Smart Hospital Construction: The New Trend of Medical Development Driven by High-Tech Innovation

The deepening of the new medical reform in China has brought an unprecedented development opportunity for the transformation and upgrading of the medical and health industry. As a core carrier of the modern medical service system, smart hospitals have gradually become the inevitable direction of the development of medical institutions with the strong support of cutting-edge technologies such as the Internet of Things (IoT), big data, cloud computing and artificial intelligence (AI). Constructing a comprehensive and perfect smart hospital system is not only an important issue in the current development of medical and health care in China, but also a key measure to improve medical operation efficiency, enhance medical quality and safety, and optimize patients’ medical experience. A team of researchers from the First Affiliated Hospital of Sun Yat-sen University has conducted in-depth research and practical exploration on the construction and development of smart hospitals, and their research results, which focus on the practical experience of tertiary first-class hospital construction and the future development layout, have provided valuable reference for the high-quality development of smart medical care in China.

Smart hospital construction is not a simple superposition of information technology and medical services, but a systematic project that covers the whole process of medical services, medical treatment and hospital management, with the patient’s objective needs as the starting point and foothold. As early as 2015, the State Council of China issued the Guiding Opinions on Actively Promoting the “Internet +” Action, which put forward guiding opinions and clear positioning for the construction and application of the “Internet +” in the medical field, laying a policy foundation for the development of smart hospitals. In 2017, the Action Plan for Further Improving Medical Services (2018-2020) further clarified the goal of building smart hospitals around the “Internet +” model, and in May 2020, the Notice on Further Improving the Appointment and Treatment System and Strengthening the Construction of Smart Hospitals once again emphasized the need to accelerate the construction of smart hospitals and continuously improve the intelligent level of medical institutions. At the same time, a series of medical reform policies such as the cancellation of drug price addition, the two-invoice system, the opening of drug dispensing models and disease-based charging have been continuously promoted, which have strongly driven the intelligent operation of hospitals. The continuous emergence of remote medical care, hierarchical diagnosis and treatment, and medical consortiums has also built a solid framework for the construction of a national smart medical service system. At present, various regions in China are actively carrying out smart hospital pilot projects, and the National Health Commission of China has clearly defined the definition and connotation of smart hospitals, and launched the hierarchical management of hospital smart services, marking that the construction of smart hospitals in China has entered a stage of standardized and institutionalized development.

The construction scope of smart hospitals is clearly defined and mainly covers three core areas: smart services for patients, smart medical care for medical staff, and smart management for hospital administrators. These three areas are interrelated and mutually supportive, forming a complete smart hospital operation system, and promoting the all-round upgrading of medical institutions from service, medical treatment to management.

Smart services for patients are the external manifestation of the construction of smart hospitals, and the core goal is to use information technology to optimize the entire medical process, improve service quality and enrich service content, and create an efficient and convenient integrated diagnosis and treatment platform for medical staff and patients. The construction of smart services cannot be separated from the support of perfect intelligent infrastructure, which is the cornerstone of the development of smart medical care, including modular computer rooms, virtual resource pools, medical clouds, weak current intellectualization, intelligent terminal equipment and other key facilities. These infrastructures provide a solid technical guarantee for the construction of smart hospital campuses and the smooth operation of various intelligent services. On the basis of perfect infrastructure, the “Internet + medical care” model has realized the all-process, all-round and multi-campus benefit service for patients. Taking a tertiary first-class hospital in Guangzhou as an example, the mobile terminal for patients, including mobile APP and self-service machines, has realized a variety of convenient functions such as face recognition and real-name authentication, which has laid a solid foundation for the standardization and safety of medical services. Patients can complete outpatient appointment registration, same-day registration and in-clinic additional registration through the mobile terminal, and can also help their relatives make appointments, breaking the time and space limitations of traditional registration methods. The mobile terminal also provides functions such as self-service check-in for outpatient clinics and real-time queuing, which allows patients to reasonably arrange their medical time and effectively reduce the waiting time in the hospital. In addition, the whole-process message reminder function for outpatient treatment covers key links such as in-hospital registration, outpatient check-in, inspection check-in, report inquiry and pharmacy drug collection, sending real-time push information to patients and making the medical process more transparent and predictable.

Patients can also query expert introductions and outpatient information through the mobile terminal, and complete online payment according to the prescription list, including supporting mobile medical insurance payment, which has solved the pain point of traditional offline payment with long queues and complicated procedures. The mobile terminal also supports the inquiry of historical medical records such as past outpatient and inpatient treatment, including drug prescriptions, inspection and test reports, and image review, which allows patients and medical staff to grasp the medical history information in a timely and comprehensive manner. What is more worth mentioning is that the multi-campus homogeneous service has been realized through the information platform, so that patients can enjoy the same high-quality medical services in different campuses of the hospital, which has greatly improved the accessibility of medical services. In the future, based on the Internet hospital, the hospital will further establish a personal health file system for patients, carry out regular follow-up and professional health management work, and strengthen the remote collaboration of medical consortiums, so that smart medical services can be extended from the hospital to the whole process of patients’ health management.

The extension of smart services is not only reflected in the in-hospital service process, but also in the post-diagnosis health management closed loop formed by online and offline integration. At present, many smart hospitals have opened cloud consulting rooms, where doctors can conduct video consultations, make diagnoses and issue prescriptions, realizing the whole process of online medical treatment, and allowing patients to receive professional medical services without leaving home. The one-click drug purchase and prescription function has simplified the drug purchase process, eliminating the need for registration and queuing, and the drugs can be delivered to the door, which has brought great convenience to patients with chronic diseases and inconvenient mobility. Intelligent follow-up has realized the batch and intelligent follow-up of patients through information technology, which not only achieved a high follow-up coverage rate, but also completed multi-dimensional statistical analysis of follow-up data easily, providing a reliable data basis for doctors to adjust diagnosis and treatment plans. In addition, targeted rehabilitation guidance services such as medication reminders, health education and reexamination plans have been provided for patients, forming a comprehensive medical service system covering diagnosis, treatment and rehabilitation, and truly realizing the extension of smart medical services to the whole life cycle of patients’ health.

In order to further optimize the patient’s medical experience, smart hospitals are also actively exploring the construction of smart parking and medical navigation systems. The future smart parking system will realize functions such as automatic license plate recognition of vehicles entering and leaving the hospital, vehicle anti-following, parking space planning, parking guidance and visitor appointment, which will effectively solve the problem of difficult parking in hospitals. At the same time, based on the park’s GIS map and 3D real scene map, the precise navigation function will be realized, guiding patients to quickly reach the target diagnosis and treatment area, reducing the time of finding the way in the hospital, and creating a smooth and efficient medical experience for patients.

Smart medical care for medical staff is the core content of the construction of smart hospitals, with the goal of taking medical care, nursing, pharmacy and medical technology as the foundation, building an information system with electronic medical records as the core, running through the whole process of smart medical care, and comprehensively improving medical efficiency. The construction of smart medical care is carried out from multiple dimensions such as medical staff, medical administration and quality control, scientific research and teaching, and has realized the all-round intelligent upgrading of clinical medical work.

The intellectualization of medical facilities is the key to improving the work efficiency and quality of doctors, and the core is to liberate doctors from heavy non-medical core affairs through information technology, so that they can devote themselves to clinical diagnosis and treatment and scientific research work wholeheartedly. AI voice medical record entry is an important application of artificial intelligence in clinical work. By applying medical artificial intelligence voice technology on the mobile terminal for medical record entry and synchronizing with the Hospital Information System (HIS), the accurate recognition of medical terms can be realized. After in-depth customization and repeated training, the accuracy rate of voice recognition is expected to reach more than 95%. This standardized, convenient and fast medical record entry method has greatly reduced the heavy medical record writing work of doctors, making them have more energy to carry out diagnosis and treatment work, and effectively improving the efficiency of clinical work. The mobile doctor workstation has realized the intellectualization of medical facilities, and the unified mobile work platform has realized the efficient collaboration inside the hospital. Doctors can make ward rounds through handheld PDAs or mobile medical vehicles, and the information sharing platform connected to the whole hospital allows doctors to easily query patients’ personal health files, which has improved the efficiency and accuracy of diagnosis and treatment. In addition, smart hospitals are constantly absorbing cutting-edge technologies and introducing cutting-edge medical technologies such as surgical robots and AI-assisted diagnosis and treatment, which have injected strong technological impetus into the development of clinical medicine and improved the diagnosis and treatment level of difficult and complicated diseases.

Remote medical care superimposed with 5G, cloud and AI technologies has realized the smoother collaboration of multi-campus consultation, which is an important embodiment of smart medical care sharing. Based on the regional medical information platform, open remote consultation platform and interoperable platform, a unified integrated collaboration platform has been built, which is mainly applied to remote consultation, two-way referral and hierarchical diagnosis and treatment. The superposition of 5G technology ensures high-definition and smooth video transmission in remote consultation, solving the problem of poor video quality in traditional remote medical care; the superposition of cloud computing technology realizes the efficient transmission, storage and sharing of medical images, allowing medical staff in different regions to view high-definition medical images in real time; the superposition of AI technology realizes intelligent image reading, which can quickly identify abnormal signs in medical images and provide auxiliary diagnosis suggestions for doctors, greatly improving the efficiency and accuracy of remote consultation.

The construction of digital wards has realized humanized smart nursing, and smart hospitals have realized the comprehensive perception and interconnection of all nursing scenarios through the Internet of Things and big data technology, replacing the manual running of medical staff with data transmission, making nursing work more efficient and convenient. The mobile ward round based on the Internet of Things technology has realized the real-time recording and transmission of ward round data, and the wireless nursing system can realize functions such as doctor’s order reminder and health education, ensuring the timely and accurate implementation of nursing work. The infusion monitoring system can realize abnormal alarm, drop speed control and automatic interruption, which has effectively improved the safety of infusion nursing. The smart health watch, as an important intelligent terminal, has multiple functions such as mobile communication, regional positioning, information reminder, one-click call, fall alarm and physical sign monitoring, which can monitor the physical condition of patients in real time, and send an alarm to medical staff in time in case of an emergency, realizing the whole-process monitoring of patients’ safety. In addition, smart nursing also covers functions such as personnel and asset positioning, medical waste management, mother and baby identification and infant anti-theft, which has formed a comprehensive and three-dimensional smart nursing system and improved the overall level of hospital nursing work.

Intelligent medical administration management and quality control have realized the safety, order and convenience of the whole medical process. Hospitals are actively promoting the construction of a large medical quality control platform system by using big data and AI technologies, building a full quality control system covering basic quality, link quality and terminal quality. By using end-to-end all-round information technology, real-time data can be obtained and displayed in a timely manner, and technology and systems run through the whole medical process, which has improved management efficiency and medical quality. Taking the information construction centered on electronic medical records as an example, the interconnection of electronic medical records, inspection and imaging data has been realized, and the whole-process quality control of electronic medical records has been done well, ensuring the standardization and accuracy of medical record writing. The smart drug management system based on the Internet of Things technology has realized the safe and orderly management of the whole process of drug management, and connected with the doctor’s order system to verify drug information and patient information, which has not only improved the safety of clinical drug use, but also improved the work efficiency of clinical nursing staff.

Smart technology has also empowered clinical scientific research and teaching, and effectively improved the level of medical scientific research and teaching in hospitals. By introducing high and new technologies such as artificial intelligence and 5G, hospitals have realized efficient data mining and governance, and built a comprehensive clinical scientific research and teaching system. On the one hand, the integrated AI platform for clinical, experimental and scientific research has rapidly improved the level of scientific research. Through the comprehensive application of medical natural language parsing, deep learning, structured electronic medical records and intelligent follow-up, and with the support of professional animal experiment systems and clinical drug trial systems, a top-level scientific research information platform based on real-world data has been built for clinical work, providing a strong data support for medical staff to carry out clinical scientific research and improving the efficiency and quality of scientific research. On the other hand, the superposition of 5G and VR/AR technologies has innovated the integrated teaching mode of demonstration, teaching and standardized training. The introduction of 5G network and VR/AR new technologies can present the panoramic view of the operating room and surgical details in high definition, with clear, stable and delay-free video, which has greatly improved the effect of surgical demonstration and teaching. The interactive remote training based on actual clinical cases has broken the time and space limitations of traditional medical teaching, allowing medical students and young doctors in different regions to learn advanced clinical technology and experience. The real-time interactive and rich cloud medical teaching resources have created a ubiquitous teaching and learning environment, realizing the all-round upgrading of medical teaching from offline to online and from on-site to remote.

Smart management for hospital administrators is the important guarantee for the sustainable development of smart hospitals. Hospitals have the characteristics of complex department organization, large personnel mobility, busy vehicle traffic and rapid business growth, so refined management and operation need to run through the whole process of human resources, finance, materials and medical treatment. Building an intelligent operation center of the hospital has become an inevitable choice for the refined management of modern hospitals.

The construction of the hospital’s intelligent operation center is based on the characteristics of the hospital, using standardized and master data management to support the refinement of operation management, integrating different functions such as operation analysis, comprehensive security, personnel management, energy efficiency management and asset management, and realizing the sustainable development and strategic transformation of the hospital. In the era of big data, hospital management departments can carry out comprehensive planning according to multi-angle and in-depth information when making medical decisions, comprehensively consider from the perspectives of “human resources, finance and materials”, “medical treatment, teaching and scientific research” and “nursing, pharmacy and medical technology”, scientifically formulate medical decisions and efficiently realize the operation and management of the hospital. The intelligent operation center has become the “brain” of hospital management, realizing the visual, digital and intelligent management of the whole hospital’s operation, and providing a reliable decision-making basis for hospital administrators.

Comprehensive security is an important part of smart management, and the security system of smart hospitals has realized the linkage of access control, smoke sensors, cameras, fire protection systems and other facilities, sending all kinds of security information to the security command center in a timely manner. The security command center combines map navigation and personnel system to analyze and process the information, and uses the Internet of Things and AI technologies to realize intelligent early warning, timely find and eliminate potential safety hazards, and ensure the safety of patients, medical staff and hospital property. The high mobility of personnel and vehicles in hospitals makes the comprehensive security system an important guarantee for the normal operation of hospitals, and the intelligent security system has greatly improved the efficiency and level of hospital security management.

The “Employee 360” system has realized the accurate and efficient performance management of hospital staff. This system has realized the all-round integration of relevant information of in-hospital staff, integrating data from various systems such as medical treatment, teaching, scientific research and personnel, providing automatic information management and staff self-service in all links of the hospital serving staff, and realizing the closed-loop human resource management of the whole process. From staff recruitment, training, assessment to promotion and salary management, the whole process is digitized and standardized, which has not only improved the efficiency of hospital human resource management, but also ensured the fairness and transparency of performance assessment, and effectively stimulated the work enthusiasm of medical staff.

Energy efficiency management has realized the refined, green and demand-based adjustment of hospital energy consumption. The traditional hospital energy efficiency management is extensive, with manual control, slow response, unable to adjust control parameters according to demand changes, and serious energy waste in unmanned areas. Smart hospitals use big data analysis to carry out refined energy efficiency management, realizing real-time data statistics, abnormal power consumption monitoring, power consumption prediction and optimization, and energy-saving space analysis. Through the visualization of energy consumption data, hospital administrators can grasp the energy consumption status of the hospital in real time, and put forward targeted optimization suggestions according to the energy consumption data, realizing the green and low-carbon operation of the hospital, and reducing the hospital’s operation cost while saving energy and reducing emissions.

Asset management is the key link of hospital refined management, and smart hospitals use the Internet of Things and big data technologies to realize the whole-process management of hospital assets, avoiding abnormal loss of assets. The smart asset management system has realized multiple functions such as asset inventory, asset utilization analysis, asset track tracking, online management of office resources and unattended computer room and remote inspection. The second-level inventory of valuable assets and consumables has improved the efficiency of asset inventory; the asset utilization analysis can activate idle assets, avoid repeated purchase and realize the efficient use of assets; the real-time asset track tracking can monitor the location of assets in real time and send an automatic alarm when the assets cross the area, ensuring the safety of assets; the online management of office, meeting, ward and laboratory resources has ensured the efficient progress of office, meeting, diagnosis and treatment and experiment; the unattended computer room and remote inspection can actively detect the status of IT equipment and carry out daily preventive maintenance, ensuring the stable operation of hospital information equipment. The intelligent asset management system has realized the digitization and intelligentization of hospital asset management, improved the utilization efficiency of hospital assets and reduced the operation cost of the hospital.

The construction and development of smart hospitals is a systematic project that requires the joint efforts of all departments of the hospital, and the information department, as the core technical department, can participate in the hospital’s intelligent planning and construction in a wider range. Through information technology, the informatization of the business level can be realized, and the visualization, management and control of the whole hospital’s operation can be achieved by using high and new technologies such as the Internet of Things, cloud computing, big data and AI. The top-level framework model of smart hospital construction proposed by the research team includes six core aspects, which form a complete system and provide a clear direction for the high-quality construction of smart hospitals. First, strengthen the basic guarantee, ensure the efficient operation of the logistics department, realize the intelligent control and management of equipment and facilities, supply chain operation, energy consumption and buildings, and promote the modern management of hospital infrastructure and logistics. Second, improve medical quality, strengthen the construction of hospital information platform based on electronic medical records, and make information work meet the needs of improving medical quality and safety. Third, optimize the medical process, provide patients with convenient services such as appointment and treatment, mobile payment, result inquiry, information push and drug delivery to home, reduce waiting time and improve service efficiency. Fourth, improve the medical experience, expand the content of medical services by using information technology, and provide appropriate, convenient and humanized patient services. Fifth, enhance operation management, strengthen hospital human resource management, financial and cost accounting management, material and fixed asset management through information technology, and realize the closed-loop and traceability of human management processes. Sixth, promote discipline construction, implement the policy of “revitalizing the hospital through science and technology”, support medical scientific research with information technology, strengthen the construction of key disciplines, enhance the advantages of the hospital and improve the core competitiveness of the hospital.

In the process of smart hospital construction, while focusing on technological innovation and service upgrading, we must also pay attention to the network security risk problem. Medical data and patient privacy are the core assets of smart hospitals, and their security is related to the legitimate rights and interests of patients and the normal operation of hospitals. Therefore, smart hospitals need to strengthen the construction of network security system, take more strict security protection measures for medical data and patient privacy, establish a perfect data security management system, and use advanced encryption technology and access control technology to ensure the confidentiality, integrity and availability of medical data, so as to lay a solid foundation for the healthy and sustainable development of smart hospitals.

The informatization construction of smart hospitals cannot be separated from the support of data base and platform architecture. The current problem faced by many hospitals is the islanding of systems and the chimney of data, which leads to the inability to realize the effective sharing and utilization of data. Therefore, smart hospitals need to accelerate the construction of a unified data platform, break the data barriers between different systems, and realize the integration and sharing of data. The accumulation of hospital data will form a high-value data pool, which can provide a strong data support for clinical diagnosis and treatment, scientific research and hospital management. The introduction of information technology can help medical staff carry out accurate and timely medical intervention, strengthen the pertinence of medical diagnosis and treatment, and improve the level of clinical diagnosis and treatment. At the same time, the use of big data technology can help hospitals improve their ability to deal with emergency medical events such as disease prevention and infection control, and build a solid defense line for public health safety.

The construction and development of smart hospitals is an inevitable trend of the transformation and upgrading of the medical and health industry in the era of digital economy. Driven by high and new technologies such as the Internet of Things, big data, cloud computing and artificial intelligence, smart hospitals are constantly breaking through the traditional medical service model, realizing the all-round upgrading from service, medical treatment to management. Taking the patient’s objective needs as the breakthrough point, smart hospitals are constantly strengthening the basic guarantee, improving medical quality, optimizing the medical process, improving the medical experience, enhancing operation management and promoting discipline construction, realizing the coordinated development of medical and health institutions, and making timely, convenient and high-quality smart medical services benefit more people. With the continuous deepening of medical reform and the continuous innovation of science and technology, the construction of smart hospitals in China will enter a new stage of high-quality development, and will play a more important role in building a healthy China and improving the people’s health level.

Author Information: WU Zhentian, ZHANG Wujun, LONG Sizhe, LIN Lin, LIU Jianxun, WANG Yi, LIU Hanteng, ZHANG Ruilin, LI Duo, YU Junrong; The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China; Published in Modern Hospitals, March 2021, Volume 21, Issue 3; DOI: 10.3969/j.issn.1671-332X.2021.03.032

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