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Invisible Building Blocks of Digital Innovation: the Internet of Things in a Hospital

Invisible Building Blocks of Digital Innovation: the Internet of Things in a Hospital

Innovating —the act of doing anything new in a creative way — is inherently disruptive. This is doubly true inside complex systems and regulated industries. And organizations are built to avoid disruption. Often, what we see as an example of a simple innovation is actually the result of small, invisible — but nonetheless crucial — enablers. I love these enablers and how they allow us to innovate with much less discomfort. They are the unsung heros of change and rapid cycle development. Lately, we've been on the bleeding edge of inexpensive Internet of Things technology in the hospital. And none of it would be possible without these enablers having laid some invisible bricks of digital innovation.

A few years ago, our team got very interested in voice-first interfaces; or, for the less nerdy, Amazon Echos. We were working on a project to give patients more control over their hospital rooms. It felt like voice control was a prototype worth pursuing. We were early enough to express interest to Amazon and cleared their waiting list quickly. We unboxed our magic cylinder, plugged it in, and then realized the next big hurdle: wi-fi!


our digital pal

this Echo sits in our team's space and spits out jams all day long!

Hospitals, even among regulated industries, take data privacy and security even more seriously than most. We also have lawyers with keen eyes on protecting patient data and mitigating the organization's risk. So, like any sophisticated large organization, our Wi-Fi networks are rather locked down. Unlike the set-up most of us have at home, joining wi-fi at the hospital requires a corporate username and password. While that authentication mechanism is easy enough on a laptop or smartphone, it's outright impossible for most consumer-oriented devices. Simply put, there's no way to put a corporate username and password into an Amazon echo.

Around the same time, we met someone (who would quickly join our team) who knew how to move quickly in the digital world. Matt strolled into our innovation studio one day and immediately belted out: "I know what this place is!" We often say we know our kind of weirdo when we meet them and Matt was clearly our kind of weirdo. In joining our team, he helped us create our Digital Services model. We cribbed notes from our friends a few miles across town in the federal government — the U.S. Digital Service. That team was formed to bring modern, Silicon Valley-style tech skills to existing U.S. government teams.

For us, and our friends in the U.S. Digital Service, digital services is different from IT. Where IT is responsible for designing and maintaining our networks, electronic medical records, and business systems, digital services is all about building and testing new things quickly to address the needs of end-users and innovators.

Matt's presence on the team expanded our horizons about what could be possible. We realized we needed a safe sandbox —a place to safely test our ideas before going public. We implemented our own entirely separate, airgapped network. We installed a commercial-grade business line for Internet from a different Internet service provider than the one used by the hospital. We set up our own wi-fi network to be completely separate from any of the hospital's corporate infrastructure. We also set up a second network dedicated to Internet of Things devices like the Amazon echo.

Having our own separate infrastructure provided a platform on which to rapidly experiment with emerging technology without putting the organization or patients' data at risk. And having a platform in our team's control means we can get devices up and running without burdening another team in the hospital.

Today, we have expanded our network to cover large portions of the hospital. It enables us to test new devices and concepts in patient rooms, waiting areas, and clinic spaces. Our innovation network has also given us the ability to help others in the organization in ways never before possible.

A few months ago, The head of our case management department approached our innovation team's lean engineers with a challenge: she needed a new way to capture data on the types of services and programs that patients needed. She wanted something like the famous Staples easy button. Matt had been waiting for a use case like this, and knew exactly what he wanted to deploy.


a stack of Amazon Dash buttons awaiting deployment



Around the time Amazon introduced its echo device, it also came out with something called IoT buttons. Originally offered as a convenient way to reorder frequently consumed products, the unbranded versions are amazingly flexible. Imagine something the size of your thumb with adhesive on the back and a button on the front. You attach them to your wi-fi network and can easily program them to do internet-y things. Well, someone like Matt can easily program them.

Matt set up five of the $20 IoT buttons for case management. Each one corresponded to a type of patient need. When pressed, they automatically create a row in a Google Sheet spreadsheet; instant data capture. When our radiology department needed to capture data on patient flow, the IoT buttons let them log things like arrival time, navigational issues and reasons for being late to an appointment. Matt and the lean engineers deployed them in hours at nearly zero cost.

We've also been using the IoT buttons in a patient-facing prototype. For another project, we want to capture real-time feedback from people about their experiences. Matt and team mounted some of the buttons in a cardboard box, covered it with a slickly-designed label, and we had an instant, wireless feedback device. We were able to iterate on how we asked questions about patient experiences quickly and deploy the experience boxes into patient areas without any obstacles. And, since they are easily programmed, we can get the data in really convenient ways. When a button is pressed, not only is it logged into a Google Sheet, but a robot pops a notice into our team's Slack board telling us what the feedback is and from where in the hospital it originated.

There is so much neat tech in the world and we're in a time when the release cycle is speeding up exponentially. Taking advantage of these things for testing, inspiration and innovation is a game-changer. But, it requires some building blocks like a sandboxed network and digital services leads like Matt. Investments in those enablers pay dividends in efficiency and expediency and they do it in ways we haven't traditionally embraced in healthcare.

version 1, 2 and 3

IoT button-powered patient feedback boxes 

Cutting through traditional organizational silos or finding outside contracted partners takes time, burns momentum and all too often stifles innovation entirely. Teams that want to move quickly need the resources and people who make speed and agility possible and inexpensive. It also reduces the cost of failure. Find a Matt for your team, get a mobile hotspot or your own network and you start changing healthcare with $20 buttons.

IoT enabled in-room signage (version 1.0)

IoT enabled in-room signage (version 1.0)