SUPER GREEN - the International Academy of Design and Health

Technology Report: Palomar Pomerado HealthDubbed ‘Iris’ because it functions as another pair of eyes, the robot rolls through units and patient rooms, controlled remotely by doctorsusing a joystick and laptop. Via a high-speed internet connection, the robot allows remote consultation with colleagues, patients and visitors,as if the doctor were in the room. The robot, developed by InTouch Health, can navigate down hospital corridors, rotate 360 degrees, zooma camera in on a patient’s eyes, or view x-rays or vital sign monitors.High-technology patient bed monitoring units add to the armament of high-tech devices that support continued monitoring of patientstatus and needs, supplementing visual surveillance by nurses. The LifeBed, produced by Hoana, uses a non-invasive ‘smart’ fabric on topof the bed to record vital signs, pulse, breath rhythm, heart rate and respiration without any connection whatsoever. Hoana’s technologytransforms any hospital bed into a LifeBed. If the patient begins to deteriorate, the LifeBed immediately notifi es the hospital nursing staff.Changes in a patient’s condition identifi ed early, may result in earlyinterventions and positively impacts patient outcome. LifeBed,reports some hospitals, have reduced falls by as much as 90%. 3Cisco Systems has developed RFID bracelets that will guidepatients. Encoded on the band is the patient’s name, date ofbirth, gender and a medical record number, linked to the hospitalnetwork that connects the patient record to labs, billing and tothe pharmacy.Doctors and nurses will be equipped with a tablet-style PC withan RFID reader and a Wi-Fi connection to access the network.The system consists of an integrated RFID application, developedby Siemens Business Services (SBS), which connects the hospital’selectronic medical records, lab systems and billing system. Theexisting computerised physician order entry system allows for a seamless RFID implementation. Tablet PCs are embeddedwith SBS RFID software and used as hand-held readers for RFID wristbands provided by Precision Dynamics Corporation(PDC). PDC’s Smart Band RFID wristbands include a 13.56 MHz RFID inlay from Texas Instruments 4 .RFID systems linked to sinks are being considered as a method of alerting clinicians with the sound of an alarm as theyenter a patient room to encourage them to wash their hands before contacting the patient.Patient room designPatient rooms for the new hospital have been designed as fl exible acuity rooms, based on concepts described by Hendrichet al 5 . A mock-up has been built for user feedback, demonstrating improvements in surface fi nishes, headwall design, familyzones and accessible shower rooms that add to amenity and patient comfort. The square footage of each room has beenexpanded from 140 square feet at the present facility to approximately 350 square feet.Hendrich et al 5 reported a decrease in errors and injuries related to the reduction in patient transfers in acuity-adaptablerooms, and improved fl exibility of use. Their comparison of pre- and post-patient room conditions revealed that as patienttransportation was reduced by more than 90%, medication errors decreased by 70% and the fall index for patients in the highriskcardiac test population fell from six to two falls per 1,000 patient days. Palomar will track such outcomes, as well as metricsthat include costs, quality of care and patient satisfaction in fl exible acuity rooms compared to the previous designs. Palomaris modeling scenarios with governmentregulators and collaborating with anadvisory group to ensure that nurses andancillary staff are appropriately trained forthis new nursing model.The patient room has also been adaptedfor information systems. As physiciansmake rounds, large LCD panels in eachpatient room will provide the means toconcurrently display patient demographics,vital signs and medical information.Patients will be able to remotely controlroom temperature, order a meal, surf theinternet, conduct videoconferences withtheir doctor, and play music. Patients mayalso display images, family photographsand possibly works of art from theMuseum of Modern Art.Voice-based fall alarms will not onlyPalomar Pomerado Health’s new hospital on site and under constructionThe robot rolls throughunits and patientrooms, controlledremotely by doctorsusing a joystickWORLD HEALTH DESIGN | October 2008 37