovative ways tom improve operational efficiency enables health care coordination and improves patient outcomes
Question was asked about actual case studies. Quoted was a 2009 completion of a cooperative effort in a Swedish hospital that is not the full vision, but implemented key parts. It was originally designed for a capture population of 300,000, but due to the efficiencies they've implemented, they've expanded the capture population to 500,000 people.
Another question was regarding integrating current technologies and or other vendors who are best in breed in their particular devices. HP claimed full ability to interoperate with all other vendors as needed.
Question posed if there is a nationwide forum of practitioners in healthcare that HP is consulting. HP claims 9,000 people in health related technology roles. HP runs a health care information system in several Spanish hospitals that they completely develop and support. There's a cared management system called Atlantis that is available to se on the show floor.
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Location:Las Vegas, NV