Laying strong foundations: New Dunedin Hospital – Whakatuputupu

FEATURE -  eHealthNews editor Rebecca McBeth

The New Dunedin Hospital project is a proving ground for many digital hospital concepts.  

After a formal review of costs and options, the new Health Minister Simeon Brown confirmed in late January that the new Dunedin Hospital will be built on the former Cadbury Factory site as planned.

A dedicated digital health design lab has been established over the road from the outpatients building to test and validate technologies before they are deployed in the actual facility. 

Phil King, senior portfolio lead, data & digital facilities technology team says all the technology going into the outpatients building will go through the design lab. 

“It means we can get all the vendors on board, they can go through cyber assurance and technical validation testing,” King says.  

This approach allows clinicians and other staff to experience the new digital workflows in a realistic setting, providing feedback to refine designs before implementation.  

From the ground up 

Phil Baskerville, digital project director New Dunedin Hospital – Whakatuputupu, explains that integrating digital planning from early in the design process ensures that every aspect of the hospital, from its layout to its lighting, supports the seamless integration of technology.  

“It is about building a hospital that is inherently smart, rather than retrofitting technology into an existing space,” he says. 

This involves considering the various layers of operation: everything from the building's physical infrastructure to the digital systems that manage patient information and workflows. 

First is the passive layer of what is needed to make the building work, such as cabling, access control and eight ‘communication rooms’. 

On top of that are the active systems such as wifi, digital signage and firewalls, then comes the digital facility systems such as real time location monitoring and patient wayfinding.  

Finally, you have the digital systems for the end user such as clinical room scheduling and the South Island Patient Information Care System (SI PICS). 

“One of the key things we are delivering is the patient and whānau-centric operation inside the new building, so that all users are catered for,” Baskerville says. 

“Whether someone is digitally enabled or not, they both get that efficient process through the building.” 

A patient-centric approach  

For Southern patients, the digital journey will begin before they arrive at the hospital.  

Baskerville outlines how patients will receive appointment reminders via email or text message, along with options to provide pre-appointment information electronically. Upon arrival, patients can check in via smartphone app or kiosk, similar to modern airline check-in processes. 

"It will be an email a week or two weeks beforehand, then a 24-hour bump with a text message," he describes.  

"On the day, patients can check in and we will text them to say, 'Hey, could you come up to the lobby on the second floor for your appointment.'" 

Digital wayfinding solutions will help guide patients through the facility, which is especially valuable when people are not feeling their best.  

"When you are sick, you're not at full cognitive function, so digital wayfinding will help people,” Baskerville says.  

“It's like a private Google Map that can literally give step-by-step instructions on how to get to the appointment room or how to get out of the building." 

For staff, the digital hospital promises more efficient workflows and real-time location systems will allow better coordination of people and resources. 

"If we need an ultrasound machine for a guiding needle biopsy, let's find the one three meters away, as opposed to the one on a different floor," Baskerville explains. 

A new nurse call system will also route requests more intelligently.  

"If a patient just needs some water, it will send a message to the nearest orderly who can bring you that water, that is versus duress-type alarms which require a different response," Baskerville adds. 

Automating workflows 

Phil King describes digital hospitals as those that leverage technology to automate workflows and reduce the burden on clinicians.  

The digital infrastructure to support this automation is enormous. Modern hospitals may have thousands of interconnected devices and hundreds of critical applications that must function for the facility to operate.  

"If you went into a hospital back in 1990, you would be lucky to find one or two PCs in the corner," King says.  

"Nowadays, there are thousands of interconnected devices, whether they are scanners, laptops, workstations on wheels, biomedical equipment - the majority are all now on the network." 

They must also ensure new facilities are ready for both current and future technologies. 

King explains that new builds are designed to be at minimum "digital hospital infrastructure ready" with enough power, cooling, and data capacity to support advanced systems. 

"We are putting enough resilience and power and data in so that in five years, if Health NZ does decide to invest in an enterprise-grade Electronic Medical Record (EMR), we do not have to pull those walls apart," he says.  

King says this proactive planning is critical, as retrofitting existing hospitals for new technologies can be extremely costly and disruptive. By building digital capabilities in from the start, the aim is to create more flexible, future-proof facilities. 

A sustainable future  

While the focus is currently on infrastructure and foundational systems, future phases will tackle clinical applications and more advanced capabilities. 

The team is already working closely with clinical services to plan the digitisation of workflows and migration away from paper-based processes. 

The approach and lessons learned from the Dunedin project are also being shared and applied to the Nelson and Whangārei Hospital Redevelopments. 

New Dunedin Hospital 
Passive infrastructure, engineering systems 

• Nurse call 
• Engineering systems 
• Communication rooms and structured cabling 
• Access control 
• Security systems 
• Electronic bed cards 

Active Infrastructure Facility Systems 

• Active network and wifi 
• Compute and storage 
• User computing 
• Digital screens and signage 
• DAS 
• Handsets 
• Cyber security – firewalls 

Digital Facility systems 

• Fridge monitoring 
• Message integration engine 
• Real time location services 
• Digital way finding 
• Patient queue management systems 
• Patient journey boards 

Digital Health solutions – end-user 

• HCS – file scanning 
• Clinical room scheduling 
• HCS – clinical workflow forms 
• SI PICS – patient journey updates 
  

If you have any questions re the above feature article, please contact the editor Rebecca McBeth.

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