Lewisham and Greenwich NHS Trust

Justin Beardsmore

The modern hospital campus is slowly developing into a highly integrated system, underpinned by a robust digital network. This network in a smart hospital is not solely about connectivity. It is an indispensable intelligent infrastructure that makes decisions at the source, driving patient safety and enhancing operational efficiency. Without a seamless digital backbone, the 400-bed campus cannot achieve the high standards of coordinated care demanded by Western society.

This environment came of age during the years of rapid growth in Electronic Patient Records. Prior to this, healthcare could continue as normal during an outage, overtime could be paid to catch up on patient admin work, demand was lower and budgets had space to flex. The second phase, focusing on bed management and vital signs, pushed the investment case forward in various haphazard ways, which improved connectivity, but not always the experience or security.

The challenge made against these is that this period was more about expansion, both wired and WIFI. Connectivity for staff to use devices. The larger the hospital, the larger the staff, the larger the deployment. The smarts, if any, were in the application layer, which was siloed. Now that EPR systems have matured to their full potential and longer-term planners see less need for headcount to deliver the same, the question remains— what, who and where drives the next phase of investment?

There is an argument to be made that, due to geopolitical instability and the increased surface area of attack created by expansion, the focus should be on locking down, even at the expense of innovation. These are acceptable arguments; removing several hospitals from a local healthcare economy will be a direct way to create wider civil disruption beyond the walls. It is certainly true that large organisations are reconfiguring with this in mind, not at the expense of technology. The US Marine Corps is returning to its first island defence role, which means lightening and self-sustaining high-end equipment. Shrinking, not removing, technology.

"Civil planners will need to decide what is important, so it may well be that some major trauma sites are ring-fenced and some innovation is sacrificed for the benefit of Business Continuity."

Crucially, the digital network will need to serve as the primary defence against internal and external threats, making data security and compliance mandatory functions. Threats and issues will need to be addressed at source, in the early stages. This will need to be built into the network architecture rather than having hoc bolt-ons of previous years. Digital teams will still be leaders in this space. The less-is-more approach, with fewer moving parts and hands in pots, is a good principle to develop. Civil planners will need to decide what is important, so it may well be that some major trauma sites are ring-fenced and some innovation is sacrificed for the benefit of Business Continuity. It’s common to see the Ministry of Defence Police, rather than the Metropolitan Police, at the doors of government buildings.

For the innovation the drivers for the next phase of funding, the baton needs to be passed to the Estates and Site Redevelopment Teams. Both soft and hard experts will be slowly complemented by digital leads who will naturally follow the problem and the funding. The industry already knows that EPR vendors are facing a perfect storm of AI and IoT, which is opening up their systems; they know they need to collaborate to service their customers or be taken over. The healthcare technology shows are slowly seeing the flexing muscle of infrastructure and platform providers, which had been missing for a while. With more self-service and automation directing alerts away from clinical staff directly to support services, it is necessary to provide the same service with fewer resources. Estates teams too have reorganised over the past few years. Less board-level responsibility and splitting BAU and redevelopment to redirect years of experience and knowledge to solving the problems. . Therefore, it is a good time for them to pick up this indispensable baton.