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GE Healthcare Camden Group Insights Blog

Digital Twins Revolutionize Strategic Planning in Healthcare

Posted by Matthew Smith on Aug 29, 2016 1:04:36 PM

By Jeff Terry, MBA, FACHE, Managing Partner, GE Healthcare Partners

Digital_Twin.pngWhat’s a Digital Twin?

A digital twin virtualizes a hospital (or other) system to create a safe environment in which to test the impact of potential change on system performance. In other words, to play “what if?” with system dynamics. This is important because healthcare delivery is massively complex. Common sense, spreadsheets, and statistics just don’t have the horsepower to inform strategic decisions. 

Are Digital Twins New?

Not exactly. Digital twins use discrete-event-simulation techniques which have been around for 30 years and applied successfully in healthcare to model departments like radiology. But modeling a hospital above about 400 beds has proven too difficult for all but the most experienced modelers using the best tools. 

What is New?

What’s new is using digital twins to design efficient new hospitals and to redesign system dynamics in existing large hospitals. "System dynamics" includes bed mix, staffing, model of care, floorplan, bed algorithm, etc. This is becoming more common with better toolkits and more experienced practitioners at companies like GE and EY. For example: GE analytics consultants using our healthcare-specific simulation platform have modeled >1,000 bed academic medical centers 75% faster than teams of PhDs using traditional methods.  

How are Digital Twins Revolutionizing Strategic Planning?

Digial twins enable massively collaborative, data-driven, and scenario-based decision making. Without a digital twin, leaders rely on tribal knowledge and basic analysis to plan new facilities and next year’s budget for existing facilities. This is normal but it leaves much to be desired. With a digital twin, leaders virtually test changes to bed mix, bed algorithm, task assignment, floorplan, equipment, ALOS, model of care, staffing etc.

The traditional answer is to do our best and see what happens.

  • For example: neuro has recruited two new surgeons, medicine is closing a unit, we’re opening a transitional care unit, the State is buying our rehab unit to convert it to psych beds, and we expect to reduce ALOS for knees by .75 days and for general medicine by 0.2 days. What will that do to ED Boarding? What is our maximum volume with different scenarios of growth by cohort? Can we accommodate the neuro volume? What’s the best day to add these cases to the OR schedule?
  • With the Digital Twin, we learn that we can accommodate the volume but only if the ALOS work succeeds. We add the cases Wednesday and shift two orthopods from Thursday to Tuesday. Alternatively, we could upgrade the transitional care unit to an ICU (but that’s expensive). These answers lead to new questions… which are tested in the digital twin.

Digital Twins Revolutionize Planning in Four Ways:

Digital twins close the gap from “requirements” to system dynamics. Today this is a leap of faith. The simulation model closes that gap when we design new facilities, when we redesign existing patient flow, and when we convert service-line volume plans to annual budgets.

  1. Digital twins target process improvement efforts by putting each process improvement project into larger context. This enables us to charter projects with specific goals tied to both local and system performance. 

  2. Digital twins facilitate massively collaborative strategic planning. Health systems are full of super smart leaders with ideas. Those ideas need to be heard and tested. The digital twin gives us the tool do so. In many cases the result is to demonstrate that some ideas are bad. That’s a great result because it allows that leader to move forward and embrace the eventual strategy the Digital Twin helps to clarify.

  3. Digital twins can also power ongoing short-term forecasts. For example, when we build a digital twin in our Hospital of the Future Analytics Platform to redesign a medical center's system dynamics, we use the same simulation model to power predictive decision support apps outside-the- EMR.

In the end, digital twins help leaders design and execute models of care which are good for patients, families and caregivers. Revolutionary.

 
 Digital Twins, Capacity Management, Hospital Operations
 

Jeff_Terry.jpgMr. Terry is a Managing Principal of Healthcare Partners, the consulting arm of GE Healthcare that works with healthcare systems to define and achieve transformational outcomes related to quality, access, culture and cost. Partners' capabilities include management consulting, mobilizing change, technology integration and advanced analytics. He has a diverse background in consulting, sales, product development, Lean Six Sigma, business strategy, and services. Areas of focus have included clinical asset management, patient safety, patient flow, hospital operations, radiology and advanced analytics. He may be reached at jeffrey.terry@med.ge.com.

 

Topics: Hospital Operations, Command Center, Jeff Terry, Hospital Command Center, Capacity Command Center, Capacity Management, Digital Twins, Hospital Occupancy

5 Things to Get Right in Your Hospital Command Center

Posted by Matthew Smith on Apr 14, 2016 11:56:48 AM

shutterstock_25235185.jpg“Command Centers” are happening in healthcare. A few examples:

  • The Johns Hopkins Hospital set a new bar with their “Capacity Command Center” in January (View overview video here)
  • On a smaller scale, New York Presbyterian opened their “ Patient Placement Operations Center” in February
  • UCLH in London published an RFP for a “Coordination Center” in March

But how to design your “Command Center?” How will it help patients? How much to budget? How will it pay for itself? What IT is needed? 

Last week, six GE leaders met to discuss their work imagining, designing, and building command centers in the US, UK, Canada and Saudi Arabia. The first aha was that while every situation is unique and national health systems vary, the strategic objectives of providers investing in command centers are strikingly similar around the world:  How to optimize utilization of limited resources while preserving clinical quality, patient experience and staff experience? How to achieve a step-function improvement in integration and coordination of care? 

This is a huge topic. Here are five considerations for every team thinking of investing:

1. Command Center design is about more than apps and a room. The important thing is to design each facet of the command center based on the specific problems the command center is meant to address. Without being dogmatic, GE’s approach considers at least seven dimensions:Command_Center.png
  • Functions. What functions must your Command Center perform or enhance? Real-time operations management? Patient scheduling?  Staff scheduling? Risk surveillance?
  • Location. Where is the Command Center? Best to consider several options and make a final decision as other aspects of the design mature and constraints become clearer.
  • Shared Information. What information on the “big board” will creates situational awareness, risk awareness and drive action? Information must be real-time, simple, actionable, and take data from many source systems.
  • Interactions, Procedures and Operating Mechanisms. What actions do staff take in response to alerts? How?
  • Physical space. How big should it be? Ceiling height? How many workstations? How many conference rooms?  How should the environment be designed to maximize productivity and engagement of Command Center staff?
  • What staff will be collocated? What new roles will be created?  How will roles and responsibilities change? 
  • Goals & Metrics.
  • Multi-Generational Plan.
  • Contact GE here for a full description of our design methodology
2. Command Centers are exciting but not a silver bullet. They will not by themselves solve patient flow, utilization, safety, and capacity problems. Command Center must be part of an overall transformation. Command_Center_Sacred_Cows.pngWithin the context of that larger program the Command Center should play two essential roles:
  • Central hub for decision making in the context of the enterprise-situation and for the benefit of every patient
  • Center of gravity for continuous improvement. A great Command Center should capture the staff’s imagination and send a clear signal about the imperative to reach next-level efficiency. This should be a catalyst to take on sacred cows: from scheduled variation to disputes between services to better coordination with upstream and downstream providers. In short: Command Centers use data to focus improvement efforts and capture knowledge to enable continuous learning.

3. Command center apps must be agnostic to source systems. Command Center apps create information by applying logic to data from many source systems. At our client’s Command Center in Baltimore, for example, we process real-time messages from 18 different source systems from 8 different vendors. Just as an air traffic control tower is more than just flight ops, so a hospital command center is much more than bed management. Command_Center_Trees.pngWhat’s important is to connect the dots from many islands of data: beds, ORIS, EDIS, orders, ADT, transport, codes, etc.

4. Coordinating an enterprise is different from coordinating departments. It is the Command Center’s role to make sense of the many flows of patients through many departments across many resources. This requires many sources of data and it requires new thinking from command center staff. Legacy notions of “bed management” and “scheduling” must evolve such that siloes are broken down and staff are empowered and equipped to think for the enterprise rather than a function.

5. Command Centers should anticipate bottlenecks and risk. This is hard to do in healthcare but has been achieved in other complex industries. Imagine running an airport without an air traffic control tower with visibility to food service, ground control, crew scheduling, flight operations, etc. Yet this how we expect our hospitals to function. Command Centers with predictive information that prompts proactive action can change this. To do this, GE creates a digital twin of the hospital which simulates the flow of each patient along their pathway based on the local practice of care. To our knowledge, only GE has been able to achieve unit-census-forecasting with accuracy sufficient to drive action over the next 24-48 hours.

Command Centers are significant investments of time, energy and money. To realize their potential we must design them well.

Related Content

In Command: The Rise of Capacity Command Centers in Healthcare


Meet the Command Center Team

Andy_Day.jpgAndy Day is a Principal of GE Healthcare Partners. He leads analytic design and consulting for Productivity Solutions. 

 

 

 

 

Geoff_Martin.2.png.jpg

Geoffrey Martin is an Executive Vice President for GE Healthcare Camden Group. He leads the Care Delivery Management Practice in the US.

 

 

 

 

Mark_Ebbens.pngMark Ebbens is a Senior Partner of GE Healthcare Finnamore in the UK and Europe.

 

 

 

 

Zahava_Uddin.jpgZahava Uddin is Director for GE Healthcare Partners in Canada. 

 

 

 

 

Fida_Ghantous.jpgFida Ghantous is a Managing Principal of GE Healthcare Partners. He leads GEHC Partners in the Middle East and India.

 

 

 

Jeff_Terry.jpgJeff Terry is a Managing Principal of GE Healthcare Partners. He leads Productivity Solutions globally.

 

 

 

Topics: Geoffrey Martin, Command Center, Jeff Terry, Hospital Command Center, Capacity Command Center

In Command: The Rise of Capacity Command Centers in Healthcare

Posted by Matthew Smith on Feb 10, 2016 10:54:13 AM

By Geoffrey Martin, MBA, Executive Vice President, GE Healthcare Camden Group, and Jeff Terry, MBA, FACHE, Managing Partner, GE Healthcare Partners

Hospital Command Center, Hospital OperationsCommand Centers are commonplace in many industries such as military, space and aviation, government, oil and gas, and broadcast entertainment. But until now, they’ve been a rarity within the healthcare industry. This, however, is quickly changing. Many GE Healthcare clients in the U.S., U.K., Brazil, Canada, and Australia are considering the idea, and some are investing. GE Healthcare Camden Group with our sister organization, Productivity Solutions, is helping several hospitals shape and realize their Command Center vision.

While project names vary (Command Center/Centre, Operations Room, Situation Room, Control Center) the concept and objectives are similar.

  • Concept: Concentrate operational decision-makers and equip them with real-time decision support tools to enable better and faster decisions.
  • Objective: Enable a new level of efficiency, visibility and integration measured in outcomes, utilization, patient waiting, staff satisfaction, length-of-stay, and cost.

Concentrate Decision Makers

Coordinating the care of hundreds of patients through dozens of steps in thousands of pathways is immensely complex; perhaps the most operationally complex human endeavor. Functions must constantly coordinate physicians, nurses, bed managers, transport, housekeeping, case management, outbound patient placement, social work, inbound patient placement, admitting, roaming services, periop, and cardiology. GE Healthcare’s work has shown that co-locating key functions can improve coordination. But which functions and with whom? How should the functions evolve in a new setting? How do these functions interact with each other, with other units and departments, and with other, external facilities?

Consider a command center as a visible investment in your hospital’s next-level integration. The rendering below illustrates a fully-equipped command center, complete with a centralized Wall of Analytics and stations constructed for:Command Center

  • Bed managers
  • EVS coordinators
  • Transfer leaders
  • Operating Room schedulers
  • Transport coordinators
  • Staffing coordinators
  • Command Room supervisor

Real-Time Decision Support

There is no shortage of information technology in hospitals. But we all know the flood of dashboards and email alerts are too often retrospective, too complicated, or miss the point entirely. The challenge is that “doing better” is extraordinarily hard. It forces us to ask the question: What information, in what format, would be useful to whom at what moment to make a difference to what problem? Not easy to answer systemically--and what about the benefits of predictive information? 

How to Make it Happen?

GE Healthcare approaches command center design from a “problem-back” perspective:

  1. Start with problems
  2. Fixate on them
  3. Get stakeholders aligned with them

This is hard to do. Once the staff is aligned, start designing. GE Healthcare leads clients through an energetic collaborative process to design the space (lighting, acoustics, ergonomics, location), staff (which functions/what roles?), Wall of Analytics™ (predictive simple information in real-time to create awareness and impact the problems) and IPOM (the interactions, procedures and operating mechanisms of the center). Then we help clients build it, launch it and make a difference. Start to finish, the process takes between 12-18 months, including construction. This a major investment with a major return for patients and the institution.

GE’s Command Center Experience

GE operates approximately 25 command centers worldwide to manage its energy, rail, healthcare and aviation operations. For example, GE’s energy command center outside Atlanta, Georgia monitors the performance of more than 3,700 gas turbines around the world 24x7, and GE Healthcare’s InSite™ command center outside Milwaukee monitors >10,000 GE CT and MR scanners around the clock. Moreover, GE Healthcare Camden Group along with GE Healthcare Productivity Solutions has experience imagining, designing and building hospital command centers.

In the coming weeks, we will be sharing more insights surrounding our Command Center capabilities and experience—including white papers, case studies, and lessons learned in the planning, development, and construction processes. You’ll see how a one-time rarity in the hospital environment is changing the way care is delivered.

Related Content

5 Things to Get Right in Your Hospital Command Center


Geoff_Martin.png

Mr. Martin is an Executive Vice President with GE Healthcare Camden and leader of the Care Design and Delivery Practice. Mr. Martin specializes in the areas of hospital operations, process improvement, and the use of advanced analytics to develop innovative solutions. He also has extensive experience in strategy development, care design, population health development, value management, and large scale technology implementations. Mr. Martin has worked with leading academic medical centers and large integrated delivery networks across the country to improve clinical, financial, and operational performance. He may be reached at geoffrey.martin@ge.com or 773-620-7829.


Jeff_Terry.jpgMr. Terry is a Managing Principal of Healthcare Partners, the consulting arm of GE Healthcare that works with healthcare systems to define and achieve transformational outcomes related to quality, access, culture and cost. Partners' capabilities include management consulting, mobilizing change, technology integration and advanced analytics.
He has a diverse background in consulting, sales, product development, Lean Six Sigma, business strategy, and services. Areas of focus have included clinical asset management, patient safety, patient flow, hospital operations, radiology and advanced analytics. He may be reached at jeffrey.terry@med.ge.com or 212-613-2137.

 

Topics: Geoffrey Martin, Hospital Operations, Command Center, Jeff Terry

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