Taking healthcare forward with a hospital command centre

What does it take to develop a hospital command centre that ultimately leads to a better-managed health system and better patient journey?

Like an air traffic control that oversees and synchronises the flow of flights and ground operations, a hospital command centre optimises resources and provides real-time data for prompt decision making.

Asia’s first-of-its-kind command centre, Tan Tock Seng Hospital’s (TTSH) Operations Command Centre (OCC) helps perform hospital operations more cohesively in supporting its outbreak response, as “management can make better decisions supported with real-time visibility of ground operations,” says Dr Jamie Mervyn Lim, Chief Operating Officer at TTSH.

Still, even without the pandemic, the command centre helps optimise hospital resources and systems, thereby, ensuring a smoother patient journey at every touchpoint. 

How it’s conceptualised

One of the busiest hospitals in Singapore, TTSH has a bed occupancy rate higher than 90%. Ten years ago, it had been using the “Paper, Pen, Phone” method for patient admissions, involving multiple phone calls and scribbling on paper, thus, was inefficient.

With the introduction of radio-frequency identification (RFID) in 2008 to tag every admitted patient, locating every patient from admission until discharge got easier. Although the RFID tagging is not a new introduction to healthcare, Dr Lim believes it provided the management with “immediate visibility of where the resources were.”

In 2011, TTSH developed the Artificial Intelligence Bed Management Unit (AIBMU) in-house, an algorithm-based system able to triage patients based on clinical urgency and allocate the most suitable ward and bed for the patient.

From its success, the hospital tried looking at scaling AIBMU to other aspects of the hospital’s operations. “We wanted to develop a ‘brain’ for the hospital that can direct and coordinate all operations,” Dr Lim says. In 2015, they embarked on this goal, and in 2019, succeeded to build the OCC.

Command, Control, and Communications

The hospital’s new OCC features the state-of-the-art C3 (Command, Control, & Communications) Smart Hospital System, developed by TTSH, Integrated Health Information Systems (IHiS), ST Engineering and Electronics, and supported by Singapore’s Ministry of Health. As the hospital’s brain, it can sense, think, and respond allowing TTSH to run as a coordinated system. The command centre can identify operational choke-points, therefore, trigger standard operating procedures in response.

Primarily, the centre provides visibility of end-to-end care for patients. No longer distressed about triaging and finding available beds for patients, hospital staff are better coordinated whether during an outbreak, in peacetime, or a civil emergency. Patients, therefore, enjoy a smoother journey from admission to discharge.

What’s in the pipeline

TTSH aims to extend the system’s capabilities and expand its functionalities to other operational scenarios. Included in their plans are incorporating supply chain capabilities and building capabilities in video and predictive analytics, which, Dr Lim describes, can allow TTSH to “move from real-time visibility to decision support, operational analytics, and finally autonomous operations.”

With the OCC at work, the hospital sees the introduction of more sensors on the ground as well as the digitalisation of manual processes as the next necessary steps. Dr Lim believes that better awareness of the ground situation and more information at hand would improve decision-making. Through Artificial Intelligence (AI) integrated into the C3 system, the hospital hopes to achieve 80% automated operational responses so the staff are left with only 20% more complex situations to address.

Likewise, there are plans to integrate the C3 system into the pre-hospital phase and into community hospitals in Singapore for more seamless and timely care.

Primary considerations  

Before hospitals can successfully build a command centre like the OCC, considerations such as process flow, engagement with stakeholders, cybersecurity measures, and ground sensors need to be settled.

Different hospital units have their requirements, therefore, engaging stakeholders to be aligned with the goals parallel to the adoption of the command centre could be a challenge. Still, this is a crucial step so all units participate to fully coordinate the system’s responses.

Cybersecurity considerations are inevitable when it comes to digitalisation. At TTSH, this is taken care of by IHiS, which supports information technology for public healthcare in Singapore, knowing that the command centre holds the organisation’s most critical data.

Wiring a hospital with sensors can also be costly, though it’s vital to keep the command centre running. The journey for TTSH started with digitising on the ground, using RFID, RLTS (Real Time Location System), CCTVs, AI, and video analytics.

Given that having a command centre is an expensive undertaking, hospitals need to understand if the cost could really be justified with its advantages to the general operations and patient journey. Dr Lim suggests answering these three fundamental questions: What data do you want to monitor? What does it mean to the management and the ground operators? What are the necessary follow-up actions if something is not right?