One of country's biggest single-location hospital pairs new construction with technology overhaul

Technology changes quickly, especially in the healthcare world. But until last year, Parkland Hospital in Dallas was dealing with the technological constraints of still being located in the same building John F. Kennedy was taken to after his assassination in 1963. The technology of the 21^st century did not square with the infrastructure of a 60-year-old building—WiFi doesn’t move very smoothly through feet-thick concrete walls. 

So when the hospital began plans to build a new 2.8 million-square-foot facility (one of the biggest single-location hospitals in the country), the Parkland IT staff knew it was time for them to build a new technological system to go with it.

Parkland Chief Information Officer Matt Kull said the plans for new technology infrastructure had to come a few years behind the new building plans. Spots for wires and Ethernet cables came early on. But the bulk of the planning started about three or four years ago, he said. And they still updated those plans as the new infrastructure continued to take shape and new technologies developed.

“If we would have planned this seven years ago when they started thinking of construction, quite frankly we’d all be carrying Blackberries right now,” he said.

Kull said one of the biggest improvements at the new hospital is the “portable" desktop system. It allows doctors, nurses and others to virtually access their own desktop from any of the 7,300 physical workstations by swiping an ID badge on a sensor. They don’t have to sign in or out or open or close programs when entering or leaving a room, processes that can take time and attention away from patients.

And Kull explained that since the new hospital is so big, patient rooms don’t surround nurses’ stations with line-of-sight access like they might in a more traditional hospital.

"Our hospital has 72 rooms along one hall. It's almost three football fields in length from one end of the building to the other end of the building--it is one long hall. This creates a very decentralized model," Kull said. 

So the hospital used technology to deal with that too: 1,600 clinicians wear mobile devices that receive push notifications about patients. They’ll get an alert if one of their patients (or a patient nearby) calls or shows an alarming reading on a biomedical device—they’re all connected to the system.

And the whole building is connected—there are 2,000 wireless drop points throughout the facility and every room has multiple Ethernet connections.  They even included updates to the patient experience, such as access to online TV.

The system is connected through VMware VDI, a health IT software program which connects clinicians to health records and other hospital information through access to the portable, virtual desktops. According to the company, OhioHealth system and Baystate Health system have implemented similar systems using the VMware software.

At Parkland, the final transition happened nearly overnight.

“We had a Big Bang kind of deployment,” Kull said.

Hospital employees had two days in August 2015 to move themselves and their 700 patients from the old building to the new building while keeping everybody safe—and that meant staying connected even during the technology changeover, said Kull.

Doctors, nurses, administrators and others had to understand and be ready to use the new technology on day one. For months before the move, the hospital staffed patient floors with more people than usually necessary for caregiving. Overflow staff spent those shifts learning to tap in and out of desktops, respond to mobile alerts and read the new biomedical devices so they’d be ready to jump into the new system right away.

“We went through a number of months of day-in-the-life training,” Kull explained.

According to him, there were no major problems, though they were ready to respond with various backup plans in the hypothetical worst-case scenario of a system outage. In fact, he said the most unexpected issue during the transition was the three-person IT team trying to learn their way around the new building as they responded to clinician questions.

Another unexpected result turned out to be a good thing. The hospital was able to replace every workstation in the facility. Originally, Kull said, they thought they’d need to retain and update about 40 percent of the hospital's devices. But as plans shifted, they realized they’d be able to replace every computer and stay within budget.

Kull declined to share the whole budget of the project, though he said the IT updates didn’t exceed its limit. He said the total technology number was hard to pinpoint, since it included not just computer and software updates but also setting up elevators, new biomedical devices, waste system installation and every other piece of a hospital that could fall under the “technology” umbrella.

The biggest impact of the transition, said Kull, is the effect on patients and clinicians. Information is more easily shared through connected devices. Being able to swipe in and out of workstations means less time dealing with the logistics of computers, which Kull said has translated into “several hours of additional patient contact time per physician per month.”

And allowing doctors and nurses to fill out charts in patient rooms makes for more thorough records, which has turned into one of its own unexpected benefits—they’re able to collect data they didn’t even know could be useful. Plus, information from the connected biomedical devices are easily accessible.

“I think, quite frankly, some of the unanticipated sources of data that we’re able to capture now are being put to use in ways that we didn’t initially anticipate,” Kull said.

Specific software aside, Kull thinks other hospitals could benefit from similar updates, especially a virtual desktop system.

And if all goes according to plan, Parkland will be able to implement future updates into the current system, too, so they can avoid another big overhaul and the “patchwork” infrastructure they had in the old building.

This time, that kind of overhaul was good for the patients, according to Kull.

“I think given that mission [of caring for Dallas’ underserved population], it was really an enabler for the transition to be as easy as it was, focusing on the patients, focusing on the caretakers,” Kull said.