disruptive technology
TRANSCRIPT
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.
