Designing for patient engagement: Smart hospital rooms of the future

Most patients would agree that being hospitalized is not always a pleasant experience. Even in the best hospitals in the world, spending time in the inpatient setting can be disruptive, confusing, and anxiety-inducing, especially when it is difficult to communicate with care teams, understand treatment options, and get adequate sleep.

The hospital-at-home is becoming significantly more popular for just these reasons, giving many patients the option to stay more comfortable in their own houses while receiving a high level of care — and changing their expectations around what it means to engage with the healthcare system when serious illnesses or injuries strike.

But the hospital-at-home model isn’t suitable for everyone, and there will always be a need for the level of intensive monitoring that only the inpatient setting can provide. In these cases, hospitals have increasingly strong incentives to make the experience as positive as possible, to keep patients satisfied, reduce costs, and foster better clinical outcomes.

They can do so by bringing in elements that have become hallmarks of the hospital-at-home model: digital patient engagement tools and innovative care models that are built around the holistic needs of the person in the bed.

At Nebraska Medicine in the Omaha region, “Project Next” is tackling the challenge of making inpatient care as person-centered as possible. With its new Innovation Design Unit, the health system is merging a number of cutting-edge digital strategies with an extensive re-think of the current care model in an effort to prepare the health system for the future of hospital care.

“Technology is moving so fast, and it’s surprisingly difficult to design a hospital room that isn’t obsolete as soon as it’s finished,” said Scott Raymond, VP Chief Information & Innovation Officer at Nebraska Medicine. “When it can cost upwards of $2 million renovate a single room, it’s important not to get it wrong.”

“We need to think about how we can future proof our physical environment so that it is truly designed around what the workflows and care models are going to look like ten, twenty, or thirty years from now.”

Envisioning a digital-first future in an established physical setting

Designing the next-generation hospital room starts with understanding the existing architecture of the inpatient setting. Not every health system has the budget or the real estate to build a new campus from the ground up, so working around the limitations of older structures is essential.

“Some of our buildings were built back in the 1950s, and have to design around those bones,” explained Raymond. “Older buildings are always full of quirks.  For example, we found that our building was constructed with these huge girders that go down from the ceiling at an angle, which restricted our ability to make rooms bigger and rearrange things like the plumbing.   Fortunately, our designers and architects have done an amazing job with problem solving, but these are challenges that we wouldn’t necessarily have with a new-build hospital.”

To maximize the configurability of existing spaces, Raymond’s team started with installing movable walls that can be rearranged to divide spaces or change the orientation of furniture, gasses, and devices.

Then they started to layer in the technology to bring the room alive.

“We’re using this innovation unit as an opportunity to envision new digitally driven care models,” he said. “We decided on four primary technologies to anchor our work.  As an Epic customer, obviously those technologies are going to be in there.  We’re also going to have a virtual nursing system, a real-time location system (RTLS), and our new patient engagement platform from Vibe Health, which includes a digital footwall where the patient can access information, control features in the room, and communicate with their care team via cameras, microphones, and tablet devices.”

“It will work with the RTLS, for example, to let them know which staff members are in the room, and it will show the patient’s schedule for the day if they have any tests or procedures and provide other personalized information as necessary. No more dry erase boards – it’s all going to be interactive, which is a very new way of thinking about what goes on in the typical ward.”

Keeping the patient at the center of the care process

The multi-technology platform is designed to actively connect the patient to their care, so they can remain engaged in the process and feel more in control during what can be a disorienting and stressful time.

“The inpatient experience can be very isolating,” noted Raymond. “It’s easy to feel disconnected from your life outside of the hospital, from your family and loved ones, and that’s not very helpful for the healing process.  We want the hospital environment to be as comfortable as it can be, and as connected as it can be, so that people have the opportunity to rest and recover so they can go home faster.”

Integrating virtual nursing services will be a major component of the revamped, person-centered experience, he added.

“We believe it will reduce some of the administrative friction around getting paperwork signed or getting discharges completed,” he said. “It also has benefits on the clinical side, especially when combined with in-room technology.  If the patient has an issue, but the on-site floor nurse is busy somewhere else, we can have a virtual nurse pop up on the screen immediately to assess the situation and provide a speedy solution.”

“We’re hoping that this is not only a patient satisfier, but a way to increase the quality of care and decrease safety events such as a patient falling down because they needed the bathroom, but a nurse wasn’t coming fast enough for them.  We feel it’s going to be one of those rare win-win situations in healthcare.”

Responsibly integrating innovation into the next iteration of inpatient care

Designing for the future can be exciting, but it must be done with caution and care.  Not only do leaders have to consider the budgetary implications of bringing in new technologies or care strategies, but they also have to think about how these additional factors will affect the day-to-day operations and experiences across the entire care ecosystem.

“Innovation for innovation’s sake is a fool’s errand,” Raymond said. “You have to have a very defined problem to solve before you start bringing in technology.  Knowing what your goals are and having a really thoughtful plan to use technology as a way to achieve those goals is incredibly important, both from a business perspective and for the clinicians who are going to have to be using these new tools every day.”

In the Innovation Design Unit, Raymond is aiming keep tabs on these broader impacts by bringing in informaticists and PhD-level nurses to perform studies to validate the effectiveness of new technologies and pilot programs.

“If we make a change and it doesn’t improve care quality or doesn’t improve experiences, we want to know about it,” he stressed. “We need to document and analyze everything we do so that we can iterate appropriately and keep moving in the right direction.”

“We all want to try out the latest and greatest solutions, and there’s certainly a benefit to being open to new things. The organizations that see the most success with innovation are creatively minded and willing to take risks, but they also know how to make sure their technology stays aligned with their mission, so they can maximize the value of everything they do.”

Jennifer Bresnick is a journalist and freelance content creator with a decade of experience in the health IT industry.  Her work has focused on leveraging innovative technology tools to create value, improve health equity, and achieve the promises of the learning health system.  She can be reached at jennifer@inklesscreative.com.