After Attending the Hospital Informatics Project Review Meeting, I Felt 'The Winds Have Changed'

Recently, the hospital held its annual symposium for the evaluation of information technology projects. This was a closed-door meeting primarily attended by the hospital’s decision-making leadership, and I was not originally on the attendee list. However, by chance, I had the privilege of auditing the entire session as an observer, from which I gained substantial insights. Following the meeting, I compiled my extensive notes into this article to share with you. I look forward to clarifying these perspectives through exchange and dialogue, thereby guiding my continued professional practice.

Time: Early February 2019

Location: Hospital Academic Hall

Attendees: Hospital executives in charge of informatization, directors (or their representatives) of clinical and medical technology departments, directors of the Equipment Department and the Information Department, external experts, etc.

Topic: Feasibility Study for the Hospital's Annual Information Technology Project Construction

Annual IT Project Feasibility Review Meeting is typically held at the beginning or end of the year. As the “premier meeting” for planning annual IT initiatives, this session primarily serves two key purposes:

First, set the direction. Direction is crucial. Although all roads lead to Rome, it is essential to align with trends and your own positioning to identify a more cost-effective and sustainable path.

Second, prune the branches. Information technology initiatives are complex and multifaceted. Given limited human, material, and financial resources, each department has its own considerations; it is essential to prioritize tasks, reach consensus, and exercise prudent financial management to ensure funds are allocated where they yield the greatest impact.

According to incomplete statistics, leaders or representatives from nearly 30 departments across the hospital attended the meeting. Each department presented its requirements for information technology development and briefly addressed key questions such as “why implement it,” “what are the benefits,” and “what is the rationale.”

Following the departmental presentations, the attending experts and hospital leadership optimized and adjusted the project by eliminating redundancies, merging overlapping components, and integrating related elements, ultimately formulating an annual IT construction plan with strong feasibility and high cost-effectiveness.

As the saying goes, “Those involved are often confused, while onlookers see clearly.” From a product perspective, this is an excellent exchange session on healthcare IT products. The attendees comprise both hospital decision-makers and frequent, advanced users of these products. Long-standing product questions—such as “What do users think?”, “How to identify needs?”, and “How to judge trends?”—will all be addressed during this conference.

Based on past experience, departments’ demands for informatization have primarily focused on addressing pain points in specific processes. Issues could generally be resolved through “minimally invasive” measures such as upgrading existing software, applying patches, or installing plugins. This year, however, marks a shift: an increasing number of departments are requesting comprehensive system solutions that cover entire business workflows, building upon the existing informatization infrastructure.

For instance, the Equipment Department has pointed out that the existing equipment and consumables management system, which has been in use with patchwork fixes for five to six years, remains functional but offers limited room for optimization and enhancement due to constraints in software architecture and top-level design. The traditional warehouse management model and its supporting software can no longer meet the managerial demands driven by the hospital’s business growth. In particular, the surge in inbound and outbound volumes of high-value consumables has outpaced management capabilities, leading to persistent issues such as losses, leaks, and waste. Therefore, there is an urgent need for a new equipment and consumables management system with a focus on high-value consumables management.

A typical case in the Emergency Department (ED) illustrates this point: despite the widespread adoption of health information technology in hospitals today, ED informatics remains in an awkward and neglected position. It would be inaccurate to claim that the ED lacks informatization altogether; in recent years, amid the wave of digital transformation, ED informatics has gained some traction. However, the overall level of development in ED informatics is still mismatched with the core emergency care objective of “saving lives and treating patients in the shortest possible time with the highest efficiency.” Therefore, leveraging the hospital’s upcoming integration into the province-wide public security system’s green channel for emergency care, the Director of the Emergency Department reiterated the call at the meeting to implement a comprehensive, end-to-end ED informatics system covering all processes and elements.

These are merely two representative cases. Judging from the reports submitted by department heads, the volume, scale, and operational complexity of many information systems are in no way inferior to those of traditional Hospital Information Systems (HIS). The era of HIS dominance and the “equal distribution” model have come to an end. Specialized informatics is accelerating its development and expansion, with comprehensive solutions encompassing entire clinical workflows gaining increasing preference.

When a hospital reaches a certain scale in terms of size and clinical capabilities, health information technology is no longer a discretionary “nice-to-have” add-on, but an urgent and critical necessity. The director of the Ultrasound Department presented his requirements in a straightforward manner, beginning by displaying two photographs capturing the overwhelming patient queues at the department’s entrance (as shown in the figure below). He emphasized that the department urgently needs a time-slot appointment scheduling system to address the current passive situation characterized by widespread patient dissatisfaction and immense operational pressure on the department.

The remarks made by the Director of the Ultrasound Department resonated with the heads of the CT and MRI departments, among others. They unanimously expressed that, with outpatient volumes continuing to climb, time-slot appointment scheduling is an essential measure for maintaining orderly clinical operations. Through collective efforts and joint advocacy across various departments, a hospital-wide time-slot appointment system for medical technology examinations is now on the verge of implementation.

There were many similar cases at this conference, which will not be elaborated further. Digitalization is no longer merely a backdrop or promotional facade for hospital development; it has become a load-bearing wall.

Based on past experience, hospital information systems are typically maintained by the IT department and used by clinical departments. However, during this meeting, I observed that many departments proposed cultivating their own IT specialists and establishing dedicated data centers to achieve the goal of “housing server rooms within departments and keeping data under their direct control.”

Setting aside for a moment whether this goal is realistic or feasible, the very proposition itself represents an evolution. Over the past year, the most prevalent assertion I have heard is that “data is an asset.” I believe hospital departments have adopted this perspective; they are no longer content with merely storing their valuable data assets in the “bank” represented by the Information Technology Department. Instead, they are beginning to learn how to “manage their wealth,” seeking to acquire more data and expecting to extract greater value from it.

Improving user literacy is certainly a positive development, signaling a more vibrant and sophisticated ecosystem for hospital informatization. On the other hand, the urgent need for data governance is compelling IT departments to proactively enhance their capabilities. In the future, hospital CIOs must possess a proficient understanding of algorithms and data, with their roles gradually transitioning toward that of Chief Data Officers (CDOs), becoming professionals with strong analytical competencies.

In healthcare settings, there are numerous moving people and objects, such as medical staff, patients, medications, and medical devices. Ensuring that these entities remain continuously connected throughout complex clinical workflows is a prerequisite for identification, localization, tracking, and monitoring. Internet of Things (IoT) technology offers distinct advantages in the real-time, precise sensing of mobile individuals.

As IoT technology and its industrial chain mature, IoT applications have gradually permeated the highly complex healthcare sector. IoT-enabled solutions have also emerged as a highlight of this conference. Terms such as electronic tags and sensors have appeared in presentation proposals from many departments.

For example, the Nursing Department pointed out that traditional inpatient or outpatient infusion therapies rely on manual observation and intervention, which is not only time-consuming and labor-intensive but also prone to safety hazards. For certain special medications requiring precise control of infusion rates, drip rates can only be regulated through visual estimation, leading to potential errors. Meanwhile, the Hematology Department and the Medical Laboratory Department highlighted that blood products and biochemical reagents have stringent requirements for temperature and humidity in their storage environments. The environmental monitoring systems integrated into existing cold storage units are mostly standalone systems configured many years ago, falling far short of departmental requirements in terms of interactivity and connectivity.

Companionship is the most enduring declaration of love; online presence is the most reliable approach to management. The proactive adoption of the Internet of Things (IoT) enables hospitals to transition from offline to online operations and from ambiguity to precision across numerous business processes, thereby enhancing overall service efficiency, reducing medical errors, controlling healthcare costs, and improving the patient experience.

Stepping out of the venue, my strongest impression was that “the landscape has shifted.” The new product ecosystem, emerging development trends, and evolving user needs showcased at this conference all surpassed my existing understanding, leaving me with an urgent need to bridge my knowledge gaps. My focus for catching up will be on the following two areas:

First, make additions: increase attention to clinical operations. Focus more on clinical operations by visiting departments frequently, observing closely, and gaining firsthand experience, thereby mastering the most authentic workflows and the most accurate operational requirements to avoid deviation;

Second, simplify: User needs are not always reasonable; they require guidance during implementation to prevent deviation. The prerequisite remains a thorough understanding and mastery of the business.

At the meeting, the Department of Laboratory Medicine proposed purchasing a laboratory document management system to establish a laboratory compliant with ISO management standards. After the department’s presentation, the Information Technology Department suggested that the existing document plugin within the hospital’s office automation system could be slightly modified to meet the document management needs of the Department of Laboratory Medicine. Ultimately, a consensus was reached to proceed as recommended by the Information Technology Department. (The Information Technology Department finally stood its ground.)