There are two major objectives of the Digital Hospital Design Workshop:

• Drive innovation in hospital design through bringing together Health IT with Architects, Designers, Engineers Health Managers and Clinicians
• Establish a core group of individuals who are interested in developing a set of guidelines for the application of Health IT in Hospitals.

Currently the Australasian Health Facility Guidelines, which are owned by the Health Infrastructure Alliance (AHIA), on which each of the jurisdictions has a representative, contains almost no details on the application of Health IT in hospitals builds.  The consequence of this is that when the final value management stage of a hospital tender is reached and a decision has to made as to what is included in the facilities build, Health IT often misses out or its capabilities are greatly diminished.   The impact of this can be hospitals which do not have the capability to take advantage of current or future information technologies and/or require expensive modifications.

With over $30 billion of hospitals being built just on the east coast of Australia at the moment, there is a pressing need for the creation of guidelines for the inclusion of Health IT in Hospitals.    These are the hospitals which will govern our care over the next 15 to 20 years, so we have to make sure they are appropriately designed.

In my discussions with people interested in this area I was made aware the "Safety Guidelines for
Working with Crocodiles in Captivity" and the attached comment "If we can establish detailed guidelines for handling crocodiles ( which mostly consist of the advise for keeping away from the end with the sharp and numerous teeth...see diagrams below)...then why can't we get together some guidelines for something as broadly important as the inclusion of Health IT in hospitals". 

My response was to empathise with their position and urge them to attend the workshop.

If you think this (IT in the Hospital IT Building Guidelines) is an important issue, then make sure you come to the conference and participate in what is going to be an active, engaging and very interesting set of discussions.

Just go to the Digital Hospital Design website at www.digitalhealthdesign.org to find out the details, you can also register from the site.

In trying to bring together all the multidisciplinary groups (architects, engineers, clinicians, information technologists, health managers etc) that need to work together to build  a hospital, one of the difficulties is where to start the conversation...while all these groups having a common objective around delivering a better hospital, they often approach this goal from widely different perspectives.  In the end, this approach can lead to opportunities for productive innovation not being realised.

What we probably need to do is to work to establish a common dialogue.  In doing this, there needs to be a set of goals that can resonate across all the groups.  In looking at the the discussions that are happening in this area I want to propose applying the theme around designing  hospitals to deliver People Centred Care.  Note this is an extension of the much discussed issue of delivering patient centered care.  This extended theme incorporates the the concept that the hospital needs to be designed to support the patient, their family and the staff that support them.

In setting up this discussion the question is how does this then relate to the four major functions of a hospital which are their:

• Clinical functions
• Support services functions
• Educational and research functions
• Social functions (ie how the hospital support the social needs of the patient, family and staff including how it integrates into the community in which it resides)

I have set up a model which describes the relationships between these elements and the objectives of the groups which build the physical environment and the groups which deliver the information system that support it.

The opportunity we have is to develop the discussions between these groups based on the tenants of People Centred Care within each of the functional areas of a hospital.

I will expand upon this in my next blog

Yes I have been quiet for a while, but a whole team of us have been working furiously in the background to establish the first event for our Digital Healthcare Design SIG.  This will be a two day workshop/conference to be held at in Melbourne on August 23 and 24 as part of HISA's HIC2010 conference.  

This workshop brings together clinicians, architects, engineers, systems designers, and health IT specialists to look at the role of information technology in the physical design of the hospital of the future.

There are two main objectives. The first is to encourage cross discipline dialogue, as we believe there is a great opportunity for synergy and innovation by bringing these groups together to cooperatively address the issue of hospital design. The second objective is the start contributing some IT focused content into the Hospital Building Guidelines.

Have a look at the conference website at www.digitalhealthdesign.org

We also have a SHOUT site set up where you can comment and give your ideas about what needs to change to improve the hospital expetrience and deliver on the objective of people centred care.

You can find the SHOUT site at http://shouts.digitalhealthdesign.org

Go to the SHOUT site and let us know what you think...you don't have to leave your name just your ideas.

Just to let you know, I will be chairing the event along with Keith Davis from Norman Disney Young.  We have lots of great speakers and a fantastic interactive format, so it should be a great event.

I have just come back from a pretty amazing two day meeting.  The Centre for Social Impact ( led by Peter Shergold) and Cisco got together with 60 senior Australian beauracrats and brought innovation experts from around the world to talk about how to innovate in the delivery of public sector policy.

Sounds like it could have been boring...but it was anything but.  When you have innovation leaders like John Kao ( re Innovation Nation), Jonty Olliff-Cooper (DAMOS) and Beth Noveck (White Deputy Chief Technology Officer for Open Government) all talking about how to transform goverment through open engagement with citzens it was a "mind shifting" two days.

How does this relate to Digital Healthcare design. The link came first in John Kao's discusion around the use of design thinking.  Quoting Wikipedia:

"Design thinking is a process for practical, creative resolution of problems or issues that looks for an improved future result. It is the essential ability to combine empathy, creativity and rationality to meet user needs and drive business success. Unlike analytical thinking, design thinking is a creative process based around the "building up" of ideas."

What became clear in the discusisons (and presentations) that followed was that this concept of design thinking has been central in the delivery of successful public sector innovations (and public sector innovation is what designing new hospitals is all about).  The innovations we heard about were driven by the public sector deeply engaging with the citizens, empowering them with the ability to gather together and exchange/build ideas.  Finally it engaged the public sector management in a way that created empathy and understanding.   Yes there were lots of web 2.0 tools and innovative ways to drive engagement and feedback, but the issue was not the technology, the issue was creating the opportunities to listen in a way that creates understanding.

This struck me as the challenge that we have in front of of us.  We are all comming to the task of how to better deliver healthcare with great personal passion, but the issue we face is can we put aside our individual passions and listen to those in the system, providers and users, so we can really uderstand their needs.

A difficult challenge, but one with great practical rewards.

For those interested in exploring this field I thought I would do a bit of a summary of the key sites active in this area.  There are few activities dedicated to the application of health IT in healthcare design, however, the X3 Summit is a major conference in the US on the subject.  On the event website at www.x3summit.com  you can see  the program for this year's conference (Duke University May 5-7) and past programs.  It gives you a good idea of what is happening in this field.

While there is not a single site dedicated to issues around Digital Healthcare Design (if I am wrong please leave a comment on the blog...I would love to know the details)  there is a large amount of acitivity around healthcare design issues in general.  One of  the leading Australian centres active in this area is CHAA (Centre for Health Assets Australia). Associate Professor Jane Carthey is Director of the Centre and it is part of the Built Enviroment Faculty at the UNSW. They are responsible for producing the Health Facility Guidelines.  This is the publication that we want to supplement with a set of Health IT guidelines.  You can find CHAA at www.fbe.unsw.edu.au/chaa/.

Internationally, the major site is probably from the Health Design Technology Institute, which was supported by the Robert Wood Johnson Foundation in the US.  This group has a focus on evidense based design and has some fantastic papers on the subject that can be downloaded from their site (see www.healthdesign.org ).  All this is an important foundation to the work for developing the focus on Digital Healthcare Design in Australia.

Some other intesting sites are

• Centre for Health Systems Design
• Informed Design
• www.facilitiesnet.com/healthcarefacilities
• Picker Institute
• Healthcare Design Magazine
• Healthcare Building Ideas Magazine
• Academy of Architecture for Health
• Health Environments Research and Design Journal
• Healthcare Design Conference

I will get back to you soon with some details about an event we are organising in Australia on digital healthcare design, looking at how to design a digital hospital for 2020

Best regards

Brendan

It has been a while since I have been blogging.  The transition to Cisco (from the CEO position at HISA) temporarily diverted my attention away from blogging,  but I am now back.

Taking up the position at Cisco has opened my eyes to what is a bit of a missing link in the delivery of healthcare in Australia. 

Australia has over $20 Billion in hospitals currently in the planning, design and construction phases.  However, even with this enormous financial investment, there are no guidelines or even guiding principles for how information technology can be best included in these designs.

There is a big need for a multidisciplinary group that brings together architects, designers, engineers, IT professionals, healthcare providers and consumers to look at the interface between design and information technology. The objective is to bring these groups together and to drive innovation in healthcare delivery.  

If you are interested in this field, then join up to he Digital Hospital Design Group on The Health Hub ( see http://www.thehealthhub.org.au/pg/groups/3304/digital-healthcare-design/ ) and help us build this group and bring some guidance to the health facilities and systems that are going to deliver care to Australian communities over the 20 years.

This is an important task.  I hope it is going to take us all out of our comfort zone, with conversations involving a broad range of professionals and health consumers who have previously not had an opportunity to interact.

It is an experiment, but then the exciting parts of life, personal or professional usually are.

I hope to see you at the HUB.

If you want to send me a message to talk about involvement just click on the message function in the drop down menu and we can talk. 

See you in the Digital Healthcare Design Group.

Best regards

Brendan

Last week the Department of Health and Aging released its report to support Australia's first National Primary Healthcare Strategy.  This is an important report to read for those interested in Consumer e-Health.  You can download a copy of the report from  http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/nphc-draftreportsupp-toc .

There are two important things to take home from this report.  The first is there is a clear recognition throughout the report that e-health technologies, including web based information sources, mobile computing systems and online health records are vital elements that need to be further developed to better engage consumers in better maintaining their health.  This is not only discussed in the chapter dedicated to e-health (Element 6 of the report), but also inferred throughout the report when delivering on the reports objectives are discussed.

The second important consumer e-health aspect to the report is that while there is a recognition of the need for these systems there is no real detail on what they would look like or how they would be delivered.  There is some discussion regarding access to a personal health record, but again little detail on the what or the how around it. 

To me, this further emphasises the need to rapidly develop the discussion around what are the required consumer e-health systems and how we could develop and deploy them.  Unlike the professional systems that are in the spotlight now, where the roll out is gated by large capital investments from the Federal and State governments, the implementation of consumer systems are going to be driven much more by open market developed applications and the implementation will only be gated by the cost and the value that they deliver to consumers.  This is a notoriously difficult genie to control once it is out of the bottle.

If we want to make sure that Australia's health consumers have access to the applications which will really improve their ability to manage their health then we need to work out  how to create the market conditions that foster these types of applications. 

Hopefully through the Health Beyond group on the Health Hub we can develop that sort of conversation.

Sorry I have been "off the air" for a  few weeks, but there has been lots happening which has kept me away from the Health Hub.

The first distraction was the HIC'09 conference in Canberra which HISA ran.  This was a great success, with a very wide range of topics covering leading edge science to the latest e-health systems implementations in Australia. There were some consumer e-health relevant presentations (I did one at the Nursing Informatics event), but there were not enough, next year we need to mobilise and get a workshop going for the event.

However the most important news from my perspective (which was also announced at the HIC conference) was that I am resigning from HISA.  After three and half fantastic years as CEO I have decided to leave HISA and take up a new role at Cisco.

BUT...I will still be in the e-health space and will continue to blog on the Health Hub.  Consumer e-Health is an exciting and rapidly growing segment in which I will maintain a strong interest.

Next week is HISA's national conference (HIC09) in Canberra and it's time for reflection on some of the big issues in e-health.  In consumer e-health this has got to include how consumers are going to take advantage of the significant planned invest in the "professional" e-health systems.

First, what do I mean by professional e-health system.  Well, these are the technologies that link our hospitals/clinics,  pharmacy, diagnostic and care planing operations.  They will enable the health consumer to get safer and more cost effective care.  This is all about how we treat patients when they are in care.

Ok, these are pretty significant benefits, BUT....they don't reflect what could be some even larger benefits generated through our e-health investment.  These are the benefits driven from actually keeping patients out of care and they are realised through engaging consumers more effectively in their own health mangement. 

While there is a strong recognition of the need for a personal health record for consumers, that system, by itself, is not going to entice consumers to take better care of themselves.  Health consumers require high value experiences to better engage themselves in managing their own care. 

Some of these experiences are now being partialy delivered (albeit in a relatively disjointed fashion) with highly engaging online systems that support all types of health and fitness needs, with well qualified information resources, online therapy, training and social networking processes.  These are supported with an exciting range of sensors and devices which often use game technology to make information input and tracking an enjoyable and a higher value experience.  What they often lack (except in the case of some excellent mental health examples) is the linkage with care providers and the provision of high quality coaching and feedback to guide the consumer.

The ability to link these consumer e-health systems, perhaps through the Personal Health Record, to the professional health systems will allow a crucial link between the consumer and the care provider to be forged.  This will enable the consumer to experience highly relevant and context specific professional feedback that will drive more effective everyday decisions about their health.  It could also deliver an accurate and rich source of valuable patient information to improve the care process when the consumer does find themselves in the health system.

So what REALLY excites me about consumer e-health is its this ability to cost effectively link the care professional and the consumer with information and tools which enable long term better personal health decisions.

I have written a presentation on this issue for the Nursing Informatics Conference next week.  It has a more extensive discussion of this issue with lots of links to sites of interest.  You can download a copy by clicking here

This may sound a pretty dry topic...but it is not.

Continua is an organisation which develops specifications for uniform communications interfaces in consumer health devices and certifies products compliant with these specifications. 

Ok, I can now see the yawns and eyes drifting shut, but this is important. 

For consumers to really embrace e-health requires that the input of information be as simple as possible.  In fact, ideally it should be totally transparent to the user.  This is the sort of future that Continua looks to enable.  The availability of standard interfaces opens up the apllication of these devices to all the small and innovative software development companies that can integrate the devices into home based health products. 

So a potential scenario is that a person on a weight management program can hop on the scales in the bathroom and their weight can be recorded on their electronic health record...a scary thought for some, but very helpful for many.

So the latest products announced by Continua are an A&D blue tooth weight scale, and a blood pressure monitor, plus a Roche blood glucose meter (see http://www.continuaalliance.org/products/certified-products.html ).

Continua are only just starting to announce the products that are passing through their certification process, so look out for more announcements in the future.  These are the products which will be defining in the next generation of consumer e-health systems.