Dallas County gets futuristic general hospital

The new Parkland Memorial Hospital is more than a sleek mass of glass and steel, towering 17 stories above Harry Hines Boulevard.

Dallas County’s new $1.3 billion public hospital is one of the first “digital hospitals” in the United States. The new campus is teeming with technology that wasn’t even envisioned when planning for the hospital began in 2002.

“This building is a whole new world,” Lou Saksen, who is overseeing the five-year construction project, told The Dallas Morning News (https://bit.ly/1qVRFxy). “It’s no longer electrical or mechanical, it’s digital — run by a keypad, not a wrench.”

The digital technology, which cost about $80 million, should improve patient care, streamline record-keeping, enhance security and enable Parkland to operate more efficiently.

“It’s an apples-to-watermelons move — larger scale and new and advanced capability,” said Joe Longo, Parkland’s assistant vice president over information technology.

Visitors will sign in at touch-screen kiosks, which guide them from the lobby to their destinations in the hospital’s public areas. Patients will lie in smart beds that can weigh them and alert a nurse if they get up when they shouldn’t. The location of babies will be tracked by devices attached to their umbilical cords. Hospital corridors will be lined with video cameras that can detect movement in any direction.

Other hospitals may tout similar technology, but Parkland is among the few with a completely integrated digital system controlling nearly every aspect of its operations.

“Hospitals understand the importance of technology and connecting information across medical devices,” said Chantal Worzala, director of policy for the American Hospital Association. The national group tracks trends in 5,500 U.S. hospitals, including the adoption of electronic medical records, which has been mandated by the federal government.

“Only 44 percent of hospitals report having and using what we define as at least a basic (electronic records) system,” concluded a study of nearly 4,500 hospitals, published last year in the journal Health Affairs. The survey did not ask about other types of digital improvements.

“There are all sorts of exciting ways to involve technology in a hospital that go beyond medical records,” said Worzala, a co-author of the study. “The ultimate goal is having the highest-quality care. And as we learn how these technology systems can support that, hospitals will be adopting them across the board.”

At Parkland, the emphasis is on improving patient quality by promoting digital harmony.

“All of the technologies have merits to themselves, but the objective was to harmonize them to each other,” Longo said.

The new hospital will be similar to a smart home, said Fernando Martinez, the hospital’s chief information officer. “All the digital devices in a smart home can talk to each other because they’re connected to a common hub. That’s not unlike what we do, only we’re much bigger.”

Over the next nine months, Parkland staffers will learn how to use this cutting-edge technology. They won’t be taping homemade signs to patient doors anymore to warn of infectious diseases within. They won’t be filling out or filing stacks of paper as they manage thousands of patients. And they won’t be answering call buttons and scurrying up and down endless corridors.

Instead, about 2,500 nurses will receive hand-held digital devices that will alert them to patients’ needs, connect to medical and billing records, and enable them to communicate with other caregivers.

Instead of waiting for a patient to summon them, nurses will be automatically alerted by monitoring equipment in the room. They’ll know, for example, if an IV bag is empty or if a patient’s blood pressure is rising. The patient may not even realize what’s happening.

“Every bed is on the digital network with all its electronic information,” Longo noted. “The bed can create an alert to the nurse’s call system, which says, ‘You need to go see the patient.’ And the bed can shift a patient to remove the risk of bedsores.”

So much information, however, can cause “alert fatigue,” a feeling of being inundated with data to the point where the caregiver stops paying attention. “So we take a tiered approach, where the high-impact alerts go first,” said Martinez. Longo agrees: “We want to avoid alert whiplash.”

Despite the importance of these hand-held devices, Parkland has yet to select which ones it will use. Its IT staff is worried that the equipment could quickly become obsolete.

“We know we want to get years of useful life out of a device that doesn’t even last one year in the consumer world,” Martinez said. “We’re future-proofing the organization.”

Doctors will have to provide their own digital devices, probably smartphones, to be outfitted with hospital software that ties them into the communication system.

Some information, such as hourly blood-pressure readings, will go directly into patients’ medical records. Such automatic reporting tends to be more complete and accurate, since transcription errors are eliminated.

The hospital staff and visitors will be monitored by 1,200 digital video cameras.

Keeping track of movements throughout a 2.1 million-square-foot hospital could prove overwhelming. It’s more likely that the system will focus on aberrant behavior, such as a fight in a hallway or an unauthorized person trying to access a secure area.

Radio signals will be used to track mobile medical equipment. This will make it easier to find the equipment when it’s needed, and should also prevent thefts.

“We will get alerts when medical equipment that’s not supposed to leave a building is moving through an exit,” Saksen said.

Parkland’s most vulnerable patients, newborn babies, will get their own tracking system. Each infant’s umbilical cord will be tagged at birth, allowing the infant to be tracked within secure areas of the hospital. It also will be matched to the mother, reducing baby mix-ups.

“The tag on the baby is tamper-proof,” Longo said. “If someone carries the baby into an elevator, where it should not go, the tag can disable the door.”

Information from: The Dallas Morning News, https://www.dallasnews.com