Viewpoint paper

Envision the
digital hospital
See the future of healthcare

http://www8.hp.com/h20195/v2/GetDocument.aspx?docname=4AA1-1462ENW&cc=us&lc=en
Viewpoint paper | Envision the digital hospital

Table of contents

1 Evolve to meet drivers

1 Envision 21st century healthcare
2 Review strategic themes and enablers
4 See what’s central to the evolving healthcare system
4 Journey through the vision—Part 1: Orchestrate care inside the digital hospital
11 Journey through the vision—Part 2: Review the future integrated community
13 Know where we are in this journey
Viewpoint paper | Envision the digital hospital

The healthcare environment is evolving rapidly—patient centricity,

accountable care, integrated systems, rapid communication,
reduced funding, higher quality standards, advancing technology,
and an evolving business and care-delivery model. But how is
the healthcare model—the actual physical and systemic
environment taken holistically—evolving to meet these
drivers? In short, healthcare providers need a paradigm shift
to provide care more efficiently. It’s called digital hospital.

Evolve to meet drivers

The HP vision of healthcare’s evolutionary journey addresses the needs of a patient-centric,
outcome-based integrated care delivery model. Healthcare needs a care scenario that delivers
better quality, enhances operational efficiencies across care providers, and speeds innovation
to enable better patient outcomes.

Envision 21st century healthcare

Two areas taken together become a holistic model of the broader healthcare system:
• Improving and orchestrating care inside the digital hospital’s four walls
• Integrating health and social care for a “virtual health community,” ensuring patients remain
well and are helped to remain at home and out of the hospital

The digital hospital vision takes the traditional doctor’s office and transforms it into an efficient,
interconnected, patient-centric health environment for the 21st century. Moreover, the vision
extends beyond conventional bricks and mortar. Through this extension, the hospital becomes
a fully integrated element of a health and wellness system within the community.

It’s this extension and integration that drives the second element of the vision—virtual health
management. Here, the focus continues to be on the patient, but emphasizes wellness and
prevention, treatment, recovery, and rehabilitation outside the digital hospital. In the future,
patients will have increasing control and consent management of their health and medical
details, ensuring they are assessed by the right people, at the right time, at the right point of
care, and that the right care is administered and delivered.

This vision integrates multiple levels of care delivery—home, primary, secondary, ambulatory,
emergency, and long-term recovery care. It ensures a 360-degree view of patient health and
social services care management information to all relevant stakeholders.

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Viewpoint paper | Envision the digital hospital

Figure 1. Our vision

Improving
health
HP digital Virtual health
outcomes
hospital management
Orchestrating care Extending care
inside the four into the ecosystem
walls of a hospital (physician office,
Enabling home, mobile
care consumer)
coordination

Healthcare’s
Increasing
technology operational
journey efficiency
HP horizontal products solutions footprint

The patient journey through The integrated healthcare

the digital hospital with community of the future—
enhanced experience and focusing on patient wellness
improved care delivery and preventive medicine

Review strategic themes and enablers

The vision’s foundation includes the following strategic themes and enablers.

Speed innovation to practice

• Integrated care management—Integrates healthcare and social services to provide a
seamless care model. Patients will not be aware of the separate health and social services
organizations, as care and relevant information will be passed seamlessly between teams.
• Enhanced access to care—Provides 360-degree access to care and underlying information
to support all stakeholders—using appropriate secure, role-based multilevel security. This
ensures access to treatment plans, case management, and history using appropriate devices
and tailored stakeholder views and summaries. It includes health information exchange (HIE)
where needed, but focuses on direct portal access to the real repositories.
• Future-ready longitudinal care—Provides integrated electronic health record (EHR) case-
management services to support a one-view model. This model:
–– Determines eligibility
–– Assesses needs
–– Engages the population in a client-centric model
–– Supports social caseworkers in delivering services and longitudinal care
–– Engages primary and secondary care in a collaborative model
–– Drives cost controls, outcome, and quality goals for agencies seen on a frequent basis
• Personalized medicine—Uses tools for genomic medicine to analyze aggregated, over-time
patient information in context of latest discoveries in genetics and pharmaceuticals to provide
personalized—predictive and preventative—care and treatment plans.
• Evidence-based medicine—Enables systematically reviewing, appraising, and using clinical
research findings, health studies, and historical data to aid in delivering optimum clinical care
to patients.

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Viewpoint paper | Envision the digital hospital

Improve operational efficiencies

• Optimize resource use with dashboard control towers’ compliance and oversight—Alerts
trigger escalation and process breakdown, and compliance and regulatory violations for all
key stakeholders.
• Automate and optimize business processes, frictionless workflows—Optimizes rules, best-
practice alerts, and threshold triggers. This is based on the integration engine, enterprise
data warehouse, and analytics sent to nurses’, patients’, and doctors’ preferred devices
and preferences.
• Integrate care management—Ensures secure information flow and real-time information
access within the provider organization, social services, and provider network. It enables
superior clinical decision-making and better care quality while improving process, workflow,
and operational efficiency in the provider setting.
• Get population health analysis—Automates tools required to manage patient populations.
It aggregates data and uses information to understand trends assist in the care process,
focusing on cost control and team-based approaches.
• Incorporate invisible, intuitive technology—Uses voice recognition and activation technology,
including touch-, voice-, or gesture-activated devices and invisible smart-bed sensors.

Improve quality and outcomes

• Patient-centric care with patient or family control and consent—Provides secure, self-
governed online access to self-help, education, best practice, and easy-to-follow treatment
plans while supporting workflows; automated rules and alerts assist with health, lifestyle,
fitness, and diet for overall wellness.
• Care team coordination—Extends workflow, information management, and real-time alerts to
provide care across providers, social services, and mental health teams.
• Right care, right place, right time, right cost—Provides mobility care and mobile devices with
information at the point of care using light-weight, always available applications.
• Real-time connected community care—Connects information to tele-medical (tele-med)
centers, nurse call centers, real-time virtual meetings, shared dashboards and images,
artificial intelligence (AI) avatars, social media, and support networks for patients and doctors.
• Remote medicine—Coordinates medical activity involving remote medical resources and
services using data, audio and video links, websites, email, telephone, fax, electronic file
exchange, or other communications systems to transmit medical information.

Figure 2. Impact of strategic themes and enablers

Integrated care Patient-centric care with

management Future integrated patient control/consent
health & social care
Enhanced access Care team
to care Collaborative coordination
Speed treatment Improve
Future ready Right care, right place,
innovation longitudinal care right time, right cost quality &
Performance
to practice metrics outcomes
Personalized Real-time
medicine community care
Velocity of care
Evidence-based
Remote medicine
medicine

Optimized resource Automated &

utilization (with optimized business Integrated care Population health Invisible “intuitive
dashboard process “frictionless environment analytics technology”
control towers) workflows”

Improve operational efficiencies

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Viewpoint paper | Envision the digital hospital

See what’s central to the evolving healthcare system

A digital hospital leverages innovative technology to orchestrate care coordination, increase
operational efficiency, and improve patient outcomes. It provides a real-time information
integration environment that enables optimized care coordination, more efficient hospital
operation and administration, and improves patient care quality.

Journey through the vision—Part 1: Orchestrate care

inside the digital hospital
There are nine key areas of focus for a digital hospital:
1. Admissions—scheduled, unscheduled walk-in, and emergency
2. Triage and diagnosis
3. Diagnostic imaging and pathology labs
4. Operating room—surgery and therapy
5. Ward care—patient recovery and support
6. Discharge and aftercare
7. Integration engine—real-time care coordination enabled
8. Background and operation functions
9. Leadership and administration

The following are descriptions of each area of a digital hospital.

1. Admissions—scheduled, unscheduled walk-in, emergency

Walk-in workflow
• Patient arrives and checks in at self-service kiosk.
• Admitting nurse oversees self-check-in kiosk process for all patients’ information. Initial
patient record is created, building on existing external cross-provider digital records.
• Patient is added to a queue management system, which prioritizes and expedites patient
attention and admission processes.
• Patient receives text or email alert with directions when the doctor and examination room
are ready.

Emergency workflow
• Ambulances have a digital routing system, and the hospital is alerted by a look-ahead-
planning system.
• Emergency medical technicians—ambulance personnel—complete a relevant report on a
mobile wireless tablet and upload it wirelessly to patient records. For emergency admissions
patients, they go straight to the emergency room (ER) triage area.
• Hospital administration routes patients to hospitals with appropriate treatment facilities
and bed space.
• Emergency staff is preassembled and ready for patient arrival.

Family and visitors workflow

• People use kiosk way-finder for directions to patient’s room or ward.

Key data flows

• External cross-provider updates EHR.
• Integration engine orchestrates updates to EHR, patient administration system (PAS),
emergency whiteboards, and syncs elevators—if required—from helipad.

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Viewpoint paper | Envision the digital hospital

• Data from ambulance dispatch checks hospital availability.

• Data from ambulance, concerning patient details and status, is updated.
• Queue, room availability, and scheduling information are sent to the admitting nurse.
• Text or email alerts patient on queue status and directs where to go.

Enabling technology
• There is a self-service check-in kiosk.
• Mobile tablets capture and upload patient status information.
• Digital signage displays waiting room statistics and status.
• Queue management software improves patient flow and optimizes critical resources scheduling.
• Unified messaging alerts patients on status and booking.
• RFID or bar-coded patient “smart band” is created.

Benefits
Enhanced quality of care and improved patient experience
• Admission time is rapid and painless because a healthcare record is already in the system.
• Patient is issued a smart band that tracks movements, provides medication alert checks
during stay, and ensures information is displayed and available automatically to staff.

2. Triage and diagnosis

Digital hospital workflow
• RFID sensors alert ER that the patient is approaching and updates whiteboard status displays.
• Triage clinician receives complete patient records from admissions, including any external and
internally generated information.
• Patient is quickly triaged and appropriately routed.
• Testing technicians are alerted to X-rays and other ordered tests via unified communication or
paging mobile devices.
• Physicians are alerted to the new patient, patient’s needs, and relevant information from the ER.

Key data flow

• Critical patient data is available to triage, assisting with speedy processing.
• Online orders are created for the next stage, such as X-rays and blood tests.

Enabling technology
• Whiteboards or digital signage display ER and wait status.
• Desktops and tablets provide real-time patient information at the point of care.
• Real-time location services (RTLS) or RFID smart bands alert staff and automatically display
updates regarding the patient.
• RTLS locates wandering patients.

Benefits
Enhanced quality of care and improved patient experience
• Diagnostic time is improved because healthcare record is already in the system, enabling
triage staff to quickly and efficiently process patients.
• Patients are happier because they do not have to explain or repeat their medical history
information.
• Hospital administration and operations improve—no unnecessary or wasteful treatments are
ordered. Whiteboards improve awareness and eliminate clinical delays and wasted time.

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Viewpoint paper | Envision the digital hospital

3. Diagnostic imaging and pathology labs

Digital hospital workflow
• X-ray technician has all patient records and orders X-ray on patient’s arrival.
• RFID sensors alert when patient approaches and updates lab queue management and
whiteboard status displays.
• Lab samples are taken, tests performed, and patient EHR is updated and displayed on touch-
screen monitors.
• Physician receives results immediately on diagnostic terminal and can annotate results, decide
next steps, order medicine, and schedule surgery and other procedures.
• Ward orderlies receive room orders on a mobile device and begin preparation for patient’s
special needs.
• Pharmacy receives pain and infection mitigation medicine order, fills it automatically, and
delivery is made by the pneumatic tubing system.

Key data flow

• Clinical data is handled by clinical systems but integrated for the physician’s use by the
integration engine. Workflow, message routine, and information are managed by it.

Enabling technology
• Whiteboards display lab status and provide greater visibility, work coordination, and
throughput.
• Large, high-resolution displays provide real-time images and patient information.
• RFID patient smart bands alert staff and update displays automatically to ensure information
is relevant to the patient.

Benefits
Enhanced quality of care and improved patient experience
• Imaging and pathology lab test results are automatically added to the EHR and routed for
analysis and diagnosis.
• Patients are happier because they do not have to explain or repeat their medical history information.
• Hospital administration and operations improve—no unnecessary or wasteful treatments
are ordered.

4. Operating room—surgery and therapy

Digital hospital workflow
• Each operating room (OR) has a whiteboard or dashboard and underlying schedule
management system that dynamically updates as emergency patient events, room
availability, or doctor schedules change.
• Central sterilizing and reprocessing (CSR) staff are alerted to set up all necessary equipment
for surgery, and systems track high-value reusable instruments with scanners or tags.
• OR staff receives physician’s order and sets up what the doctor has ordered, on time, and in
accordance with the doctor’s preferences.
• Physician arrives with everything in place, patient anesthetized and prepped, and X-ray and
other results are ready for reference on a large touch-screen, where clinical data has been
integrated with patient’s EHR.
• Nurse updates and maintains records on sterile, washable keyboard.
• Patient RFID alerts anesthesiologist, physician, nurses, and other staff to execute the series of
events surrounding an operation, preoperation, and postoperation.

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Viewpoint paper | Envision the digital hospital

Digital hospital data flow

• The integration engine synchronizes real-time alterations from patient and doctor RFID with
OR whiteboards status changes. It also maintains automated guided vehicle (AGV) movements
and building management systems (BMS) to support OR equipment readiness.
• Clinical and EHR information is integrated and available to the surgical team on large displays.
• A procedure trolley is set up, and assets are accounted for and monitored within asset
management systems.
• Laparoscopic data is displayed and recorded.

Enabling technology
• Large, high-resolution displays assist surgical teams in theater, and provide valuable
expanded visual reach and magnification.
• Whiteboards and underlying scheduling algorithms display emergency OR status key
performance indicators (KPIs) dashboards.
• Nurse updates and maintains EMR records on medical-grade, sterile washable monitors,
keyboard, and mice and computers on wheels1 (COW) devices.
• Large interactive whiteboards and advanced queuing software enable staff to replan and
reschedule OR to ensure optimal use of physical and people assets.
• Large, high-resolution displays provide real-time display of images and patient information in
theater and for real-time training and lecture rooms.

Benefits
Enhanced quality of care and improved patient experience
• Faster processes enable more operations, resulting in additional hospital revenue.
• Real-time scheduling ensures optimal use of key physical and clinical staff.

5. Ward care—patient recovery and support

Digital hospital workflow
• Bedside terminals let patients control entertainment, room environment, visitors, and nurse
calls; make soft telephone calls to friends and family; and schedule services for food, drink,
and cleaning.
• Nurses are alerted to urgent patient needs on a mobile device and can call patients back
directly, saving time and unnecessary checks on them. Nurses can raise a team scramble alert
to respond to critical conditions.
• General ward care is organized, displayed, and prioritized on a digital whiteboard containing
patient needs, status, visitors, and so forth.
• Orderly and auxiliary staff respond to patient food, room, and cleaning requests on their
mobile device located via RTLS. They also may be scheduled to perform various tests and
measurements, and patient medical records are updated in the process.
• Physicians—during their rounds—can access a patient record or results on their mobile device
or tablet, at a patient’s bedside terminal, or on a large touch screen in patient’s room. They are
kept informed of progress and alerted to unexpected developments.
• Physicians and nurses can use a large touch screen in a patient’s room for easy, quick access
to EHR and test results, conduct conferences with the patient and other medical staff, and
provide in-room training and advice on patient well-being, diet, and therapy. This helps stop
readmissions and speeds up recovery.
• Physicians can also contact patients and nurses directly from their mobile devices or
workstation areas and schedule remote discharge for simple cases.
• AGVs are scheduled to pick up supplies, dirty clothing, and equipment, and perform simple
tasks such as delivering medicine and food. They also request elevators and move safely
through the hospital.

1
 lso known as carts or workstations on
A
wheels (WOWs)

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Viewpoint paper | Envision the digital hospital

Digital hospital key data flows

• Patient records are available at the point of care, and on whiteboards and mobile devices.
• Patient monitoring equipment sends out exception data to the appropriate lifesaving team.
• Patient is traceable by RFID, and smart bands enable medication to be checked.
• Orderly and porter requests are managed by queue management systems.

Enabling technology
• Bedside patient terminals provide entertainment and training priority alerts and requests.
–– Session persistence removes (re)logon for EHR and core applications across time and
multiple devices.
• Queue management and mobile workflow are orchestrated.
• Whiteboards and activity monitoring provide real-time KPI dashboards for:
–– Operational visibility and decision-making
–– Real-time and historical trending of KPIs
–– Statistical algorithms to monitor if processes are in or out of control
–– Review and monitoring of corrective actions

Benefits
Enhanced quality of care and improved patient experience
• Nurses are no longer required to do unnecessary checks on patients and provide
nonclinical services.
• Patient can provide self-service and has access to treatment plans and training for faster recovery.
• No unnecessary orderly work or cleaning is done.

6. Discharge and aftercare

Discharge digital hospital workflow
• Physician agrees that the patient can be discharged—simple discharges can be done virtually,
saving patient waiting time.
• Discharge nurse collects all discharge directions and information, which is organized in one
document to review with the patient.
• Patient is discharged with an electronic information packet containing orders for all future
medication, diet, behavior changes, and follow-through appointments.
• Physician is kept informed about patient’s discharge and recovery, and is able to review
records and follow-through orders.

External after-care workflow

• Pharmacy receives prescriptions and details electronically from the hospital.
• External caregiver’s EHR is updated for the patient.
• Patient can access all critical information and updates through the tele-med system, enabling
receipt of nonurgent care through at-home devices.
• EHR is updated for insurance claim purposes.

Discharge digital hospital key data flows

• EHR is updated on dispatch with all treatment and after-care information.
• Virtual interaction takes place with physician and patient.
• Patient takes record, instructions, and prescriptions on a mobile device.
• Prescription orders are sent directly to the pharmacy.
• Information relevant to patient’s condition is automatically searched for and provided to
the patient.

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Viewpoint paper | Envision the digital hospital

Enabling technology
• Workflow coordinates all test results, medications, and approvals required for release.
• Doctors can access EHR and talk directly with the patient via video link or phone to expedite
discharge of simple cases.
• Reporting tools help:
–– Create personalized output
–– Generate multiple output types and formats
• Follow-up email supports patient communications, including:
–– Personalized discharge
–– Continuum of care
–– Wellness campaigns
–– Patient retention
–– Hospital brand and marketing

Benefits
Enhanced quality of care and improved patient experience
• Patient is provided with full discharge information on a smartphone or tablet and has access
to treatment plans and training for faster recovery.
• Hospital administration improves because patient leaves on time, with clear, easy-to-follow
instructions. Discharge is rapid, and digital patient documents save paper and printing costs.
• Process meets government health mandates for digital information and reduces costs.

7. Integration engine
Digital hospital key enabling capability
• IP-based messaging integration system advances mobile device messaging and automates
human workflows.
• Pervasive real-time integrated information and service engine orchestrate workflow and
integrate applications, information, building, IT, and communication services.
• Digital hospital ensures all necessary information is available when and where it’s needed. It
helps ensure all critical information is orchestrated and comes together to enable efficient care
delivery workflows and analysis.
• Patient records are updated and available at all points of care—the right time, at anytime,
from anywhere.
• It uses industry standard interfaces and protocols to make implementation cheaper and more
reliable. This includes data collection and production, integrity, and transmission to external
connections through to support community care.
• Digital hospital provides security and privacy controls to meet regulatory imperatives. It
integrates IT systems, facility management systems, med-tech centers, and people using
mobile devices to provide coherent work processes across the entire hospital.

Key benefits
• Digital hospital integrates IT systems, facility management systems, med-tech centers, and
people using mobile devices to provide coherent work processes across the entire hospital.
• It streamlines work processes, increases mobility, and provides a more pleasant environment
for patients and staff.
• It disguises integration complexity.

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Viewpoint paper | Envision the digital hospital

Figure 3. Digital hospital integration engine—enables real-time care coordination

Staff Sup. service Clinician Nurse Patient

Video/audio Video/audio
Dashboard/ Bedside
Medical device middleware United communications
nurse station terminals
Monitors email WS
PA system
IV pumps IM
WS
Kiosk software

WS
Power systems Video conferencing

............... VoIP telephony Wayfinding

& signing

Active
External directory
organizations Integration engine LDAP
Audit
BACNet, OPC, WS repository
HL7/WS

Nurse call
Building automation system Hospital/clinical information system
TAP, ESPA 4.4.4

Mechanical Free alarm Staff scheduling

system
Lighting Payroll

Hydraulic Security Materials management

Chute system Location Finance

system
Electric EPR/EMR

Escalator HIS/PAS

Caroussel PACS/RIS

Vertical transportation LIS

AGV Maternity

Pneumatic tube Operating room scheduling

8. Background and operation functions

Key background workflows
• Orderly and auxiliary staff responds to patient and nurse needs on their mobile device—
wheelchairs, food, and room cleaning requests—and are located via RTLS.
• Hospital administration and scheduling systems track and schedule maintenance and room
cleaning. Admitting nurse receives updates as rooms become available.
• Pneumatic tubes transfer medication and lab supplies to the appropriate place.
• Pharmacy receives and processes orders and delivers them via automatic pneumatic
tubes and AGVs. Whiteboards track pharmacy processing, order status, and KPIs. Patients’
wristbands are checked before administering medication.
• RTLS are used for patient wandering and infant protection systems; they are also used for
tracking key assets.
Enabling technology
• AGVs automate waste handling, delivering supplies, and so forth.
• Pneumatic pharmacy pill-pick tube systems transport items to labs and pharmacy.
• Pill pick automates dose packaging, storage, and dispensing.
• RTLS finds porters and key assets, including available wheelchairs, suction pumps, and so forth.
• RFID-tagged staff clothes are tracked, and inventory is reduced.
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Viewpoint paper | Envision the digital hospital

Benefits
Enhanced quality of care and improved patient experience
• Improves hospital operational efficiency and reduces inventory and operating costs.
• Reduces staff walk and wait time with simple task automation.
• Tracks key assets to optimize their use.
• Delivers medication and samples quickly to and from labs and pharmacy.

9. Leadership and administration

• Direction, targets, and KPIs are set.
• Regular strategic planning is conducted to define new working practices, enterprise
architectures, and support workforce and organizational management of change.
• Innovation continues to enhance the hospital and patient and family experience.
• Oversight and governance resolve issues, ensure delivery plans, and achieve milestones.
• Progress is continually monitored to ensure strategic goals are met, and business case
benefits are realized.

Journey through the vision—Part 2: Review the future

integrated community
The digital hospital model integrates multiple levels of care delivery and supports a 360-degree
view of the patient’s health and social services care management information to deliver
information to all relevant stakeholders at the right time and security level.

At the core is a common shared clinical information system with a central EHR module and
integrated care (case) management system. It provides secure information flow and real-time
information access within the provider organization, social services, and payer and provider
network. It enables superior clinical decision-making and better quality of care delivery while
simultaneously improving the process workflow and operational efficiency in the provider setting.

Enabling the availability of all relevant patient information to different stakeholders—including

those at the community care level—through secure health information exchanges helps
ensure a continuum of care and better disease management post-hospitalization. Patient-
centric underlining EHR systems enable real-time information access across all care-delivery
channels, helping improve patient outcomes. It also reduces overall healthcare delivery costs
by eliminating medical errors and ineffective treatment modalities.

Imagine a patient
Let’s take a look at how a patient might flow through some of this integrated health and social
care community’s components.

Family and patient at home—fit, well, and healthy

In the future, normal day-to-day health and wellness will be managed by patients or parents
with children. They will have a health portal and smart applications accessible via their
smartphones or other connected devices. The home health management activities may include:
• Remote monitoring of diabetic sugar levels, weight, and diet for overweight and at-risk
congestive heart failure patients
• Smart-bed sensors to detect elderly injury, motionless, and persons confined in bed with
no movement
• Automatic appointment alerts, including six-month blood tests, vaccinations, flu advice,
mammogram testing, and reminders to schedule regular checkups
• Medication renewal reminders and convenient delivery time prompts at the patient’s
preferred pharmacy
• Alerts and setup of life-event notifications to cancel papers, alert school, or hold mail
• Access to trusted health and social care information pages

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Viewpoint paper | Envision the digital hospital

Elderly and at-risk patients will be regularly visited by mobile nurse care units to ensure all
is well and modify their care plans accordingly. Additionally, patients can access their own
personalized wellness dashboard, displaying their wellness status against their lifestyle
goals and thresholds, and possible insurance claims. The portal will enable patients to submit
e-visits, hold online chats, make AI avatar requests to the tele-med center, or schedule an
appointment to visit the appropriate care providers in the community.

None of the stops in this journey are isolated from the others. Information from all providers
and agencies—with which the patient has contact—is securely available and updated in real
time. Because of this, patients will be preceded at every stop by the most current information so
that treatments are the right ones, at the right time, for the right reason.

Tele-health—Providing extra virtual advice, help, and query

When patients need help or advice, they schedule an ”e-visit”—a virtual health (v-health)
connection with the tele-med center. Alternatively, they can telephone nurses at the tele-med
center for advice and help when they feel concerned, need reassurance, or advice. Additionally,
if a patient’s personal monitoring device detects a possible issue, it will notify the patient and
have the tele-med center automatically make contact. This will escalate a face-to-face visit
with the primary care physician, specialized consultant, or doctor, or schedule an ambulance
or other transport.

Tele-med center nurses have access to evidence-based treatment repositories and clinical
decision-support tools to help them provide the correct advice to the patient. All call and
contact details, diagnosis, medication, and recommendations are entered into the patient EHR.
This provides continuity of care and ensures that future visits and consultations have access to
this information. It also minimizes errors and ensures correct, high-quality treatment and care
plans, and provides information instantly to other providers down the line.

Face-to-face advice and help

If a patient wants—or the system recommends—an in-person checkup or lab work, patients
will go to their own primary care practice, use a walk-in center, or see a specialist. All patient
historical information and social care history are available, along with any measurements
recently captured via home monitoring.

If the doctors or nurse thinks the patient’s condition is serious, they will schedule a hospital visit
for the patient to see specialists, undergo surgery, or be admitted to emergency. All diagnosis and
treatments are entered into the patient’s EHR to provide continuity of care. This information serves
as an up-to-date reference if the patient is referred for secondary care or specialist attention.

Critical condition
Hospitals will still exist in the future. But they will be far more integrated—the digital hospital—
and fully connected to the rest of the healthcare system. They will provide emergency care
and high-cost, specialized, critical care services. And because of the advances in information
flow and patient-centricity, they will optimize the use of expensive assets, such as operating
theaters and scanners.

These advanced digital hospitals will have their own genome testing facility to identify which
treatment or medication to apply. OR doctors will have live video links to other doctors for real-
time consultation during operations (tele-presence). Emergency paramedics will have live video
feeds into the hospital to get information and advice at the point of accident. AI avatars may
be used on way-finders and patient terminals to provide visibility and transparency of care and
treatment plans. Surgeries in hospital operating theaters will be recorded by 3D cameras used
to educate staff for better insights. Specialists will view completely up-to-the-minute patient
medical history and get detailed information about services provided by the primary care
provider and tele-med inferences of health status.

Within the digital hospital, systems ensure seamless patient administration services such as
patient registration, appointment scheduling, waiting list management, and the consultation
event. Moreover, these systems manage nursing and clinical workflow and equipment logistics.
Integrated into the digital hospital environment is admission, discharge, and transfer (ADT), bed
management, and ambulatory care delivery. Healthcare clinical information systems keep track
of RFID-enabled medical devices and hospital personnel for effective scheduling and optimized
operational workflow. Furthermore, technology is leveraged to optimally schedule operating
rooms and other scarce resources for better use and more effective care delivery.
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Viewpoint paper | Envision the digital hospital

Mobile technology will automate and optimize the infrastructure and process workflows
within the hospital setting. This will improve patient throughput, leaving doctors and nurses
with more time for patient care rather than administrative responsibilities. E-prescription and
computerized physician order entry (CPOE) will automate and quicken medicine delivery and
improve laboratory management.

The digital hospital goes all the way to plant management and heating, ventilation, and air
conditioning (HVAC) systems, optimizing the facilities and environment for maximum comfort,
care, and efficiency.

Recovery and long-term care

Patients will visit out-patient, specialized rehab centers and clinics, or be admitted to long-term
care facilities for ongoing nursing care and support. Patients’ most up-to-date information will
precede them to the facility so on admission, dietary instructions and treatment plans will be
ready and available. This ensures continuity of care and provides personalized patient wellness
and preference information.

Know where we are in this journey

Think back to the advent of health maintenance organizations (HMOs) and other managed care
models—or even further back to 1920, when Dr. Frank Lahey first developed his integrated
team approach. There you will see the seeds that have led us to this vision. The one thing these
models lacked was the advanced, sophisticated IT infrastructure to properly tie it all together
and link it to the healthcare system and wellness models.

Looking at the present, you can see these ideas have blossomed into a healthcare system and
digital hospital that is rapidly adopting the fully integrated, real-time environment envisioned.
Realizing the vision is a step-by-step process requiring change in philosophy, behavior, and
sophisticated technology.

Every step along this journey further positions healthcare to better address the needs of a
patient-centric, outcome-based integrated care delivery model, delivering better care quality,
enhancing operational efficiencies across care providers, and speeding innovation to enable
better patient outcomes.

Learn more at
hp.com/go/healthcare

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Viewpoint paper | Envision the digital hospital

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