Image from ‘A Peek into the Hospital of the Future‘ by Dr. Bertalan Mesko and Dr. Diana Anderson, published by The Medical Futurist. Licensed under a Creative Commons Attribution 4.0 International license.
By Corey Gaarde

Smart patient rooms must be:   1. Easy for everyone – care providers, patients, families, and guests  2. Measurable (e.g., HCAPHS, Press Gainey, Gallup) and aligned to the Quadruple Aim of Healthcare to enhance patient experience, improve population health, reduce costs, and improve the work life of health care providers  3. Flexible, adaptable, and scalable   4. Interoperable  5. Safe and secure   6. Supportable   7. Cost effective   8. Constructible and not too futuristic or forward thinking   9. Fun, cool, and innovative – why not?

Most of us have fully integrated technology into our lifestyles with smartphones, smartwatches, tablets, and AI home devices like Amazon’s Echo and Google Home. Unfortunately, such technology isn’t often adapted to the patient and caregiver experience. 

The complete patient experience encompasses the journey to the hospital, the care experience, and the trip back home. All these touchpoints come with an expectation and must be considered when designing a hospital’s smart patient experience. The caregiver experience, the building and its systems, floors/units/departments, and more are part of the experience as well. This blog, however, focuses on the smart patient room.  

The technology to connect patients and family members to their caregivers is already here, but with so many options, it can be difficult for a hospital to decide what its smart patient room strategy should include. However, the first and most important step in creating a smart patient room is defining the vision for the experience. Neither technology itself nor a single vendor should ever be the driver of the vision. Rather, technologies should be chosen to enable the vision.  

Creating a vision and framework for implementing smart patient rooms is best accomplished by assembling a multi-disciplinary team to build the strategy and discuss use cases aligned to outcomes.  Following are several key suggestions to guide the conversation.  

• Focus on tools and technology that improve caregivers’ efficiency to help avoid burnout rather than adding to their workload. Providers, nurses, and support staff are much more likely to adopt new technologies if they are smoothly integrated into their workflow and processes. Tools such as the digital whiteboard and digital signage outside rooms integrated to the EMR can update real-time patient precautions and key information. General patient information – such as a pediatric patient’s favorite Marvel character – can greatly improve their experience. Other technologies that can ease the burden on your hospital staff include smarter nurse/patient server; integrated medical devices (wired or wireless); ambient clinical intelligence using voice dictation directly into the EMR; smart patient beds for continuous heart rate and respiratory monitoring; automatic supply replenishment based on weight (such as PPE); and even robots that deliver food or medications. 
• Let the patient control their environment from their bed. Bedside tablets like an iPad, BYOD, and voice-controlled devices like Alexa can make a room safer for patients by controlling the frequency of unaccompanied bed exits, thus preventing falls and injuries. Simple things like enabling patients to control their lights, shades, and room temperature help make a patient feel like it is “their room.” Other technologies like multi-use cameras can be accessed bedside for telemedicine use, provide eICU/Acute Care, function as a tele-sitter, and allow for patient/family interactions. Entertainment and education solutions that are integrated to the EMR and dietary for ordering food, or even a simple relaxation channel on the TV, also can ease patients’ minds. 
• Select systems and infrastructure mindfully. The building and its systems can be detrimental to patient and caregiver comfort if not carefully designed. Acoustical design considerations of the room and floor are critically important for patient satisfaction, and now even regulated in some jurisdictions. Proper acoustics also impacts privacy and the ability to successfully use voice controls. Lighting can be conducive to a positive patient experience as well, assisting with wayfinding, providing night lighting for bathrooms, scene-based lighting for sensory distraction, and even intelligent lighting that supports circadian rhythms. Lighting also can be tied to codes, staff, and assets to help inform caregivers, and occupancy sensors can adjust lighting to conserve energy when a room is not in use.  
• Get creative with technology. No matter what outcome is desired, technology can help you achieve it in creative ways. Examples include using intelligent real-time displays for patient monitoring, data aggregation, and alarms to support collaborative care and provide information to the patient and family; artificial intelligence for proactive patient monitoring and alerting; virtual, augmented, or mixed reality devices for education or therapy; screen mirroring and sharing (such as Apple TV) to allow caregivers to share pertinent information such as PACS images; digital art that changes for each season and leveraged for therapy; RTLS for situations such as caregiver presence and hand hygiene compliance; and air quality monitoring devices for building operations management.  

In considering these suggestions, however, be cautious to not over-engineer the space. Your HIT advisors, technology engineers, and medical equipment planners should work with the entire design team to find the balance between a facility’s wants and needs to give you the best value for your investment while also allowing for future options.  

The key thing to remember is to not add technology just because you can; it must be purposeful and tied to a workflow and target outcomes. Above all it must support the vision of your smart patient room.