At the risk of paraphrasing one of my heroes, I have a dream that someday we will have a smart hospital—one that knows where every patient, provider, and piece of equipment is at all times and what it’s supposed to be doing. And that can reschedule itself in response to emergencies and the other exigencies of health care.
What would that mean? Well, for example, when an appointment is cancelled in physical therapy because a patient has a fever, the schedule is re-arranged to accommodate the most appropriate next patient, without requiring a dozen phone calls. Or when a discharged patient leaves the hospital, housekeeping is notified automatically that her room needs to be cleaned. And that a meal isn’t sent to an empty room because a patient has been taken to dialysis; rather, the kitchen is informed when the patient leaves the dialysis unit, so lunch can be waiting when he gets back to bed!
It would mean that a physician or therapist doesn’t have to run around trying to find a nurse in order to find out where a patient has gone. Or that a patient is scheduled to go home tomorrow, and needs a follow-up X-ray before discharge. Etc., etc., etc All without having to spend time entering and reentering data.
The technology to do parts of this already exists. We can use bracelets with RFID chips to track patients (Ms. Jones is now in Nuclear Medicine for her bone scan); CPOE (computerized provider order entry) and standardized care plans to know which patients need what tests and treatments (Mr. Lightly needs to have his blood drawn before breakfast, and his nurse needs to be notified if his blood glucose is above 200 mg/dL); and intelligent algorithms to rearrange schedules without disrupting the entire day (Ms. Lee is leaving OR 9, so it’s time for transport to pick up Mr. Hall from room 422). What we need is a way to put it all together.
Think about how great it would be to work in a hospital that was so well-organized that you almost never had to waste time wondering where somebody was or where they belonged.
Too much to ask for? I don’t think so.
About Warren Browner
Warren S. Browner, MD, MPH is the CEO of California Pacific Medical Center, the largest hospital in San Francisco and part of the Sutter Health system. He is a long-time resident of the city, having moved here in 1975 to attend medical school at the University of California, San Francisco (UCSF). He also received an MPH from Berkeley. Both his children (Elise and Michael) were born and raised here.
Warren trained in internal medicine and clinical epidemiology. He practiced as a general internist for many years at the San Francisco VA Medical Center, where he was on the UCSF faculty; he still holds an appointment as an Adjunct Professor of Epidemiology & Biostatistics. Warren is engaged in research focusing on the genetics of human longevity and frailty. He has also studied the association between osteoporosis and other diseases, including atherosclerosis and breast cancer.
You can find him in his gym clothes most Saturdays around 1 PM buying produce at the farmer’s market on 24th Street in Noe Valley.
You can find his blog at http://talktowarren.wordpress.com/