If the hospital thinks

Who enters the University Hospital Essen, enters a normal hospital. A hospital with a receptionist, dedicated nurses, busy doctors, and slowly shuffling patients. But behind the scenes, the university hospital is in turmoil. The digital transformation is to take hold and turns the well-tried work processes on its head. Clinic chief Professor Jochen Werner wants to turn the house into a smart hospital – a hospital in which as many processes as possible are automated.

He has two goals with the Smart Hospital: “On the one hand, we want our patients to feel well cared for. On the other hand, we want to improve the working conditions of our employees, “explains the head of the clinic. Now, food is not the only hospital that gets fit for the future. Most houses in Germany have a digital strategy – but with a focus on cost-effectiveness. By contrast, the University Hospital Essen – in keeping with a trend from the USA – puts the well-being of the patient in the foreground.

“Digitalization should not be a question of economics. It has to be a question of the patient’s well-being. ”
Prof Jochen Werner, University Hospital Essen

An important building block in the digitization strategy is the digital patient file, which provides more transparency for all sides. The core of the digital patient file includes data from laboratory medicine, ie blood tests and information from radiology – in particular X-rays or MRI. In addition to the image data, the diagnostic data flow into the file. And of course the therapies and related medications. These three data silos must communicate with each other. And here hospitals have the same problems as the entire industry.

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But it’s not just the data silos in-house. There are also the interfaces with the doctors, the rehab centers and the patient who are still worried. Hospitals with a hospital information system can communicate with other hospitals.

But a uniform standard does not exist so far. It must either be created politically or adopted by the industry. “I suspect the industry will win. With so many patients using the Apple health record and selecting hospitals that can use that data, virtually the majority of patients decide which system will prevail. And we can not wait for politics to make a decision, “says Professor Werner.

Mobile visit car with voice recognition

Many patients today already want a digital patient record. But that can not be prescribed. “We must clearly appeal to doctors and nurses that digitization will bring benefits to them,” says Professor Werner.

Most employees are still very much attached to the analogue system. When leafing through the paper patient file, they know exactly where on which page they find the content they are looking for. Now they should do without the leaves and even as soon as possible directly enter the findings so that it can be found in the computer. The requirement from the top is: The documentation must be done in real time. “If this has been achieved, everyone will enjoy it,” says Professor Werner confidently.

The transition phase is complicated. The biggest problem with digitization is not technology. It is that employees need to change good behavior. A beginning is made. And so wakes up through isolated stations of Essen University Hospital of the mobile ward car. He drives from room to room. During the visit, the data is entered directly into the patient’s file – using speech recognition and artificial intelligence.

A nice addition is the electronic drug management. It checks whether medications may be taken together. Started in neurology, where patients get a manageable amount of medication, the system will soon be established in the emergency room. There, challenges such as documentation in real time and much more complex drug prescriptions come to the system.

15% of the costs in a hospital are due to avoidable errors. Thanks to digitization, these errors can be prevented.
Source: OECD

On the pulse of the time is also the cardiology in the University of Essen. There will be a great deal to do in the coming years, Professor Reza Wakili is certain: “We have therapies as well as diagnostics based on digital technology. Heart patients with a chip under the skin, for example, can be better monitored. We can detect cardiac arrhythmias so well, even if they only occur for a short time and go unnoticed by the patient. Today, this is done in selected patients. In the future, if Google and Apple enter the healthcare market and ensure long-term data transmission, theoretically anyone can benefit from this preventative surveillance, “says the cardiologist.

The University of Utah (USA) is working on the construction of sensors that can , Measure potassium in the blood in real time. This data can be combined with wearables in the future, so that the doctor and patient are always aware of the state of health. And cardiac procedures on the heart will be digitized in the future – thanks to a catheter with a built-in camera. This allows doctors to keep track of what their activities are doing to the heart during surgery. They see if they have obliterated the defective cells causing the arrhythmia. A catheter already records 15,000 to 30,000 points today and analyzes where the arrhythmia comes from. In the future, software will detect where the problem is and tell the doctor where to start the catheter.

In the past, doctors had to remember exactly where the diseased cells were. Today, robotic assistants bring the catheter to the right place within a 3D model, such as a joystick. Professor Wakili hopes to be able to use the new camera technology in cardiology in Essen as early as the middle of next year. “And maybe we can soon give our patients a CD of their surgery showing the catheter at work in their hearts,” he says, half joking, half serious. “It’s a bit like the automatic parking aid and the reversing camera in the car. You’ll also see exactly what’s happening behind your car. “

Children’s Hospital: With an app in the MRT

Digitalisation does not only bring toys for the big ones. Also for the little ones there are exciting concepts – in the children’s clinic. A big issue here is to take the fear of medical examinations. Adults already feel in the tube – technical term MRT – not very well. And for children it is even worse, because it is not only tight, but because they also have to lie quietly.

In order to relieve the children of anxiety and spare them sedation, in cooperation with the Chair of Media Informatics Duisburg-Essen, Lavalabs and Dr. med. Oliver Basu, Pediatrician and Head of the Department of Medical Informatics of the Children’s Hospital developed an app that prepares the little ones for the examination. “We bought 25 VR glasses. The children should be able to experience the MRI before. The story we came up with went like this: A penguin comes to the hospital with his mini-penguin and experiences the adventure MRT. But children are strict and so we were taught, the graphics are not beautiful and the beak of the penguin move when speaking wrong. ”

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On top of that, the fear of the little ones could be alleviated in advance. But in the real MRI tears came again. To find out why, the doctors had the children paint what they think on MRI. That is how the concept of the Space Pass and the Pingunauten came into being. The pingunauts explain what children are allowed to take with them on the MRI and what not (no mobile phone or cuddly toy with music box). Next, kids can use the app to train how they can keep quiet. The app records all training data. With the help of this data, physicians then decide whether sedation on MRI is necessary.

This project was financed by a grant from the state of North Rhine-Westphalia. Many patients also need to be cared for at home and have daily medical records. The hospital intends to develop a kind of diary. In order to motivate children to enter data diligently, they receive digital rewards such as: Emoji. Furthermore, the app offers appointments, news, a media library and an indoor navigation through the hospital, so that the app becomes the link between hospital and home.

Biobank: research without prejudice

Research also benefits: Blood and tissue samples from the hospital will be stored in the biobank, if the patient agrees. If z. B. 7.5 ml of blood are left with the diagnosis of pancreatitis, they are stored. For this purpose, the blood is distributed to smaller samples of 0.5 l each and stored together with the date and findings. This allows researchers to do hypothetical research.

If the pancreatitis patient is diagnosed with cancer in three years, researchers can analyze if there was an indication even then. Thus, the use of biobanks can make great progress in diagnostics and therapy.

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