Smart health enterprise model could enhance patient experiences, outcomes

By Anwesha Dutta, managing director, and Haleigh Sinkewich, senior manager, Deloitte Consulting LLP

Rising medical costs, low patient volume, elevated interest rates, ongoing workforce shortages, and non-integrated antiquated technologies are having a negative impact on health system margins and care delivery (see Health care CFOs plan to curb costs). At the same time, the health care sector is facing competitive pressure from outside disruptors, and some patients are demanding a health care experience that is on par with the flexible, consumer-centric, tech-enabled encounters that have become common in banking, entertainment, retail, hospitality, travel, and other industries.

As the health care sector moves into the Future of Health^TM that Deloitte first outlined in 2019, care may no longer be confined to the four walls of a hospital or physician’s office. But incorporating smart-enterprise capabilities, focusing on wellness and care delivery, and connecting the new ecosystem, will likely require thoughtful technology investments and careful coordination. 

In the future, we expect health care delivery will be more intentional, more proactive, more integrated, and more sustainable. The core components of this new delivery system should be based on human-centered design principles in an integrated, interoperable, and orchestrated way that focuses on the current and future needs of the patient. Smart hospitals of the future (and other health enterprises) will likely leverage cutting-edge technologies such as smart building capabilities, smart factories, and digital automation that can improve efficiencies while creating a better user experience for staff and patients. In addition, tech-enabled models of care (e.g., telehealth, remote-patient monitoring, hospital-at-home, digital engagement, and use of unlimited reality pre- and post-visit) could reduce the burden on providers by diverting lower acuity cases from traditional brick-and-mortar facilities (see Leveraging alternative care sites).

Can smart technologies improve the patient experience?

Every aspect of care delivery—from making an appointment to finding a parking spot to navigating the labyrinth of buildings and hallways that make up a hospital—can be frustrating for patients and their families. How can smart technology improve the patient experience? Consider this possible future scenario:

The year is 2027, and Ella (75) has been experiencing intermittent blurred vision, difficulty speaking, and numbness on one side of her body. A wearable device shows that her already high blood pressure has gotten worse. During a virtual check-up, her doctor diagnoses a carotid artery blockage, which has been causing transient ischemic attacks (symptoms are similar to a stroke). He determines Ella should be admitted to her local hospital, which recently underwent a smart-facility re-design. After the visit, Ella’s adult son accesses the hospital’s app on his smartphone and schedules a same-day tele-consult with a care team. During the consult, which takes place in Ella’s living room, the care team explains that Ella will need carotid artery stenting. Prior to the meeting, the care team used a drone to deliver an augmented-reality headset to Ella’s home. This made it possible for the care team to walk Ella through the entire process, answer questions, and reduce Ella’s anxiety. Ella’s family members receive a text asking them to complete a digital pre-appointment planning checklist and a patient intake form ahead of the surgery, which has been scheduled for the next day. (No time is spent filling out forms or waiting in a waiting room.)

The access and care teams notify the hospital’s digital command center that a surgical suite is needed the following morning. The digital command center helps predict the likely flow of patients, visitors, and employees. It also addresses various patient needs such as parking, hospital transportation services, and the availability of operating rooms and beds. A facility digital twin alerts the hospital that a bed will be needed following the high-priority surgery. A resource planning tool sends notifications to nursing, the supply center, and Ella’s physician. The care team connects to Ella’s wearable devices so that they can be immediately notified of a health emergency. They rely on artificial intelligence (AI) to ensure transparent and quick turnaround times for prior authorization from Ella’s Medicare Advantage carrier.

Ella speaks some English, but it is not her native language. A bilingual care manager is assigned to her upon submission of her e-Check-In form. A bilingual care manager helps the patient and her family navigate the digital channels. When the care manager is not available, automated translations appear on the room’s smart TV to help keep communication open to Ella. While completing the Drivers of Health screening, it is noted that she has limited access to healthy food at home. This triggers an automatic referral to local meal delivery programs, which will begin when Ella returns home based on the hospital’s dieticians post-procedure requirements completed digitally. 

The day of Ella’s surgery, her caretaker taps the hospital’s app to bring up the geolocation wayfinding to reserve and pay for a parking spot. The app checks them in as soon as they enter the parking structure. A map feature shows them how to find their way from the parking structure to the hospital’s elevators. The smart elevator scans Ella’s QR code and takes her and her family to the floor, where they are greeted by a social robot who speaks in Ella’s preferred language. Once settled, Ella, her caretaker, and a member of the care team access the TV screen to review the procedure. The interface also adjusts the temperature and lighting in the room to the patient’s preferences.

The operating room is equipped for the surgery via automatic notifications from the command center. The doctor’s supplies, surgical robots, temperature, lighting, and surgical table are automatically arranged to the surgeon’s preferences through smart supply chain and cabinets. The surgeon relies on an augmented reality (A/R) headset to review imaging data and to monitor the patient’s vitals. A running count of instruments floats just inside of the surgeon’s peripheral view. A camera built into the headset allows the surgeon to take pictures of the procedure and include them in the procedural documentation. This reduces the amount of time the surgeon needs to spend in surgery. The family monitors the surgery via the hospital’s app.

Ella’s medication is automatically sent to her room through smart supply chain processes and robots. Along with playing movies or TV, the room’s smart screen also enables meal planning, displays patient’s daily schedules, and presents co-payments and payment options. The monitor can also be used for video visits with the care team. This encourages patient engagement and education during and outside of traditional physical clinician interactions. After recovery, Ella and her caretaker use the TV to check out, then they visit the Tech Bar to pick up wearable devices. The hospital uses the app to notify Ella and her family that a remote-patient monitoring kit will be delivered to Ella’s home.

Upon discharge, Ella receives a list of auto-scheduled follow-up care appointments. The physicians, dieticians, and nurses use AI for chart updates. Ella’s wearables automatically share her recovery progress and medication compliance with her care team. Any technological or immediate issues can be addressed by community members at the local tech equity hub.

The Digital Command Center

The Digital Command Center (DCC) is the heart of a smart health care enterprise. It can reduce the need for manual inputs and pull an organization’s various departments and functions out of their siloes and into one unified system. A DCC can perform real-time patient and workforce management by leveraging multiple data feeds and minimizing friction as people move through a physical or virtual care environment. By integrating smart capabilities into smart supply chain (e.g., inventory management), health systems can enhance supply chain reliability, boost efficiency, and help ensure staff have the tools they need to deliver a superior patient experience. Facilities departments that integrate smart elevators, smart HVAC systems, and smart lighting systems could see improved efficiencies. Rather than responding when things break, for example, staff could rely on predictive maintenance strategies driven by data.

But it can be difficult for health system executives to determine where to start. Each organization will likely have a different starting point and could have unique challenges to overcome. But even small, incremental improvements toward smart health delivery can have a significant return on investment.

CONCLUSION

Hospitals and health systems throughout the United States are in the middle of a digital transformation. While there may be different definitions for various hospital systems, many of them have started to incorporate smart health capabilities. There is no single path toward this future. Organizations can begin their journeys by adopting the components that align to their most pressing needs. They can be scaled up or down depending on an organization’s individual circumstances and financial constraints. The most important thing is to start planning now.

This publication contains general information only and Deloitte is not, by means of this publication, rendering accounting, business, financial, investment, legal, tax, or other professional advice or services. This publication is not a substitute for such professional advice or services, nor should it be used as a basis for any decision or action that may affect your business. Before making any decision or taking any action that may affect your business, you should consult a qualified professional advisor.

Deloitte shall not be responsible for any loss sustained by any person who relies on this publication.

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