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The Smart Hospitals and the Connected Healthcare Ecosystem

MIT Stata Center_051118
(MIT Ray and Maria Stata Center, Jenny Fowter)
 
 

 

- Connected Healthcare is Transforming Hospitals

Hospitals, physicians and other healthcare providers are on the forefront of almost every healthcare intervention, from taking care of day-to-day chronic conditions to emergencies and life-threatening illnesses. Over the past century, as local community needs have changed and grown, hospitals have responded by expanding their size and services to meet the need. However, technology advances and changing patient expectations have led to new consumer-oriented healthcare services, causing many hospitals to rethink and, in some cases, reduce their size and services.  

Today, many big healthcare systems are starting to move care out of the hospital and into the home, for example, by automating routine services and providing remote monitoring and telemedicine. Better Internet network connectivity is enabling hospitals to leverage new technologies, improve clinical outcomes, and drive patient and physician satisfaction. Better connectivity would hugely increase efficiency, while also allowing clinicians to make greater use of AI and machine learning in spotting, treating and preventing medical conditions that can often be predicted in advance. Greater Internet network connectivity and data speeds have allowed some hospitals to roll out clinical-grade devices at home, including patient monitoring equipment and consoles that allow physicians to access electronic health records securely. And more services are coming, as early-adopting hospitals transition from digital to intelligent services – employing data-driven analytics to improve patient care, staff workloads and operational decision making, all in real time.

The future of healthcare delivery may look quite different than the hospital of today. Rapidly evolving technologies, along with demographic and economic changes, are expected to alter hospitals worldwide. A growing number of inpatient health care services are already being pushed to home and outpatient ambulatory facilities. However, many complex and very ill patients will continue to need acute inpatient services.  

As pressure mounts to reduce costs and improve patient outcomes, hospitals are seeking ways to improve their productivity and efficiency. The specific solutions vary. But in all cases, a key determinant of success is the network itself. Networks must be of the highest possible standard, good enough for telecommunications firms and capable of handling everything from sensor data to 3D medical imaging files. 

Naturally, hospitals envision digital technologies as a solution. Many hospitals are enhancing their health ICT infrastructure with the intention of becoming smart hospitals by embracing digital transformation. Digitization trends have a high impact on hospitals, and indeed digital hospitals are also emerging.  

 

- Networking Health: Prescriptions for the Internet

Health-related activities stand to benefit enormously from the Internet. As a highly information-intensive set of functions characterized by complex interactions among a large number of stakeholders - primary care physicians, specialists, nurses, patients, health plan administrators, public health officials, medical librarians, researchers, and others - health-related activities can take advantage of the nearly ubiquitous reach of the Internet and its capability to support communication between users who may not have interacted with each other before. 

Already the Internet is beginning to influence the health sector by forging new relationships among stakeholders and improving access to health information. Its application in the delivery of health care, maintenance of public health, payment for health care services, education of health professionals, and conduct of health sciences research could improve the quality of care and access to it as well as reduce its cost.

A comprehensive network architecture might include the following: 

  • Wired or wireless access to connect people, sensors, machines, video monitors and remote devices, all securely and reliably
  • Cloud/edge computing technology providing the ultralow latencies required for critical machine communications such as remote and robotic surgery
  • Software that allocates capacity whenever and wherever it’s needed - whether to support data transfers of genome sequences, medical imaging files or analytics processing
  • Data processing capabilities and analytics, including machine learning and artificial intelligence, capable of providing insights that enable better diagnoses, treatments and outcomes


Physicians at hospitals with these capabilities will deliver improved outcomes, at a lower cost, with a more flexible and convenient patient pathway. And with the wider adoption of telecare and patient apps, fewer people will get sick in the first place.

 

- Future Smart Hospitals

Smart hospitals are those that optimize, redesign or build new clinical processes, management systems and potentially even infrastructure, enabled by underlying digitized networking infrastructure of interconnected assets, to provide a valuable service or insight which was not possible or available earlier, to achieve better patient care, experience and operational efficiency. 

Smart hospitals rely on interconnected advanced technology and automation to improve patient care, clinician workflow, and overall efficiency. Smart hospitals utilize health ICT infrastructure technology such as mobile devices, data analytics solutions, and cloud computing. The process of transitioning ICT infrastructure to support a smart hospital can be challenging, but hospitals need to remember that the transformation must take place in stages. Not every hospital needs to become smart in a single step. Instead, the approach they need to take is to implement smart solutions, one by one, and then allow newer solutions to integrate with existing ones in the journey toward becoming smart.  

The smart hospital framework involves three essential layers - data, insight and access. Data is being collected even today, although not necessarily from all systems in a hospital, but is not integrated together to derive ‘smart’ insight, which can be done by feeding it in to analytics or machine learning software. This insight must be accessible to the user - a doctor, a nurse, facilities personnel or any other stakeholder, through an interface including a desktop or a smartphone or similar handheld device, to empower them to make critical decisions faster, improving their efficiency.  

There are three areas that any smart hospital addresses - operations, clinical tasks and patient centricity. Operational efficiency can be achieved by employing building automation systems and smart asset maintenance and management solutions, along with improving internal logistics of mobile assets, pharmaceutical, medical device, supplies and consumables inventory as well as control over people flow (staff, patients and visitors). Not only do these solutions reduce operational costs such as energy requirements, but also reduce the need for capital expenditures on mobile assets for example, by improving utilization rates of existing equipment. Patient flow bottlenecks, when addressed, improve efficiency, allowing more patients to be ‘processed’ through the system, allowing for more revenue opportunities at lower costs.  

 

- Internet of Things (IoT), AI to Play Key Role in Future Smart Hospitals

The combination of artificial intelligence (AI) and the Internet of Things (IoT) will support the development of smart hospitals and fuel the ongoing growth of big data analytics.

The IoT - also commonly known in the healthcare industry as the Internet of Medical Things (IoMT) - consists of any and all medical devices, patient monitoring tools, wearables, and other sensors that can send signals to other devices via the Internet. These tools generate massive amounts of data that must be stored, integrated, and analyzed in order to generate actionable insights for chronic disease management and acute patient care needs.

The widespread use of IoT (or IoMT), especially smart wearables, will play an important role in improving the quality of medical care, bringing convenience for patients and improving the management level of hospitals. However, due to the limitation of communication protocols, there exists non unified architecture that can connect all intelligent things in smart hospitals, which is made possible by the emergence of the Narrowband IoT (NB-IoT). In light of this, we propose an architecture to connect intelligent things in smart hospitals based on NB-IoT, and introduce edge computing to deal with the requirement of latency in medical process.  

 

 

[More to come ...]

 

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