NSW’s Macquarie University Hospital, Australia’s first university-owned hospital, is 18 months old and achieving all expected milestones. Its chief operating officer, Evan Rawstron, tells David Hutchins how it can already showcase several Australian medical firsts.
Creating a state of the art hospital is no small endeavour, but after a five-year process of planning, design, construction and accreditation, Macquarie University Hospital (MUH) is claiming an advanced position with its integration of superior digital and medical technologies.
MUH’s Chief Operating Officer, Evan Rawstron, says the facility is an advanced hospital with unparalleled capacities for harnessing the benefits of digital technology and medical science. He says planning and delivering such a venture is a huge credit to Macquarie University’s senior management, medical specialists, policy makers and key stake holders.
“The project officially began in 2005, with the investigation of an appropriate location for the site. In late 2006, an application to the Minister for Planning was submitted and approval was granted in May the following year. Construction commenced in 2008 and the build was completed two years later,” he says.
“MUH’s internationally recognised Neurosurgeon, Professor Michael Morgan, who is Professor of Neurosurgery and Vice President, Health and Medical Development is rightly credited as the visionary behind this institution.”
Rawstron says that, after training overseas, Professor Morgan felt a new type of institutional commitment to medical education and research in Australia was needed to keep in step internationally. He says creating such an ambitious facility as MUH within, and of, the University’s precincts is an opportunity with many positive community confluences.
“Teaching hospitals like MUH play three important roles. First, they work to alleviate suffering in the communities that they serve today. Second, they’re places of research in which clinicians and scientists collaboratively build on the lessons of the past to discover new ways of fighting disease and improving people’s lives.
“Thirdly, teaching hospitals are places of learning that contribute to the development of a range of health and other professionals equipped to care for patients now and in the future.
“These three roles - clinical care, teaching and research are interdependent. The benefit they generate together through synergy is greater than the sum of their respective parts. This idea is something known as academic medicine. Here at MUH, we call it our purpose and put it more simply: heal, learn and discover,” he says.
Rawstron maintains that, while MUH is an extraordinary achievement, historically strong marriages between hospitals and universities are relatively routine.
“All around the world, university hospitals are at the leading edge of academic medicine. In 2011 in the United States, 12 of the top 17 hospitals in the country were university hospitals. Over the past century, university hospitals have pioneered extraordinary changes in modern medicine and surgery and have improved the lives of many millions of people.
“Macquarie University is fast becoming one of Australia’s leading research-intensive universities. The development of the country’s first university-owned hospital on its campus reflects a tangible and ongoing commitment to support for cutting edge research, learning and teaching. It’s also a terrific example of the innovative thinking for which the University has become recognised, both overseas and closer to home,” Rawstron says.
If any other confirmation of the University’s MUH strategy is required, Rawstron notes that it’s home to some of the world’s most pre-eminent researchers, in diverse fields that range from Ancient History to Neuroscience to Climate Change.
“In fact, since 2007 the University has consistently moved up the Shanghai Rankings of World Universities. In the recent Excellence in Research for Australia exercise performed by the Australian Government, five of Macquarie’s research areas were noted for “outstanding performance well above world standard”.
With such heritage, MUH is obviously going to be vested philosophically, operationally and structurally, with a laureate of levers to push the boundaries of hospital and health knowledge and capacities.
“MUH offers not only advanced technology and training, unavailable elsewhere in the nation, but also a digital environment where paper records are a thing of the past. Well before the first sod was turned on our green field site, our key stakeholders anticipated national healthcare demands and trends and combined to establish MUH at the high-tech end of the private hospital sector in Australia, with a strong focus on the future of medical science,” Rawstron says.
“This virtually paperless system has ignited much interest from around the country and indeed the world and resulted in requests from both national and international hospital groups and government agencies to tour our facility,” he says.
“The University’s investment in digital technology has meant that the facility is the first in the country to implement a hospital-wide electronic system for documenting patient information and will continue to invest in this area to ensure we are providing our doctors and health professionals with access to the very latest systems.
“The benefits of this system are increased patient safety and increased efficiency. More accurate medical data and electronic access to a patient’s complete file all mean, ultimately, reduced patient risk and better health outcomes,” he says.
Considering the extraordinary national investments being made in e-health, Rawstron believes the hospital’s technology strategies and its move toward a paperless environment has been vindicated.
“In many hospitals, a patient’s physical chart is still the focal point for care delivery. If that chart is not at the foot of a patient’s bed, records can’t be checked or updated and the risk of error exists. MUH’s paperless system ensures information is instantly available and a patient’s journey can be tracked throughout the entire hospital system.
“Nursing staff can accurately confirm dosages and timings of medications, pharmacists can pick up and fill orders much more quickly, and reminders can be programmed into the system according to patient needs. It is a virtually paperless system where all recording is done electronically, either at the patient’s bedside or in operating theatres,” Rawstron explains.
Critical health dynamics such as the shortage of skilled healthcare workers and our ageing population will, Rawstron says, ensure hospitals around Australia will continue to apply and innovate technology to maintain quality service levels.
However, he says at MUH the most important role technology has is in ensuring patients are in the most comfortable and healing environment possible.
“The physical environment can have a measurable influence on our well-being, especially in hospitals and the benefits of a beautiful room with modern facilities plays an increasingly important role in the care we provide.”
At MUH, beds are linked to an entertainment and communication system, featuring internet and VoIP (Voice over Internet Protocol) connections, and meal ordering from the hospital’s five-star catering service. There is also an advanced nurse paging system accessible through the high-tech bed interface.
The hospital’s IT Director Robert Flanagan says installing these sophisticated systems presented unique and challenging opportunities, particularly in the domain of Information Technology.
“No other hospital had implemented a fully digital system, so there was no local model to consult. Being first to face those unknown challenges along with the scale and complexity of the implementation, makes the last 18 months a time for which we should feel very proud considering all that has been achieved,” he says.
Flanagan says pursuing, achieving and maintaining MUH’s vision of being a “digital hospital” is no small feat.
“The IT team continues to work with clinical and operational staff in order to innovate and improve. We have implemented enhanced security mechanisms for doctors to securely access patient records remotely, even if they are travelling overseas.
“Security and confidentiality of patient information is taken very seriously at MUH. We recognise all access, particularly external access, must meet high security standards, and work hard to maintain that protocol,” Flanagan says.
MUH is also developing an e-learning approach so staff and doctors can to be trained on a wide range of services, practices and techniques, independently and off-site.
A “cashless payment system” will soon be extended to patients and a range of online doctor and patient services are also being investigated.
“This is an ever-evolving environment. We constantly review our systems and their suitability to meet the hospital’s goals and are very interested in innovations that can enhance our digital abilities and improve the patient experience,” he says.
MUH has also invested significant resources in advanced medical facilities such as world class imaging, state of the art digital theatres and cutting edge medical technology, including Australia’s first-ever gamma knife - a non-invasive neurosurgical tool that treats brain cancer as well as a range of brain-related functional disorders.
It allows patients with such conditions to be treated within in a few hours and to, possibly, leave within the same day.
Rawstron says that MUH can boast several firsts in private hospitals, including its purpose-built neurosurgical theatre, which has been designed to house a series of innovations, including the first gantry-mounted intraoperative CT scanner in Australia.
Enabling CT scans to occur during operations, this technology eliminates the need to move patients to a different imaging location during surgical procedures, with the smart integration between imaging, assessment and theatre technologies giving surgeons the ability to immediately review and verify the results of a procedure.
“The hospital has a collaborative research agreement to use a cyclotron, owned by private company Cyclopet, for advanced brain, heart and cancer imaging. It produces radio isotopes that enable advanced three dimensional scanning for more accurate diagnosis of the brain, heart or cancers,” he says.
Cyclopet also has the latest GE PETtrace onsite cyclotron in Australia, which, with an external Beam line attached to the cyclotron, enables the production of short-lived PET (Positron Emission Tomography) isotopes.
MUH was the first private hospital in Australia to be fitted with hybrid theatre - containing the first robotic angiography device.
Until recently, the manoeuvring of the structure that holds the x-ray delivery and receiving instruments has been highly complicated, requiring radiologists to stop their work to change the position of various devices. The intelligent C-arm allows doctors and nurses to move around the theatre without being distracted from their immediate care of the patient.
Technology is rapidly evolving and in order to remain a leader, the hospital must continue to keep abreast of the latest technology. The recent acquisition of the multi-million dollar da Vinci Surgical System demonstrates this commitment and makes the hospital one of only two facilities in NSW to own this state of the art technology. This robotic tool principally treats urological cancer conditions by minimally invasive means, but has applications in other areas as well.
MUH is part of a large and integrated medical community that includes the Macquarie University Clinic, Macquarie Medical Imaging, a Radiology, Pathology Services, a GP Practice, Physiotherapists and a Pharmacy, as well as the Australian School of Advanced Medicine (ASAM).
Rawstron maintains that all the technical wizardry integrate as foundation stones in achieving MUHs vision to heal, learn and discover.
“A core strength of the hospital is its approach to education. The Australian School of Advanced Medicine is the first medical school in Australia to be linked to a private teaching hospital on a university campus. It brings together world-class clinicians, researchers and medical educators to create innovative training programs with a focus on future trends in medicine.
“Together, the collocated facilities offer an integrated approach to clinical care, teaching and research. ASAM provides post-fellowship, sub-specialty training in medicine and surgery as well as higher research degrees. These two partner organisation offer doctors what wasn’t previously available in Australia. ASAM is the first medical school in Australia to award degrees for sub-specialties in surgery.
“The organisation only accepts to its programs scholars who are already qualified surgeons or specialists and are seeking sub-specialty training. Scholars work as doctors, while they advance their own education and participate in research,” he says.
Rawstron advocates this environment as creating “a collegiate approach”, ensuring practices constantly evolve as specialists work in teams and educate the next generation of experts.
“Ultimately the patients at the hospital benefit from this relationship because they have access to some of the most experienced health professionals in the country,” he says.
Macquarie University Hospital has, Rawstron says, recruited some of the finest doctors in the country and has the capability to perform some of the most complex treatments available.
He says a recent example of this was the first innovative robotic leg implant for patients with above-knee amputations in Australia.
“Previously, a vacuum prosthetic leg was used. This fit over the skin of the remaining part of the upper limb, but presented a myriad problems including friction with the skin, pain and the risk of infection,” he says.
“This new technology provides a safe and permanent connection between the prosthesis and the bone, offering incredible benefits to a patient’s quality of life.”