| 1 digital hospital is paperless hospital.
In the foreseeable future, digital hospitals will continue to be a hybrid of electronic and paper information model. Digital hospitals are often seen as replacing paper-based records with electronic channels, systems and tools. Paperless hospitals may be a long-term, highly anticipated medical industry, and the road to digital hospitals can be a complex, risky and costly journey, according to our experience.
At present, only a few hospitals can be classified as paperless hospitals. In addition, many clinicians and administrators emphasize that in a particular medical environment, the use of paper-based recording tools is most effective for collecting patient information, but they also recognize the "digital implementation" of paper-based tools as a scientific and technological direction, so both paper and digital can coexist. In fact, in the foreseeable future, the digital hospital will still be a mixed information mode of electronic and paper. Another practical alternative is the "paper simplified" hospital, which focuses on ensuring that patients can "digitally access" the correct information and service systems, thus optimizing the quality and efficiency of patient care, disease research, medical education and other important medical functions. But it does not mean that all information and services are provided digitally, but selectively, in line with strategic priorities, to maximize the convenience of patients, clinicians, and medical organizations.
However, the "paper simplification" mode or mixed mode will face many challenges, including:
Visit - clinicians can easily access all the information at any time.
Safety - management of paper medical records to protect patients' privacy.
Timeliness - Prevents clinicians from wasting precious time rushing to complete paper information when making important decisions.
Integrity - integrate all relevant information to form a comprehensive record.
2 digital hospital should be designed as "digital world".
Hospitals need to communicate information between digital and non-digital providers to support clinicians and provide the best possible treatment for patients.
All hospitals, including digital hospitals, are not isolated functional bodies. Providing high-quality medical care for patients requires a local health care system and the timely exchange of patient information. The system includes primary care, specialist care and medical specialists, as well as other public and private hospitals.
Unfortunately, the speed of digital transformation of medical organizations has fallen far behind, and medical organizations in many regions are still unprepared for it. The design of digital hospital must recognize this reality, especially the need for the system to communicate with the local medical and health system, both digitally and non-digitally.
Jurisdiction and national e-health projects, such as the National Personal Electronic Health Record System (PCEHR), must also be considered and utilized where possible. Most of these projects are aimed at improving the interactivity and fluidity of patient information and increasing the likelihood of achieving hospital digital goals. As a result, they may become a technical infrastructure to support the flow of information between hospitals and the digital divisions of most medical systems, including the exchange and conversion of paper-based information within medical organizations.
3 clinical needs determine the technical capability of hospitals.
Clinical needs and technical strategies must be developed simultaneously to solve the technical bottlenecks in the construction of digital hospitals as the most core part of the value of technology is evolving. Devices such as smartphones, tablets and wireless "smart" clinical monitoring are fundamentally changing the way diagnosis and care are done. The relationship between clinical needs and technical competence is not one-sided, nor is it decided by who, but becomes more closely and interdependent. This interdependence indicates that the hospital's technical strategy is no longer simply to follow the clinical needs and nursing model, instead of the mutual coordination and common development of the two. The key is to recognize that technological advances open up many possibilities for innovative design of diagnostic, therapeutic and nursing modalities, especially for new and increasingly complex clinical needs.
Clinicians and technicians must work together to understand which diagnosis and treatment model should interact with the technology of digital hospitals and to find ways to provide innovative medical services. Then the clinical process and technological progress are refined to reach a consensus and react to medical services and hospital management.
The important aspects of design and development include:
The flow of patients and the management mode of medical resources
Information flow to support clinical referral and handover between hospital departments.
The demand for mobile medical and information access inside and outside hospitals, especially patient records
Physical and virtual access security requirements
4 the industry framework and the mature "best example" model show the digital roadmap of each hospital.
Digitalization should be driven by design strategies based on local priority services, concerns, medical models and feasibility.
Several electronic medical records (EMRs) models have been influential in recent years. Each of these models shows the priority of priority in promoting and introducing digitalization functions. Their success is undoubtedly instructive, but it should not be seen as a universal or normative model, and may not necessarily apply to all hospitals.
According to the classification model of electronic medical record application in the United States, the realization of full digital EMR represents the highest level of maturity. In fact, EMR is gradually being implemented in most hospitals as electronic medical records are used in a range of clinical, laboratory and other systems. However, full digitization is not necessarily applicable in all cases, and hybrid EMR (selected record types expressed as scanned images or stored in other formats) may be more practical in some hospitals. This is because each hospital starts its EMR journey from a different starting point, such as unique demand allocation, current and planned technology investments, relationships with service providers, the ability of medical workers to accept change, and the ability of IT departments to provide technical support. The combination of all these factors means that each hospital's path to a digital strategy will be a unique journey.
In the transition to a digital future, each hospital needs to integrate its own business and clinical strategies, as well as technical capabilities and external support. So sophisticated digital models and industry frameworks just provide direction, but don't tell you why or how.
5 clinicians need all clinical information related to patients.
Clinicians most need information that supports clinical decision making, and improve efficiency and avoid information overload.
Information overload is a challenge. Clinicians under heavy pressure often need to browse a large amount of information in multiple systems, which not only leads to frustration and stress, easily frustrated, but also wastes valuable time to provide patients with the best treatment.
In fact, clinicians have little or no need to collect all clinical information. Instead, what they want most is easy access to a subset of information presented as "structured data" that enables them to make safe and effective decisions in a timely manner. This subset of relevant information will vary from hospital to department depending on care settings, care and clinical pathway patterns.
Of course, this does not mean that hospitals should not keep detailed records of patients. On the contrary, it is also mandatory for hospitals to retain detailed medical information from patients. This information is gathered by hospitals (including medical workers), but some hospitals have confused the concepts of "medical records" and information subset, which only concern the need for clinicians to make rapid clinical decisions in specific circumstances. So these two concepts are different but must be treated equally.
Clinicians can work quickly and effectively, and monitor the progress and effectiveness of patients'treatment plans, not only by obtaining the correct subset of information, but also by presenting it in the right way. Another important consideration in data representation and workflow configuration is the special roles of different nurses and the workflow they record. The application of user-centered (UCD) system design concept makes it present the correct information in the correct way and has a perfect early warning mechanism, which will improve the service efficiency and medical service quality.
6 Independent clinical systems procurement using one company "package as a whole" is a low complexity and minimum risk approach
Wrong! Procurement must choose the right clinical decision-making process, but also need to be carefully analyzed and considered in many ways. Accuracy, timeliness and accessibility of clinical information are the main vision of digital hospitals, which requires the correct clinical system architecture strategy. When formulating this strategy, hospitals often face an important decision, that is, to choose between "whole package" purchases from independent suppliers and "best combination" products from multiple suppliers. Overall packaging from independent suppliers is usually more attractive and in many ways the simplest decision. Their full powers of packaging can be a lot of convenience. They usually provide a wide range of functional coverage to support clinical and patient management information flows and processes, integration, and consistency of patient and clinical data in each module. But experience has shown that there is no universal strategy to ensure that complexity and risk are minimized, and that each scenario encompasses both advantages and disadvantages, which must be considered in a comprehensive manner according to various factors. Therefore, choosing this path faces a common challenge: functional gap, single procurement point, resulting in no competition, so its customized development costs high, or the existing function is imperfect.
Vendors differ in how to support clinical tasks or workflows, and in how they actually manipulate them, especially in the unexpected conflicts of service products in integrating current hospital systems.
By contrast, the "best combination" product strategy allows clinicians and users to choose the best product they need, but the freedom of choice increases integration costs. Other factors must be taken into consideration in formulating a correct strategy, such as the clinical application of hospitals.
By contrast, the "best combination" product strategy allows clinicians and users to choose the best product they need, but the freedom of choice increases integration costs. Other factors, such as the hospital's existing investment in clinical applications, capital availability, risk tolerance, and employee and market capabilities, need to be taken into account in formulating the right strategy. Broader strategies must also be considered, such as cloud computing, mobile and management services.
7 cloud services are unsafe and irrelevant.
With the development of cloud technology, digital hospitals will benefit from it.
Security and privacy concerns do not impede the application of cloud services in hospitals. Private cloud, hybrid cloud and public cloud have entered the medical field. Each type of security and privacy has its own characteristics, and different hospitals have their own applicable needs.
You know, cloud service providers really value the safety and privacy of users, because ensuring customer trust is the business foundation. Because of economies of scale, suppliers will invest in the overall security architecture, and therefore will not significantly increase the cost of a single hospital. In addition, the supplier will provide customers with an independent security environment.
Safety and privacy need to be considered, but not the only ones. The size of the hospital, the demand and scalability of medical services, and the budget are all important factors affecting the choice of appropriate cloud services. These considerations may drive increased collaboration between hospitals to develop cloud services to meet business expansion needs while ensuring that individual hospitals do not have to bear excessive costs.
Hospitals and health departments do not use cloud computing, often on the basis of legislative and regulatory issues. Although current legislation requires patient data to remain in the country, it should not prevent digital hospitals from benefiting from cloud computing services.
Cloud computing services can be used to outsource IT product services, such as e-mail, human resources software, applications, hosting, and IT infrastructure management, thereby applying the spare labor and costs to internal clinics, and other systems and services, which are key to digital medicine. With the maturing of cloud technology environment and the emergence of products and services in health industry, hospitals that participated in Cloud Application in the early stage can better adapt to the transformation from IT product services to cloud services. From clinical data containing medical record scans and clinical records to clinical services such as scheduling, patient management, clinical care management and electronic medical records.
8 digital hospital data must be managed by independent data agencies.
Data management requires collaboration between hospitals and multiple agencies within a common framework, and matching clinical data management with multiple key data domains is often a mandatory practice, and each hospital has a different set of data for use in different places, such as clinical care, hospital management and clinical research. The nature and usage of the data domain affect the different management requirements in the data domain. Therefore, digital hospitals need to operate enterprise-level data management and domain-specific management procedures within a common data management framework, working with multiple data organizations. The data domain and management need to include the following elements:
Principle - to clarify the goal of hospital data management (Zong Zhi).
Organizations - Establish organizational structures, including roles, responsibilities and obligations to achieve goals, strong leadership and commitment from clinical, business, and IT stakeholders.
Standards and Processes - Standards facilitate common terminology and data definition, including data quantification indicators, and process management of hospital internal data domains.
Technology - Measures hospital data management policies, standards, and processes that support definition, application, and compliance.
Different data managers must also be involved in each data domain -- because they understand how data is created, stored, managed, and used, so that such data management can meet the relevant clinical, commercial, and research needs.
Improving data management will improve the quality of clinical services and ensure high levels of care, so the discovery of data assets in digital hospitals will be a key step in their strategy to produce outstanding clinical and scientific research results.
9 add more data and add analysis and report later.
Basic analysis and reporting capabilities, which must be seen as a key requirement early in digital projects, have focused on patient data collection and storage electronics over the past 20 years. Now, with a large amount of available electronic data, attention has shifted to the analysis of available data in order to prize the mystery and improve the level of clinical decision-making, research and hospital management.
A technical strategy for a digital hospital must see these requirements as "core" and an early plan for proper use of such tools as business intelligence (BI) and analysis tools is needed, but there are two key challenges, data quality and data accessibility.
Ensuring data quality, especially data integration from different data sources, is very difficult. This is because the medical institutions have established the traditional fragmentation IT environment, and the data standardization is not enough. The use of data analysis and reporting in medical institutions is limited, which is also a problem that digital hospitals must solve. Previously, data analysis and reporting were carried out by statisticians or IT departments, so the use and value maximization of information often depended on the ability of doctors themselves. In the future, a more convenient system should be established that allows clinicians to independently access structured reports or group information of individual patients through existing data
9 add more data and add analysis and report later.
Basic analysis and reporting capabilities, which must be seen as a key requirement early in digital projects, have focused on patient data collection and storage electronics over the past 20 years. Now, with a large amount of available electronic data, attention has shifted to the analysis of available data in order to prize the mystery and improve the level of clinical decision-making, research and hospital management.
A technical strategy for a digital hospital must see these requirements as "core" and an early plan for proper use of such tools as business intelligence (BI) and analysis tools is needed, but there are two key challenges, data quality and data accessibility.
Ensuring data quality, especially data integration from different data sources, is very difficult. This is because the medical institutions have established the traditional fragmentation IT environment, and the data standardization is not enough. The use of data analysis and reporting in medical institutions is limited, which is also a problem that digital hospitals must solve. Previously, data analysis and reporting were carried out by statisticians or IT departments, so the use and value maximization of information often depended on the ability of doctors themselves. In the future, a more convenient system should be established to allow clinicians to independently access structured reports or group information from individual patients and to study existing data to improve the quality of care, rather than starting analysis and reporting with a larger accumulation of data as before.
10 it is necessary for clinicians to access patient information through digitalized hospital systems and equipment.
Clinicians want to use their own equipment in their work, more convenient access to patient information Clinicians need to get patient information anytime, anywhere, and hope that these easy access and view. As a result, they increasingly want to be able to operate on their personal mobile devices, or on systems other than hospitals, especially for clinicians working in multiple medical institutions and in emergency settings. They may be in other medical institutions, at home or in offices, and even in different states or countries.
It will be more convenient and familiar to bring your own laptop or tablet computer. Many clinical workers hope to be able to incorporate patient information from the hospital into the personal clinical information system. Hospitals will give more consideration to this new form and establish mechanisms to ensure peer-to-peer compliance with safety policies and standards. Of course, there are three major problems facing hospitals.
Not all patient data is stored in electronic format. In most hospitals (and some new ones), electronic and paper information materials are mixed based on different tools.
Not all electronic data are kept in one place. Patients and clinical data are usually scattered in multiple patients, clinical and professional systems, and can not be seamlessly docked.
Not all electronic information has the same structure and meaning. Hospitals often use different standards, formats, and patient identification systems, making it difficult to integrate and relate information silos. If hospitals want clinicians to access patient information through their own systems or devices, they must establish a common core system that contains structured and standardized data formats. The system shares information with mobile devices and other external clinical information systems in a secure and interactive environment.
11 mobile technology "can make use of it."
Clinicians are often mobile in practice, so future mobility must be the basis of technical strategy.
Clinicians always want to get the information they want at a critical point in time, but they are often in the "on-demand move". Therefore, in digital hospitals, personal intelligent terminals and integrated clinical information systems provide doctors with better access to information and information integration. So mobile technology will be of strategic importance rather than an external supplement. Mobile medical technology needs technical framework to solve some problems, especially:
Ensure that equipment access can be accessed at any time at any time.
• access to core hospital systems and data resources.
User centered mobile applications
Clinicians need to integrate mobile devices with fixed devices, so user terminal devices need to be integrated into the hospital's overall technical strategy and address issues such as technical support, access, security and privacy. The mode of the user's final device will have an impact on the following:
* The technical infrastructure needs of hospitals, especially the wired and wireless network infrastructure, need to support a variety of mobile and fixed equipment.
Hospital technology environment design, for example, the layout of different medical systems.
Mobile is not just the development of smartphone and tablet apps, but the overall construction of hospital applications and technology architecture, affecting the choice of new applications and technology platforms. Many hospitals still use the original systems and platforms, unable to easily replace or support mobile devices, so these hospitals also need integrated docking solutions.
12, focus only on improving systems and processes, which will provide high value solutions and services.
The success of the digital conversion depends on the application of a patient-centered "outward-to-inward" approach in the design of hospitals and other medical institutions that place too much emphasis on improving systems and processes to improve operational efficiency and patient experience. But the fact is that because of budget and manpower constraints, one-time investments and reforms often fail to achieve the goal of improving the quality, efficiency and patient experience of care at the same time. Often changing the internal system or the way of efficiency innovation often reduces patient experience. Such changes, such as reducing a choice, forcing a change in behavior, may in fact create barriers to users, and if such changes accumulate over time, may eventually lead to patient dissatisfaction and unsustainable service. This, in turn, has adverse consequences for medical workers.
Improvements in internal systems and processes are often referred to as "from inside to outside" changes. The "inside out" approach does bring huge benefits to many industries.
But unlike other organizations, hospitals have a clear mission to provide medical services to patients. Clinicians or medical institutions pay more attention to the health of their patients, rather than others. Therefore, hospital digitization should combine "patient-centered" with improving the quality of medical services, and try not to reduce the cost of efficiency. Therefore, this change is "outwardly" from a patient's perspective.
Before the solution is put into practice, the hospital should adopt a "from outside to inside" service plan and delivery mode, focusing on determining customer pain points, needs and expectations. Once patient needs and experiences are validated, hospitals can focus on systems and processes that best meet user needs. Clarifying the patient-centered concept and layout will help to foster a good medical culture and encourage medical workers to integrate sincerity, responsibility and creativity to solve patients'problems.
Another key step is to implement the "user-centered" design approach (UCD), which will provide medical staff with knowledge, tools, and communication technologies, and will also help shape expectations and goals, ensure that the project is on track, and provide participants with confidence in putting concepts into the program. Then the end-user optimism, medical staff participation, to produce the best user experience, this is our values, through the "outward-to-inward" way to improve patient experience, this is to become a real "digital hospital" sign!
Reprint please indicate the source: HC3i China digital medical network.
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