Insights Series Issue 21: "Turning data into value"

Insights Series Issue 21 siemens-healthineers.com/ digitalizing-healthcare The New Normal Turning data into value A thought leadership paper with Dr. Hee Hwang from Seoul National University Bundang Hospital on his strategic approach to data integration SIEMENS Healthineers Preface The Insights Series The Siemens Healthineers Insights Series is our preeminent thought leadership platform, drawing on the knowledge and experience of some of the world’s most respected healthcare leaders and innovators. The Series explores emerging issues and provides you with practical solutions to today’s most pressing healthcare challenges. We believe that increasing value in healthcare – delivering better outcomes at lower cost – rests on four strategies. These four principles serve as the cornerstones of the Insights Series. Expanding Transforming Improving Digitalizing precision care patient healthcare medicine delivery experience The New Normal The New Normal is a special edition of our Insights Series focusing on the COVID-19 pandemic. This series provides recommendations on how to confront the current SARS-CoV-2 outbreak and its implications, as well as strategies and ideas on how to emerge from the current crisis stronger, more resilient, and better prepared to address the healthcare challenges that lie ahead. Please visit siemens-healthineers.com/insights-series Executive summary How can a society as a whole become healthier? This would Data and analytics are one of the keys to obtaining such require preventing chronic conditions from happening insights. There is a wealth of untapped information flooding in the first place and providing treatment that works. And in and the amount of healthcare data being generated the less money a society spends on healthcare, the continues to skyrocket. Yet without innovative, digitalized better. While this may sound like an obvious concept, the solutions, data becomes disparate and cannot be leveraged conventional fee-for-service model is not conducive to effectively. There needs to be a platform that connects this reaching that goal as it offers little incentive to deliver data automatically and acts as the central host of a broad efficient care. Providers, particularly large organizations, range of Artificial Intelligence (AI)-powered applications often focus on expensive treatments rather than disease for better decision-making. Standardizing quality decision- prevention. Patients receive more tests and procedures making using this data and making it accessible by caregivers than they need. at any level can turn data into value. Fortunately, the healthcare industry has been steadily Seoul National University Bundang Hospital (SNUBH) in pivoting away from such fee-for-service systems to South Korea has successfully made use of its patient alternative “value-based care” system. Value in healthcare data by developing its own integrated platform after years means maximizing patient outcomes while reducing of research. This allows for the use of AI-powered software costs. Under this system, providers are reimbursed based to support hospital staff to make evidence-based decisions on quality and outcomes, driving hospitals and health for better patient care and operational outcomes. The systems from reacting to anticipating the needs of their key to its success lies in its ability to mobilize hospital staff patients. To be successful under this model, insights and provide the right tools for them to collect and use surrounding every aspect of care delivery – quality, cost, data for better patient outcomes. By having a comprehensive utilization, variations in care, patient behaviors and view of the patient, care can be more precise and prevention patient outcomes – are required. more attainable. Its efficient use of resources through digitalization has helped SNUBH to grow its revenue more than 11-fold since it embarked on this journey in 2003.1 Siemens Healthineers Insights Series · Issue 21 3 Introduction Background South Korea is facing a demographic crisis due to low the helm of SNUBH’s IT department as the Chief Information birthrates and an aging population,2 which is a problem Officer in 2004. Under his leadership, SNUBH is recognized that many developed countries are facing. With that globally as a leading digital hospital and also the first comes the challenges of workforce shortages and the rise hospital outside the U.S. to achieve HIMSS EMR Adoption of chronic diseases. To combat that, the government in Model (EMRAM) Stage 7 status and revalidation, meeting South Korea has been committed to promoting value- the new criteria set up by HIMSS Analytics. EMRAM is based, preventive care and investing in information and an eight-stage model (0 to 7) that measures digital maturity communication technology (ICT) to improve the health in hospitals. Achieving EMRAM Stage 7 represents an of its people.2 advanced patient record environment that is truly paperless and uses information and technology in a way that South Korea’s response to COVID-19 has been impressive. creates benefits for both patients and clinicians. SNUBH has Building on its experience in handling Middle East Respiratory been consistently ranked first in quality measurements of Syndrome (MERS), South Korea was able to flatten the general hospitals and has received awards and recognitions epidemic curve quickly without closing businesses, issuing from Health Insurance Review and Assessment Service.3 stay-at-home orders, or implementing many of the stricter measures adopted by other high-income countries in When the pandemic hit, SNUBH was ready to face the 2020. Besides the clear guidelines from the government challenge. SNUBH was able to integrate and retrieve patients’ and its “test, trace, isolate” strategy, the readiness of travel record and automatically triage them to minimize healthcare providers and hospitals played a critical role. exposure of staff and patients to potential infection risk. SNUBH was operating 1,360 inpatient beds and caring The importance of value-based care was put to a pressure for an average of 7,000 inpatients daily. With the spike in test during the COVID-19 pandemic. Do institutions that COVID-19 patient volumes, it was quick to establish have switched over to an evidence-based care approach Community Recovery Centers (CRCs) to cope with the manage the pandemic better? Is the investment in value- workload. CRCs are facilities that serve patients who have based care infrastructure, such as healthcare information been diagnosed with mild COVID-19, and the exchange of technology and data integration platform, paying off? data allows medical staff to care for these patients remotely. SNUBH also developed a Rapid Response System (RRS), A case in South Korea proves such investments to be which was fully integrated into its home-grown Electronic invaluable. When it was founded in 2003, the managing Health Record (EHR) system and monitors all inpatient board of SNUBH located in Seoul, South Korea already set test results and vital signs 24/7 since 2013. The system its strategy to tackle the challenges posed by an aging works particularly well in wards where COVID-19 patients population with a focus on digitalization. It firmly believes are hospitalized. Medical personnel can monitor the that digitalization is one of the key paths to increase status of all COVID-19 patients at a glance without direct efficiency and make preventive medicine a reality. SNUBH physical contact. SNUBH can swiftly adapt and keep is a tertiary hospital that has been progressively adopting the situation under control, thanks to its well developed information technology (IT) for better patient care. IT infrastructure and data integration readiness that stems Dr. Hee Hwang, a professor of pediatric neurology, took from its commitment on high value care. 4 Issue 21 Siemens Healthineers Insights Series · How healthcare IT has helped SNUBH manage the COVID-19 pandemic Automatic triage of patients based on data, including travel data ......... Community Hospital admission Non-COVID-19 Recovery Centers for COVID-19 patients (CRCs) for mild patients COVID-19 patients Rapid Response System (RRS) for more critical COVID-19 patients Figure 1 Siemens Healthineers Insights Series · Issue 21 5 The challenge Despite the advantages of value-based care, its expansion promote preventive care, there needs to be an efficient way has been slow. One obstacle is the culture of healthcare. to collect patient information from various sources. Data The healthcare profession has historically focused on entry is viewed as an administrative task. If doctors have science and treatment, and many innovations have come to type in data in a structured format and it slows them out of that. Yet the shift to value-based care also puts a down or creates an additional burden, they are less likely to spotlight on a patient’s individual life context, as a thorough support it. Once data is collected, hospital IT and electronic understanding of the social environment surrounding medical record systems also need to make this data usable the patient is the key to successful prevention and treatment. by solving the challenge of analyzing and deploying This requires physicians and nurses to change the way data so that it can facilitate communication and support they practice. Yet many have been slow to embrace the decision making. change for a host of reasons. Research shows that one main reason is that they feel excluded from the process.4 Physicians clearly understand the challenge posed by rising costs for clinical care and Do the doctors feel they have the prescription drugs, but many do not feel they are in a right tools and all the information position to help rein in costs. Physicians who are not aligned they need to succeed?5 and engaged with their organization have more reasons to resist new systems. 60% A second obstacle is the availability of tools. Even if doctors are engaged, do they have the right tools to succeed? Respondents agreed that doctors According to a research with 451 primary care physicians do not have the right tools and health plan executives, nearly 60% said that doctors did not have the right tools to be effective, and nearly three-quarters (72%) of respondents said physicians did not have all the information they needed about their patients.5 Much of the current medical infrastructure and technology is built to support the treatment of severe 72% conditions rather than promote health and wellness. To Respondents agreed that doctors do not have all the information 6 Issue 21 Siemens Healthineers Insights Series · The solution When Dr. Hwang took on the responsibilities of CIO, he The core of his strategy lies in bringing caregivers and was clear that his mission was to help SNUBH deliver end-users to the center of the digital transformation its promise of offering world class patient-centered care process, and offering them the right digital tools they need through digitalization. Yet he was frustrated with the to succeed. SNUBH’s own home-grown EHR solution, lack of available options in the market at the time. He named BESTCare 2.0 (Bundang Hospital Electronic System decided to look inward for a creative solution. He embarked for Total Care), integrates the patients’ clinical, financial, on a journey to develop a platform that not only would medication, genetic sequencing, travel, and personal records fulfill the needs of internal stakeholders, but also of daily life, i.e. lifelog, data, thereby opening up the comply with various international and national healthcare opportunity to apply a comprehensive range of applications accreditation systems. to make evidence-based decisions from diagnosis to therapy to follow up. This holistic view of the patient enables caregivers to give the patients the best care possible with the lowest cost. SNUBH’s data integration strategic framework 1 2 Integrate data on a Engage care teams to flexible platform identify the right tools ? ? S Integrate 1 2 Engage 4 Measure 4 3 Implement 3 Measure outcomes for •Diagnosis continuous improvement •Therapy Implement decision-making •Follow up technologies along patient pathway A -B .C Figure 2 Siemens Healthineers Insights Series · Issue 21 7 Dr. Hee Hwang – CIO, SNUBH “Whatever technology we endorse, it has to contribute to better quality, service, or safety of our patients, and give us better efficiency with limited resources.” 1. Integrate data on a flexible platform SNUBH’s BESTCare system is an integrated platform of comprehensive applications for direct care and support SNUBH integrates various care of outpatients, inpatients, intensive care units, sources of patient data emergency room, and operating room units. SNUBH ensures • its platform fully complies with international standards Clinical data • Medication data such as Health Level 7 (HL7) V2.X messaging and • Financial data HL7 Clinical Document Architecture (CDA).6 The mapping • Genetic sequencing data • of the terminology to the standard takes place in the Wearables data • Travel data backend so that changes do not disrupt the workflow of • Record of daily life the caregivers. Two engineers and one nurse are dedicated to ensure high data quality by running precision comparison tests routinely. When the pandemic hit, a datalink was established between the national immigration service and SNUBH’s flexible platform to enable automatic triage Another key concept of the platform is to provide caregivers which minimized infections within the hospital. with a holistic view of the patient. Based on the data, the platform generates a patient journey map for caregivers The platform also allows healthcare professionals to access which shows all patient-related longitudinal events in the EHR system with full functionality from outside the outpatient clinic, inpatient department, emergency the hospital either by using a mobile EMR system through department, and various examination suites in a visualized Virtual Private Network (VPN), or using Virtual Desktop form. It also shows the patient’s history of surgical Infrastructure (VDI) account to access original EHR with a procedures, diagnoses, discharge summaries, test results, laptop or tablet. This enables caregivers to visit patients’ and medications to enable medical staff to understand homes without any paper or printed records and to both complex patient information at a glance. The platform access and capture patients’ data on site, resulting in further supports caregivers by enabling a host of applications improved quality of care and efficient access to medical and tools that covers the continuum of care from diagnosis, records. to therapy, to follow-up. 8 Issue 21 Siemens Healthineers Insights Series · 2. Engaging care teams to identify the right tools How did SNUBH overcome the cultural barrier to get Understanding a patient’s life as a whole instead of focusing caregivers and patients engaged? A practical way to make on simply treating an illness is a crucial factor in value-based digital transformation a reality is to bring caregivers into care. Hospitals would need comprehensive information the center of the decision-making process. Caregivers who about patient’s daily life, yet it would not be feasible are engaged in decision-making are much more satisfied to add the data entry burden to overworked caregivers. To with the working environment and are more willing to avoid the tedious data entry and to engage patients to take lead change.4 charge of their health, the platform also enables patients to access their medical records, fill out pre-visit questionnaires One thing that SNUBH has done well is listening to real online, send in data through their wearable devices, users. During the process of developing their own platform, facilitate the use of their data in clinical and epidemiological Dr. Hwang and his team actively involved doctors and research, and communicate with healthcare professionals end-users through constant communication. There were about their current health status in a timely fashion. diverse task forces for decision-making to make sure This is accomplished through an innovative EHR-tethered the platform was adjusted to effectively support the users’ Patient Health Record (PHR) system that was developed complex tasks. Dr. Hwang is especially interested in through a co-creation workshop with clinicians. Patients’ inviting critics of digitalization to the decision-making wearable data is automatically retrieved to a hospital EHR process. During the development of a quality measurement system, and patients can record their daily food intake tool, for example, a task force was formed consisting of and activity through an app. The ability to collect biological, doctors, nurses, pharmacists, staff members from the medical environmental, and behavioral data of a patient can help information team, the health insurance team, and the clinicians to gain better insights for more individualized care. quality assurance (QA) team. It is known that EHR user While it was initially designed to manage non-communicable interfaces and data entry procedures are a major obstacle chronic diseases, it became an effective tool to manage to healthcare professionals’ use and acceptance of EHRs, highly contagious disease such as the COVID-19 outbreak. meeting this design challenge is the most important factor that will influence future success. In this platform, end-users can also configure and use their own user interface (UI) rather than using fixed, common UI. Making the platform user-friendly and easy to use is the key to increase its adoption. The medical informatics team also provides training sessions regularly to users at every level. By designing a platform that incorporates user feedback, they have been able to accomplish two important goals: more data can be captured which leads to higher accuracy, and it offers caregivers the right tools they need to deliver value-based care. Siemens Healthineers Insights Series · Issue 21 9 Dr. Hee Hwang – CIO, SNUBH “The hospital is the center of innovation for healthcare IT. Big vendors are coming up with new innovative ideas for the healthcare sector, but without the support of hospital caregivers, new technologies cannot impact the daily operations in the care of our patients.” 3. Implement decision-making tools along the patient pathway With key information readily on hand, clinicians can and video conference systems into its platform. If there is benefit from a variety of digital tools to help them make a variation of standard treatment process and consultation faster and better decisions along the patient pathway. is needed, communication with other departments is just one click away. SNUBH has designed and implemented more than 150 CPs from 13 departments8 (see Table 1), Diagnosis which means it has a CP application rate of 85%. Clinical pathways ensure that best practices are applied every time The platform developed by SNUBH enables Clinical Decision which reduce variations in care and unnecessary tests and Support System (CDSS) rules to help clinicians make procedures. Combined with barcodes and Radio Frequency decisions on diagnosis and treatment with the latest scientific Identification (RFID) technology for cross-checking evidence. The CDSS can check for overlapping prescriptions, patient information with medical orders, it ensures that drug-drug interaction, renal dosing guidelines, overdose the right patient will get the right drug, at the right dose, prevention, contradictions for age, pregnancy and breast with the right route, at the right time. feeding, and drug-disease interaction, resulting in much higher safety and avoiding negative outcomes for patients. One example use case is the automatic Acute Kidney Injury Follow-up (AKI) alert. The system screens for AKI events every midnight by comparing patients’ serum creatinine data Value-based care leads to better health outcomes because to the baseline. When there is an AKI event, it automatically it encourages patients to play a more dynamic role in generates a pop-up message in the medical record and their healthcare and promotes preventive care. With the alerts the doctor to send a consultation request to the EHR-tethered PHR system, the platform allows patients nephrology division. The alert has significantly lowered to enter their health information and communicate directly the odds of overlooked AKI events and severe AKI events, with caregivers. One use case is in the management of resulting in an increased rate of early consultation diabetes. Patient-specific messages about glucose, diet, and more than four-fold and significant improvement in AKI physical activity are sent directly to patients’ mobile phones recovery rate.7 and on the website based on their data. A study has shown that patients’ hemoglobin A1C levels, an important marker for management for diabetes, were significantly Therapy decreased compared to those who did not use such service. The percentage of patients who reached their HbA1c The platform also leverages on analytics and AI technologies goal was doubled in the group using such service compared to support clinical decision-making through Clinical Pathways to the group who did not.9 With such tools, patients can (CP). The CP takes patients’ clinical status and compares not only get interventions earlier, but they can avoid getting it against the current guidelines for various diseases to sick in the first place. ensure standardized care and best practices are followed. Once the CP is confirmed in the EMR system, it activates SNUBH researchers, physicians, and nurses could analyze the CP workflow and provides the next desired steps. data in near-real time by using the tools without assistance SNUBH has built direct communication functionality tools from IT staff. With that, caregivers are empowered to such as telephone, email, cell phone, messenger, video call, take an active role in delivering highest quality care possible. 10 Issue 21 Siemens Healthineers Insights Series · 4. Measure outcomes for continuous improvement How do we know whether these tools are delivering value? activities and it objectively measures and continually To answer that question, SNUBH continuously monitors monitors medical quality of care.10 Through continuous and improves the quality of care by applying four types monitoring, it identifies and avoids predictable and of electronic indicators: clinical indicators, performance preventable outcomes which reduces costs. As an example, indicators, safety indicators, and patient experience SNUBH has been able to reduce the antibiotic cycle for indicators. preoperative patients from 6 days to 1 day, minimizing overprescribing.10 Today, the hospital manages 320 clinical This is enabled by the Clinical Data Warehouse (CDW) indicators (see Table 2) with only six nurses – compared system which includes functions to retrieve unstructured to as many as 100 caregivers in other hospitals of similar medical records such as physician comments in text data, size.11 SNUBH also sets up various task forces to continuously nursing records, prescription data, and sensor and bar collect user feedback and make decisions to upgrade code information from medical devices. The clinical tools, keeping them relevant to caregivers’ daily work and indicators are a collection of indicators related to treatment enabling them to drive better outcomes for patients. 320 6 vs. 100 Clinical indicators Nurses C' Only six nurses are needed to manage 320 clinical indicators (compared to up to 100 caregivers in other similar sized hospitals) Figure 3 Siemens Healthineers Insights Series · Issue 21 11 Conclusion The sheer volume of health care data is growing at an Clearly, the needs of each hospital are unique. Healthcare- astronomical rate. It is estimated that more than focused consulting companies can conduct a more 2,000 exabytes of data were generated in 2020,12 translating in-depth analysis of data integration needs and provide to an equivalent of more than 5 billion Netflix streaming tailored recommendations. One could also consider hours every day. Not only that, the overall rate of data joining a healthcare IT professional community specialized volume is increasing by at least 48% annually.10 This data in data integration topics to get the latest information comes from health records, medical imaging, genomic and share experiences. sequencing, payor records, smartphones, wearables and more.13 Hospitals that want to succeed in offering SNUBH’s early decision to manage data as strategic asset value-based care would need to be ready to successfully and its investment in digital transformation were the integrate data from various sources to harness its power keys to its success in handling the COVID-19 pandemic. to provide optimal care. Its comprehensive approach to data integration overcomes both the cultural and technological barriers by putting The experience of SNUBH highlights the importance of care teams and patients in the center of its development. actively listening to and involving the doctors, nurses, and It shows us that the reality of value-based care is within staff. At the center of value-based care is patient experience reach, and its success is an inspiration for all of us. and satisfaction. Care teams have the in-depth knowledge of what patients need and sidelining them will only undercut the effort. Engaging the whole care team as well as patients to employ the right tools to collect, share, and use data will be key for the value-based care model to live up to its promise. The right digital tools for the care team are the ones that prioritize patient care and experience, and are also flexible to meet their changing needs. One of the trends is to utilize a scalable and flexible cloud-based integration platform that integrates various sources of data. A single vendor but device-neutral platform can foster cross-departmental and cross-institutional interoperability for clinical and operational efficiency. Once the data is integrated, innovative AI-powered software and applications can translate data into actionable insights for caregivers to provide the most optimal care. 12 Issue 21 Siemens Healthineers Insights Series · References 1. Gwang-seok C. [Special] SNU 8. Yoo, S., Hwang, H. and Bungdang Hospital's revenue Jheon, S., 2016. Hospital Suggested follow-up on jumps 11 folds in 15 years information systems: [Internet]. KBR. 2018 [cited experience at the fully 2021Apr14]. Available from: digitized Seoul National siemens-healthineers.com/insights/ koreabiomed.com/news/ University Bundang digitalizing-healthcare articleView.html?idxno=3660 Hospital. Journal of • Thoracic Disease, 8(S8), Siemens Healthineers Insights paper issue 12: 2. Mohw.go.kr. 2021. Ministry This changes everything – The COVID-19 pp.S637–S641. pandemic leads to a significant acceleration of of Health & Welfare: Policies digitalization in healthcare. Challenges & Tasks Ahead. 9. Lim, S., Kang, S., Kim, K., Available at: siemens-healthineers.com/ [online] Available at: Moon, J., Choi, S., Hwang, insights/news/accelerate-digital-health- mohw.go.kr/eng/pl/pl0103. H., Jung, H., Park, K., Ryu, J. transformation.html jsp?PAR_MENU_ and Jang, H., 2015. • ID=1003&MENU_ID=100326 Multifactorial intervention Siemens Healthineers Insights paper issue 16: in diabetes care using Who are the leaders in digital health and what can we learn from them in times of COVID-19? 3. Seoul National University real-time monitoring and Available at: siemens-healthineers.com/ Bundang Hospital: [Internet]. tailored feedback in type 2 insights/news/leaders-in-digital-health Seoul National University diabetes. Acta Diabetologica, Bundang Hospital [cited 53(2), pp.189–198. 2021Apr14]. Available from: i Information: snubh.org/dh/main/index. 10. Yoo, S., Kim, S., Lee, K., do?DP_CD=EN&MENU_ Jeong, C., Youn, S., Park, K., The Siemens Healthineers Insights Series is our ID=001035 Moon, S. and Hwang, H., preeminent thought leadership platform, drawing 2014. Electronically on the knowledge and experience of some of the 4. Doctors Feel Excluded from implemented clinical world’s most respected healthcare leaders and Health Care Value Efforts indicators based on a data innovators. It explores emerging issues and provides [Internet]. Harvard Business warehouse in a tertiary practical solutions to today’s most pressing healthcare Review. 2017 [cited hospital: Its clinical benefit challenges. 2021Apr12]. Available from: and effectiveness. hbr.org/2017/10/doctors- International Journal of All issues of the Insights Series can be found here: feel-excluded-from- Medical Informatics, 83(7), siemens-healthineers.com/insights-series health-care-value-efforts pp.507 5. Diagnostics, Q., 2021. New 11. Microexcelhealthcare.com. Contact: Study Reveals Stalled Progress 2021. [online] Available at: Toward Value-Based Care. microexcelhealthcare. For further information on this topic, [online] Prnewswire.com. com/pdf/Seoul-National- or to contact the authors directly: Available at: prnewswire. University-Case-Study.pdf com/news-releases/new- Dr. Ralph Wiegner study-reveals-stalled- 12. Statista. 2021. Healthcare Global Head of Digitalizing healthcare progress-toward-value- data volume globally 2020 based-care-300681686.html forecast | Statista. [online] [email protected] Available at: statista.com/ 6. Yoo S, Lee KH, Lee HJ, Ha K, statistics/1037970/global- Lim C, Chin HJ, et al. Seoul healthcare-data-volume/ National University Bundang Hospital’s Electronic System 13. Micron.com. 2021. Big Data for Total Care. Healthc Inform Can Revolutionize Health Care. Res. 2012;18(2):145–52. [online] Available at: micron.com/insight/ 7. Park, S., Baek, S., Ahn, S., big-data-can-revolutionize- Lee, K., Hwang, H., Ryu, J., health-care Ahn, S., Chin, H., Na, K., Chae, D. and Kim, S., 2018. Impact of Electronic Acute Kidney Injury (AKI) Alerts With Automated Nephrologist Consultation on Detection and Severity of AKI: A Quality Improvement Study. American Journal of Kidney Diseases, 71(1), pp.9–19. Siemens Healthineers Insights Series · Issue 21 13 Table 1: Examples of Clinical Pathway (CP) implemented in SNUBH Department Clinical Pathways Department Clinical Pathways Orthopedics Simultaneous bilateral TKA OBGY Closure of clean abdominal wound Hip Joint: EM cancer laparo (OP) THRA-BIPOLAR Hysteroscopy Outpatient Surgery Benign Tumor LLETZ Outpatient Surgery POP surgery Shoulder RCT Simple vaginal/vulvar surgery Pediatrics: Benign tumor open surgery CRIF/ORIF/FBR Cesarean Section (emergency) Pediatrics: Hemiepiphysiodesis Normal delivery Pediatrics: Plastic Surgery Cheiloplasty Outpatient Surgery CR pinning Delayed TRAM Hand: Fat graft/fat graft with BRAVA CTR, Outpatient Surgery Tenosynovectomy IBG Neuro Surgery Carotid Artery Stent (CAS) Mass excision (adult) Detachable Coil Embolization (DCE) Nasal bone fracture TFCA-Outpatient Surgery Palatoplasty Trigeminal nerve MVD Palatoplasty (submucous cleft palate, VPI) Gamma Knife Trigenminal Neuralgia Pediatrics Growth hormone test Facial Nerve MVD Newborn: Normal delivery Urology TRUS-Bx Newborn: Ureterolithotomy, Ureteroscopic Cesarean section Table 2: Examples of clinical indicators in SNUBH • Total referral response time • RBC Single Unit transfusion rate • Percentage of patients receiving • ICU readmission rate • Classification of blood transfusion thrombolytic treatment within • PRN prescription order rate reactions 30 min of hospital arrival • Admissions via the emergency room • Co-administration of drugs • Average hospitalization length • Number of discharged patients and blood after isolated CABG surgery returning to ER within 1 week • Post-transfusion vital sign • Length of antibiotic therapy for • Hospital stay statistics by department measurement rate acute upper respiratory infections • Adequacy of recanalization • Ordered blood units return rate • Checking rate of TDM therapy for acute myocardial after storage • Preventive antibiotic administration infarction patients • Inpatient mortality within 48 h rate within 1 h before skin incision • Regular operation start time via ambulatory or emergency • Breastfeeding trial rate within 1 h compliance rate departments after normal delivery • Operation waiting time • Average length of hospital stay • Rate of SaO2 monitoring • Blood return rate • Outpatient reservation rate 14 Issue 21 Siemens Healthineers Insights Series · About the authors Dr. Hee Hwang Chief Information Officer and Professor Seoul National University Bundang Hospital As a professor and the CIO of Seoul National University he contributed to implementing a standard-based nationwide Bundang Hospital (SNUBH), Dr. Hee Hwang has contributed health information exchange system in South Korea. He to both innovations in medical management and developing conducted to adopt In-Memory based analytics platform new business opportunities by converging medicine into the CDW, enabling real-time analytics of over 500 clinical with ICT. SNUBH is recognized globally as a leading digital indicators. He published articles in journals proving the hospital since achieving the HIMSS EMRAM Stage7 in 2010 benefit of utilizing Big Data to improve quality of care and and 2016. As the CIO, he facilitated the development of patient safety. Throughout his career, he was dedicated SNUBH’s next-generation hospital information system (HIS) to connecting the viewpoints between medical staff and in 2013. Beyond improving the hospital’s IT environment, IT professionals, providing intuitive awareness to them. Joanne Grau Dr. Ralph Wiegner Thought Leadership Manager Digitalizing Global Head of Digitalizing Healthcare Healthcare at Siemens Healthineers at Siemens Healthineers Joanne Grau focuses on current trends and thought leader- Ralph Wiegner and his team engage in thought leadership ship content for Digitalizing healthcare. Prior to this role, and portfolio-related activities for Digitalizing healthcare. Joanne has had ten years of marketing experience in Earlier, he worked as head of Improving patient experience, Siemens Healthineers as marketing director for the diagnostics head of Marketing Strategy and in global key account division based in New York and as Head of Marketing for management. Prior to joining Siemens Healthineers, ASEAN countries based in Singapore. Joanne graduated from Ralph worked for several years in the Banking and Asset UCLA with a degree in Molecular, Cell, and Developmental Management practice of McKinsey & Company on various biology. Before joining Siemens Healthineers, Joanne was a European and international assignments. Ralph holds a research scientist in Quest Diagnostics (formerly Celera) and Ph.D. in Theoretical Physics from University of Erlangen, has authored multiple publications. Joanne is also currently Germany, with several research engagements at the a faculty member in Union University of California. Oklahoma State University, USA. Siemens Healthineers Insights Series · Issue 21 15 At Siemens Healthineers, our purpose is to enable healthcare providers to increase value by empowering them on their journey towards expanding precision medicine, transforming care delivery, and improving patient experience, all enabled by digitalizing healthcare. An estimated five million patients worldwide everyday benefit from our innovative technologies and services in the areas of diagnostic and therapeutic imaging, laboratory diagnostics and molecular medicine as well as digital health and enterprise services. We are a leading medical technology company with over 120 years of experience and 18,500 patents globally. With about 50,000 dedicated colleagues in over 70 countries, we will continue to innovate and shape the future of healthcare. Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Phone: +49 9131 84-0 siemens-healthineers.com Published by Siemens Healthcare GmbH · Order No. HOOD05162003190258 · Printed in Germany · 10522 0421 · ©Siemens Healthcare GmbH, 2021