It is concerning how few electronic systems there are for managing item (instruments, consumables, prostheses etc.) processing through purchasing, delivery, sterilisation, packing and receiving. When you think of how many procedures occur daily in additon to tools used in wards this amounts to hundreds of thousands of items.

Hospital design needs to recognise the reality that there is an increasing blurring between health research, health education and clinical practice. As a consequence there is an increasing need for the design of hospital networks to recognise that the hospital precinct is not an island isolated from the rest of the world and the rest of the health community by firewalls managed at the level of the network technicians in apparent isolation from clear systemic policy.

why is it that new hospitals are bigger? One key measure of a new hospital build is how many acute beds, ED units, aged care beds etc. We have not moved on from the old days- that is, building new hospitals with acute setting focus rather than building a healthcare service which encompasses both a requirement for specialist care as well as keeping patients away from hospital - more emphasis is required within new hospital builds to design service delivery around new models of care which consider patients in their home and community.

One of the issues which bothers me about the transformation of health with technology (and this links with the previous post) is how much technology could limit person to person interaction. Maybe as a baby boomer I'm just reacting against the technolization (yes this is a word) of the social interaction and worrying about the important effect this could have on health. We NEED BOTH THE TECHNOLOGY AND THE SOCIAL INTERACTION.

I know this is a bit left field, but have a look at the virtual street corner project in the US ( go to http://www.johnewing.org/VirtualCorners/2/).

This is a social project that linked together neighbourhoods by placing a big video screen with microphones in each neighbourhood and just letting people talk to each other.

It got me thinking about why people used it, in part I think it is about not having to have permission to talk to the other person (if you are in front of the screen you are ok to talk to).

I am concerned that the Government both state and federal are not looking a the huge range of technical advances that's available to support trainee doctors in hospitals , local GP's and visiting specialists in country Victoria.As it stands trainee doctors and junior hospital doctors in country hospitals are not getting the training and support that doctors used to get twenty years ago . Rather than ignore the situation, the only way forward is for these doctors to have tutorials with hospital specialists in major teaching hospitals via high speed tele medicine .

I know this may be scary for all the doctors and nurses, but why cant I see my progress (is hospital charts ) when I am in hospital, especially if it is linked to some question and answer stuff that allows me to understand what the terms they use mean and MOST importantly it is linked to the things I can do in hospital to get out quicker...this is REALLY in rehab facilities

I live in the country so when I'm in hospital for treatment (for up to several weeks at a time) it's difficult for family and friends to visit. Video-conferencing technology is becoming commonplace and the National Broadband Network promises to deliver high-speed connectivity to rural and regional areas.

Is it possible for the hospital to provide video services that family and friends could take advantage of ?

A facility must understand and map out the clinical process around the Models of Care going into the new facility so the technology, that is, infrastructure, hardware, software ,etc can support that models of care. The technology is only a 1/3 of the equation – the understanding of the clinical and business process is the key to success. The technologist and clinical staff need to work together in the design and implementation of any hospital that will use technology as a tool set to deliver patient care.

This was a comment on one of the Shouts that I thought should be brought to the front page...Brendan.... In my experience EDs are blocked at the back door. That is, it is the delays in finding beds in the hospital and getting the patients for admission out of the ED and into the hospital, that are causing the chaos in EDs. Good work can be done in EDs for sure - streaming, ED efficiency, improved patient flow, improved clinician efficiency...