The rise of smart hospitals: design and implementation of a decision-making support tool for the Smart ICU of the Vall d’Hebron University Hospital

Abstract

As new decade begins, healthcare system will continue to face challenges of the past as well as new issues that emerge: prolonged life expectancy along with the increasing complexity of chronic treatment, changing patient expectations partially motivated for a generational conflict or occupational burnout among healthcare providers added to a predicted shortfall of medical staff in the next ten years. All while, healthcare expenditures are spiraling out of control. Moreover, the outbreak of COVID-19 and the current threat of resurgence has stressed this already overloaded scenario in which the intensive care unit (ICU) stands as a key player in the multisectoral response of the influenza pandemic plan. This text is focused on the design, development and delivery of trustworthy software that can support real improvements in critical care outcomes. The clinical management decision-making support tool presented here wants to be a driver for improvements in operating costs and increase the productivity and efficiency of ICU. From planning to execution, the project must be understood under the scope of Agile IT following a spiral development model. Speed of execution became a major source of advantage fueling iterations to achieve first a mockup, then a minimal viable product and finally a functional product. Therefore, an evaluation and risk analysis criterion were laid out to perform an execution roadmap and a mitigation risk strategy. Finally, I attempted to review the tool presented as an integral part of a vision containing IT developments, optimization of processes and cultural change as a further approach to the smart hospital.