Leader Health - Silber's Net DIGITAL HOSPITAL
     Digital Hospital Newsletter #1 - Fall 2007  
—> Version française   
Welcome to the Digital Hospital News
In this issue  

The Theme:
Beyond paperlessness: Digital Design

Takeaway Messages
Leader Health
Leader Health is a federation of +35 international experts in healthcare leadership and eHealth, working together as a network, to bridge the gap between healthcare leadership and the enlightened use of information technology.

Oct. 22-25, 2007
World of Health IT
Vienna, Austria
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For information on Leader Health’s « State of the Art » Workshops, Clinical Mentoring, IT Governance, Industry Solutions, contact founder, Pascal Detemmerman

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Digital Hospital News, an electronic quarterly dedicated to the State of the Art in hospital information technology, is a service provided by Leader Health to hospital managers, IT specialists, and healthcare professionals. Each issue presents a real-life example. Would your hospital like to be a case study ? Please contact our Editor, Denise Silber, member of the Leader Health network and founder of Basil Strategies


Digital Hospital News, an electronic quarterly dedicated to the State of the Art in hospital information technology, is a service provided by Leader Health to hospital managers, IT specialists, and healthcare professionals. Each issue presents a real-life example. Would your hospital like to be a case study ? Please contact our Editor, Denise Silber, member of the Leader Health network and founder of Basil Strategies.
Case Study: London Health Sciences Centre

London Health Sciences Centre (LHSC) is a premier acute-care hospital and one of the largest teaching hospitals in Canada. LHSC has an academic partnership with the University of Western Ontario and is also the home of the Children's Hospital of Western Ontario. 

LHSC smart room

In addition to existing digital hospital facilities, LHSC is building a tower of "smart rooms" with integrated terminals so that the patient can control the room environment and depend less on staff for simple tasks, contributing to a greater sense of autonomy and faster convalescence.


LHSC is nationally recognized for offering comprehensive programs in Women’s Health. Modern facilities are under construction, so that all programs can be integrated on one campus alongside Children’s services.

LHSC is also known for its robotic surgery, cardiac care, clinical neurological sciences, multi-organ transplantation, critical care and trauma, orthopedics, sports medicine and research

Created in 1995 following a merger between University Hospital and Victoria Hospital (whose history dates back to the mid-19th century), LHSC (800 beds) currently serves more than a million patients per year. The 7600 LHSC employees include more than 500 physicians and 2600 nurses.

Interview: Tony Dagnone, CEO LHSC 1992-2006

Denise Silber (Digital Hospital News): Tony, when you became CEO of LHSC in 1992, the context was very challenging. Please tell us what you found and how you proceeded.

Tony Dagnone (London Health Sciences Center): Yes, LHSC was not equipped to address today’s needs. We were short on staff and long on paper. We hadn’t moved ahead on patient safety issues, such as automating protocols, computerizing order entry. The opportunity came in 1995, when we were merging three hospitals. We had to let go of the legacy IT system. So, we began to look around at what was available in software packages. It took 10 years to make a visible change. Today our system serves 7000 users each day.

DS: What were your major IT decisions and accomplishments ?

TD: We looked to see what could be computerized and in what order. We began with patient registration. Next came a computerized laboratory system. This was followed by the pharmacy order system and filmless radiology. LHSC brought together 8 hospitals in the region; we can all read one another’s images. We were careful to protect patient confidentiality. Access to an individual patient file by a healthcare professional is fully traceable.

Let me also mention the importance of change management. Launching a major IT project at the right time is key. In our case, the right time meant that the members of the organization have recognized that it’s time to abandon the existing system. And we explained the duration of the project from the beginning, so that people could work together for the long-term and avoid the frustration of missed deadlines. Over-promise is a huge issue in health IT.

DS: What about the cost angle of these developments ?

TD: Well, we have to work within a budget like any institution. We are 80% financed by the Government of Ontario and 20% by our own means, whether fundraising or the services we « sell », the cafeteria, parking,…

DS: What is on the horizon?

TD: LHSC is experimenting the use of PDA’s and laptops, since up until now the workstations are tabletops. LHSC is also examining a barcode approach versus RFID to ensure that the right patient gets the right procedure and treatments. We are building a digitally-ready tower with smart rooms, a very exciting project, whose launch I knew from the outset would extend beyond my presence at the hospital. You have to think long-term. The Canadian public is expecting hospitals to be progressive, if not aggressive about IT. The products are much mature than when I started. It’s a very exciting time to get up and go to it!


Interview: Dipesh Patel, Exec. Associate, G+G Architects. Joined in 1993.

Denise Silber (Digital Hospital News): G + G architects have been working with LHSC for 10 years, converting it into a « digital hospital », which goes well beyond the electronic medical record system. Please tell us more.

Dipesh Patel (G+G): The backbone of a digital hospital is of course the electronic patient record system, but, there are many other components : diagnostic imaging, hybrid operating theatres, in patient smart rooms, modular out-patient care, wellness centers, digitally-managed inventory and waste control….

All of these are impacting the physical lay-out of the hospital. Digital imaging requires larger, networked imaging rooms. Clinical practices require larger working spaces, so as to perform certain procedures without moving the patient. The growth of minimally-invasive surgery is increasing out-patient surgery. Single rooms provide for better control of infection.Radiology bedside unit Telemedicine enables the hospital to complement its expertise beyond its walls. Power management and redundant systems become essential. Files no longer occupy space in the hospital itself. So, change management of the IT systems is intimately linked to the architecture itself.

As digital designers we bring a multi-disciplinary approach, combining knowledge of physical architecture and the emerging information technologies.

DS: What is on the horizon for G+G?

DP: Well, of course we'll always be active in Canada, because hospitals are lifetime projects, but we are also extending our activty to Europe. I'd say we are currently reviewing our next "lifetime partners" in other countries. Technology is always changing faster than can we design it. So when we meet up with a new hospital client, we know we'll be evolving together over the years, and it's a big mutual commitment. That's what we love about the business of hospital design, not to mention the better quality of care we help make possible!


Interview: Pascal Detemmerman
Denise Silber: “Leader Health”, the name of your company is also the service it delivers. Can you explain?

Pascal Detemmerman (Leader Health): Yes, creating a name is never easy and Leader Health sums it up : we are in Health Care and we work with hospital Leaders.
Why? During the 20 years that we worked in healthcare IT on the industry side, we saw that  IT decisions in hospitals were often made on a technical basis, without looking at technology’s impact on the actual running of the hospital.
Our work at Leader Health is to help senior hospital management bring their teams together in one single vision, a vision based on improving the quality of care, thanks, amongst others, to a judicious use of healthcare IT.

DS: How does Leader Health help bring everyone together?

PD: People are our asset. Leader Health’s unique network of 40 national and international hospital leaders represents the best of breed in leadership and Health IT.
These experts  share their knowledge with one another through the Leader Health connection, and then take the message back to their home country in their own language and cultural references.
Our customers, hospital executives and leaders, work with the experts to enhance the common  vision in their specific institution.


Takeaway Messages
The Multiple Dimensions of a Digital Hospital:
Paperlessness, Global Network, Evidence-based Design, Strategic Planning

• Paperless Organization

A digital hospital is pratically paperless in that information (orders, appointments, prescriptions, biology, images, consultation notes, discharge summaries, administrative and financial data…) concerning a patient is transmitted electronically.

Additionally paperlessness makes possible the improvement of care through new approaches to design and greater geographic reach.

• Digital Design

Hybrid operating theatre: the combination of a traditional operating theare with digital or filmless radiology. Surgeons see real-time images and therefore can perform minimally-invasive interventions.

Smart rooms: digitally-enriched rooms including access to electronic medical records, patient-operated terminals, space for mobile beside imaging units,

• From One Hospital to a Global Electronic Network

If a digital hospital works electronically with its suppliers and payors, it has the capability, if not the responsibility, of connecting to outside healthcare professionals wherever they may be located, locally, nationally, globally. This depends not only on the hospital’s strategy, but on the particular circumstances of the patient, in a world of increasing individual mobility.

• Evidence-based Design

What is the role of physical plant in the development of a digital hospital? Evidence-based design is now a discipline in its own right. Architects involved in « evidence-based healthcare design » use the latest technologies and healing philosophies to create environments that are the best possible for their patients. These are long-term projects.

For more on evidence-based design: www.healthdesign.org Through research, education, advocacy and technical assistance, The Center for Health Design supports healthcare and design professionals all over the world

• Strategic Planning

« Going digital requires a well-formulated strategy implementation plan identifying the governance, education, communication, planning, training, and other decisions that need to be made, as well as the timing and sequencing of these components. » R. Thomas.
(Demystifying 'digital hospitals'. Healthcare Financial Management, Dec, 2005, Randy L. Thomas - http://findarticles.com/p/articles/mi_m3257/is_12_59/ai_n15980909)


© Digital Hospital Newsletter - 2007 - a Service of Leader Health.
Editor : Denise Silber
  Basil Strategies  e-Health Partners 
1 rue Jacques Offenbach - 75016 PARIS (France)