Akershus University Hospital in Norway has implemented

advanced wireless solution in their hospital, why?

Where and what value does it give?”

Stein Vaaler, MD, PhD

Deputy Managing Director

Akershus University Hospital

2 May 18, 2009

• Key Figures (2011):

• Area hospital for 500,000 inhabitants

• 80 to 90 % of all services (somatic medicine and psychiatry)

• > 60,000 over night stays

• > 50,000 day treatments

• > 200,000 outpatients (policlinic consultations)

• 6,000 total staffing

– Approx 650 medical doctors

3 May 18, 2009

Basic structure

Pediatrics and youth

Acute entrance

Main Entrance

Glassgate

Treatment facilities

Wards

4 May 18, 2009

5 May 18, 2009

Why?

• Our major goal is to be the most patient focused and friendly

hospital in Norway

• As Europe's most modern university hospital (1. oct 2008) we

wanted to increase our productivity and be able to meet the

economic challenge in the specialised health care sector.

• With support of modern technology and wireless solutions we want

to be an attractive working place

– with highly skilled health

professionals

6 May 18, 2009

A new building

New equipment

Incl. wireless technologySignificant organisational

development

- Independent of, and as a

result of new technologies

1. October 2008

7 May 18, 2009

New technology (the basic challenge)

New technology are

automating or changing

the work tasks

8 May 18, 2009

Smart Card – the Key to Communication

• Parking house

• Working clothings

• Door opener / key

– zones / restrictions

• Priority in elevators

• Network access

• Printing

• Home office solution (start-up and net access)

• Cantina payment

name + picture

smart chip

RFID

magnet line

bar code

9 May 18, 2009

The IP phone-system

1500 hand held terminals

300 line based terminals

Backup

300 analoge phones

Ascom alarmsystem (not IP service)

mobile phones

10 May 18, 2009

The IP phone-system

• THE CORNER STONE

• Significant initial problems due to failure of large scale testing– Always backup

• Normal function after 4 months.

• Since then no technical problems and a success due to the fact that ”the phone is always there” (role based and person based phones).

• One of the most important factors in increasing the effectiveness in a hospital where more than 90 % of the patient admissions are acute and not preplanned.

11 May 18, 2009

Computers

400 laptops (wireless)

the number is steadily increasing

3800 stationary terminals

12 May 18, 2009

Computers

• Hardware development; small, flexible and wireless

• The major challenges– On site logon time

– Too much basic software

• Role based profiles is more needed

• Personal profiles should be avoided in treatment areas

– Software harmonization an development

• To many products/programs

• To little strategic control and development

• Our major local problems is related to

– RIS/PACS

– The electronic curve

– Speech recognition

14 May 18, 2009

Automated Drug Management System

• Electronic prescription

• Decision support

• Information to the pharmacy

robot (”pill picker”)

packing and marking (bar code + text)

deliveries by tube transportation

message to the nurse (IP phone text message)

• Administration and documentation

(patient specific deliveries)

• The electronic curve – connected to the electronic prescription

15 May 18, 2009

16 May 18, 2009

Transport

17 May 18, 2009

18 May 18, 2009

We had great ambitions

• The goal was automatic delivery of patient specific

medication based on electronic prescription from day

one (1.october 2008).

• It did not work!

– Due to technical problems and the highly complex

integration process between the electronic curve, the

pharmacy system and the production systems

• We had to restart with two focuses:

– Automated delivery to local storage

– Electronic subscription and follow up (the electronic curve)

19 May 18, 2009

Status, automated drug delivery

Ward

Local storage

(Delta)

Pharmacy

Delivery, pneumatic tube system

Packing

Distribution

(Swisslog)

Bedside prescription

(DIPS)

Electronic

curve

Prescription

registration

Nurse

Patient

20 May 18, 2009

AGV: Automatic guided vehicle – a success story

• Carry goods < 750 kg

• Top speed: 5 km/hr

• Know the way, use the

elevators

• Leave the goods, send a

report to the nurse (txt)

• Wireless technology

21 May 18, 2009

We are gradually improving!!

• People have learned to use the new infrastructure

(buildings and ”known” equipment)

• We are reorganising nurses and doctors (in mixed

units again)

• The infant diseases of many new technical systems

have been solved

• An last but not least: The personell are gradually

willing to change the ways they are working as a

consequence of new (wireless) technical solutions

and eqiupment

22 May 18, 2009

What are the results?

• Parameters of medical quality are improving

– Hospital infections

– Waiting time for operations

– Etc

• Budget balance (5 – 6 % increased productivity) are

expected in 2011

I would do it again

-

but I would have done it in another way!!

Stein Vaaler, MD, PhD

Deputy Managing Director

Akershus University Hospital