Command Centre Clinical Tiles Series: Key Technologies

By Shahana Gaur

If the COVID-19 pandemic is an indicator of anything, it is that the world moves fast and it may be hard to keep up. Fortunately, Humber River Hospital remains at the forefront of digital advances in hospital technologies to not only keep up but remain prepared for what is ahead. A major player that sets Humber River apart from other hospitals is the Command Centre.

The Command Centre is a facility that acts as the “mission control” of Humber River Hospital, enabling a team of trained staff and healthcare professionals to see the real-time status of patients, beds, tests and scheduling, all in one place. Not only is data fed to the same place, but personnel from various departments are in one location to easily communicate with one another in person, avoiding a good ol’ game of phone tag. Access to all data is available on every computer across the hospital for staff and physicians.

To keep things integrated, different professionals within the Command Centre are in charge of monitoring different aspects of the hospital. They are able to do so through the various clinical applications or analytic tiles, displayed on large monitors at the front of the Command Centre. These tiles are also available on large screens in the inpatient area, and the medical imaging and emergency departments. Each tile consists of one to two large screens that break down the appropriate information required for monitoring specific patients. HRH has collaborated with GE Healthcare Systems to develop these tiles to combine real-time data, early warning systems, machine learning and predictive analytics in an effort to alert staff in changes of patient status, and potential risks.

In this series of blogs, we will break down each of the ever-growing list of tiles that are at the heart of the Command Centre, providing a detailed look at what they do and how they work. However, in order to understand how the tiles work, it is important to describe the technologies that allow the Command Centre to monitor patients throughout the hospital.

Key Technologies

Firstly, a piece of technology that is crucial for patient care are patient monitors. These monitors are devices that measure and record patients’ vitals through combinations of biometric values, such as heart rate, temperature, blood pressure etc. They are attached to all 600+ rooms in the hospital and are connected to the hospital’s electronic medical record (EMR) so that patient data can be distributed throughout the hospital. Any time a nurse, physician or caretaker enters a patient’s room or inputs new data on the monitor, the information is transmitted through servers and sent to all staff in the EMR and Command Centre within minutes.

This aspect increases patient flow, as individuals within the Command Centre can specifically request the closest physician or nurse to attend to a patient that needs attention within their designated department. All technologies work together to ensure patient care and safety.

Another significant component of the patient tiles is artificial intelligence (AI). AI is able to perform tasks and make decisions without human intervention. For example, if patient data has not been updated for an extended period of time, or if a patient’s condition is perceived to be changing, this is flagged by the systems AI and the Command Centre, nurse, charge nurse and physician are all alerted to take the appropriate action. This type of real-time alerting prevents errors within the system for safer outcomes.

A subset of artificial intelligence that also has a major role in the patient tiles is machine learning. Once a more novel concept, machine learning is now expected in many aspects of our daily lives. If you think about it, machine learning is all around us, making human tasks much easier and faster. Image recognition on your cameras, music recommendations on streaming platforms, self-driving vehicles, and spelling correction when you are writing a blog all utilise machine learning.

So why not incorporate machine learning in a hospital? Hospitals like Humber River Hospital are a complex system with a lot of moving parts, so it is not only important to keep track of current patient concerns and trends, but also future ones. Machine learning can assess a patient’s health in real-time as well as create predictive models to aid Command Centre personnel, the data collected by the technologies mentioned above.

How does machine learning work?

To put it simply, machine learning uses data to answer questions. In our case, the questions revolve on how to improve patient care and process flow. Machine learning is all about training our systems through patient data. As our systems continuously gather patient data through hospital servers, a predictive model can be created and fine-tuned so that certain patterns and trends are identified. A simplified example would be if a number of patients in separate cases go through similar sets of symptoms that lead to a particular alert, the model learns from this and can predict if another patient may set off a similar alert based on their symptoms.

Not only are predictive analytics important, but so are follow-up actions. Alerting the appropriate healthcare professionals and support staff to deliver care to patients is crucial. If the system creates an alert for a potential problem, both staff in the Command Centre and clinical care areas are able to see it. Monitors on the floor, as well as Ascom phones aid in this process. These are devices that connect various staff and care teams with systems and information with two-way communication. Other hospitals use alternative systems that perform similar operations, however, they do not always have two-way capabilities. These phones are carried by healthcare professionals with a designated phone number that remains the same according to their position. Therefore, if you need to contact a nurse in the radiology department, dialling a designated number allows you to reach the person you need. Alerts and instructions are directly sent to these phones so that a patient can be assisted immediately. Ascom phones are integrated with the nurse call system, this means that when a patient requires assistance, they are not waiting for the call bell to be answered, but are able to speak with a nurse directly. Command Centre alerts flow directly to the nurse’s Ascom phone to help with timely resolution of alerts. If an action is not completed in a given amount of time, the alert will be handed over to the next professional that can complete the task. This is another facet of the Command Centre that grants ultimate flow.

The previously mentioned technologies notify nurses and physicians if their patients’ condition changes, and enables them to stay at their bedside. With professional healthcare expertise provided by Command Centre staff in conjunction with technologies that collect real-time data and develop predictive analytics, Humber River Hospital is capable of providing an additional layer of protection for patients.