Written and presented for the European Healthcare Design Conference, 9-10 June 2025, London

1. The Problem of High-Tech Silos

The task set before us – to modernise hospitals, making them faster, better, more cost-effective – is staggeringly complex. That an event like EHD exists is proof that the industry is aware of the scale of the challenge, and aware that there are solutions close at hand. Those of us on the technology side of the medical industry are convinced we have a role to play in this transformation.

For many years at health IT conferences, the buzzword was interoperability. It was printed in large font on trade show booths, it featured prominently in the programme session titles. It was something, in fact, that everyone agreed needed to happen. Yet there was no blueprint or even a shared roadmap for how it might proceed. 

What in fact happened was hospitals broke the impasse. They selected technologies that solved some of their largest pain points. They took risks. They moved interoperability from a theoretical discussion of what might be to a requirement for all technology vendors.

Today’s buzzword is transformation. Similar to interoperability, all agree it’s needed but there is no clear path forward. The digital transformation of workflows is one such path. 

It would be tempting to wait until the best vendor is anointed for each of the 30-50 most important systems in a modern hospital, but there will never be consensus and central planning is not well equipped to make decisions for all hospitals. In the US, the joke goes “if you’ve seen one American hospital, you’ve seen one American hospital.” That is to say, one size does not fit all; technology vendors must be, above all, adaptable.

Hospital workflows

What does workflow mean, in this context? In the broadest sense, a workflow is a sequence of actions carried out to obtain a certain result. Scanning patient ID bracelets before administering medication, the steps to admit an ER patient, to handoff nursing coverage from shift to shift, to discharge a patient and ready their room for another. It’s any repeated process that is followed as part of the day-to-day activities of a healthcare provider.

There are thousands of workflows in a modern healthcare system, and vendors muddy the waters when promising “optimised workflows” too broadly. In reality, each vendor may only address those areas within its purview. Population health, for example, has a specific area it can reasonably hope to target, likewise virtual care, or revenue cycle management.

Care Communications

The scope of this discussion is in-hospital communications. Staff to staff, staff to patient, and situational awareness, which is the right data in the right context. Within that sphere, the system which stands squarely at the intersection of multiple key data systems is nurse call. 

Until recently, nurse call was a simple button to summon help in the event of patient distress, no better than a fire alarm. But with the advent of IP technology, nurse call evolved from simple building system to IT data system. We vendors tend to use the phrase healthcare
communications platform as the system capabilities have gone well beyond buttons and lights. Because nurse call touches other clinical data systems, it is in a unique position to leverage communication workflows. Nurse call has come a long way from a “call bell” system.

Nurse call vendors saw the potential in exploiting digital screens’ limitless display capabilities and added software buttons to contact ancillary team members. “Don’t ask overworked nurses to locate the housekeeping team,” was – and still is – the marketing message. Just place a button on the interface that will summon housekeeping, wherever they happen to be. Workflow, as a function of a nurse call system, was simply more efficient communication.

Today, it’s communications plus situational awareness. Care communications platforms now bring context-dependent information to touchscreens and other displays.

Digitising workflows is not rocket science or, more aptly, brain surgery. We’re talking about using technology to do the work of raising calls and alerts, communicating with all relevant departments, making data visible that was previously hidden inside another vendor’s application.

Importantly, it’s also not a big bang – we’re not proposing an enormous shift in processes, but sustainable, incremental gains, that can adapt with the future needs of the hospital. We’re talking about shaving seconds off a task that staff perform many times in a day. Those seconds add up to minutes a day, hours per month, and entire days worth of nurse hours per year. Digitisation of workflows is about working smarter.

The reality within hospitals

Today, communication workflows are still done with paper signs and manual phone calls. They’re not being measured to gauge their effectiveness. The data that care staff need exist somewhere, but it’s not available at the exact time and in the exact location that will most benefit them. We’re asking nurses, a precious resource, to perform many tasks that have nothing to do with nursing.

Nurses might have 20 systems they are expected to use; silos are a significant source of burnout. Staff can’t be expected to remember that patient allergy information is on the 4th screen of the EHR desktop application, or the phone extension of the Porter team, or to walk out of their way to the nurse’s station to look at a dashboard to find out the patient’s doctor or discharge date.

Digital transformation of communication workflows is frustratingly slow. What more can be done? What new technologies and integrations are available that make processes more efficient? How can we take pressure off staff? 

It starts with good planning.

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