Aviation, military, NASA, or even utilities like the New York Power Authority—almost all high-consequence, complex organizations have one thing in common: a command center. The concept of a command center or a ‘war room,’ or ‘air traffic control’ has been around for a while. Command centers help counter logistical challenges, enable cross-collaboration and guide decision-making with state-of-the-art technology and communications. With them it seems there is absolutely nothing that cannot be accomplished—and now it’s time for command centers in healthcare.
The evolution of command centers
One of the earliest command centers I can think of is the War Room at Stevns Fortress, used in Denmark during the Cold War. However, it hardly had the sophistication we realize today. When we think of a command center, we think of NASA or Air Traffic Control, that has a multitude of applications, and acts as a hub of information to support direction and strategy.
Conceptually, a command center is a gathering place and resource for leadership decision-making and guidance to ensure that operations and order are maintained. We can see some examples of command centers in present-day hospitals in the form of an incident-response system, which is activated in case of emergencies or security systems, that perform surveillance and raise alarms. There are also dashboards that display information to support patient flow, bed management and acquity scores. Often, these are manual processes.
While integral processes, the teams managing them are still disconnected. This is where the value of a command center powered by cloud computing makes sense for the health system environment. Healthcare is fraught with disparate systems and silos of information in numerous locations. A healthcare command center can relay information coming from all a wide array of different systems across a health system’s enterprise. Most importantly, it can not only inform with critical data on a dashboard, it can also support what information is needed to make sure that care is coordinated between different teams and locations.
Why do health systems need command centers?
It’s been almost a year since COVID-19 disrupted the world and only now can we start to see an end on the horizon. Because of the pandemic, hospitals and health systems across the country face a new normal of maximum occupancy, resulting in exhausting staff and supply inventories that challenge every routine process. The cases of COVID-19 and the continuing complications created by the disease will require more real-time information and tighter coordination of activity across the enterprise. This helps to make the case for a healthcare command center powered by a cloud platform.
In reality, these challenges don’t stem from COVID-19 alone—they were there before the pandemic struck. There has been little investment in managing patient flow and resources. Added to this is the lack of real-time information among different nodes of healthcare. As a result, what we have are unchecked levels of resource utilization, staff fatigue and roadblocks to efficient, accessible and safe patient care.
We recently partnered with a progressive health system to build such a cloud-based command center during this pandemic. The organization wanted to be able to assign the appropriate care management pathways for their patient populations across the enterprise, especially during the pandemic. They were challenged by disparate systems that made it nearly impossible to implement a cohesive care management program. We helped them implement a dashboard that provides 360-degree visibility into their COVID-19 operations, enabling them to monitor and predict inventory and resources, including crucial resources such as bed capacity, PPE supplies, staffing, ventilators, and oxygen supplies. It also tracks compliance to CDC reporting and pre-procedural testing in real-time at each facility and at the organizational level.
Command centers with or without a pandemic
As I reflect on the use case for the COVID-19 Command Center, I realize that most healthcare organizations need this type of solution even if there wasn’t a pandemic. Every year, millions of patients end up forgoing care or keep waiting because resources have not been scheduled, and they are rarely available when they are needed the most. Clinicians as well as administrators need to be able to see the bottlenecks in their operations. A command center can present critical information about increased waiting time for patients or congestion in the network at the point of care.
As we continue to strain our healthcare system in the face of more chronic disease and a burgeoning aging population, managing the challenges of increasing patient wait times, inefficient utilization of resources and staff fatigue is only going to become more difficult. Healthcare organizations need to evolve beyond the silos of clinical systems— the cloud-based command center concept is integral to this evolution. We need to integrate our processes and utilize the wealth of data we are sitting on to anticipate, identify and resolve bottlenecks and fulfill the care requirements for those in need. As we head towards a post-pandemic world, unified, real-time information needs to be virtual and decentralized so that it can be available to care teams across the enterprise.
The foundation of modern command centers
The technology to power healthcare command centers is available now, albeit the use of the cloud to do this remains somewhat novel. The foundation of an effective command center lies in incorporating all operations onto a single cloud platform with all patient experience-defining functions available in one place.
The power of the cloud platform is the integration of existing patient and healthcare network information that can be organized to maintain real-time information exchange among different care teams. One of the biggest challenges, however, is to handle the growing amount of data from multiple departments to power the command center. The command center at a healthcare organization will ingest numerous kinds of data—historic and real-time, clinical and social, financial and operational—and the amount of storage will grow continuously.
Historically, hospitals have kept their data on-premise, which makes access to data in real-time difficult and increases the cost of data management. Through isolated data, healthcare organizations can only have insights into a specific department or a hospital. Even if they built separate command centers and each command center presents its information in real-time, there seldom would be any interaction among them. A command center in the ED will probably never know of diminishing PPE supplies in real-time. As long as data remains isolated, powering a command center that can transform healthcare operations will remain a dream.
The command center in the cloud
The foundation of this ‘smart command center’ will require a cloud platform that can grow as the amount of healthcare data grows. The platform should be able to ingest and present a holistic, 360-degree view of the healthcare network—a view of everything that can impact care delivery. This command center can then power the sprawling healthcare operations and make sure they run efficiently.
Through this ‘health cloud,’ healthcare organizations can have a bird’s eye view of everything in their network and can take actionable steps. From connecting with patients on the go to delivering point-of-care information to physicians, a lot can be achieved if fragmented healthcare information is brought together on a cloud-based platform. When all the different arms of an organization are centralized—care management, patient engagement, resource utilization—healthcare staff can quickly access information that empowers them to improve the quality and efficiency of care delivery on a truly smart command center.
Backed by a comprehensive health cloud, a smart command center can enable healthcare organizations to quickly anticipate the needs of clinical teams, allowing them to provide the proper tools and resources when and where they are needed most. Additionally, the use of predictive analytics and artificial intelligence can enhance the hospital command center with real-time insights that empower healthcare leaders to make critical decisions across their enterprise.
The idea of a healthcare command center may not be a new one, but how it is implemented can make all the difference. The old ideas of command centers put an image of people huddled around screens in a single room in our minds. However, to achieve high-quality healthcare delivery, we need something substantial that is available to anyone, anywhere, anytime from any location and on any device. A command center powered by the health cloud can help organizations deliver and use accessible information to help them chart their course intelligently.
About David K. Nace, M.D
David K. Nace, M.D. is Chief Medical Officer of Innovaccer. In this role, Dr. Nace helps the company boost its efforts to drive healthcare efficiency by unleashing the power of data. Having served in several key positions at multiple organizations, Dr. Nace comes onboard with over 3 decades of experience in senior management. In the past, Dr. Nace has served as the VP of Population Health at McKesson Corporation, the Chairman of the Board at Patient-Centered Primary Care Collaborative, SVP at the UnitedHealth Group, and VP & Chief Medical Officer at Aetna.
Dr. Nace has been associated with Innovaccer since 2017 when he joined the company as an Executive Advisor. Dr. Nace has been a board member for the Integrated Healthcare Association, a statewide multi-stakeholder leadership group that promotes quality improvement, accountability and affordability of healthcare in California; and the Care Continuum Alliance, based out of Washington, DC. He also served as an adviser to the American Medical Association, National Business Group on Health, World Health Organization, and the International Labor Organization on issues ranging from health promotion and wellness to employer policy and health care financing issues. Dr. Nace earned his medical degree from the University of Pittsburgh.