Akershus University Hospital in Norway has implemented advanced wireless solutions in their hospital, why? Where and what value does it give?. Vaaler S. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)

1. Akershus University Hospital in Norway has implemented
advanced wireless solution in their hospital, why?
Where and what value does it give?”
Stein Vaaler, MD, PhD
Deputy Managing Director
Akershus University Hospital

2. • Key Figures (2011):
• Area hospital for 500,000
inhabitants
• 80 to 90 % of all services
(somatic medicine and
psychiatry)
• > 60,000 over night stays
• > 50,000 day treatments
• > 200,000 outpatients
(policlinic consultations)
• 6,000 total staffing
– Approx 650 medical doctors
2 May 18, 2009

3. Basic structure
Wards
Pediatrics and
youth
Acute entrance
Treatment facilities
Glassgate
Main Entrance
3 May 18, 2009

4. 4 May 18, 2009

5. Why?
• Our major goal is to be the most patient focused and friendly
hospital in Norway
• As Europe's most modern university hospital (1. oct 2008) we
wanted to increase our productivity and be able to meet the
economic challenge in the specialised health care sector.
• With support of modern technology and wireless solutions we want
to be an attractive working place
– with highly skilled health
professionals
5 May 18, 2009

6. 1. October 2008
A new building
New equipment
Significant organisational
Incl. wireless technology development
- Independent of, and as a
result of new technologies
6 May 18, 2009

7. New technology (the basic challenge)
New technology are
automating or changing
the work tasks
7 May 18, 2009

8. Smart Card – the Key to Communication
name + picture
• Parking house smart chip
RFID
• Working clothings magnet line
bar code
• Door opener / key
– zones / restrictions
• Priority in elevators
• Network access
• Printing
• Home office solution (start-up and net access)
• Cantina payment
8 May 18, 2009

9. The IP phone-system
1500 hand held terminals
300 line based terminals
Backup
300 analoge phones
Ascom alarmsystem (not IP service)
mobile phones
9 May 18, 2009

10. The IP phone-system
• THE CORNER STONE
• Significant initial problems due to failure of large
scale testing
– Always backup
• Normal function after 4 months.
• Since then no technical problems and a success due
to the fact that ”the phone is always there” (role
based and person based phones).
• One of the most important factors in increasing the
effectiveness in a hospital where more than 90 % of
the patient admissions are acute and not preplanned.
10 May 18, 2009

11. Computers
400 laptops (wireless)
the number is steadily increasing
3800 stationary terminals
11 May 18, 2009

12. Computers
• Hardware development; small, flexible and wireless
• The major challenges
– On site logon time
– Too much basic software
• Role based profiles is more needed
• Personal profiles should be avoided in treatment areas
– Software harmonization an development
• To many products/programs
• To little strategic control and development
• Our major local problems is related to
– RIS/PACS
– The electronic curve
– Speech recognition
12 May 18, 2009

13. Automated Drug Management System
• Electronic prescription
• Decision support
• Information to the pharmacy
 robot (”pill picker”)
 packing and marking (bar code + text)
 deliveries by tube transportation
 message to the nurse (IP phone text message)
• Administration and documentation
(patient specific deliveries)
• The electronic curve – connected to the electronic prescription
14 May 18, 2009

14. 15 May 18, 2009

15. Transport
16 May 18, 2009

16. 17 May 18, 2009

17. We had great ambitions
• The goal was automatic delivery of patient specific
medication based on electronic prescription from day
one (1.october 2008).
• It did not work!
– Due to technical problems and the highly complex
integration process between the electronic curve, the
pharmacy system and the production systems
• We had to restart with two focuses:
– Automated delivery to local storage
– Electronic subscription and follow up (the electronic curve)
18 May 18, 2009

18. Status, automated drug delivery
Patient Bedside prescription
(DIPS)
Electronic
Nurse curve
Prescription
registration
Ward
Local storage Pharmacy
(Delta)
Packing
Distribution
(Swisslog)
Delivery, pneumatic tube system
19 May 18, 2009

19. AGV: Automatic guided vehicle – a success story
• Carry goods < 750 kg
• Top speed: 5 km/hr
• Know the way, use the
elevators
• Leave the goods, send a
report to the nurse (txt)
• Wireless technology
20 May 18, 2009

20. We are gradually improving!!
• People have learned to use the new infrastructure
(buildings and ”known” equipment)
• We are reorganising nurses and doctors (in mixed
units again)
• The infant diseases of many new technical systems
have been solved
• An last but not least: The personell are gradually
willing to change the ways they are working as a
consequence of new (wireless) technical solutions
and eqiupment
21 May 18, 2009

21. What are the results?
• Parameters of medical quality are improving
– Hospital infections
– Waiting time for operations
– Etc
• Budget balance (5 – 6 % increased productivity) are
expected in 2011
22 May 18, 2009

22. I would do it again
-
but I would have done it in another way!!
Stein Vaaler, MD, PhD
Deputy Managing Director
Akershus University Hospital