Digital Vision
The departments at Odense University Hospital (OUH) have for many years worked with innovation and digitalisation at various stages and paces. But in no instances we have got to know the full benefit or possible synergies of a thorough transition to digital workflows.
PROJECT PERIOD
Start: January 2019
End: December 2021
This is why the hospital launched its research and innovation project Digital Vision. The project aimed to speed up the digitalisation process in one hospital department to see the synergetic effects in a highly digitalised unit where the systems work together. Until Digital Vision, innovation and digitalisation have usually taken its starting point in the individual solutions, which are implemented in multiple departments without special attention to the specific context of the department and its remaining activities.
The department’s relations with other departments and the primary sector were to be identified and taken into account in the project, as being digital in one department will not suffice if extra administration is required when partners are not digital.
AIM
Digital Vision aimed to ensure smooth workflows, free time for the patients and ease patient pathways. It intended to prepare the department for the new hospital in Odense – and to create a model for a similar transition of the other departments at OUH.
PROJECT STRUCTURE
As the ambitions of the project were very comprehensive, it moved through many phases. The first phase mapped out the procedures and workflows of the department as well as the use of technology in patient pathways and internal procedures. The focus lay on finding existing technological IT-solutions that were not put to well use or were even creating problems and annoyances for the personnel, and also on finding areas in which new digital solutions might improve collaboration with other departments on patient pathways, for instance.
The next phase focused on the problematic areas and improved the use of existing solutions. At the same time, the next phase was prepared all around the units of the department: the testing of brand new systems.
Simultaneously with the implementation and testing of the many digital solutions, the individual initiatives have been evaluated, and eventually by the end of the project, a collective evaluation will be carried out on the effect of the project on the personnel and patients.
RESULTS
The project carried out a series of initiatives improving known technologies and launched a number of efforts to test and implement new digital solutions. Click on a title below to read more.
The first phase of Digital Vision made it clear that a big problem for digital workflows is a lack of smartphones. Add to this that many employees feel looked down upon by patients when using work phones, as they can appear to be busy with private matters.
As a result, Digital Vision designed a special phone cover, which clearly signalled the phone being a work tool. The new covers were implemented in October 2019, where the personnel at bed unit S1 got access to mobile phones using the Cetrea system and the MyMedCards app, among other things, giving easy access to relevant clinical instructions and guides.
In December 2019, the Endoscopy Unit was also given phones and access to the new mobile systems.
For some years, the Cetrea system and one of the associated screens have been present at the bed unit of the department, but as the screen hung inappropriately and people did not really understand its message or purpose, the utility value was low.
After a process on possibilities and wishes for the system, the screen was moved to a more visible spot and the content and visualisation got optimised so the staff could get valuable information from the system. Thus, the Cetrea-screen today contributes with a valuable overview of patients and beds among other things, saving paper workflows.
This process and the new enthusiasm among personnel for the possibilities of the system has led to identification of more flows and activities that might improve Cetrea. More screens have already been bought for hanging in different places around the department, including the room for doctor’s conferences, coordination, and for the patients, giving them the opportunity see which employees are present.
The latter makes it possible to cut a workflow by replacing the whiteboard, which previously showed the overview of employees, securing reliable and updated information for the hospitalised patients.
Cetrea is now also available on the new work phones of the department, giving employees easy access to information, regardless of whether they are near a screen or computer.
In autumn 2019, the department implemented Manatee, the software robot that is used in many places at OUH. Manatee flows have so far been created for documentation tasks for doctors in all the units of the department. Subsequently, implementation of the system for other personnel groups at the department will be initiated.
Part of the treatment for chronic inflammatory bowel disease for hospitalised patients at Department S is having their excretions weighed and described.
The bed unit has since January 2020 been testing Measurelet Scale – a scale integrated with a tablet, which makes patients able to participate in their treatment. This is both more effective and comfortable than the previous solution, in which the patient had to carry the basin with its contents from the toilet to another room, where the nurse would weigh and describe it.
We know the concept from cafeterias and amusement parks: one orders food, gets a small coaster-looking item, and when it beeps or blinks, the food is ready to be picked up. The endoscopy unit at the Department of Gastroenterology has now implemented something similar.
The patient is handed a buzzer when arriving, and from their smartphone, the nurse can write a message to the patient when the ward is ready. In this way, the patients can move freely instead of cramming together in a waiting room, and the nurses save time by not having to search for the patients.
This project at the bed unit tested virtual reality as a true-to-life environment for practising probe application.
The personnel often feel short of time, resources, and energy for training and being trained in nursing procedures. This creates uncertainty, challenges the patient security and may result in the personnel not having the necessary professional capabilities.
Practising in a virtual 3D-environment makes you able to refresh and try probe application repeatedly with no consequences of potential failures. This can provide security for personnel and patients.
The project is financed by the EU as a part of the OPI programme (Public-Private Innovation). The project will end in 2021 and be evaluated thereafter. It is created in collaboration between the bed unit, UCL and the municipality of Northern Funen.
It is possible to improve the options and quality of treatment in the patient’s own home by securing quick, easy and safe transfer of home measurement data from the My Hospital app to the national KIH database.
The measurements could for example be of temperature or pulse, measured using wearables (wireless monitoring equipment).
The project will improve the quality of virtual consultations when combined with objective data. This supports our approach of patients not only being treated at OUH.
The project is financed by the Ministry of Health and ends in 2021. It is a collaboration between the HPN Clinic and the Department of Internal Medicine and Acute Medicine at Svendborg Hospital.
Patients receiving treatment for chronic inflammatory bowel disease must regularly deliver stool samples either at the hospital or by mail for it to be measured at the hospital.
The Calprosmart home test kit makes the patient able to perform the test at home and read the results on their phone. The project will develop a secure data integration for the measurements to be transferred from the My Hospital app to the electronic patient journal, thereby sparing the patients the discomfort and time spent by delivering the samples.
This project has received DKK 75,000 from the Innovation Fund of OUH and DKK 100,000 from the Beckett Foundation.
When an alarm from technical equipment goes off today, medical staff do not know whether it comes from a sharp decline in blood pressure or just a low battery. This often puts the employee in tough dilemmas when having to leave a patient in favour of an unknown situation.
This project at the bed unit of Department S will develop a digital tool that differentiates between clinical and technical sounds, making the medical staff able to hear whether they should react immediately or complete their current task first. They will even be able to see the cause of the alarm on their smartphones. The alarm system will make it possible to turn down the sound and light of the equipment at the wards, thereby giving the patients and their relatives more peace.
The data-filtering alarm system has received DKK 350,000 from the Innovation Fund at OUH. The development began in autumn 2020.
If a patient needs help, they can pull the string at the bed and wait for an employee. The employee don’t know the cause of the call and may have to suspend current activities to examine the problem. This is especially a challenge on isolation wards like covid-19 units, where the personnel must put on personal protective equipment (PPE) before walking into the ward, simply to be asked for a glass of apple juice, for instance.
They must then take off all the PPE, get the juice, put on the PPE again and deliver the juice.
With the Digital Care-Call, the patient can make specific calls via a tablet by the bed and instantly receive the reply that the call has been heard. It is especially beneficial at isolation wards but could also serve a purpose at regular bed units, as it gives the patient peace of mind and the personnel fewer interruptions.
Digital Care-Call has received DKK 246,000 from the Innovation Fund at OUH. It has been introduced at the bed unit of Department S and the Department of Internal Medicine and Acute Medicine at Svendborg Hospital.
The project takes on-the-job coaching to the next level by using Virtual Reality (VR). Understanding the spread of disease is necessary when moving about an isolation ward, but it can be difficult when bacteria and viruses are invisible. Moreover, the busy workday effectively means that procedures are not always performed correctly, making it difficult to learn correct behaviour from colleagues. Using VR, medical personnel can see how infections are transmitted at the unit, and learn how not to carry it out of the room.
The virtual training will make the personnel feel confident when nursing contagious patients and making sure procedures are performed correctly.
Employees have the MyMedCards app installed on their work phones. It includes guideline cards, introduction material for new colleagues and links to Infonet among other things.
The project enabled patients to see artwork at Kunstmuseum Brandts with a VR headset. It was possible to see each work from 2-3 positions and get additional information about the artwork through sound, pictures, text and speak.
EXTERNAL FUNDING
OUH spent DKK 4.5 million on the project with the expectation of receiving a similar amount from external funding during the project’s lifetime. OUH intended to use the money for subsidiary projects.
Rikke Lyngholm Christensen
Programme Manager
Centre for Innovative Medical Technology (CIMT). Odense University Hospital, Dept. of Clinical Development - Innovation, Research & HTA
(+45) 2462 9727 rikke.lyngholm@rsyd.dk
Kathrine Rayce
Innovation Consultant, PhD
Odense University Hospital, Dept. of Clinical Development - Innovation, Research & HTA
(+45) 6541 7940 kathrine.rayce@rsyd.dk