How to build a smart hospital

What does for you an “innovative hospital” mean?

We used to call an innovative hospital a “Smart Hospital” since a cross-linked platform within the public healthcare system has been launched at the University Hospital Essen. This unique communication platform enables close cooperation between a classical clinical medicine, registered doctors, rehabilitation facilities and pharmacies. Besides, from our point of view, a smart hospital must represent values like humanity, progress, medical quality and innovative approach. Economic success also should be included. The clinic walls do not determine this, but the patient outcomes do.

Digitalization also positively influences the workflow of our employees, especially of the nurses. The recently established electronic patient file, as well as the future support of robotics, is aimed at the goal: reducing the time spent on documentation and all the administrative tasks that do not affect the patients’ care directly. This unlocks more time for communication so patients can share their fears and problems with doctors. So, an innovative hospital’s intention is the well-being of patients, their relatives and the employees.

Prof. Dr Jochen A. Werner, the CEO of the University Hospital Essen (Germany), wants to design and form a place where technologies address specific problems, following the principle: putting the peoples’ concerns in the centre. By combining strong leadership, clear vision, innovation-driven organisational culture and right mindset of all workers, he has already created one of the most innovative hospitals in Europe.

How to create a digital-oriented mindset in a healthcare setting, so all the doctors, nurses and medical workers are involved in the change process?

Probably the main challenge on the way to becoming a smart hospital is a sustainable cultural change. The new model of the clinic requires from all our employees an entirely different mindset. In short, we need a new way of thinking and acting, less hierarchy and more interaction and cooperation between different peer groups within the hospital. A new category of doctors is needed: specialists who are not captured in their discipline, but who stay open to all other external knowledge and ability to communicate across professional borders.

Interaction and dialogue are the keys. One the one hand, we keep informing all our employees using a whole range of analogue and digital communication instruments such as magazines, videos, newsletters, intranet, and so on. On the other hand, we are focusing principally on our new co-workers to make them the ambassadors and opinion leaders of the digital transformation. To do so, at the beginning of every month, we perform an extensive, four-day-long introduction session. It aims not only at educating and enabling our new employees to start their work smoothly but also at explaining them the idea and the spirit of our Smart Hospital project.

But one thing has to be admitted: every change process is a long road – it is not only about changing people’s mind but their behaviour. Our transformation towards becoming a Smart Hospital is an ambitious, probably never-ending process.

During my career, I have noticed that only doing, not talking, can change the reality around.

What does drive your motivation to apply digital innovations at the hospital you run?

In my former function as a practising physician, but also my current position as a medical director, I have strived for one main aim: improving the lives of people, improving the lives of my patients. During my career, I have noticed that only doing, not talking, can change the reality around. So many good ideas have not been implemented because there was nobody to turn a concept into result. In this case, even the best approach will remain useless. Discipline and hard work determine the success of every project. So,

»The main challenge on the way to becoming a smart hospital is a sustainable cultural change.«

my motivation is based on my personal experience: digital innovations are the prerequisite for improving medicine and healthcare. But the accomplishment is the only way to make real progress.

Are the medical workers ready for the digital transformation of healthcare?

Medicine and healthcare, in general, are currently facing the most dramatic change in the history of humankind. Thus, most medical workers cannot be ready for digital transformation. We also have to ask ourselves, what does it mean “to be prepared for the digital transformation”? As mentioned before, it does not only imply being able to work with modern medical devices or to use algorithms. It signifies a new kind of communication and interaction between all relevant groups and disciplines inside and outside the hospital.

We have to teach the young physicians adequately at the universities, continuing education when they start to work at the hospitals. They should be able to use all the new medical opportunities arising from the digitalisation. Furthermore, they should introduce a new way of communication in clinical structures. At the same time, we have to motivate the experienced physicians so we will take advantage of their knowledge and expertise. Only all generations and disciplines working closely together can successfully master the long way to the innovative Smart Hospital.

In which areas of healthcare should we invest in?

I want to mention three segments:

IT-Infrastructure. It is the basis of all digital applications. At the University Hospital Essen, we spend twice more than the market average in the technical equipment and hardware, as well as in highly qualified IT-experts.

Artificial Intelligence. We use AI for several tasks, among them to learn algorithms to define the age of bones, predict the probability of metastasis or to diagnose diseases of the lung. Prospectively, Artificial Intelligence and digitalisation will significantly contribute to the treatment of complex diseases. I want to mention cancer, rare diseases and all conditions, where a vast amount of data can be gathered and interpreted.

Our employees. Every change process starts with the employees. We invest continuously in human resources to enable our doctors and nurses to work in a digitalised working environment. For example, by using our new electronic patient file, as well as keeping them in touch with all developments within the framework of becoming a Smart Hospital.

We all know that digitalisation in healthcare faces many legal and financial challenges. Some changes will take years. What can hospital managers do now to create an innovative hospital?

Just doing what their job is: making the right decisions and follow a clear strategy. From my perspective and knowledge, some hospital managers are acting halfhearted. Indeed, they anticipate the challenges of digitalisation, but – due to several reasons – cannot respond appropriately. That may have a lot to do with a conservative structure of many hospitals and especially with their physicians’ attitude, but also severe legislative conditions or budget limitations. The result is what we see now in many hospitals: a lot of siloed digital projects without a consistent strategy, and finally – a waste of time and money. On the other hand, in every country and all over the world there are a lot of good examples of how digitalised hospitals can combine medical performance and, at least in the long run, economic success. But that requires courage and a clear vision of where to go.

The hospital of the future is not driven by the reign of bits and bytes, but use them for a much more human-oriented medicine.

Some hospitals are leading in digital transformation, some are lagging behind. If we assume that they have the same financial resources, what are the most significant differences between them which determine the level of digital maturity? From my point of view, there is only one significant difference: the strength of conviction, faith in success. Most hospitals implement a variety of several digital projects, but often without a strategic approach. At the University Hospital Essen, we always have the “big picture” in mind to entirely transform a traditional top-notch University Hospital into a fully digitalised, patients– and employeesoriented organisation. So, also our medical and entrepreneurial strategy follows the approach: recruiting the young digital and medical talents, discussing and approving all investments in medical equipment and infrastructure with the clinical directors. We enable our employees to become leaders in their working places. We are firmly following the primary strategy of becoming a Smart Hospital instead of doing a couple of incoherent projects. It makes the difference!

What digital solutions have inspired you most recently?

There are a lot of them. I am always inspired by new solutions and applications which provide real help and improvement in my life, for example, referring to communication or mobility. An excellent example of such a helpful tool in the medical setting is the Ada app, created by a German physician. With the help of algorithms, Ada aims to enable patients from all over the world to get access to personalised medicine. People can type in their symptoms and get back a health assessment, including a hint on what to do next. This is crucial mainly in regions with an undeveloped healthcare system. Ada is a very inspiring example of how digital solutions can help people immediately.

What is your vision of the hospital in the future?

A hospital that addresses the needs and expectations of the patients, their relatives and the employees; a place entirely focused on the well-being of all mentioned groups.

The “Smart Hospital” is an answer to the challenges that healthcare is facing right now: digitalisation, demographical transition in the industrialised countries and limited financial resources. The hospital of the future is not driven by the reign of bits and bytes, but use them for a much more human-oriented medicine. 