Disruptive Technology

WorldConnex Summit 2008April 28 – May 1, 2008Hilton Head Island, SC, USA

Paul FaguyExecutive Vice PresidentHamilton Health Sciences

Paul FaguyExecutive Vice PresidentHamilton Health Sciences

Disruptive Technology,Convergence & the Purpose of Being

Disruptive Technology,Convergence & the Purpose of Being

“Vision without action is a

daydream. Action without vision is a

nightmare.”

Japanese Proverb

“Information technology

and business are

becoming inextricably interwoven,

I don’t think anybody can talk meaningful

about one without the talking about the other.”

Bill Gates

Points for Consideration

Where am I coming from? Current reality of large multi sited academic

health sciences centre Disruptive Technology Convergence Hospital’s purpose for being

“Technology is meaningless

except in how it

can assist you,

and then it should

disappear and be invisible.

It allows you to think of things

you couldn’t think of,

it doesn’t think of them itself.”

Richard Saul Wurman

HHS is a Family of 5 Unique Hospitals and a Cancer Centre

McMaster University Medical Centre

McMaster Children’s Hospital

Hamilton General Hospital

Henderson General Hospital

Chedoke Hospital

Juravinski Cancer Centre

Our MissionOur MissionTo provide excellent health care for

the people and communities we serve and to advance health care through education and research.

Our VisionOur VisionLeaders in exemplary care, innovation and academic

excellence.

Our ValuesOur ValuesRespect - In all interactions, we will treat every person with dignity and courtesy.

Caring - At all times we will act in a way as to be concerned with the interests and well being of others.

Innovation - We will be creative and open to new ideas and opportunities.

Accountability - We will create value in our activities and accept responsibility for our actions.

Hamilton Health Sciences

More than 1,000 beds and 24 bassinettes Over 108,000 emergency visits a year 45,000 inpatients 50,000 surgeries 650,000 clinic visits $1.1 billion annual budget 11,000 employees

2007 Portfolio Data - A Statistical View Parking Spaces 5989

Codes Dispatched Total 930

Security Occurrences 60,591

Fire Safety Training 5,373

Total calls processed 1,750,522

Pagers in Service 3,934

# of pages processed per day 20,800

Photocopies 15,563,629

Postage (includes (FHS) $389,250

Kilos used (Linen) 3,465,205

General Waste all sites 2,458.75 tonnes

Biomedical Waste all sites 383,168 kg

Pharmaceutical Waste all sites 44,749.5 kg

Sharps Waste all sites 287,489 L

Purchase Order Lines *47,160

Number of Inventory Items 3325

Work Orders (biomed) 18,058

Devices Processed (biomed) 12,611

Drug Expenses $32.0 million

Prescriptions Filled (inpatient) 765,513

Drug Doses Filled (inpatient) 6,366,946

Prescriptions Filled (outpatient) 55,644

Revenue - Outpatient Pharmacy $18.7 million

Sterilized Loads 28,439

Disinfected Loads 71,640

OR Cases 26,679

Annual Patient Meals 329,090

Electronic Purchase Orders 38,363

CT (DS) exams 42,159

MRI 23,152

Ultrasound 74,930

X-ray 233,417

Other 41,428

Who Am I?

Professionally trained as a labour negotiator

20+ years senior hospital management experience

5 hospitals – 6 mergers and integrations President and CEO Shared Services

organization

MSS Organizational Chart

Operating Committee

Operating CommitteeCEO

Mohawk Hospital

Laundry Services

FOHSCI Supply Chain

Services

IT

Human Resources

Finance Hurst Place

Operating Committee

DI R

Mohawk Shared

Services, Inc. Board of Directors

Operating Committee

Clinical Support and Hospital Services

Human Resources Organizational Development Labour Relations Volunteer Services Core and Clinical Housekeeping Waste Management Portering Supply Replenishment Shipping / Receiving Service Response Centre Room Bookings Laundry and Linen Telecommunications Security Parking Audiovisual Transportation Printing Mail

Diagnostic Imaging Computed Tomography Ultrasound MRI Nuclear Medicine PET/Cyclotron Radiopharmacy Forms Clinical Chemistry Immunology, Genetics Haematology Transfusion Medicine Microbiology Anatomical Pathology Biomedical Technology Patient Equipment Reprocessing (CPD) Nutrition Services Pharmaceutical Services Purchasing Warehouse and Logistics Hospital Retail Services

“Opportunity ideas do not lie around waiting to be discovered. Such ideas need to be produced.”

Edward de Bono

Talk about three concepts;

disruptive technology convergence the purpose of being for hospitals

Disruptive technology is a term coined by Harvard Business School professor Clayton M. Christensen to describe a new technology that unexpectedly displaces an established technology. In his 1997 best-selling book, "The Innovator's Dilemma," Christensen separates new technology into two categories: sustaining and disruptive. Sustaining technology relies on incremental improvements to an already established technology. Disruptive technology lacks refinement, often has performance problems because it is new, appeals to a limited audience, and may not yet have a proven practical application. (Such was the case with Alexander Graham Bell's "electrical speech machine," which we now call the telephone.)

Railways Digital cameras Personal computer Voice data convergence Collaborative software Federated systems Nanotechnology

What are the disruptive technologies we don’t yet know about and how might they benefit us tomorrow?

“Just because something doesn’t do what you planned it to do doesn’t mean it’s useless.”

Thomas A. Edison

Technology convergence is the modern presence of a vast array of different types of technology to perform very similar tasks.

Why is convergence important in healthcare?

We always start in the middle Compel and empower interoperability Speed of change in technology Soft land disruptive technology Technology and suppliers converging Leveraging and harvesting sunk costs Lack of warm bodies – need to reduce the

need for labour, it will not be there!

You’ve got to be very careful if you don’t know where you’re going, because you might not get there.”

Yogi Berra

“If you don’t know where you’re going, any road will take you there.”

George Harrison

“If you don’t know where you’re going, you will probably end up somewhere else.”

Laurence J. Peter

What are we doing now at HHS?

Convergence

Nurse call systems Fire alarms Multiple phone switches Bed boards Tracking systems

Many new mobile e-health products and services are available or emerging which can, not only put diagnosis and treatment management into the hands of the provider but the patient as well.

blood pressure, heart rate and blood glucose monitoring CPOE and e-prescribing mobile MRSA detection systems tagging systems to ensure medical staff use hand washing stations

or prescribe appropriate medications. send critical results or information (and eliminate non-critical or

unimportant information) to PC’s, PDA’s or Smart phones.

Point of Care / Mobility

Enabling Themes

To achieve the core themes substantial infrastructure and other enabling investments & resources are needed;

Project Management / Business Analysis Wireless Data Quality / Data Retention Business Continuity Security & Privacy Technology Education

What’s possible on our horizon?

Rfid and wireless disruption

External and patient driven portals

Critical-to-flow test results

Effective leadership is putting first things first. Effective managementis discipline, carrying it out.

Stephen Covey

Let’s ask ourselves, what is the purpose of a hospital?

Is it “our hospital exists to help make our community

and surrounding areas a healthier place to live by

working with individuals to maintain, improve, and/or

cope with their health status.”

Or “a hospital exists to provide the most

amount of necessary services to the

greatest amount of people with the most

effectiveness and efficiency.”

“Most people spend more time and energy going

around problems than in trying to solve them.”

Henry Ford

Lack of access relates directly to the serious

inability to manage the flow of patients to and

through our hospitals!

ED Problems Result of Bed Shortages,Doctors Contend

“The crisis in hospital emergency departments (EDs) across Canada, which has led to strikes, walkouts, investigations and finger-pointing, is directly linked to shortages of hospital beds, says emergency physicians.”

…”The correct approach to solving overcrowding is in fact to increase acute care bed capacity and increase bed flexibility and appropriate utilization of beds. That’s really what it comes down to, “ says Drummond, who practices emergency medicine in Perth, Ont.

…”Over the past decade there has been a 40% decrease in hospital bed capacity in Canada. Closing beds translates into more patients being “warehoused” on stretchers and treated in corridors in hospital EDs when they need to be admitted.”

OverproductionProducing too much

or too soon

Transportation

Any unnecessary movement of

materials or Work In Progress

InventoryAny more than the

minimum to get the

job done

WaitingWaiting on parts,

waiting for information

ProcessingOver-processing

Process VariabilityOver Handling due to

defects

Rework/DefectsAny repair, defect or

rework, doesn’t conform to Critical Quality Standards

MotionAny motion of the worker that does

not add value

IntellectAny failure to fully utilize the

time and talents of people

Identify and Eliminate the 8 Types of Waste

Question to continually ask ourselves is how can we use existing and new technology to eliminate waste, and destroy the current barriers of time and space.

Focus on outcomes not inputs.

…if all I have is a hammer, all I see are nails…if all you see are nails all you reach for is a hammer.

Questions / Comments

Find me, I love to chat about our business

faguy@hhsc.ca