At the 650-bed Humber River Hospital in Toronto, Ontario, CIO Peter Bak has been leading an initiative that has already shown important results in terms of leveraging a variety of technologies in order to enhance clinician and staff effectiveness and improve patient outcomes. The building of a new replacement facility that consolidated what had been three separate campuses with aging legacy facilities, led to both opportunities and challenges, in terms of how the healthcare professionals at Humber River might move forward in the context of overall digital transformation. After a vendor selection process, Bak and his colleagues ended up choosing to partner with the Toronto-based vendor ThoughtWire, in order to build the kind of “app-oriented platform” that Bak was looking for in order to maximize the efficiency of physical resources and to optimize the efficiency of the physical activity of clinical and non-clinical staff in the new facility.
Bak spoke recently with Healthcare Informatics Editor-in-Chief Mark Hagland regarding Humber River Hospital’s experience so far on this digital transformation journey. Below are excerpts from that interview.
What was the situation that caused you and your colleagues to need a solution in this area?
Humber River Hospital was three separate campuses, and they were separate hospitals that amalgamated. The government runs and owns hospitals here. So these hospitals were amalgamated, and the buildings they were in were very old, dating from the 1940s. And we service an area of Toronto with about 850,000 residents, with a significant population growth happening. These facilities were simply not capable of handling the growth. So the executive team agreed that we needed more beds and a new facility, and we got funded for that, and transformed into a new single facility with 650 beds.
When did your new facility open?
It opened middle of October 2015, so, almost a year and a half ago. And it was a 12-year journey from the start to opening the doors. Our senior executives were looking at the opportunity, in building a new hospital, to lead the way; instead of following old models of care, how would we do things differently?
So there were two elements to this—a design element that was different, and a digital opportunity. And the whole world is going digital, but the question was, what should that mean? I was brought in as a consultant in 2009 to start the process of asking, what is a digital hospital? So, why? What are you trying to improve or do? And this is really all about business efficiency, quality, and safety. So as with any organization or industry continually looking to do better, the motivation for going digital was to leverage technology to do better. And that’s a pretty obvious statement, but interestingly, not everyone feels that way.
What did this quest look like on a practical level?
Part of looking at how we might be a bigger, better, or different hospital—we shifted from semi-private rooms and wards, which was and is the norm in Canada, to single-patient rooms. So right there, that increases your footprint and your physical space pretty dramatically. The second thing was, we want to also move from a model where you walk in through a central door into the hospital and fan out through various areas. We said, no, let’s follow an airport model, where you go to specific terminals or concourses. So we ended up with a different design from what we typically see in hospitals. And then the third element was energy: hospitals are inherently energy hogs. And community hospitals are typically very high consumers of energy. We looked at this and said, we want to be a more energy-efficient building, because that saves money. So these were some key drivers to try to save energy consumption while working in a hospital that would be physically much larger. And by the way, our ministry doesn’t have unlimited funds, and we won’t get a bigger budget just for becoming physically larger. So how do you deliver equal or better care, energy-efficiently? So we looked to technology to assist us in that. So that was a big driver when we were looking for technology.
So, how did you develop a strategy for this?
I would say that with any transformation strategy in any industry, there’s a fairly well-understood process for doing that—you need to understand what your pain points are, and what problems you need to solve. It’s a fundamental strategy, because if you look at change management, which is a key element here, many people fail around the change management piece. And the thing is that you need to change for the better, not just for the sake of change, or change will be rejected. So we went through a whole “voice of the customer” exercise. We really asked people, on a day-to-day basis, what is the most frustrating and painful stuff for you? And there’s a general theme that emerges that I think you’ll find in most hospitals, and it’s really rooted in the use of paper, and the inefficiency of using fax and paper, and all that. So it’s a good exercise. So we walked through that whole process, including participating in current-state/future-state analysis and gap analysis. We did all of that, and what came out of that was that there was a lot of technology available; the trick was to make it all work together. The key was interoperability, not just integration. Integration connects two pieces together, but doesn’t change anything. So we were looking at interoperability workflows.