Hospital operations could hold the key to transforming patient experience, cutting costs and boosting efficiency, according to the pioneers behind Kontakt.io, a company on a mission to fully digitise the patient journey.
Over the last 20 years, healthcare innovation has, for the most part, concentrated on advancing technologies that will improve clinical decision-making. Surgical robots, enhanced MRI machines and AI tools, for example, have all played a role in transforming healthcare delivery.
All the while, hospital operations have been overlooked.
“The neglect in the operational side of care delivery is something that every person that has visited the hospital can acknowledge,” said Rom Eizenberg, chief revenue officer of Kontakt.io, an industry leader in indoor location services and Bluetooth low-energy beacons.
“The experience is horrible. We are forgotten in corridors, we wait in waiting rooms and we are confused with the experience. We hardly see nurses and it [can] take an entire day to find the doctor when you are in a department hospitalised.”
It is Eizenberg’s view that the failings of health systems are not solely due to the “usual suspects” of limited budgets, labour shortages and high demand. More attention should be given to inefficient operations, he said.
He points out that other industries are capable of operating under similar conditions.
“DHL is able to pick up a letter from you in the [UK] at 8am in the morning on Tuesday and deliver it to Anchorage in Alaska on the other side of the planet 36 hours later while exposed to uncertainty in weather that cancels flights and trucks that get stuck and employees that are sick and low-cost labour.
“All of the circumstances that a typical hospital will use to explain why they’re doing so bad. And yet they make it in 36 hours. The reason why they can do it is because they deploy algorithms and computing technology that was developed over 20 or 30 years ago.”
Kontakt.io draws on this knowledge and technology from other industries, using the likes of Internet of Things (IoT), artificial intelligence (AI) and real-time location services (RTLS) to modernise the care delivery process.
The company uses wireless networks and sensors in walls and equipment to quantify interactions within the hospital environment. These could be interactions between people, people and equipment or people and space.
The data can then be used to solve problems in a way that Eizenberg claims was “never possible before”.
He said: “We’ve been spending the last 15 years connecting elevators and water pumps and building utilities, making them smart and connecting them to the internet so you can better control them.
“But still, [the] smartest buildings we have deployed are completely ignorant of the human elements. Buildings don’t know if there are any people inside at all, and if they do, they don’t know how they’re using the space and the equipment.”
“We are in a moment where continuing to do things the way we’re used to is simply no longer sustainable,” he added.
Operational efficiency is “front and centre”
Eizenberg does not claim to have the answers to why operational efficiency has been neglected in favour of clinical decision-making, but he has a few theories.
Firstly, a managerial structure that sees clinical experts climb the ranks into operational roles has a part to play in producing a natural bias towards innovations that improve clinical practice.
In addition, there is the simple fact that workflow efficiency is a less glamorous topic than breakthrough technologies like AI and VR which dominate headlines.
The impact of the pandemic and rising inflation may also be a factor. Healthcare systems globally are struggling with budget constraints. These issues are only exacerbated by staff shortages. In the US, around 12 per cent of nurses left the profession during the pandemic. The UK is seeing a similar exodus of healthcare professionals.
With healthcare providers facing enormous financial challenges, fixing hospital operations has historically been knocked down in the list of priorities.
“The clinical part is the crown jewel,” Eizenberg said. “It is what creates the echo effect, it is what people talk about, it’s what gets written about in the newspaper.
“We find ourselves reminding people that the crown jewel needs the crown to hold it in place.”
Now, the sector is catching on to the urgent need for better operations as healthcare services look to boost efficiency, free up hospital beds and reduce the overall cost of delivering care.
“It is now front and centre,” said Eizenberg. This changing dynamic is, in part, due to the patient’s voice becoming louder.
“Before, patient experience was something that nobody cared about,” Eizenberg said. “Efficiency, maybe. But [not] how you feel.
“Our parents never complained. Getting a [bad] experience was just how the world was. But we are a lot more opinionated and our voice is being heard.
Filling the missing piece of data
Hospitals are missing a key piece of data, which Eizenberg calls “ground truth”. This is the time gap between a patient leaving the hospital and the nurse logging the update in the electronic patient record which typically occurs at the end of a shift.
“That gap is when inefficiency hides,” he said. For example, an infusion pump may be disconnected from a patient at 11am but it is only at 4pm that the device is logged as being available to use.
Kontakt.io uses RTLS, AI and machine learning to close this gap. The platform paints a picture of the resources available and how patients, staff and medical equipment are interacting throughout the hospital in real time.
“If we can do that, then we can use AI and things like process mining and machine learning to understand and expose inefficiency and to create better experiences for people,” Eizenberg said. “We use this technology to not only solve problems in real-time but to also make useful suggestions – what we call next best action – to mitigate issues before they even happen.”
Device utilisation is a key area where this technology has the potential to have a big impact. Inefficient workflows are the main culprit for this and the impact on healthcare providers is significant.
“In the average hospital in the UK, medical device utilisation is at 60 per cent,” Eizenberg said. “40 per cent of the time devices you have and could use, you’re not using them. You almost have to buy two devices to do the job of one.”
Simpler solutions, like automatic reminders on hand hygiene stations, can also make a difference in clinical outcomes.
In the UK alone, hundreds of thousands of hospital-acquired infections are reported each year. Many of these cases stem from poor hand hygiene.
Kontakt.io digitises hand hygiene stations so that they can track where and when medical professionals have washed their hands and remind them if they forget when entering or leaving a patient’s room.
Insight to foresight
Eizenberg expects to see technology like IoT, RTLS and AI become steadily more pervasive across hospitals as the technology develops and digital transformation continues to be given greater attention from healthcare providers.
He predicts that hospitals will become fully digitised, with Bluetooth technology built into medical devices and patients wearing tech-enabled wristbands as standard, tracking their journey through the hospital system.
The expanded use of AI is also set to transform hospitals, Eizenberg said. “The use of AI is moving us from insight to foresight,” he said.
“Instead of showing executives a report or some dashboard that describes all the problems they had in the last year, we are now moving to systems that tell operators how they should act right now to prevent a problem from happening.”
“There is also a growing focus among the demands we hear from users. They say, ‘Don’t tell me the problem I had yesterday, tell me how can I fix the problem I have right now this morning.”