Imagine a hospital room that can track patient movements, alert nurses that a patient identified as a fall risk has left the bed, and provide clinicians with relevant, real-time patient information such as vital signs, test results and medications that are due.
IBM and the University of Pittsburgh Medical Center pioneered the idea of “smart” patient rooms back in 2005, with the idea that such integrated technology would improve workflow efficiencies, quality of care and patient satisfaction. Since then, Cerner has entered the field, offering a smart room that includes medical device interoperability, room controls and instant access to EHRs.
But today few hospitals have smart rooms, in large part due to a lack of capital or the infrastructure to support this visionary technology.
“The reality is that advancements toward a patient smart room of the future have to be accomplished very economically,” according to an e-book published by Amplion Clinical Communications, which specializes in designing and implementing patient-care communication technology for hospitals. “You would be hard pressed to find many hospitals throwing a million dollars a bed into smart room initiatives.”
To really make a difference in patient care, smart rooms need to be proactive and predictive, the e-book says. This requires the ability to combine disparate data to fuel reminders and make preemptive recommendations on what the patient needs.
Building a smart room also demands a team of different hospital disciplines and vendors working closely for months to piece everything together into a seamless whole, says Paul Butler, a director at Top Tier Consulting, who worked with Los Angeles’ Martin Luther King, Jr. Medical Center's smart rooms build at the newly renovated 131-bed comprehensive care facility.
Another problem is the hospital of the future is constantly evolving. “Hospital executives are often less excited about investing precious dollars on a ‘future’ of uncertain promise versus, say, regulatory and compliance projects that must be attended to now,” Butler tells Healthcare Dive.
Before going live
Before a smart room goes live, all of the disparate technology needs to be integrated and tested in a simulated environment. Typically, this means outfitting a patient room in the hospital with the desired technology. “The tests need to be planned to test the limits of the technology, because just about anything can and will happen in a real-life environment,” says Butler. “Just because it worked great in the vendor’s canned demo doesn’t mean it will work well in an actual hospital.”
All sorts of unanticipated scenarios have to be imagined and tested. For example, the room may have a customer satisfaction feature that detects an ID chip in staff badges and displays the person’s name on a smart TV the moment they walk into the room. But what happens if a doctors walks into the room seconds after a nurse does? Does the doctor’s name cover the nurse’s on the TV screen or sit next to it? “While this is a simplistic example, situations like this come up all the time and they need to be tested,” Butler says.
Because smart rooms require integrating many different components, problems can and do occur. Troubleshooting to minimize disruptions is paramount, Butler says. So is providing additional training for nurses and doctors to ensure the technologies are used properly.
For instance, smart beds may be equipped to alert nurses when a frail patient leaves the bed. But if there are too many false alarms, the nurses are likely to ignore or silence the alarms. “These are not trivial problems to overcome, especially among old-line nursing staff that sometimes do not have the patient to use technology that is not 100% reliable,” Butler says.
It can also be difficult to diagnose the cause of the false alarms, he adds. They may be due to an overly sensitive sensor, but could be the result an improper data feed due to a coding error from an IT contractor. “Until these pieces are more seamlessly integrated, it will seem to be a disadvantage to many on the bleeding edge of this new technology.”