Less is more? (or how to make the most of our new hospitals) Nanna Skovgaard Head of Division

Agenda 1.Background – why and what we build 2.Demands on ICT for the new hospitals 3.Demands for connected care 4.Goals from government perspecitive 5.Initiatives 6. In what sence could less be more?

Hospital structure - Fit for e-health?

Activity aims towards year 2020 (from 2007) Out patient treatment up with 50 percent Number of beds down with 20 percent Bed days down from approx. 5 days to approx. 3 days

Results Average length of stay, days

Building a hospital structure for the future In the next 15 years, 7 billion US-$ will be invested in 16 main hospitals according to a national strategic plan covering all Denmark From 40 to 20 main hospitals –specialization and centralization Common emergency wards and single bed rooms The largest capital investment in the history of Denmark – since medieval church construction A unique chance for a coordinated boost of patient treatment and technology in the health care sector – and strong demands for more connected care and telemedicine – given reduced number of beds etc.

16 building projects

National standards and strains Demands on efficiency gains of 6-8 percent on activity Strong focus on budget control – overruns not accepted Approx. 20 pct. of construction costs is reserved for IT, medico- technical devices and apparatus etc. This high share to ensure that the hospitals are new – also when doors open in 10 years »We will gain a unique experience when it comes to building robust buildings, new solutions and green profile

Demands on hospital ICT and equipment If treatment to the same level is to be given faster, it takes new ways of organizing treatment and supporting it by ICT etc. If demands on capacity is rising - so are demands for timely delivery of resources and flows – less slack It takes well functioning and integrated EPR’s, mobile solutions, CBI Focus on clinical and service logistics to optimize man power and equipment – RFID, emergency boards etc. Merge of equipment, medical devices, ICT – work end-to-end How to develop, purchase – and combine with existing gear?

Electronic registration boards for emergency care in all hospitals

To keep people out – can ICT help us? If we build more efficient – and more distant - hospitals We also need efficient surroundings – to keep people at home New ways of working between patients, local nurses, GPs, hospital doctors – telemedicine is key here Infrastructure, devices in place, logistics, new concepts on service - organization, clear tasks etc. Digital communication between sectors – and clear clinical guidelines and clinical path ways to enhance seamless treatment of patients cross sectors – cross diagnosis and geography. Also we will probably se more hospital treatment at home – changing demands on devices and ICT.

Structural challenge and ambitions * The more we want to do with data, the more mutual dependencies we face * Strong need for commitment on information, tasks, competences, work flows - end to end * Systematic reliability and systematic semantic - digital communication cross sectors

Government goals – ICT and hospitals The new hospitals must achieve targets on treatment, implement common emergency wards - and keep building budgets Use opportunity to develop new solutions to shared challenges - how to work with ICT in buildings, logistics, design etc. Share experiences and strategic decisions – develop business cases and chose new solutions on larger scale. Establish the new hospitals as knobs in structure for connected care – demands on ICT and agreements “our of the building” Demands on efficiency gains of 6-8 pct. – can you help them out? Wider benefits – growth – international cooperation and exports.

Government initiatives Demands for transparency on shared experiences and results of cooperation between regions - and private companies Network to share “best results and solutions” and present abroad Work with national standards on ICT, equipment etc. – to make procurement of new gear cheap, reliable and connected Further develop National action plan on telemedicine – and test bed to facilitate uptake of new solutions Further develop health.dk – as a shared site for citizens data

So – in what sence could less be more? 1.Reduce number of hospitals – to gain specialization and concentration 2.Reduce number of in beds and in bed-time 3.Reduce the number of ways we do things – do it right once 4.Work with standards and models for procurement of equipment and ICT to make sure it functions end-to-end and is cost effective 5.Not least: With data and right timing – we need to do less to achieve more in treatment of patients.

For discussion: It looks delicious – but how, when, who?