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Starting small to make digitization a success

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As published by ICT&health

If no one notices that we use track and trace, the system works”

Jaap Groen

Clinical Physicist, OLVG Hospital, Amsterdam The Netherlands

Clinical physicist Jaap Groen, who works at OLVG hospital in Amsterdam, is a big supporter of automation in healthcare. But it must be done in a good way. For example, a few years ago, OLVG started two pilots as part of the European BigMedilytics program, with a focus on analytics and reducing search time for mobile medical equipment for nurses, as well as improving hospital-wide asset management with data analytics. According to Groen, the attempt to introduce the system gradually failed, partly due to the Corona crisis. The many lessons learned from the pilots – intended to test the technology – and a broader strategic partnership with Philips led to a revised approach this year. “If you are successful on a small scale, it is easier to take the next step.” 

 

Groen came across track and trace through a former colleague who now works elsewhere. Groen states that he is a big supporter of automation in healthcare to free-up healthcare professionals for high-quality work instead of all kinds of administrative tasks.


“We do a great deal manually in the field, among other things, registration, or have separate programs developed for such purpose. This can all be done much more streamlined through automation and digitization. But it is often very slow. This is also because healthcare is a rather conservative sector. If what we have been doing for the last 10 years still works, we will continue to do it the same way 10 years from now.”


According to Groen, it is about people and human lives. “You really need a culture change in healthcare if you want to build confidence in the benefits of digitization and automation. We do observe a difference between older and younger generations. Although younger healthcare professionals are accustomed to having a digital environment in their working and private life, it is still moving slowly, but will accelerate as more young people join in.”

Start small

Groen explains that it is especially important to start small and have clear goals to drive a cultural transformation. “Technology can basically do everything these days, so theoretically we could implement track and trace of devices in one go throughout the entire hospital, but that would not work. You must do it step-by-step to allow employees to see that automated device tracking offers advantages over doing it manually, on a small scale, which will also build confidence in the entire system.”


Groen and his digitization colleagues have also seen this in previous pilots that OLVG started in 2017. One pilot on three wings of the maternity ward and one in a combined nursing unit.

 

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Lastly, the benefits related to infection prevention and control are obvious. Tele-ICU reduces traffic in and out of patient rooms whether employed between hospitals or within. Philips Senior Director and Head of Medical Affairs for Monitoring, Analytics and Therapeutic Care, Adam Seiver, MD, PhD, who also serves as eICU Physician Specialist for Sutter Health in Sacramento, California, reported that the solution even proved valuable in ensuring proper donning and doffing of personal protective equipment – the tele-ICU physician serving a “buddy” function during this process. ​

Tele-ICU is one example of an eHealth solution allowing provider-to-provider consultation. Another, remote overread services for radiology images, has been available for decades and we increasingly observe remote readings of digitalized pathology slides becoming standard practice. Both extend the reach of specialized services and provide a platform on which to scale clinical decision support, including AI powered solutions.

Lessons learned

Groen elaborates: “A good idea, my predecessor thought: If we always know what is located where we will not have to search so long. But after those two pilot projects, it has stagnated a bit, partly due to the impact of Covid. For example, one of the neonatal unit wings temporarily closed its doors which reduced the necessity to search for devices.”


In addition, not all floors in the combined nursing units were equally equipped with track and trace sensors, which led to an imbalance in the system precision. Subsequently, the batteries of the infrastructure ran out after a couple of years, and it was no longer clear where they were.


“This shows that it is also extremely important to effectively manage the ownership of the system, and not only rely on the clinical physicians and nurses to be responsible for the use of the platform. Broader involvement is necessary, for example care technologists, administrators, IT, care providers, and business managers. Depending on the issues you want to tackle, you must consider whether you have involved the right people.”

Revised approach

After an evaluation of the pilots, OLVG and Philips chose to work with a new approach and solution. Groen and the other parties involved did not rush any decision. Through several interviews with employees, they mapped out what people thought a track and trace system could provide in terms of benefits and where the exact need exists. The first tests had already made it clear that the Philips PerformanceFlow solution worked and what was needed for the rollout to be a success.


OLVG and Philips now focus on an agnostic IT platform that is integrated into departmental workflows and focuses broadly on logistics, not just an application that can simplify the search for medical equipment. From a dot-on-the-map to actionable insights adding context through enrichment of various data points, where also operational information from smart devices will be included.


Groen says: “If you apply it properly, nobody will know that the system is there, that is what we want to work towards. In recent months, we have continued to design this new approach with a limited group of people involved to achieve a new success. If you can provide that, you can expand such a solution step-by-step by adding smart equipment and operational information.”

Increased user-friendliness

The desired user-friendliness is now also considered in the PerformanceFlow solution, says Groen. For example, during the first two pilots, employees first had to find a computer, log in and click several times before they could see where something was located. "That does not work. Data access should be as simple as possible, for example via an app on your smartphone. You must make it easier for people, not harder. It must be embedded in the existing processes as much as possible.”


“We are now going to monitor infusion pumps in all departments, including some locations where decentralized stock is located. This means having a limited number of devices and only a limited group of employees who must partially adapt their care processes. The bigger goal we are working towards with this is getting the right resources to the right place, at the right time, with the right people.”

Future horizon

That, emphasizes Groen, is a vision that you do not accomplish with the first or second project. Organizations will have to do several projects in succession with an increasing size to reach that future horizon.


“For now, we are mainly focusing on making stock management as efficient as possible, so that nobody misses out and always knows where to find an available infusion pump. Of course, we always keep a long-term solution in mind. You can choose to buy 100 extra pumps, which in the short term is easier than setting up an entire system with trackers and software, but this is not the efficiency gain you are looking for.”

You have to make it easier for people, not harder”

About PerformanceFlow from Philips

PerformanceFlow is a real-time IoT platform with agnostic technology that provides operational decision support and the ability to track and trace mobile medical equipment. These assets range from ultrasound machines to infusion pumps, beds, bladder scanners, and many more.


Smart and connected device data can be easily linked to the system – in specific cases even without using tags. This helps to find equipment faster and provides insights into real-time inventory levels, equipment usage and movements to and from departments to enable timely maintenance. The gathered data helps us (or the staff) to work more efficiently as well as to make data-driven decisions regarding purchasing new equipment. OLVG used the solution for the first time in 2020.

 

The information that is collected by PerformanceFlow can be visualized in real-time on highly configurable dashboards. These overviews are tailored to the specific needs of departments and / or dedicated user groups. Mobile medical equipment can be located and reserved, but also intelligent rules can be defined to trigger notifications and the automatic creation of work orders in maintenance and logistics systems.

About the author

Jaap Groen is a clinical physicist at the OLVG Hospital, Amsterdam, The Netherlands. 
He supports the specialties radiology and nuclear medicine. Philips, along with OLVG Hospital, are members of the ICT&health Innovation Partner Group.

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