The new Clinical Command Centre in the UK’s Bradford Royal Infirmary, part of Bradford Teaching Hospitals NHS FT, is the first of its kind in Europe. The Command Centre in Bradford – like the many other Command Centres around the world – was designed by and for caregivers, to equip them with real-time data to support informed in-the-moment decision making. The more than 60 Apps, or “Tiles”, in GE Healthcare’s Command Centre Library support a range of settings of care, clinical pathways and operational issues which provide insight at the patient, ward, hospital and system level.
The Command Centre Tiles are available anywhere caregivers can access a browser, so in addition to the dedicated ‘Command Centre’ room they can be accessed on clinical workstations, tablets and mobile phones. During the pandemic, the GE Healthcare Command Centre team created two new Tiles that help hospitals manage their COVID-19 patient base and the critical resources involved in their care, such as ICU beds, negative pressure rooms and ventilators.
The Tile helped recognise a positive patient on a general ward
Dr Gerald Dunstan, GE Healthcare’s head of Clinical Command Centres business in Europe, said the COVID-19 Infectious Disease Tile had received fantastic feedback from its users, and that the Tile had more than proven its value. In one instance, “Using information based on the system’s clinical protocols, the Tile helped recognise that a COVID-19 positive patient was placed on a general ward, which triggered an alert in the Command Centre before it had been detected in the pathology system. The care team were able to respond in real-time, rapidly moving that patient onto an isolation ward.”
Dunstan said of the Bradford Command Centre, which harnesses AI and advanced analytics to streamline patient care across entire systems, “It’s about helping care-givers make better decisions in real-time, and connecting data from different source systems that don’t usually talk to one another or interact. The Command Centre connects source systems across hospitals and gets data to work together, integrating it, to find ‘the needle in the haystack’ issues that are so crucial in optimal decision-making. If you’re trying to find a free bed and work out which patient gets it, you’re going to be hopping between systems, making notes in your notebook from each of those systems, and trying to join the dots. The Command Centre does that for you and suggests, using AI and ML, which patient might be best for that bed.”
He argued the Command Centre is so much more than just capacity management and patient flow. For example, the Patient Deterioration Tile provides a backstop to the great work of caregivers by using early warning scores as provided by the hospital using their specific protocols to help classify patients who need more frequent monitoring or to flag those patients whose condition is rapidly declining. The Care Progression Tile alerts to patients whose progress on their clinical journey is slower than expected. It also highlights potential clinical risks, for example, patients on high-risk drug combinations or patients whose kidneys may not be functioning well enough to handle an upcoming contrast study, all based on medical provider created and defined processes and protocols.
Dunstan added that the Command Centre also helped reduce footfall during the pandemic and cited the Chief Executive of Bradford Teaching Hospitals NHS FT, Mel Pickup, who described the Bradford Control Centre as “invaluable” in reducing footfall in clinical areas.
GE Healthcare equipped 700 extra beds across Europe
The healthcare company has helped tackle the surge of cases elsewhere too. When ICU departments extended their capacity, GE Healthcare equipped 700 extra beds across Europe, with digital solutions in a matter of days, according to Peter van Heezik, GE Healthcare’s Digital Solutions marketing manager Europe.
They have been implementing their Critical Care Information System for 25 years and launched a new platform, linking operating room, recovery and intensive care three years ago. Van Heezik said, “COVID-19 proved that GE systems offer flexibility and scalability. Because the ICU beds were equipped with our Clinical Information System, the hospitals extended the system to cover additional recovery beds, cardiology beds and operating rooms, where they treated infected patients. The powerful part is you can drive the same adherence to goals, prescribe the same treatment plans and use the same analytics from a central point.”
Dr Kirsten Colpaert, senior ICU intensivist and associate professor at Ghent University Hospital in Belgium, agrees that GE’s Clinical Information System, gave them a complete overview at the bedside and remotely. She said, “We didn’t have the extra burden on working with COVID-19 patients and had time to focus on treatment.”
Respiratory lung protection ventilation strategies have been vital for many infected patients during this time. Van Heezik described GE anesthesia machines providing high-resolution data, compared to traditional interfaces on clinical information systems. Analytics in this domain, provide both retrospective analytics using device data, and near real-time analytics. He said: “These devices show what’s happening to the patient right now…The information is based on operator behaviour, enabling you to look at data, and store it in the cloud, providing real-time analytics.” “These anesthesia machines with our cloud-based analytics platform create an intelligent ecosystem. Our applications use advanced algorithms that interpret this data and uncover actional insights and display them on your person device.”
Forty per-cent of Europe’s ICUs are still using paper
He added that 40% of Europe’s ICUs are still using paper and the basic infrastructure is missing, so the extra workload has made it harder for some. “If you miss all the digital support, managing double the number of patients is a big, big challenge and puts extra pressure on clinical staff, especially with less experienced ICU staff.” He shared that GE’s unique implementation approach allows for quicker, shorter implementation times because it uses existing built-in system best practices which can be refined.
Even though demand for chest X-rays has increased because of the crisis, many staff members have had to work from home. GE Healthcare’s Analytics and Cross-Enterprise Reporting have enabled institutions to identify where the capacity is and radiologists to report remotely. André da Silveira, senior product marketing manager, GE Healthcare Digital EMEA, said, “When reporting is done remotely and patients do not have to travel again to hospitals to repeat studies, it is safer and improves efficiency. With attention being shifted to COVID-19 patients and a lot of the capacity being shifted to those places, it is important to improve efficiency everywhere else.
Edison Open AI Orchestrator also has an important role improving efficiencies and clinical outcomes by enabling the quick deployment of AI and non-AI based clinical applications in clinical workflows. As an example, an AI algorithm that detects lung abnormalities can be easily ‘plugged in’ and will relieve resources that are now overwhelmed diagnosing coronavirus related pneumonias, and if COVID-19 is detected, the patient can be moved to an appropriate care plan with no delays. ”
Let’s work smarter, not necessarily harder
It seems the pandemic may have driven this message home as Dunstan said, “Organisations have been saying, let’s not go through this again with the tools we had. Let’s be more effective and not emerge from something like this quite so exhausted. Let’s work smarter, not necessarily harder.”