The Health Care Factory

Introduction

In the computing and automation age, the hospital organization still remains bureaucratic and paper-based. Certainly, many sectors, such as the operating-theater, have made formidable progress, but such progress is isolated. Many organizations still use paper documents to store the patient record and to analyze reports. This approach does not help hospitals to become more efficient, rather it hinders information sharing among units by introducing useless steps for document format conversions and interpretations. This problem has become more evident with the modern tendency for patient dehospitalization; in fact, paper archives are impractical when the patient and the monitoring devices are outside the hospital.

In the past, medicine was hospital oriented, nowadays, it focuses on dehospitalization¹. Hospitals integrate human and instrumental resources that ensure high QoS. Hospitalization has three main drawbacks:

• 1.

  The high cost of, often long, confinement in bed due, above all, to the cost of nursing and furnishing;

• 2.

  The cost of nurses’ and technical staffs’ inactivity; and

• 3.

  The psychological difficulty that affects the hospitalized patient.

With the new hospital tendency to reduce the length of stay, health structures need monitoring systems for dehospitalized patients (Grimson, Grimson, & Hasselbring, 2000).

Moreover, hospital services can be improved with the introduction of new technologies to improve the quality of dehospitalization and to reduce the recovery time.

Today we witness to the development of new generations of testing devices. They can be deployed remotely and applied in several fields of the care giving process: health monitoring, support to prevention, performing early diagnosis, disease management, treatment and home rehabilitation. The combined use of the most recent developments in micro and nanotechnology, in the information processing and wireless communications will soon offer possibilities for smart miniaturization and non-invasive biomedical measurement as well as for wearable sensing, processing and communication.

Electronic data management and remote control technologies facilitate the implementation of Point-Of-Care (POC) tests. Rapid testing is needed in critical care units, clinics and physicians’ offices. Recent studies (Felder, 1996) have proved that patient management is more efficient and effective when laboratory testing is done at the time of diagnosis. However, significant technological advances are necessary before POC testing can be implemented effortlessly and affordable on a wide scale.

Future technologies will be aimed at enabling the patient to take a more active role in their own care. A patient will be able to view, interpret, and add important information to his own medical record through web-based tools. The patient will take ownership of his medical data, granting or rescinding the access rights to care-givers or other agencies.

Therefore, instruments must be simplified, their maintenance minimized to assert user friendliness without training. Moreover, they should be more tightly coupled with existing automated infrastructure. Modern devices will force the evolution of the IT used in the healthcare systems.

In future scenarios, analysis systems will be worn by patients (wearable devices); so that, the new hospital will become de facto ubiquitous, that is, it will be able to supply services and co-ordinate work on a territory larger than its physical dimensions.

Hospital automation (like factory automation) may suggest the idea of a system completely managed by machines and robots in which doctors and nurses loose the control of the performed activities. Our vision is to automating all the low level and ordinary activities (mainly data acquisition storage and presentation), while giving back to doctors and nurses a complete vision and control over all the care giving processes in a modern hospital and remote centers, a task difficult to realize without the modern technology.

In this paper, we describe our idea of how the current healthcare IT process should evolve to become more effective (e.g., by improving its Quality of Service [QoS] and reducing costs and resource wasting), to take advantage of novel technological advances and to fulfill the patient requirements.