We can track boxes in a warehouse, taxis on the road, and commuters navigating the London Underground — but whenever a new patient arrived at one Manchester hospital, staff scattered to check whether a bed was available. Soon, clinicians will not only have a perfect digital view of which beds are free and precisely where equipment is located, but be able to predict how long patients will stay at the hospital and what is needed for best care, helping to improve patient care while significantly reducing costs and improving staff experience.
The NHS faces an existential challenge: budgets are shrinking as the number of patients is set to rise. With an established history of using technology to address problems, Salford Royal NHS Foundation Trust knew some of the answer to that quandary may lie with innovation, turning to Hitachi for a decade-long, hospital-wide transformation project that begins with building a digital control centre to help manage patients, staff and equipment, giving the trust the tools it needs to power its good work.
Raj Jain, CEO of Northern Care Alliance NHS Group, says the project had dual motivations: improving care while reducing costs. “One is the recognition of opportunity. We could see how enabling our clinicians and operations managers to make better decisions could lift up our productivity for better patient care,” he says. “The second was when we do our financial forecast, we recognise that we have to make a transformational leap in productivity to carry on offering what we do.” James Ritchie, a doctor at Salford Royal as well as the clinical programme director for the Digital Control Centre, says such efforts will also benefit staff working on the front line of clinical work. “It will help alleviate people’s day-to-day frustrations — people come into healthcare roles because they want to deliver care, not battle capacity problems.”
Those goals — improve patient outcomes, free up clinical staff to do their real jobs, and drive efficiencies — will be achieved via a combination of digitisation, automation, sensors and predictive analytics, giving staff accurate information exactly when and where they need it, automatically filling in forms to reduce paperwork, and tracking beds and other equipment to ensure such resources are used in the most efficient way for the best care.
Having such information at their fingertips will empower staff to make the best use of hospital resources, such as beds and surgical theatres, for the best patient outcomes. While longer term plans will cover not only the hospital but other Northern Care Alliance sites, the first phase will focus on urgent care at Salford Royal, with the Digital Control Centre using flow management and predictive analytics to give staff key information such as admission history, tools such as semi-automatic bed planning, and risk assessments to help assign patients to the right care pathways.
“We want people to move through our organisation quickly and safely,” says Ritchie. The longer a patient is in hospital, the more risks there are for complications — and it also means another patient can’t make use of that bed. That’s particularly important during the winter, when demand rises for beds and the resources to staff them, meaning scheduled surgeries are cancelled, which is stressful and frustrating for patients as well as staff. “And cancelling operations doesn’t solve the problem, it just pushes it back,” says Ritchie.
One of Salford Royal’s objectives is to improve capacity to free up 70 beds — that doesn’t mean physically removing them, but reducing the staff and other costs around supporting a patient in the hospital. That will not only save £8 million per year — which Jain says is a conservative estimate — but it means those now unused beds remain in place as extra capacity, letting the hospital meet growing needs without investing in a new building. “We need to use our existing assets more efficiently,” he says.
Of course, real-time resource management has long been possible for warehouses and retailers, but healthcare systems around the world have been slow to adopt logistics technology and flow management, says Jain, despite such ideas transforming many sectors in the 1980s. “We’re catching up with what other industries are doing,” he says. “But then we’re going a little bit further with AI supported predictions.”
That leap forward is partially possible thanks to Salford Royal’s long history of innovation, which gives the Trust a base of data and metrics to start analysing in order to attempt to predict how long a patient will remain at the hospital and foreseeing any potential risks to their health. “It will help clinicians make better judgements faster, bringing information together for them,” says Ritchie. “By predicting risk for readmission or the risk a patient will deteriorate while in hospital, we can be more proactive in our management.” None of that replaces clinicians, but instead empowers them to make better care decisions, more quickly, he adds. “It’s not making decisions for them, but providing more information.”
Such work will be supported by what’s called a digital replica or twin, which is a model of the hospital’s data and systems. That lets the hospital take what the situation looks like now, and fast forward to what it is likely to be in three days or more. “We can hopefully simulate what the impact of our operational responses would be,” says Ritchie. In the future, the aim is to use the digital replica as a model to try new ideas. “We hope that we can begin to simulate service change,” Ritchie says. Ideas from staff to improve operations can be trialed digitally before being rolled out. “We can take staff ideas, improve them, and then execute them.”
Paul Watson, Vice President of Healthcare of Hitachi Consulting says “The hospital-wide transformation of operations requires the application of systems-thinking techniques to manage the complex nature of change within an integrated care environment. It also requires us to embrace a digital ecosystem of partners to make it happen. Turning data into actionable information and providing this to staff at the right time, to enable appropriate and informed decisions is critical to delivering the desired outcomes.”
Rolling out such technology across a hospital isn’t easy. “Healthcare is at best a complex system,” says Ritchie. “It’s as much, if not more so, a change programme than a technology program.” While Salford has decades of successful digital projects behind it, NCA turned to Hitachi to fill in gaps in skills, as well as to help push the innovation beyond what the experienced team at NCA and Salford Royal knew was possible. “We were looking for a partner that not just delivered what we asked for, but a partner that helps us do more, that helps us get better,” says Ritchie.
Because at its heart, that’s what this digital project is all about: helping the hospital work better for people. “Everything that we’re doing is about patients and staff,” says Ritchie. “If we’re not looking after people better, we’re missing the point.”
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