Smart Hospitals Making the Future of Patient Experience a Reality

January 24, 2020 - When Alpa Vyas first asked patients at Stanford Health Care what they would like in a smart hospital room, she was almost certain they’d want to see a digitized care itinerary.

“You can imagine if you’re an inpatient and you have an itinerary that says, ‘physical therapy will be by at two o’clock, you will go for your x-ray at four o’clock,’ that’s pretty nice to be able to know when things are happening,” Vyas, who is vice president of patient experience at Stanford Health Care, told PatientEngagementHIT in an interview.

But that wasn’t exactly the case, she recounted.

After consulting patients through the health system’s patient advisory council (PAC), Vyas and her team learned that smart hospital room tech that could improve the patient experience was in fact much simpler.

Patients at Stanford Health Care really just wanted to know who their care team was and what they needed to get back home, she recounted. “So, the word we started using was ‘guidance.’ How can we create an experience that offers personalized guidance for patients and family members?”

Many PAC meetings and considerations about patient guidance later, Stanford Health Care was able to open its doors on the new Stanford Hospital last November.

Built with California’s infamous earthquakes, innovations in health technology, and the patient in mind, this newest hospital boasts numerous in-room entertainment options, complete with pillow speakers and patient-operated controls. On the television, patients can watch their favorite shows or movies, access educational materials, and learn more about their own medical records or care team.

And from a family engagement standpoint, smart hospital rooms are connecting caregivers with more information about patient health and real-time updates about health status and procedures. This helps family members learn more about their loved ones’ health and know where they are on the care journey.

The smart hospital also connects to existing Stanford Health Care facilities by way of skybridge, creating an encompassing system-wide experience.

These hospital rooms might sound like something out of The Jetsons, but they are increasingly becoming a part of today’s reality. With the surge of digital assistants like Siri and Alexa, the push for connected health, and industry-wide pleas for a better patient experience, smart hospital rooms are becoming accessible models for care for some health systems and health centers.

What does a smart hospital room look like?

While smart hospital rooms might vary between different organizations, the intent is largely the same: how can technology create a seamless patient experience, improve communication, and streamline clinical workflows? To that end, there are a number of tools that are seen in nearly every room.

It should come as no surprise that these rooms don’t come cheap – while few organizations are able to share the exact price tag on their smart rooms, it’s safe to say they can run up tens of thousands of dollars per room. One infamous Amazon listing offered the MedModular smart hospital room from EIR Healthcare for a whopping $285,000 for just one room.

But when larger, well-funded institutions can afford these tech-enabled rooms, the end result can be pretty impressive, according to Brett Seyfried, chief information officer at the Medical University of South Carolina (MUSC), which has implemented its own smart hospital rooms.

Digital signage, for example, has largely taken the place of traditional banners outside the room. At MUSC, Apple iPads connect to the EHR to display relevant information outside of the patient room, Seyfried explained in an interview with PatientEngagementHIT. This includes patient name and attending physician, but also extends to certain infections a patient might have or her fall risk.

This real-time data helps notify family visitors or other clinicians of certain compliance protocol before entering the room. And the digital signage also helps hospitals keep track of individuals entering the room using a real-time location system (RTOS), which can simultaneously display the name and badge photo of that individual on the patient’s TV display.

At both MUSC and Stanford Hospital, patients can control most of the digital technologies in the room. Using a tablet, both hospitals are able to integrate multiple operations, including the room lights, television, HVAC, and the patient portal and education platform displayed on the TV.

Patients and providers can bounce between different platforms and screens, allowing the provider to seamlessly pull up the EHR for both them and the patient to view, or letting a child keep watching his program on the tablet while his clinician discusses charts with his parents.

Designers also looked at how to support patients through the care journey. At Stanford, Vyas and her team designed a program that helps patients with self-management even when they are still in the hospital.

“Oftentimes, patients have goals around pain and mobility,” she offered as an example. “We want to make sure that their pain is managed and that they reach potentially some level of mobility, and so we included those goals within the application as well.”

And at both Stanford and MUSC, digital displays help walk patients down the path toward hospital discharge.

“In the room we have a flight path, which includes the items that need to be accomplished in order for you to get discharged,” Seyfried explained. “It gives you daily and weekly goals so that you can try to achieve those and get discharged more quickly.”

Those care instructions continue post discharge through the patient portal, both Seyfried and Vyas noted.

These technologies have been instrumental in changing the patient experience for the better, creating a connected care encounter inside and outside of the hospital. But they would be nothing, both Vyas and Seyfried pointed out, if the hospitals did not keep the patient at the center of these efforts.

Source: Will Pryce

Building a smart hospital room with the patient in mind

Smart hospital rooms are a lot like snowflakes – although they share a lot of common features, none of them are exactly the same. This is because the best digital hospital rooms are designed with a hospital’s specific patient population mind, featuring different tools that will make the care experience better for that demographic.

“When we were first thinking about designs of the new hospital, one of the very first things we said was, ‘well, if we're designing this for patients and families, shouldn't we invite patients and families into the design?’’ Vyas said. “So, consults started early on, even with concepts and decision making, or prioritization of services or elements that needed to be incorporated.”

At MUSC, including patients and family at every step of the design was the most logical approach. Keeping the patient in mind during each construction decision is what has helped MUSC develop a room that has yielded such positive patient experiences.

“There have been multiple patient family advisory committees involved in every one of the decisions around how the rooms were laid out, around what they would like to see from a clinical perspective, around what they would like to experience more or less in a hospital,” Seyfried said. “All of that was taken into consideration in every single aspect of the design.”

Forming a PAC when designing hospital rooms – especially ones building on technology, which can come with a high price tag – is intuitive for all the reasons Vyas said. Why would a hospital build a room for patients without patient input?

But the eventual outcome is more than that, Seyfried suggested.

“Ultimately, for the patient, the more comfortable that she feels, the more control that she has over her healthcare and what she needs in order to get better,” Seyfried said. “It ultimately is going to lead to better outcomes and quicker discharges.”

The work of patient-centricity shouldn’t end with PACs and room design, both Seyfried and Vyas said. Patients must remain at the center of care once smart hospital rooms are up and running, with providers practicing strong patient engagement strategies amidst a tech-heavy environment.

Putting patients at the center of smart healthcare delivery

The advent of smart hospital rooms is a major disruption to the industry, and yet Vyas asserted that one thing will always remain the same: patient interactions are crucial.

Patients want personalized healthcare encounters, complete with good relationships with their doctors and nurses.

A 2017 report from the Council of Accountable Physician Practices (CAPP) found that patient-provider interactions are the single most important aspect of quality care. Patients are looking for a provider they feel listen to them, understand their needs, and can explain complex information in understandable terms.

On the surface, adding more sophisticated technology into the patient-provider relationship doesn’t sound like the path to that ideal patient interaction, but it actually helps promote it, according to Vyas.

“The idea here is that we're bringing things to automation, where we can then use the human capital to really focus in on the interactions and work at the bedside,” she explained.

Seyfried sees smart hospital rooms as a way to bring patients and their providers closer together. Before implementing their smart technologies, providers at MUSC sat at a small computer screen, often physically far away from the patient, to discuss patient cases.

“The patient and family can't see what the provider's doing on that PC. They can't see what they're looking at, but they're asking questions and the provider’s back is turned to them,” Seyfried recalled.

“The whole concept around that single TV point of focus in the room was to actually bring everyone together,” he continued. “Now, the whole care team is able to focus on that patient, face that patient, review the data together, place orders together as they're all reviewing the same concept, and get away from the old way of providing care.”

Providers who want to get to that point – where the tech is enabling interpersonal connection, not hindering – need to remember that technology is an accessory, not a replacement. Patient education delivered on tablets cannot replace the personalized care instructions a nurse can offer a patient, nor can a good entertainment system stand in place of an empathetic medical assistant.

“Our hope and intention is that the technology never supersedes the human interaction,” Vyas aid. “It only enhances it or supports it in some way.”

That mindset was front and center from the start for Vyas and her team. Going into smart hospital room design, they were adamant that technology should not disrupt clinician workflows, leaving them fumbling with a portal password or distracted by entering information, at least at the point of care.

“When we did the workflow designs, it was intentional that a nurse or a provider or a physician should never have to enter information into anywhere to make the portal work,” she explained. “It has to be incorporated into their existing data entry workflow.”

Accounting for family, caregiver engagement

Smart hospital rooms were designed not just for the patient, but for family caregivers, too. After all, medical experts are increasingly regarding the family as an equally important part of the patient engagement equation.

Strong family engagement, especially at the point of care, has been tied to better health outcomes, namely preventable hospital readmissions, multiple reports have found.

The new technologies cropping up in this wave of smart hospital rooms are set to address family engagement, both Vyas and Seyfried suggested, with both experts citing family members multiple times when describing hospital room design. Building the hospital room of the future is going to require hospital leaders to look at patient and family engagement as two sides of the same coin.

“The concept is about engaging not just the patient but engaging the care team, engaging the family or other personnel or persons in the room,” Seyfried explained. “It's about utilizing technology in a fashion to better educate and integrate the clinical care side of things.”

Like he mentioned above, Seyfried designed the smart room TVs to be a central point of reference and discussion between the patient, provider, and the family caregiving team. MUSC also offers a FaceTime capability on bedside tablets that help patients speak with – and possible confer with – family members who are not physically in the hospital room.

But looping in a family member in a smart hospital room is not always easy for the same reasons family engagement is always challenging: it wholly relies on patient consent. In order for a provider to discuss medical records with a family member, the patient must first give her permission for that family member to have access.

And while this is not usually a huge problem, clinicians have faced hurdles in cases where patients want some medical conditions kept private or family politics cause tension.

Clinicians may use their patient (or family) communication skills to overcome some of these differences, but at Stanford, Vyas and her team were able to use hospital design to accommodate the family in other ways.

“Some of the feedback that we heard was really like, ‘I would love to have a place to go as a family member, but I don't want to go too far. I don't want to leave my loved one, but want a place to be by myself or collect my thoughts.’ And that's fair,” Vyas said.

Source: Will Pryce

Stanford Hospital created non-technology spaces catered to family members, a key foil to its efforts to build smart hospital rooms. Rooftop gardens, walking paths, artwork, and integration of other natural elements were important for creating a safe space for family and loved ones.

Stanford Hospital also has a health librarian, who is ready to help family members do research on a particular diagnosis as they prepare to be an at-home caregiver.

“As an academic medical center, we have very complex patients,” Vyas explained. “Oftentimes, there is a family member or a loved one who is with the patient, who may be the person who's going to take care of the patient once she’s discharged. Helping those folks prepare and feel at ease, or that they actually can be confident in the next step in the process, is important.”

Stanford’s focus on these non-technical elements proves that the patient experience must be front and center in any technology initiative. Balancing out these new, futuristic room elements with natural oases and empathic provider communication will be essential as more hospitals begin to invest in a tech-enabled hospital environment.

Walking paths and rooftop gardens aren’t quite The Jetsons, but that might be the point. As hospitals and health systems surge into the future, they must stay grounded in the very thing that has always defined a good experience: elements that put the patient at ease, comfort her, and make her feel cared for.