The Digital Hospital Design group (Health Informatics Society of Australia) held an expanded roundtable discussion as part of the HIC 2016 conference.  The focus of the discussion was around three large hospital innovation projects in Australia and the common lessons that could be learned on the drivers of innovation with these facilities.

The three projects selected were:

• The construction of the Box Hill Hospital, a new 600 bed facility in Melbourne
• The construction of the Bendigo Hospital, a new 400 bed regional Victorian facility
• The EMR roll out at Princes Alexandra Hospital in Queensland, an existing 1000 bed facility in Brisbane.

Each of these sites represented very different environments for innovation.  There were 7 lessons distilled from the discussions:

• The importance of a transformational mindset
• Thinking in terms of a clinical change and not an ICT project
• Patient safety needs to take primacy
• Simulation of workflows de-risk "go live"
• Clear benefits need to underpin a successful business case
• You must get the underlying infrastructure right
• Creative communications are important in getting through to the clinicians

From these discussions there were three issues that emerged as prerequisites for success

1. Major investments in and a sophisticated approach to change management are critical. Clinical leadership, not just clinical buy-in, is a prerequisite for success particularly in large scale implementations
2. Benefits need to be clearly understood if they are to be realized. While there will generally be unintended consequences a clear view of intended benefits needs to be established early so that the realisation can be planned for
3. The underlying infrastructure needs to be robust and scalable. Gaps in the infrastructure platform are a common source of failure for initial implementations.

The issue of how to drive innovation in our healthcare system is critical for its future sustainability.  These discussions further emphasized the importance of the two balancing forces of innovation, technology and the people who are enabled by the technology.  Getting engagement, educating and enthusing the hospital staff is a critical element of what needs to be a planned and explicit innovation process.

Further details on the discussion can be found in the paper "HIC Digital Hospital Design and Implementation:Good Innovation Practice in Australian Healthcare".