Digital wayfinding can be challenging

Orientation Strategy and specific navigation solutions will have a clear digital element in hospitals now and in the future. Digital technologies will be more mobile and able to handle larger amounts of data so that the hospital users ( patients, relatives and employees, etc. ) will increasingly benefit from solutions that can support a personal, contextual, secure and clear way of navigation.

The following conceptual elements can be a help for hospitals that want a way-finding strategy and concrete solutions afterwards.

Principles of digital find your way systems in hospitals

The following principles will guide the preparation of the actual digital navigation solutions.

1. Digital way-finding information must be easily accessible and offered on multiple platforms and they must be overlapping.
2. Digital way-finding information has to be context-sensitive, for example, be based on the current location as well as for example the time of day.
3. Digital way-finding information must be specific to the individual, for example, be based on the actual booking and show the way there.
4. Digital way-finding information must be offered to both external (patients / relatives / suppliers) and internal personnel (employees).
5. Digital way-finding information should complement analogue information (signs, letters, colours, landmarks, entry numbers, addresses, etc.) as a single coherent system.
6. Digital way-finding solutions must exploit the existing (if any) Real Time Location System (RTLS)
7. Digital way-finding systems should support the trip To the hospital (home-> Hospital/parking-> entrance->destination) but also support the trip home (destination->Exit-> Hospital/parking-> home).
8. Digital way-finding systems must import map data from central systems such as Facility management’s operating system. Imports must be automatic and for example serve as a subscription (master-slave).
9. Data should in whole or in subsets be exhibited to third party suppliers. This could be addresses, entrances, parking lots, playgrounds, sections etc.
10. Digital solutions must be based on business requirements and wishes materialized in the way finding strategy and clinical concepts on the hospital.
11. Digital signage must be coupled with clinical and administrative data, in order to offer a relevant way-finding information. For example: Digital signage at the local level coupled with clinical booking / scheduling system, so content on the door screens outside each room reflects the actual planned treatments or signage in conference rooms / auditoriums reflect agreements in meeting room booking system.
12. Data on the use of the way-finding solutions(eg type of searches and where they occur) must be accessible, so it is possible to continuously analyze and optimize the composition and signage information based on real-time usage patterns.

Three geographic levels of way finding

Navigation on the hospital should be able to guide the patient from a remote location (eg. Home) through to the hospital. Upon arrival, systemss) recommend the most appropriate parking area in relation to the recommended input on the New OUH, and thus the location of the department, the patient must visit. Intern in New OUH's building stock to be offered a clear, timely and contextual navigation assistance to all staff and visitors / patients.

Digital way-finding information can thus be divided into three geographic levels.

These are:
1. From the remote location (or home) to the hospital
Patients, relatives, business etc must be helped to find their way between a remote location and forward to hospital. This could also be navigation for internal transport between different hospitals within a organizational unit.

2. From the hospital premises to parking and entrance
When patients, families, external suppliers etc. arrives at the hospital, they are offered navigation to the area that are closest to their destination. For patients, this information may be retrieved in a clinical booking system, while external transport will have to navigate to the goods reception.

From the entrance to the local destination.
Patients, families, employees, etc. should be able to get navigation aid within the hospital, which are contextual and based on the relative position between their current position and their destination.

Client Equipment usually found in way finding suites across the hospital

Way-finding stands
Larger stands with touch screens for interactive use, for example in a vestibule.

Digital signs
Smaller screens for digital signage for either use in hallways vertical or horizontal signs or possibly as elevator sign

Digital information screens
Larger screens for use as info screens for use in waiting rooms, receptions and other places where patients and relatives are present.

Way-finding  Apps
Way finding apps on the smart phone could focus on the parking area, entrances or guiding to final destination.

Digital door signs
Small door signs with text on room number and booking info as relevant clinician or type of room.

Digital signs in terrain
Larger signs in the terrain that can show info on contextual directions, overview maps and general information.

HIMSS Continuity of Care Maturity Model - an importent patient focus acros the continium of care

In a few weeks Himss is announcing the European model of HIMSS Continuity of Care Maturity Model: Transforming Health through Effective Usage of Interoperability and Analytics in Nice in the start of April at WOHIT.

Himss is renowned for its maturity model EMRAM within the hospital sector, where 7 stages defines the maturity of digitalization within the hospital. The Nordic countries and maybe Denmark in particular have always focused on the patients journey.The entire continuum of care from the GP, to the hospital, municipality, pharmacy etc. Denmark has a widespread digital landscape that shares data as messages between the participants with the patient in the centre.  The Continuity of Care Maturity Model will address exactly that, and more importantly it will drive change into a focus around the patient and not the Hospital. You could call the new maturity model a patient centred model!

I have participated in the project of developing the model with Himss analytics as the project manager. It has been fun and very rewarding to work closely with other healthcare partners across Europe, but also to develop something different, something new and substantial important for the health services and organisations across the European Union.

The above sounds like a little flamboyant, but a maturity model is important. Not that it matters if you get a 5, 6 or 7 in an isolated perspective, but the model and the eagerness to achieve greatness will drive the business, the hospitals and partners in a certain direction. It will be a driver of change, and the model will point the direction and set out the goals – so of course it is important, that it is designed properly. Data shows in the US, that the higher grade you have in the EMRAM the greater your hospital will be within quality metrics end efficiency. So it is ultimately not about the digitalization, the grade or us bragging in the bar late at night about my hospital being EMRAM 6 or even 7! – it is and always will be about cutting costs and improving quality – it is about the patient and nothing more actually. 

I truly believe Continuity of Care Maturity Model will in the future be a factor in that equation.

Himss on the model:

HIMSS Europe is presenting the Continuity of Care Maturity Model, that evaluates various aspects of delivering continual care covering both capabilities at organization and pan-organization levels. The Model will measure the readiness of an organization to deliver continuity of care as well as the maturity of a healthcare system in the continuity of care delivery. There will only be a global model but regional specifications are possible within the model’s framework.

The model has been designed by HIMSS Europe in collaboration with a pan-European workgroup including country teams from Spain, the Netherlands and the Nordics. It comprises 32 individuals representing regional and national health authorities, strategic planning organizations, CIOs of groups or regions, industry and HIMSS consultants.

Fremtidens borger er digitalt forbedret og monitoreret hele døgnet

Den sidste uudnyttede ressource i det danske sundhedsvæsen er patienten og de pårørende. I fremtiden vil opgaver, der i dag udføres af hospitaler og praktiserende læger samt kommuner, skulle varetages af patienten selv eller dennes pårørende. Man kan ikke udelukke, at med den korrekte teknologiske understøttelse, vil patienterne være i stand til at monitorere egen sundhedstilstand samt være indlagt i eget hjem og der tage vare på egen behandling i samspil med det relevante sundhedspersonale. At patienterne ikke er bange for ny teknologi på sundhedsområdet, har jeg tidligere skrevet om, så det er ikke her udfordringen nødvendigvis er placeret.

Så hvordan ser tendensen ud? Den går i mod, at borgere og patienter i højere grad genererer og opsamler sundhedsdata om sig selv, færden, søvn rytme, motionsvaner, ernæring osv.og udstiller disse til hele verden.

Så for at foretage et skifte mod, at patienten og borgeren bliver en aktiv medspiller i eget forløb, i stedet for en passiv modtager – ja der er ikke langt. Vi er i gang med at øve os på, at opsamle og monitorere vores egen sundhedstilstand. Nu gælder det for sundhedsvæsnet om at høste disse gevinster og vurdere hvorledes disse data kan indgå i fremtidens behandling.

Sam Gaddis har skrevet en fantastisk artikel om, hvorledes vi som borgere er i gang med at indkøbe teknologi til egen monitorering. Denne artikel er benævnt: Wearable tech: It’s not a device, it’s a system. Han skriver om hvorledes disse nye enheder kan indgå I et system således, at et armbånd taler sammen med mobiltelefon, en webside og I sidste ende måske en patientjournal eller omsorgssystem? Sam Gaddis eksempler er de nye armbånd som kan være forklædt som et ur, men som også for nogens tilfælde kan monitorere aktivitet og antal skridt, hjerterytme, puls, søvnrytme osv. Vi har her at gøre med en teknologi i ekstrem høj udviklingsfart, hvor nye funktionsområder præsenteres månedligt og flere og flere borgere indkøber og disse systemer.

Han nævner eksempelvis:

• Jawbone
• Fitbit
• Nike Fuelband

Der findes armbånd som efterhånden er ret elegant designet, så de fleste kan gå med dem uden at ødelægge deres personlige stil.

Disse systemer er sammen med tendensen om The internet of everything eksempler på hvorledes fremtiden kan se ud. Altså hvor vi monitorerer mere og mere omkring vores sundhedstilstand, vores aktivitet og stiller det potentielt til rådighed for alle andre via dedikerede sites på nettet eller deler det på tværs af disse teknologier. Alt kobles sammen og dermed skabes grundlaget for, at data kan skabe værdi afhængig af den situation de skal indgå i.

Der gik ikke mange år fra Apple præsenterede Iphone til stort set alle unge som gamle ejede en smartphone. Så at påstå, at teknologi ikke tages i brug af forskellige grupper af borgere eller patienter er efterhånden noget der hørte fortiden til. Monitorering og opsamling af data om en selv, at udstille disse data til hele verden og på den måde skabe uanede mængder af relevante (sundheds)data vil være en del af vores fremtid og måske allerede en del af nutiden. Lige om lidt vil vi også kunne måle iltmætning (saturation), blodtryk, ekg, temperatur osv, – hvordan vil vi som sundhedsvæsen udnytte disse data, er så det nye store spørgsmål.