Hôpital du futur - Leader Health

There is talk of Leader Health on the future Hospital: 3 questions for Thierry Courbis in Architecture Chronicles


What funding model? What models abroad? What are France obstacles to the development of the digital hospital? Thierry Courbis has practiced for over 20 years in France and abroad in all areas of large hospitals Branch. He is now CEO of Leader Health, a consulting and strategic assistance to specialized Project Management including digital processing * Chronicles. The model of the Central Hospital where he is focused-functions condemned?
Thierry Courbis: The classic concentration economy may still be working, according to its history and location, but it is anyway affected by the new digital model. For example, the Mount Sinai Hospital in New York includes seven hospitals but if previously the links between them were physical and were reflected in space today with the addition of coordinated networks with many hospitals affiliates, Mount Sinai now functions as a hub. It is the same for Cleveland Clinic, other international reference. This new model is that of coordination of collective intelligence. Only digital technologies can enable operational constitution of this network.

Take into account an important factor which can result in cost m². To cure the cheapest m² is housing and that of the intermediate structure, and that of the hospital. But surgery is less bloody, less invasive, the success of minimally invasive surgical robot Da Vinci, used by around fifty establishments in France since 2008, attests. This tool allows for heavy interventions while making only small incisions with a corollary real benefits for the patient. For operations of the prostate, for example, the robot demonstrated logically, unrivaled dexterity, other machines offer innovative operative procedures: gynecology, neurosurgery. The technology is not only less invasive, but also relocates. It can operate remotely. Today in Strasbourg IHU, advanced teams working on minimally invasive technologies for image-guided incisions allow more low (or even passages by natural means) and cuts more fine. These teams have already made remote interventions. No doubt that tomorrow, they could offer a service to the home, in a housing prepared for it.

The economy of the hospital production projects and the function and clinics are transformed by the digital revolution. On the one hand, medicine becomes hybrid, combining the medical art to the art of the engineer. Each specialist can see its scope expanded response. What a revolution when technology allowed a radiologist to now be able to do surgery! Today we go further, faster are used augmented reality. In the light of the last great French projects, that is to say the future CHU Nantes and Caen and the two new hospitals Epinal – Golbey and Lens, it is necessary to launch a debate in France in order to identify major areas for consideration when determining a digital hospital from the design phase. This debate is essential to changing paradigms.

The word revolution is often used to describe the conceptual changes underway in hospitals. This word is it wise?
If not a revolution, building owners and contractors must prepare for a radical transformation. Working on the new project of the building of Emergency University Hospital of Geneva, we recounted the digital revolution emergency in some American HMO where unscheduled consultations carried out remotely from already account for 18% of the market and are billed twice less expensive.

These are not the only areas of research. In Norway, policy makers now calculate amortization not considering the hospital as a building with a mission but a “public good” reusable. After its life cycle, the hospital will be relocated, but the building will serve as a dormitory or social housing. Moreover, following the model of “layers” we will take into account the different lives of the buildings according to their functions, 15 years for a laboratory, 50 to a room, etc. And we will adjust the construction techniques to these different cycles. This will regularly rebuild the functional subsystems and therefore more flexible. All these considerations affect the architectural design of the works, but before that it is the project owner to innovate, and to see further.

Another known example, in Groningen, the Netherlands, where operators have developed a permanent construction cycle, a Phoenix hospital, but never finished reinvented continuously as needed or technological developments. Here again we must consider a new way to design the hospital.

What are, in France, the brakes in this transformation?
In France, one of the difficulties is the programming phase. The search for the next guided programmiste is a set of often very traditional fillers. I have in mind a large reconstruction project of a Parisian university hospital where the demand expressed for the “digital” part held in less than a page (and yet he was there!) While needs for cooking or laboratories were enlarged. Is this reflects less interest? Of course not, it simply demonstrates that the project managers have long expressed their basic needs but have difficulty to project towards innovation. Therefore the programmiste will offer its services, leaning on the request of the building owner and … his program will ultimately translate this fact. As the program is the basis for future specifications construction loads, it is not surprising that the French approaches remain cautious and somewhat innovative, except enlightened work of masters, with conviction and leadership to get their modernist vision before further consideration.

Moreover, another problem also is that the instability of the French management. Too often, each turn gives rise to a new version of the project, up to four times, which tends to paralyze the projects.

Finally, the French financing model seems unsuited. We remember for example that at first, the payment was for the day and to the act, which resulted in drifts, with interest while keeping the patient and multiplying acts. This explains why in a second phase was introduced a block grant system which proved an untied situation soon annuity business; hospitals that saw an increase in their activity were penalized. Whence then the package pathology (per treated case) the famous “T2A” inspired by American models DRG payments. These financing arrangements encouraged specialization and high productivity while excellence and innovation found themselves again penalized, prices of the few interventions being unrepresentative of actual costs.

This time, the difficult and innovative actions are the most poorly paid. In the French model of the T2A for example, funding for telemedicine activities is blocked. Experiments take place, but we are far from the economic motivators for innovation. T2A pushes the hospital to “run faster” but it prohibits him not “turn”. We must feed the machine. Prevention, innovation, coordination of a network, home care are all poorly funded sectors.

It is possible to imagine that in the future, since the hospital will be at the heart of a coordination network, its funding is linked to that network, which would treat anyone anywhere at a cost less than if the intervention was to take place within the hospital. Moreover, the principle of shared network data (big data, multidisciplinary teams) also enables citizens to become a player in this collective, not least by encouraging the efficiency of a collective economy. The design itself of the hospital of the future depends on these shared competencies.

to Christophe Leray
* Thierry Courbis has also prefaced the book by Louis Omnès Designing and Building a digital hospital. April 2016 Editions Eyrolles.

Lire Article on the website. ..


Digital Hospital

Digital Hospital


There is talk of Leader Health : a review article published in Finance Hospitallers . And if the performance was going through a digital transformation in depth? And if the digital hospital became the next obvious in terms of hospital architecture ?

Leader Health thanked the University Hospitals of Geneva for their confidence.

We will in the coming months with our partners to design a new building dedicated to emergencies in the canton of Geneva and beyond . The goal , transforming the service to make it efficient, to the point of the state of the art and enable work without stopping the activity. A challenge to the height of Health Leader ambitions and his teammates.

Tokyo

R & D in Japan, three days to understand the changes and innovations in the world of health Cybernetics . The future is here . What these technologies? Is it a brake to a human hospital , is it an opportunity? The role of Leader Health is launching its lines of inquiry still further, to avoid rebuild today , hospitals are already overwhelmed . RDV in April 2016 on our Business Tour to Japan to share with us the evolution of robotics and cybernetics.


CH Saint Brieuc

The Saint- Brieuc CH wished to increase efficiency by delivering flat throughout its pharmaceutical organization , logistics and IT to integrate automation and digital in its operation.The tandem Adopale Leader Health , already operational in several similar projects won this market, which should enable the CH St Brieuc to be a reference in Britain.


CHU Poitiers

Leader Health and BRM cabinet were chosen by the Poitiers University Hospital for a strategic audit and an operation “due intelligence” Telemaque , computerized patient record CHU . The expertise of the company in terms of determining a commercial value , accompanying measures for IT asset disposal and the total vis-à- vis the publishers independence are the foundation of this choice.

CHU Hanoï

In response to the request of the Government of the Socialist Republic of Vietnam to support the modernization of Hanoi Medical University (UMH) and the creation of a University Centre in Hanoi Hospitalo (CHUH) on the model of French Hospital, an agreement was signed between the French Development Agency and the Vietnamese Ministry of Investment Plan to help establish the new university hospital in Hanoi.

This project will increase the capacity of the current university hospital would increase from 300 to 750 beds (250 of the 500 current site and build a new site), improving the quality of care and the device medical education, improving the capacity and number of research.

Technical assistance with implementation of the UMH has proposed an action plan to meet those goals.

And in the broader context of the development of the Project Hospital Establishment (CDB) of the future CHU, the commitment of a study on the Master Plan of the Information System (SDSI) appears as an unavoidable necessity in view of major challenges currently faced by the university hospital, the constraints imposed on the institution in the transitional period 2014/2020, institutional expectations and needs expressed by the different actors involved in the project. Furthermore the state of the art in the field of hospital construction (see section Hospital Management Paris France in November 2008 Digital Hospital: a new evidence-based design in architecture White Paper “Future Hospital” publication ANAP GE Healthcare Sanesco 2012, or yet Congress Proceedings University of Montreal “Hospital of the Future” in June 2013 etc.) require organizations to review the care sectors, teaching and research in terms of the potential of digital innovations and before considering an architectural design of a new hospital.

To pretend carry out a mission of this importance, it was an international expertise, a true knowledge of digital technology, particularly in terms of building digital hospital, but also a capability based on field experience to understand organizations, situations far removed from the usual standards.

It is these advantages that the Co Leader Health was selected for this particularly interesting mission in the heart of a project of excellence.

 


CHU Lariboisière

“Leader Health was selected with Polyprogramme to achieve in record time programming of the new University Hospital Lariboisière (Paris) including a vision” Digital Hospital “. This first performed at the prestigious APHP could open a field new possibilities of the St. Louis Hospital Group Lariboisère Fernard Widal and even have value “pilot project” for other developmental projects in Paris. “

Health Leader exhibiting at HIT

Leader Health exhibit at HIT in the “village of architects” could develop before a large audience of professionals concrete its innovative concepts of “digitalization of hospital processes.” The “Digital Hospital” was the “Healing Hospital” the heart of the debate opened by the firm John Paul Pargade before his peers (read the account published by Editions Le Moniteur in publication section).

An expert federation helps healthcare institutions to think before thinking digital concrete

<div style=”text-align: justify;”>PARIS, January 22, 2015 (Direct Hospital) – The consulting firm Leader Health has a network of professionals practicing in hospitals, who use their experience to give hospital managers the vision of a hospital “digital thought before be considered concrete “, as part of renovation or reconstruction projects.

Founded in 2005 in Switzerland, Council Leader Health firm has more than 50 international experts hospital -most active in hospitals- recognized for their management innovation, management or construction of new generation and working in hospitals network.

Our mission is to promote the efficiency of hospital management and care through the use of technological innovation, “said Thierry Courbis, former director of the Princess Grace Hospital in Monaco and CEO of Leader Health.

The company puts the “sum of unique experiences” of his experts “within reach of the teams with the desire, need or the idea of rethinking differently,” he says.

To carry out this mission, the company usually starts together several of its experts in the applicant institution to present its vision. “This will show a wide audience -cadres health, doctors, unions, etc.- that the train went very fast and that what they think is a ‘vision of the future has already been exceeded for several years “says Thierry Courbis.

Leader Health then meet in working groups managers and suppliers of the institution to reflect on its main processes and on its strategy. This work builds a “digital design” which will then be forwarded to the architect.

This “digital design” brings together the most innovative technologies adapted to the institution. “We have compiled about 200 ultra sophisticated solutions, but I do not know any hospital that needs all,” says the former director.

“We have selected 45 project for the future hospital on the island of Nantes, 30 for the new hospital of Epinal … What is needed is to choose solutions consistent with the settlement strategy and thinking in processes, not gadgets, “he says.

These choices are not trivial. “A hospital built on a digital design does not look like a concrete hospital where technology is integrated then,” said Thierry Courbis. He cites the example of an institution that decides to be “paperless” management of space, including the needs of archive rooms, is modified. “At 70,000 euros per square meter for the Monaco hospital, it is important …”

The experts of the company face two types of reactions of hospital managers and architects, shows the leader of Leader Health: “We see technophobes people who do not believe for a moment, but also people who find this approach intellectually exciting. ”

This second category will only increase, he says: Leader Health has already accompanied hospitals Lens (Pas-de-Calais), Epinal, Annecy, Lariboisière Hospital (AP-HP, Paris) or CHU Caen, “all of whom wished to rethink before reconstruction as Digital Hospitals”.

mb / ab

Source: www.directhopital.com</div>


Testimonials

«Confrontée à l’instauration d’un schéma directeur d’information au sein de l’EHPAD SOLEMNES de Tremblay et utilisatrice trop souvent limitée des nouvelles technologies, j’ai apprécié l’expertise affûtée néanmoins didactique de notre partenaire Leader Health. Nous lui devons de franchir un palier qualitatif qui nous permet de faire face plus sereinement et complètement à nos obligations réglementaires. » Dr Nativelle Médecin coordonnateur Groupe Solemnes EHPAD Tremblay-en-France

« Notre Groupe spécialisé dans la gestion des personnes âgées atteintes de la maladie d’Alzheimer se développe dans la région Ile de France. Nous avons souhaité mettre en place une politique très innovante en nous appuyant sur les nouvelles technologies. Nous avons trouvé chez Leader Health un partenaire remarquable qui nous a permis de définir notre schéma directeur en lien avec nos partenaires du court séjour et les attentes de nos clients.» Eddy CHENAF Directeur d’Etablissement Groupe Solemnes

« Le CHU de Toulouse a fait appel à Leader Health pour mesurer le ROI de technologies numériques innovantes (réanimation, anesthésie, dictée vocale, reconnaissance vocale) par rapport aux modèles nationaux éprouvés. Ces travaux ont été conduits par Thierry COURBIS Directeur Général de Leader Health et une équipe de consultants seniors qui ont déroulé une méthodologie et des outils parfaitement adaptés. Leader Health a démontré un véritable savoir-faire, une parfaite connaissance du fonctionnement de nos hôpitaux et un grand professionnalisme .» Yann MORVEZEN Directeur Systèmes d'Information et Informatique CHU Toulouse

« J’ai fait appel à Leader Health pour plusieurs projets stratégiques pour les HUG : la centralisation de nos laboratoires dans un bâtiment unique BATLAB, le projet de reconstruction de notre nouveau Bâtiment des Lits pour lequel Leader nous a fourni les éléments utiles de comparaison de notre vision avec les références internationales, et enfin, une réflexion particulièrement innovante sur la chambre patient de demain et les outils de mobilité interne. Ces travaux ont été conduits par Thierry COURBIS Directeur Général de Leader Health et les équipes mise en en place pour chaque projet ont démontré un véritable savoir-faire, une parfaite connaissance du fonctionnement de nos hôpitaux et un grand professionnalisme… » François TAILLARD Directeur Général Adjoint des HUG, Genève

« Je tenais à vous remercier pour votre remarquable travail des derniers mois. La communauté de l'hôpital vous a fortement sollicité et vous avez su répondre avec efficacité, professionnalisme et beaucoup de gentillesse. Je remercie à travers vous l'ensemble de vos équipes et je pense que vous saurez leur transmettre » Pr Rémy Nizard Président CME du GH Saint Louis Lariboisière pour le projet Nouveau CHU Lariboisière à destination du team lauréat de programmation

« Le CHR d’ANNECY a été construit en s’appuyant sur les technologies les plus modernes de son époque. Grâce aux experts de Leader Health nous avons pu mesurer l’apport de cette vision par rapport aux modèles internationaux et en dégager les objectifs de rentabilité économique. Ces travaux ont été conduits par Thierry COURBIS Directeur de Leader Health et l’équipe en place a démontré un véritable savoir-faire, une parfaite connaissance du fonctionnement de nos hôpitaux et un grand professionnalisme . A recommander. » Serge Bernard Directeur Général du CHR Annecy

« Aujourd’hui, le Centre Hospitalier Emile Durkheim - Epinal, Vosges – en coordination avec l’Agence Régionale de Santé (ARS) de Lorraine prépare la reconstruction de son hôpital – site de Médecine Chirurgie Obstétrique. Cette nouvelle entité du CHED doit être conçue comme un hôpital de dernière génération (DHI : Digital Hospital Infrastructure), équipée en conséquence de toutes les dernières innovations issues du monde numérique et de l’industrie… Afin d’inventer collectivement les solutions fonctionnelles et innovantes de demain, nous travaillons depuis 3 ans avec la société Leader Health et certains de ses partenaires. Par son expertise, sa compréhension générale des enjeux et du fonctionnement hospitalier (son directeur est un ancien directeur d’hôpital), Leader Health nous guide efficacement dans les choix stratégiques, comme par exemple des choix structurants en matière logistique. Dr Claire PLIVARD, Pharmacien PH, Responsable Logistique et Travaux

«Le Centre Hospitalier d’Epinal a fait appel à Leader Health pour l’aider à concevoir une vision moderne et efficiente pour la construction de notre nouvel hôpital. L’équipe mise en place dirigée par Thierry COURBIS, composé d’experts français et internationaux, a été non seulement d’une redoutable efficacité mais a su convaincre nos collaborateurs et tutelle d’aller vers cette cible très innovante. Un grand bravo » Thierry Gébel Directeur Centre Hospitalier Emile Durkheim

« Nous avons fait appel aux services de Leader Health pour des missions de confiance, complexes et difficiles. L’apport de Thierry Courbis et de ses experts nous a permis de trouver des réponses particulièrement utiles à notre établissement. Nous pouvons témoigner de la qualité du travail fourni et de la richesse du réseau professionnel de cette société ». Marc PENAUD Directeur Général Adjoint CHU Grenoble Personnes à contacter:
Pierre THEPOT Directeur CH Arras
Antoine AGATHON Directeur Projet IHU Strasbourg
Professeur Jacques Marescaux Directeur IRCAD Strasbourg
Germain ZIMMERLE DSI CHU Strasbourg et coordonnateur national des DSIO de CHU France
Claude Henri TONNEAU DSI Centre Hospitalier Sud Francilien
Christiane COUDRIER Directrice Générale CHU de Nantes
Cécile JAGLIN-GRIMONPREZ Directrice Stratégie CHU de Nantes
Thomas ROUX Directeur Hôtel Dieu de Nantes
Pierrick MARTIN DSI CHU de Nantes
Thomas LECHEVALIER Chef de Projet DPI CHU de Nantes
Alex ADGAGBA Directeur Agence Médecine Préventive
Didier ALAIN ANAP
Astrid HAUGEN St Olav CHU Tromdheim
Philippe CASSEGRAIN Directeur Général Clinique Beaulieu Genève
Alexandra BALAFREJ Clinique Fondation Alliance Maroc
Susanne BERGENBRANT GLAS CHU Karolinska Stockholm
Ben MALEK Ingénieur Hôpitaux Universitaires de Genève
Bernard GRUSON Directeur Général Hôpitaux Universitaires de Genève
Bjorn Bergh CHU Heidelberg
James BISSEL Clinique de la Tour Genève
Dr Fabrice BOULARD Médecin DIM Hôpital La Basse Terre et ARS Guadeloupe
Rodolphe BOURRET CHU Directeur Général Adjoint CHU de Montpellier
Fabrice BRUNET CHU Sainte Justine Montréal
Docteur Marie Pierre CHAILLET Médecin DIM CHU de Nantes
Dr Philippe CHANDERNAGOR ANAP
Dr Arnaud HANSSKE expert SI FHF
Jacqueline HUBERT Directrice Générale du CHU de Grenoble
Bruno LAVAIRE DSI Centre Hospitalier de BEAUVAIS
Luc Olivier MACHON Directeur Finances CHU de Nantes
Eric MANŒUVRIER Directeur pôle Finances et système d’information CHU de Nantes
Jacques LEGLISE Directeur Général CHU de Toulouse
Marie Agnès SAUTIER DSI Hôpital Princesse Grace Monaco
Mme Valérie BERNARD, Présidente de la CME Hôpital Princesse Grace de Monaco
Philippe SUDREAU Directeur Général Groupement Hôpitaux Saint Louis Lariboisière APHP
Philippe LECA DSI CHU Lariboisière APHP
Pr Rémi Nizard Président CME CHU Lariboisière APHP
Philippe DOMY Directeur Général du CHU Montpellier
Jean Bernard DUPUY Ingénieur Logistique et Chef de Projet AMO Logistique et Pharmaceutique
M. LETOEUF Directeur Général Médical CHIREC Bruxelles
M. LEFEBURE CEO Cliniques CHIREC Bruxelles
Nicolas CAMPESTRE Directeur Adjoint CH Basse Terre
Pauline MAISANI Directrice de la Stratégie CHU Montréal
Anne Claire SWAN Directrice Adjointe CHU Nantes
Dr Benoit DEBANDE, Directeur Système Information HUG, Suisse
M. Jocelyn BOUCHER, Directeur Finances et Logistiques du CHU de Montréal
M. André GUINET, CEO American Hospital of Paris
M. Christian PAIRE Directeur général CHU Montréal, Canada

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