The IT strategy behind a groundbreaking new $2 billion children’s hospital
Children’s Healthcare of Atlanta Arthur M. Blank Hospital is expected to open in September. It was built from the ground up with the latest healthcare information technology.
It is one of the largest and most advanced children’s hospitals in the world. It cost over $2 billion. It is 19 stories high, with almost two million square meters. It has 90 robots – which have their own six elevators.
It features deep device integration, artificial intelligence, location awareness, video and patient engagement technology – all aimed at helping doctors save steps and make better decisions while delivering an excellent patient experience.
Jeremy T. Meller is Chief Information Officer at Children’s Healthcare at Arthur M. Blank Hospital in Atlanta. We caught up with him to get the inside story on the creation of this institution’s healthcare IT strategy and implementation of cutting-edge technologies.
Q. What was the overarching healthcare IT strategy used to build the hospital from the ground up?
A. We are so proud of all the planning and work that went into the opening of the Atlanta Arthur M. Blank Hospital for Children in September. The entire hospital vision process started more than seven years ago. Children’s worked with our Patient and Parent Advisory Council to understand what our families thought was most important for a new hospital.
We received so many valuable and creative responses that led to recommendations such as a second television in the room and washers and dryers on every floor. Our councils worked to understand the themes for what would create the most healing environment, with the best possible care for the children we treat.
We also worked cross-functionally to learn about the leading practices in hospital design, understand the pain points our staff were experiencing and where we thought technology and innovation would go in the future. But things are moving fast. When we started the process in 2017, we assumed that there would be room for self-driving cars.
Meanwhile, we had no idea that a global pandemic was on the way and that we would be dealing with staffing issues. People were still confusing algorithmic bots with AI and no one was talking about generative AI. We have adapted our plans in recent years to the new realities and needs we have learned.
Our technology strategies began to evolve when we conducted large-scale workflow simulations as part of our facility design process. Children’s created “Cardboard City” by transforming a 100,000-square-foot warehouse into one of the largest large-scale hospital models in the country. Using more than 12 miles of tape and 10,000 square feet of cardboard, our hospital planning and simulation teams built the mock-up to test the 3D design plans and determine how the layouts could impact employee workflow, patient care and family experience.
“We are investing in predictive analytics for the long term, but more recently are looking at how generative AI can be used in meaningful and safe ways.”
Jeremy T. Meller, pediatric health care resident at Arthur M. Blank Hospital in Atlanta
During this process we learned that space requirements needed to be adjusted in some areas, that the plug locations might be wrong, or that we needed technology to address an issue.
An example of this is the physical side of the Arthur M. Blank Hospital. At almost two million square meters, it rivals or even exceeds many professional football stadiums in size. This is partly because each patient room is spacious, with separate areas for parents. Parents have a desk, a sofa bed and their own television.
These features will certainly improve the quality of the experience, but also come with technological implications, such as increased network load. The physical size itself means that moving simply takes more time.
10,000 extra steps could impact the time it takes a nurse to reach a patient room. Therefore, we were challenged to find ways in which technology could help with communication, reduce the number of steps (both physical and process steps) and improve patient quality. care that we were going to provide.
Q. Were there any special IT considerations because it is a children’s hospital?
A. Pediatrics involves additional complexity in almost every respect. Equipment should be tailored to the stages of anatomical development of childhood. Care protocols are different and more complex.
Children respond differently to medical interventions, and most systems are not designed from the ground up to target pediatrics. The electronic health record is more complex and providing access to patient records is more complicated because a legal guardianship relationship must be established.
There are real reasons why pediatric hospitalizations are resource-intensive, but this doesn’t mean finding experienced clinical staff and physicians is any easier. Our needs are more intensive and we must do everything we can to support our doctors in providing the best possible care.
To help save physical steps and reduce the time burden, we have integrated screens outside each patient room with halo lighting that changes color depending on who is in the room. This is dependent on the RTLS badges that staff will wear once the hospital opens, providing a visual cue that can reduce the number of steps.
Locations are updated on status boards and doctors can see who is or was with the patient. This will help improve staff coordination and therefore patient care.
Q. You have 90 robots. Please talk about the place robotics will have in the hospital and what kinds of things they will do.
A. We are very excited about the opening of the Arthur M. Blank Hospital with the world’s largest fleet of robots. We will have two types of robots: autonomous mobile robots and Robos. About a third will be patient-facing, helping to deliver meals or medications and pick up labs or other items that can’t pass through the tube system.
Our back hall “tugs” are designed with a platform that slides under specially designed carts that will carry heavy linens and trash. Arthur M. Blank Hospital has six elevators designed specifically for the robots. The system will include advanced algorithms and camera technology to determine location and bin usage.
The logistical planning for the new hospital was also crucial for our teams. Our intelligent supply chain management system uses RFID technology to better automate inventory and invoicing processes. Our pneumatic tube system has traffic control, and our pressurized waste disposal system even has radiation monitoring.
Everything is connected. We have nearly 60 facility and supply chain-related systems – most of them are systems we have in other facilities, but in our new hospital they are connected, automated and monitored.
Ask. You told me that the hospital will have deep device integration and artificial intelligence. Please provide some more information.
A. Like many organizations, we are investing in predictive analytics over the long term, but we are recently looking at how generative AI can be used in meaningful and safe ways. Everyone is talking about how AI will change the world, change healthcare. But for AI to be useful, it needs content, and it needs data. For predictive deterioration algorithms to be most effective, timely biophysio data are needed.
Many hospitals have IT systems and medical equipment, but these are not deeply integrated. A nurse stands at a computer, looks at a patient monitor (another computer) and enters hourly vital data. This is an outdated paradigm that needs to shift to real time.
We integrate virtually any type of device that can provide this data and pull it into our analytics systems and are currently developing eleven predictive models to help our clinical teams decide what to focus on or make better, safer decisions.
Waveforms will be available to clinicians in real time on their mobile clinical smartphones, allowing them to better assess alarm responses, such as seeing when a lead has been disconnected. The nurse call system is integrated into our RTLS so that alarms are automatically disabled when a nurse enters the room.
Q. What types of patient engagement technologies do you have and what are the expected outcomes?
A. We know that patients would likely prefer to be at home rather than in hospital, so we have designed rooms that are all large and designed for the greatest comfort and connection for the whole family.
We will have multiple screens in each room. We will have the traditional patient education and entertainment screen, as well as a second TV for parents and a vertically mounted virtual whiteboard. The RTLS system is integrated into the room and when a doctor enters, a pop-up appears on the television and whiteboard showing who has just entered.
The whiteboard provides information useful to the patient and family, including a daily schedule and a list of care team members. When the doctor or nurse enters the room, the display changes so that the caregiver can display relevant information and radiological images to communicate with the patient.
Each room also has a high-quality pan-tilt-zoom camera installed that allows caregivers, interpreters or even family members to dial into the room. When not in use, it turns away for privacy reasons and all calls are answered or rejected via the pillow speaker.
Q. What are your ultimate goals as CIO of this new high-tech hospital?
A. The new Arthur M. Blank Hospital will be one of the most advanced facilities in the world when it opens in September. My goal is for us to use technology to help physicians deliver the best possible care through more intelligent systems, save steps through improved communications and technology-enabled visual processes, and improve care and experience through improved patient engagement.
Of course, we can’t do anything IT-wise without cyber security in mind, so that’s been an integral part of everything we’ve done leading up to the hospital’s opening. All new systems and capabilities have been carefully evaluated and implemented to provide the utmost safety and security.
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