Humber River Hospital to launch patient care Early Warning Systems

Toronto’s Humber River Hospital continues to be the trendsetter when it comes to building the “digital hospital” in Canada. Just last November, Humber River launched North America’s first “Command Centre”, a room filled with large computer screens that display real-time information about what’s happening in key areas of the hospital. The data feeds include ED capacity and waits, as well as patient status and length-of-stay in other parts of the hospital.

Humber River created the Command Centre in partnership with GE Healthcare, which designed the wall of computer screens – called “tiles” – that display the data in easy-to-read formats. Trained staff monitor the tiles, and if there’s a bottleneck in the ER or a delay in getting healthy patients out of beds on a medical floor, they can intervene to smooth out these wrinkles.

Soon, however, the hospital plans to add to the functionality by implementing “predictive” analytics in the Command Centre.
Sophisticated software will analyze the data feeds to determine which patients in the hospital are about to crash. Teams can then rush to those patients before things get worse, stabilizing them when it’s still possible to do so.

The software could have a huge impact on quality and patient outcomes.

“We can start predicting when things are going to deteriorate, and we can intervene,” said Peter Bak, the hospital’s CIO. “We’re implementing these tiles now, and we’ll have them working by the end of the year.”

Bak was a keynote speaker at the annual Internet of Things in Healthcare, held in Toronto in May.

Also in progress at Humber River Hospital is a more computerized way of communicating among the various members of the hospital. “Why pick up a phone to move a patient,” asked Bak. “We should have electronic systems. That is our next phase in high-reliability care, and we’ll have it up and running by the end of November.”

Bak observed that the digital hospital, including the Command Centre, has already created returns on investment. He estimates the system has allowed the hospital to support an additional 20 beds without taking on more support staff.

Moreover, with the use of predictive analytics and computerized communication, the hospital will be able to support another 20 beds using its current level of human resources, for a total of 40.

Bak estimated the 20 beds that were already added are the equivalent of $6.5 million in return-on-investment each year, a return that will soon be doubled.

The digital revolution at Humber River doesn’t stop there, though.

Bak said another aim of the Command Centre is to monitor patients after they are discharged and have returned home.

“With COPD patients, for example, they come in, they’re treated and discharged, but we know they’ll be back.”

Why not send them home with some medical devices and wearables that can be monitored using the Command Centre? Then, if there is a sudden gain in weight or reduction in oxygen levels, help can be sent before they need to be rushed to the ED and re-admitted.

Staff in the Command Centre may be able to monitor 2,000 patients in the community. However, Bak said that by deploying artificial intelligence software, one nurse or staff member could very well monitor 20,000 patients.

This could keep all kinds of patients with medical conditions out of hospital. “We’re not going to hop into an Uber when something goes wrong,” he said. “But we can contact the community services that normally help these patients.”

Bak observed that other hospitals have created command centres, but most of them have been limited to applications like the ICU or telemedicine. “What we’re talking about is a holistic view,” he said, explaining that Humber River’s solution covers all important metrics, inside the hospital and eventually, outside too.

Later in the IoT conference, Bak joined a panel with Dr. Aviv Gladman, chief medical officer at Mackenzie Health, and Jan Walker, vice president at West Park Healthcare Centre, an advanced rehab facility, to discuss intelligent hospitals.

During the panel discussion, a member of the audience lauded Humber River and Mackenzie Health for their plans to build smart hospitals. But she questioned whether many other hospitals, especially smaller ones, could afford the investments required.

Mackenzie Health’s Dr. Gladman answered, “Can we afford not to?” He said computerized systems and communications are crucial to solving the problems in the hospital sector. “Look at all of the waste in the system, the duplicate tests, the time taken to transfer information,” he said. “The potential gain is huge.”

Bak said all of the technology implemented at Humber River Hospital – which cost $1.8 billion to build – amounted to only $60 million, a tiny fraction of the total. That included hardware, software and engineering. “It’s not a substantial number, and we’re demonstrating ROI on this. Others can too.”

Bak noted the technology component of a smart hospital is actually the easy part. “It’s the change management that’s challenging, especially for smaller organizations. For them, the resources are often not there.”

He noted the implementation of a CPOE system at Humber River Hospital. “It was a major undertaking,” he asserted. “It involved eight months of change management. And that was after a year of building order sets.