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Demystifying 'digital hospitals': the IT industry is at it again. The term digital hospital is spreading fear, uncertainty, and doubt among hospital executives. What is it? Do I need to be one? How can I become one?

Healthcare Financial Management, Dec, 2005 by Randy L. Thomas

The concept of a digital hospital is being treated like some new, scary species--possibly from outer space. And because it is so new and scary, we don't really understand it or know what to do about it. To quote Mary Poppins, "Posh, pish!" Becoming a digital hospital requires nothing more--or less--than a sound IT strategy.

What Is a Digital Hospital?

The commonly accepted definition of digital hospital is one in which no paper is used to record or communicate information about a patient. Orders, lab results, images, and progress notes are all collected and communicated using electronic tools that capture, store, and transfer the pertinent information. Whenever a clinician needs to know something about a patient, the information is available online, through whatever access means have been provided.

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Of course, the paperless environment extends beyond direct patient care. A digital hospital is also a place where supplies are requisitioned, tracked, and replenished without paper forms or even a person taking stock of inventory. It is a place where financial transactions are handled electronically, without paper bills or checks being processed.

Inevitably, a digital hospital extends beyond the walls of the facility. In a digital hospital, supply orders are handled electronically with suppliers. Financial transactions are electronically transmitted to payers. Payments are deposited directly to the bank via electronic funds transfer. It makes sense, then, that a digital hospital is also one that communicates with other providers about the clinical care of a patient. It has the attributes of a regional health information organization, able to "plug into" the emerging local networks of health information.

How Do We Get There?

But what does it take to become a digital hospital? On the surface, it can seem like an overwhelming task: defining this new beast and bringing it to life. But determining how to become a digital hospital involves nothing more (or less) than defining an actionable IT strategy that aligns with and supports the clinical and business goals of the organization--and then executing that strategy.

A digital hospital is one that provides IT support for healthcare delivery processes--the goal of every IT organization. The label "digital hospital" does not change the need to define a strategy that addresses the IT staff, processes, infrastructure, and applications that are required to meet the needs of the organization. It also requires a strategy to identify the timing and sequencing of how to move the current state of IT within the organization to the desired state (e.g., paperless and externally connected).

In defining the IT strategy needed to support a digital hospital, it is vital to focus first on the goals and objectives of the organization--the underlying drivers behind the decision to "go digital." "A good IT strategy tells a logical, compelling story about where the organization is headed and how IT will help it get there," writes Jim Adams, executive director of the IBM Center for Healthcare Management, in the Summer 2005 edition of the Journal of Healthcare Information Management.

Developing this compelling story starts with identifying the organizational priorities, metrics, assumptions, and guardrails. These can be translated into a set of business and IT principles that incorporates the vision, goals, and objectives of the organization into a series of actionable statements. Guardrails are a definition of the boundaries, such as financial constraints that an organization must operate within, while assumptions are those implicit or explicit understandings of the executive team regarding certain possible future events, such as the proliferation of pay-for-performance or the role of the federal government in healthcare IT. The combination of these elements forms the foundation upon which the IT strategy will be built.

Of course, the desired state of the organization must be clearly articulated, along with an understanding of the current state of the organization. If the digital hospital is a new facility, the current state may be a description of the state of the industry, the existing healthcare organization, or both. But the juxtaposition of the current and future states-described within the context of the business and IT principles--paints the picture of what must be achieved to obtain the goal of becoming a digital hospital.

Going digital will profoundly change the jobs performed by employees, from administering medications to stocking supply closets. For that reason, the issue of work process redesign throughout the organization must be addressed, along with the vital role of change management in ensuring a smooth transition to the new world of the digital hospital. Without proper attention to work process redesign and change management support to ensure all staff understand their revised roles and how to carry them out, the goals of the digital hospital will be compromised.

Health Care Industry

Demystifying 'digital hospitals': the IT industry is at it again. The term digital hospital is spreading fear, uncertainty, and doubt among hospital executives. What is it? Do I need to be one? How can I become one?

Healthcare Financial Management, Dec, 2005 by Randy L. Thomas

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