S10 EP2: Ben Woenig, Innovation and Technology

Benjamin is a world leader in the world of Health Technology.

If you would like to learn more about the AHDC, please connect with us on our website www.aushdc.org.au or on LinkedIn at linkedin.com/company/aushdc.

Transcript

[00:00:16] David Cummins: G'day and welcome to the AHDC podcast series, Health Design on the Go. I'm your host David Cummins, and today we speaking to Ben Woenig, who is the CEO, Founder and Principal Technology Architect of Visione Group based in Adelaide, South Australia. 

[00:00:30] Ben is a global speaker and world leader in the world of adapting operational technology, software, and converging hospital facility architecture with technology architecture to help improve technology outcomes with respect to facility layouts, clinical processes and operational management.

[00:00:47] We welcome Ben to hear more about the world of it and its future. 

[00:00:50] Welcome Ben. Thank you for your time to be here. 

[00:00:52] Ben Woenig: Thank you very much for having me. 

[00:00:54] David Cummins: For those of you that don't know, you've just done a world trip where you've been lecturing around the world, especially in London at the European Health Design Council. how did that go and what did you talk about? 

[00:01:03] Ben Woenig: it was a fantastic opportunity that, came my way, basically as a result of my participation in the 2022 Australian Healthcare Design, Conference in Melbourne. 

[00:01:14] Basically there was an interest, with respect to technology architecture from that initial talk, Building Layout Design, I participated with three other people from Australia, around clinical process design and the building architecture design and the nuances of how technology architecture needs to be considered when we are considering, clinical processes and the building layout. 

[00:01:35] David Cummins: So for those listening that don't really understand all those words, because I only understood every second word there... In reference to technology architecture, you were talking about how technology works and how it interacts with a hospital and based on the architecture of the technology and how it's integrated, correct?

[00:01:52] Ben Woenig: That's correct, but it actually goes further than that. The responsibility of a technology architect for which there are multiple domains and names... you may hear terms such as an enterprise architect, data architect, business architect, solution architect... there's a whole string of technology. 

[00:02:07] I've myself, have worn most of those hats, when working in this profession but when we take into account, the design of a hospital facility, it's important to understand the clinical processes and how the users interact with the systems and data that they're responsible for, with respect to the patient care and the outcomes associated with good patient care.

[00:02:30] That needs to be factored in with the building layout design and I'm a advocate for the early adaption of information technology considerations in any building design as opposed to leaving it till the last minute, which is often what happens. 

[00:02:47] David Cummins: Yeah, I think we've all been on enough projects where people have not prioritised or respected enough the importance of technology, especially when it does come to models of care.

[00:02:55] And I'll always prioritise technology as one of their first talking points, but it's very obvious that a lot of facilities, they leave IT to the very end and then it's up to the phenomenal efforts of IT to try and come up with solutions, based on something that they didn't set up. 

[00:03:09] So how important is it to have that conversation at the start. And what are the benefits of that? 

[00:03:14] Ben Woenig: It's absolutely critical to have that conversation at the start because the worst case scenario is that a building can be realised and its layout is fixed. It's very difficult to change, clinical processes in alignment to the building layout.

[00:03:29] Nothing is impossible, hospitals are very expensive projects and having to rework a building to facilitate or accommodate clinical processes where technology considerations weren't designed usually means that something is compromised. 

[00:03:42] By doing this work upfront, we mitigate that risk of shortfalls, that the business may not realise until they've moved in and start operating within the facility. 

[00:03:51] We can leverage a number of techniques and tool sets and frameworks to help us model and understand how clinical business is going operate facility and how that aligns to the application services by medical devices and the facility services and systems to make all of that work harmoniously. 

[00:04:10] David Cummins: I think you only need to be on a project where it's been forgotten once and then you make sure it is a number one priority. But you were mentioning earlier that you've spoken to a few people around the world, especially the European Health Design Council, but it seems to be a global common theme that people talk about IT infrastructure too late.

[00:04:30] Why do you think people forget about this important architecture so late in the point. Why is there a global, consensus where people just don't prioritise it? 

[00:04:39] Ben Woenig: I think that there's probably a PhD thesis into that question alone but in my view, I think it comes down to basically cultural silos also, hospitals are incredibly busy places and clinicians are often rushed off their feet and not easily accessible through a design engagement process. 

[00:04:59] So this is where assumptionsare made and the right access to the right people may be limited or not possible at all and then the correct requirements information is not collected/collated. 

[00:05:10] And the way to mitigate that is to have earlier adaptation, communication, change control, change management and all those facets of how we apply technological change but to engage with the business early and engage with all the people involved. 

[00:05:26] So from a design construction and solution realisation perspective, from a technology perspective and also biomedical systems perspective. 

So really the best mitigation is early engagement and have the right change people to take people through the journeys, through the process.

[00:05:42] As a technology architecture is realised in alignment with the building services and the clinical processes that will be deployed within them. 

[00:05:49] David Cummins: The funny thing about technology is that realistically, the life expectancy of technologies these days is only, what, two to five years, if anything... but most of our projects, especially the bigger ones, when you start doing the design phase, by the time the design phase is finished, and certainly by the time the building's built and then handed over. 

[00:06:08] Most of that technology would already be considered out of date. So how do you account for the long lead times in planning, in design, in build, with an ever changing technology?

[00:06:20] Ben Woenig: A key principle in technology architecture is to leave the procurement decision as late as possible in the process and in a long project, I myself, I worked nearly three years on a major hospital project, which was the Royal Adelaide Hospital, that project was more than 10 years, and there were lifecycle challenges within that timeframe and that that is known and understood.

[00:06:44] But the best way we can mitigate that, is to make the procurement selections as late as possible. The last thing you want to do is choose a product, deploy it, and then find by the opening date it's already to be decommissioned and replaced. 

[00:06:58] It is inevitable that that may happen still, but the best thing we can do is mitigate that as much as possible.

[00:07:04] David Cummins: Yeah, it's a really interesting point, and especially when it comes down to operations and maintenance for that technology where some situations, they might actually be out of warranty by the time they're almost commissioned. Would that be a fair comment? 

[00:07:16] Ben Woenig: Yeah. That often is the case and in some instances there's even new technologies that arise halfway through a project that didn't even exist during the inception of the design brief. That's a very real example of where that has happened. 

[00:07:31] The project must accommodate a certain level of budget in its contingency to mitigate that risk and ultimately the business can make a decision. Do they want to adapt the new technology for potentially better healthcare outcomes or will they sweat it out for some sort of duration to ultimately move on from it?

[00:07:50] At the end of the day, all technology has a lifecycle management, and again, during the design process, we can accommodate the lifecycle management. It's understood and it's not a surprise at the end of the project or during go live. So if as long as we understand those life cycles and they're communicated to the right stakeholders and this budget allocated, we can mitigate that as much as possible.

[00:08:13] But, unfortunately, I don't think it is impossible to eliminate due to the length of the projects often take, especially for complex, large hospitals. 

[00:08:20] David Cummins: What advice do you have for retrofitting of hospitals? A lot of people talk about these new Greenfield hospitals and like, Royal Adelaide certainly was a Greenfield hospital, but not every hospital is a Greenfield hospital.

[00:08:31] A lot of hospitals are Brownfield with extensions or with refurbishments, with technology that is probably decades old. So what's your advice to how to deal with such old infrastructure and new technology and the importance of connecting old and the new? 

[00:08:48] Ben Woenig: That's a multi-varied question. 

[00:08:49] Again, early engagement and what I would advise is for a technology architect assigned on a project, working with the builder, working with the clinicians, working with the building architect, is to engage early with the information technology department responsible for the facility. 

[00:09:08] And not only that, also the biomedical engineering department, if such a department exists, so that way the team can understand the frameworks and the reference architectures and data architectures and all the controls and the guardrails, so to speak, of how the business operates.

[00:09:26] So that way we can build up a picture of what needs to be acquired and to work with the existing technology as much as possible. We can build a picture upfront and not just bring a new surprise where the team is just suddenly expected to react and make that work at the last minute. 

[00:09:43] And then we also understand the change process of the business by that early engagement. With respect to legacy infrastructure, yes, absolutely, a hundred percent typical for any, any Brownfields or refit out. 

Again, everything needs to be considered within its lifecycle, and if there's network switching infrastructure or various systems and applications, we have to go through them methodically, work out what the requirements are with respect to the new fit out, and then just make the client aware of the risks and options that they have with respect to each of those capabilities.

[00:10:18] And it's a collaborative conversation. We work through what they wish to prioritise, what they wish to deprioritise and for a later project, and then what will be ultimately realised when the facility is handed over to the business.

[00:10:33] David Cummins: With that aging infrastructure in an existing building when trying to connect with a new building, that would actually cause a lot of problems, would it, with the technology trying to talk to each other, especially when you're talking about telemetry or wifi or, any form of communications, whether it be, telephones or medical devices, correct? 

[00:10:51] Ben Woenig: One way of mitigating that is looking at the wider business and the facility and potentially aligning the changes with the new facility, with the lifecycles be in place for the existing technology, so for example, if the core computer network infrastructure is due to be refreshed after say seven years, what my recommendation would be is to align the refresh of the existing building with the deployment of the new infrastructure in the new facility or the new fit out area, or the new built extension or whatever it is,

[00:11:21] And you would do your best to try and align it so that when you're doing the refresh, you avoid a mismatch of technologies between the various departments. 

[00:11:28] But in saying that, if that's not possible, then we just do our best to align the technologies as close as possible, by leveraging the same vendors and similar technology within the vendor's product range, so that we can mitigate the challenges. 

[00:11:43] The last thing you want is to have a mixed vendor environment for the same, for example, networking infrastructure. 

[00:11:49] It increases support, complexity. you have multiple contracts, so commercially it's more complicated, contractually it's more complicated.

[00:11:56] As a technology architect, they were ultimately responsible for trying to leave a simple, environment, not just the technology itself, but commercially and contractually as simple as possible for the client as well. 

[00:12:07] David Cummins: In the introduction we talked about the importance of strong and earlier engagement with IT and how it can help with the clinical outcomes for not only patients and staff, and I'm racking my brain to try and think of a area in a hospital that does not rely on IT in some capacity, whether it's from a BMS or a blood fridge, whether it's from wifi, whether it's technology, CT machines, medical imaging theatres, it's pretty hard to think of areas that are not reliant on IT these days.

[00:12:40] It seems like every part of a hospital does need some form of technology, so how difficult is it to try and understand the use of a patient and a staff member in that journey when it comes to models of care? 

[00:12:52] Ben Woenig: Again, that's a multi-dimensional question. If I come back to the technology itself. A patient's journey can often mean the difference between life and death, with respect to having the right information at the right place, at the right time for somebody to make a clinical decision. 

[00:13:07] So from a technology perspective, we will offer an engineer very high levels of availability and robustness, particularly with the core systems, and to take that as far as possible so that we can mitigate failures and outages and ensuring the systems are online supported, and available so that clinical staff have access to the right information at the right time, and not to hinder the ability to provide clinical care. 

[00:13:34] It should be an enabler and a facilitator, and to accelerate their ability to provide care as appropriate. And that is incredibly challenging due to the large numbers of application services that clinicians are often responsible for accessing on, workstations and laptops. 

[00:13:52] But not only that, the biomedical systems, they need to be highly available as well and even the technology architecture will, will work with the engineering and the facility systems to ensure that the power services and things like that have the appropriate availability and uptime to ensure the information technology and all the operational building services such as the BMS and environmental management systems and even lighting and things like that are absolutely critical to the operation of the facility.

[00:14:18] And technology architects really need to be across everything because nearly every single device with a power connection has got a network port on it.

[00:14:28] David Cummins: Yeah, you're a hundred percent right, and as technology enhances and we change our models of care to be more online, what do you think the future holds for not only in healthcare within the hospital itself, but outside of the hospital and how do you think the relationship is going to be with models of care when it comes down to patient care in and out of the hospital? 

[00:14:47] Ben Woenig: One area of clinical care and with respect to the, biomedical systems, which is of huge interest for me, and I think there's a fair bit of talk around this is a vast majority of biomedical devices output large amounts of data in relation to how they're leveraged and work with a patient. 

[00:15:05] In a lot of facilities at the moment, the local information provided by a medical device is presented onto a local screen, and clinician will make clinical decision based on the information from that machine. 

[00:15:18] I see a huge opportunity here on a patient's journey as a patient, say, moves from an emergency department into an operating theatre, that journey of being attached to those various biomedical devices, all of that information can ultimately be collated and aggregated and then pushed into, securely, in theory, into the cloud and where further analysis can be undertaken to provide correlated, analysis between the disparate biomedical devices.

[00:15:47] And I believe that there will be new opportunities, developed and evolved from that research, to again, make, different decisions and that ultimately lead to better patient outcomes from the information that has been collated from all the biomedical devices. 

[00:16:07] The data is then collected and collated and assigned to the patient record and it becomes part of their record of journey through their care experience. So then the clinicians can have access to that information through that entire journey and then review and research and provide further input, if needed, to make clinical decisions with respect to opportunities from that data that's being collated. 

[00:16:31] And to collate that we need a robust network. So in a clinical facility, it is absolutely paramount that we have very high quality network infrastructure, preferably from one of the major multinational vendors with excellent support and it's the business' responsibility to maintain and endure that the infrastructure is supported and fit for purpose and operational at all times because without the network backbone, just about everything else won't work within the hospital from an information technology perspective.

[00:17:00] David Cummins: It seems like a never ending live beast and the fact that technology we so reliant on it and the possibilities are endless, but the reliance is so strong. 

[00:17:11] My mind is boggling with the amount of information that you have in your mind. No wonder you're a world leader, no wonder, you do all these features around the world.

[00:17:19] I think you're absolutely phenomenal. I think the possibilities are endless, especially as we change our models of care. 

[00:17:25] And I think really the take home message is to make sure that we engage with IT as early as we can to ensure that we do get the strongest and best clinical outcomes, not only for the patient, but for the staff, but also for the hospital and the future. 

[00:17:39] So I just want to say thank you so much for your time.

[00:17:41] I know you're busy, I know you're still probably jet lagged from your trip as well but I just think you are very, very fascinating and I think the more people that listen to your message, the better we'll be. 

[00:17:50] So thank you so much for your time, Ben. 

[00:17:51] Ben Woenig: Thank you very much. It's been an absolute pleasure to have this discussion this evening.

[00:17:55] Thank you. 

[00:17:56] David Cummins: You have been listening to the Australian Health Design Council podcast series, Health Design on the Go. If you'd like to learn more about the AHDC, please connect with us on LinkedIn or our website. 

[00:18:06] Thank you for your time.