This paper presents the execution of a smart hospital environment in form of ‘Connected Room’ that employs ‘Ambient Intelligence technologies’ for augmenting a typical hospital room with smart and connected features that assist both patients and medical staff. In it, various wireless, wired sensor technologies, voice command IoT, IoM have been integrated, allowing the patient to control the environment and interact with the hospital facilities, while a clinically oriented interface allows for vital sign monitoring through ‘Connected Devices’ with EMR integration.
Today’s technologies combine critical resources, technology, and gadgets targeted at patients across the continuum of care. However, this vision for patient-centric technology extends across hospital systems and, truly, all healthcare organisations that make up the patient care community.
One way to make this vision a reality is to focus on the technologies used in patient rooms in order to measurably enhance the patient experience before, during, and after their stay. Effectively, this implies re-modelling patient rooms into “connected rooms” that take technology utilisation to the next level. This transformation has already begun, and we as Apollo Hospitals Group anticipate it to grow in the coming years in India. With 72 hospitals and more than 10,000 beds, our aim is to provide world-class patient experience to our patients with ease of operability and patient centric care from “Illness to Wellness”.
It is a well-known fact now that technological advancements in healthcare have helped save countless lives and in improving the quality of care and ensuring substantial cost savings, very much in line with the goals of most of the healthcare provider organisations. Healthcare technology has enabled the professionals to connect with the patients in a more efficiently than ever before. Remote patient monitoring (vital sign monitoring, softcopy radiological film review, condition specific diagnostics and treatment) were the first set of applications appearing in the domain, mainly addressing the need to support diverse clinical requirements. Also, in the field, much work has been conducted to provide assistive environments, e.g., smart homes or hospitals, using RFID, monitoring cameras, and environmental sensors. Through the above efforts, the need to provide integrated services able to interconnect all the fragmented available e-health systems and automation systems and sensors by a binding architecture became imperative. Wireless technologies and smart environments play a fundamental role in achieving this vision by providing natural and user-friendly ways of coping with the surrounding environment. Such technologies and approaches further promote clinical quality of care and operational efficiency in the healthcare processes, while sustaining at the same time the patient’s independence and quality of life. Furthermore, enabling the “virtual visit” of a medical doctor has the potential to reach a larger patient base and reduce costs for the healthcare system, avoiding unnecessary patient travelling, and social costs for the families and relatives of the patient.
Technology means utilising more gadgets and smart devices: on the other hand, it is important that the care givers such as nurses and doctors attend to their patients and not the technology. Therefore, the smart environment should ease their workload and not bring additional administrative tasks.
We at Apollo Hospitals have always been looking to utilise innovative technologies, be it the in the clinical areas or in areas where it helps to enhance the patient safety and experience. One such initiative is the “connected patient room”.
What does it mean to create smart and connected spaces in healthcare? It means leveraging technologies, such as internet of things (IoT) devices, tablets, smartphones, smart TVs and more, both inside and outside the walls of the hospital, in order to deliver care and resources to the patient at any time in a care journey. It not only includes Non-Medical room automation devices with ambient intelligence technologies but also includes medical point of testing and monitoring devices with IoT, IoM, artificial intelligence (AI) with electronic medical records integrated to have end-to-end continuum of care.
We have utilised the concepts of ambient intelligence (AmI) environments. AmI supports the pervasive diffusion of intelligence in the surrounding environment, through various wireless technologies (Zigbee, Bluetooth, RF, IR blasters, WiFi) and intelligent sensors. This environment integrates various hardware and software technologies, allowing users to control electrical and electronic devices automatically or manually. Besides, it also works through an app or voice assistants like Alexa, and Siri. For issues such as nurse on call, emergency call, and other alarms for patients and nurses.
It also means thinking differently about patient care; being proactive versus reactive in how hospitals “see” a patient. Patients’ healthcare journeys do not begin and end within the four walls of their hospital rooms or last for only the amount of time they are there. They often have a considerable healthcare history well before their admission and have a healthcare future that extends beyond the moment of discharge.
It’s time to leverage technology and information in smarter, more significant ways to better engage patients and transform their expectations when it comes to their experience. How do healthcare organizations embrace patients before they even arrive? And how do they more thoughtfully engage patients during and after their stay? With sensors, infra-red blasters, motion sensors and voice command devices and cloud-enabled medical devices, live data in reference to patient’s medical and environmental history can be mapped to ease the stay in hospitals for both the patient as well as the care providers.
In connected rooms, the patient/attendant gets a tablet/smart devicethat interfaces with the in-room TV. Both the patient and the physician can call up information on their respective tablets and mirror it on the TV screen or between tablets, apart from the easy access to in room automation of lights, fans, AC and the in room entertainment system.
Patients can also use tablets to access educational materials about their illness, surgical procedure and discharge/aftercare instructions, all to prepare for what the coming days and weeks will involve.
Easy access to allied services like food and beverages (F&B) and housekeeping coupled with nurse call and emergency alert ensures the right set of people in the system are activated based on the specific needs of the patients and their attendants, taking the efficiency in the process a level up and ensuring nursing is more focused on the “tender loving care” that Apollo is known for.
Smart sensors in the room, bathroom and the patient bed prevent patient falls and alert the care givers in case of risks in time. The wireless, hassle-free vitals monitoring smart patch coupled with an AI algorithm to detect and send early warning signs to care givers ensures that even the patients outside the ICU are monitored 24X7 by trained doctors in a connected command centre, taking the level of patient safety to new heights in healthcare.
The connected room makes sure that care givers have all the information regarding the patient handy during visits to the room and even before in order to enable not just the ease of point of care clinical documentation but also provide access to information to take relevant clinical decisions.
The extension of this initiative also enables the patients through their own smart devices to help monitor their condition post-discharge, ask questions of their care team and further read up on recovery instructions. Now the smart device has become a care platform (inclusive of virtual care features) that supports the ongoing nature of the patient’s healthcare journey. This would be the best possible patient experience scenario: leveraging connected technology outside of hospital confines to help a patient achieve a more successful transition back into daily living and to help reduce their chance of readmission.
It begins by leveraging technology to access patient records. The right tools and gadgets at the patient’s side can help physicians and clinicians get a clearer image of patient history, current needs and discussion points to making each interaction more productive and less difficult on patients.
But access to patient records is just the beginning. Patients themselves must also be able to use technology to access educational content and in-room entertainment. The days of five-channel TVs with rabbit ears mounted on a wall are quickly disappearing. Flatscreen monitors that are tied to hospital networks and to devices within the patient room are becoming the norm. This technology can inform the patient and authorised care team members about the patient’s health while in the hospital, and it can prepare the patient to better adhere to care plans prescribed at discharge. With motion sensors and bed side rail sensors, chances of patient falls can be reduced as the alarm can go off, informing the nurses/care providers to monitor the same.
Tablets provide even greater flexibility. Patients access cable, internet and mobile apps on hospital-provided tablets to help them relax and take their mind off their illness.
This scenario only scratches the surface of the potential technology has to transform the quality, speed, accuracy, and experience of patient care. The goldmine of structured data generated through this will further pave way to creating/enhancing multiple AI/ML algorithms in the near future to bring in more efficiency in the process. As tele-health, m-Health and other leadingedge technologies evolve further, so will innovation at all points in the care continuum.
But transformation takes time. It doesn’t happen overnight. The key is to be aware of the changing landscape from patient engagement to patient empowerment and to recognize how this transition is unfolding as the market itself transforms from encounter-based care to value-based care models. We have made a start and will follow the path towards innovating and utilising technology to keep raising the bar for the care we provide to our patients.