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The Smart Hospitals

MIT Stata Center_051118
(MIT Ray and Maria Stata Center, Jenny Fowter)


Hospitals, physicians and other healthcare providers are on the forefront of almost every healthcare intervention, from taking care of day-to-day chronic conditions to emergencies and life-threatening illnesses. Over the past century, as local community needs have changed and grown, hospitals have responded by expanding their size and services to meet the need. However, technology advances and changing patient expectations have led to new consumer-oriented healthcare services, causing many hospitals to rethink and, in some cases, reduce their size and services. 
Today, many big healthcare systems are starting to move care out of the hospital and into the home, for example, by automating routine services and providing remote monitoring and telemedicine. The future of healthcare delivery may look quite different than the hospital of today. Rapidly evolving technologies, along with demographic and economic changes, are expected to alter hospitals worldwide. A growing number of inpatient health care services are already being pushed to home and outpatient ambulatory facilities. However, many complex and very ill patients will continue to need acute inpatient services. 
As pressure mounts to reduce costs and improve patient outcomes, hospitals are seeking ways to improve their productivity and efficiency. Naturally, hospitals envision digital technologies as a solution. Many hospitals are enhancing their health ICT infrastructure with the intention of becoming smart hospitals by embracing digital transformation. But singular, siloed implementations don’t necessarily serve the purpose. Digitization trends have a high impact on hospitals, and indeed digital hospitals are also emerging. 
Smart hospitals are those that optimize, redesign or build new clinical processes, management systems and potentially even infrastructure, enabled by underlying digitized networking infrastructure of interconnected assets, to provide a valuable service or insight which was not possible or available earlier, to achieve better patient care, experience and operational efficiency. Smart hospitals rely on interconnected advanced technology and automation to improve patient care, clinician workflow, and overall efficiency. Smart hospitals utilize health ICT infrastructure technology such as mobile devices, data analytics solutions, and cloud computing. The process of transitioning ICT infrastructure to support a smart hospital can be challenging, but hospitals need to remember that the transformation must take place in stages. Not every hospital needs to become smart in a single step. Instead, the approach they need to take is to implement smart solutions, one by one, and then allow newer solutions to integrate with existing ones in the journey toward becoming smart. 
The smart hospital framework involves three essential layers - data, insight and access. Data is being collected even today, although not necessarily from all systems in a hospital, but is not integrated together to derive ‘smart’ insight, which can be done by feeding it in to analytics or machine learning software. This insight must be accessible to the user - a doctor, a nurse, facilities personnel or any other stakeholder, through an interface including a desktop or a smartphone or similar handheld device, to empower them to make critical decisions faster, improving their efficiency. 
There are three areas that any smart hospital addresses - operations, clinical tasks and patient centricity. Operational efficiency can be achieved by employing building automation systems and smart asset maintenance and management solutions, along with improving internal logistics of mobile assets, pharmaceutical, medical device, supplies and consumables inventory as well as control over people flow (staff, patients and visitors). Not only do these solutions reduce operational costs such as energy requirements, but also reduce the need for capital expenditures on mobile assets for example, by improving utilization rates of existing equipment. Patient flow bottlenecks, when addressed, improve efficiency, allowing more patients to be ‘processed’ through the system, allowing for more revenue opportunities at lower costs. 
The widespread use of Internet of Things (IoT), especially smart wearables, will play an important role in improving the quality of medical care, bringing convenience for patients and improving the management level of hospitals. However, due to the limitation of communication protocols, there exists non unified architecture that can connect all intelligent things in smart hospitals, which is made possible by the emergence of the Narrowband IoT (NB-IoT). In light of this, we propose an architecture to connect intelligent things in smart hospitals based on NB-IoT, and introduce edge computing to deal with the requirement of latency in medical process.  



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