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Community staff in Nottingham trial wireless record access

Tags: Broadband   CfH   Community   Informatics   Labour   Quality   Security   Solution   SystmOne  

10 Jul 2007

Elaine Morris

Community-based health professionals in Nottingham have taken part in a successful three month mobile technology trial, using wireless broadband-enabled laptops from Dell to access and update patient records on the move.

The trial enabled staff to remotely access and update electronic patient records from the SystmOne primary and community care system supplied by TPP.

The results of the trial showed that on average staff had 38 minutes additional productive time per person per day with the potential to save 60 minutes a day. The trust saw a reduction in travel times of 32% and realistic additional potential to reduce commuting by 50%, with the potential for a 25% increase in productivity.  

On average 96% of patient notes completed on the day, rather than a typical delay of up to 48 hours before. Users perceived an average of 70% improvement in facilities to do their job, Dell claims.

Staff involved included community-based clinicians and therapists, including: community matrons, paediatric physiotherapists, paediatric occupational therapists, paediatric speech and language therapists who spend a lot of time working outside of the trust’s premises.

Using high-speed wireless laptops securely connected to N3 authorised staff were able to log onto the Care Records Service using their NHS smartcard and can gain access to patient records on the move. They can also update these on the spot in patient's home, rather than having to return to the office to key in details of home visits.

Clinicians and therapists working in Nottingham were provided with 3G-enabled Latitude notebooks from Dell, which wirelessly connected to the NHS N3 network using its remote worker function over a secure Virtual Private Network.

The trial was carried out by Nottingham’s Health Informatics Service together with Dell, the first time the company has attempted this kind of secure mobile access over N3.

Users were given training on the technology and monitored throughout the trial. This included daily diary reports from the users and weekly telephone interviews to chart progress. Approximately 1,000 user days were analysed in total during the full trial programme.

Staff were given hi-tech laptops, which could automatically select either GPRS, 3G or 3G broadband network access dependent on availability and immediately saw the benefits of the new way of working.

A team of experts from within Dell, Intel and Vodafone developed the wireless laptop solution for the NHS. In addition to the initial research and development the solution was carefully evaluated by conducting interviews with clinicians to understand their working practices, identifying the technology required and providing training for end users.

Elaine Morris, community matron at Nottinghamshire County Teaching PCT, told E-Health Insider: “Mobile working has completely changed the way I work for the better and improved patient care. I don’t have to report back to the office throughout the day to write-up my notes and so my travelling time has substantially reduced and that really helps to reduce everyday stresses.

“I feel the service I am giving to my patients has really improved and they are reassured that I've got good current information to hand at all times. I wouldn’t want to give-up this way of working now.”

She added that patients welcomed clinicians using laptops with them, with no complaints during the pilot. Issues did arise due to poor signal at times, but this was countered when staff drove nearer to areas where coverage was stronger.

“All staff in the trust who work with patients and use the SystmOne system are able to log on using their restricted smartcards and go through records with patients and update them on the spot, instead of commuting back to the office. Patients and staff both appreciate this and I can’t see why any trust would not want to embrace this technology.”

Dell’s director and general manager for the UK public sector, Iain Campbell, told E-Health Insider: “Mobility is one of the key areas that we wanted to do a bit of testing in, as it is such an important requirement for both healthcare and education.

"Nottingham were long-standing customers of ours, and they wanted to explore how to use technology away from clinical settings, and what the potential was for labour and time savings, so we went about exploring mobile access with them.

“It was imperative that we found a way that authorised clinicians could get access to the data they needed for an individual patient, and could then store this on a record and not on the machine. Given the sensitivity of the data, it was important to ensure it remains secure and is available to the right people with the right robustness of security.”

Barbara Stuttle, NHS Connecting for Health's national clinical lead for nursing said: “The Dell mobility trial has helped to transform the way community clinicians and therapists work. Users have access to real time information, enabling them to plan their day better and have direct contact with colleagues and hospitals. This solution is helping to deliver the highest quality care for patients. Services like this will help improve the overall service the NHS provides by giving a more ‘joined-up’ approach to patient care.”

Dell’s sales manager for public sector health and emergency services, Richard Rawcliffe, told EHI: “We worked with the IT department in the trust to ensure that the VPN works wirelessly within their specific IT governance guidelines. Essentially, the security requirements needed to be controlled so unauthorised access could not be possible. Smartcard controlled functionality ensures this.

“The great thing is that because staff were used to SystmOne and most know how to use a laptop, the training was minimal and the benefits were easy to see. The response has been fantastic, and we have had support from CfH for our system.”

© 2007 E-HEALTH-MEDIA LTD. ALL RIGHTS RESERVED.

Reader's Comments
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Reader's Comments

1

any more details?

rmills@nhs.net

10 Jul 07 13:07

I'm interested in this as a similar selection of suppliers including CfH were engaged with my organisation to trial this - remote access to the clinical system while in a patients home, sat in a car, at McDonalds, etc.

Unfortunately the concept was signed off but after a few months it never came to anything as the means of access being proposed -BTN3 token based access to N3 - didn't offer end to end encryption and the N3 extended VPN solution was not (and still isn't) available.

How did this trial get around the encryption requirement? Did the application being accessed offer encryption?

I'm presuming that th eencryption issue was tackled successfully


2

Encryption

10 Jul 07 20:07

Yes, the clinical application (TPP SystmOne) and our Outlook Web Access email service offers suitable encryption so there were no problems with using the n3 tokens. If you require further information please reply to the post and I will pass you my email address, I was in post as Head of IT at the time of the trial but have since left the service. Kind regards Leon Judge


3

hi Leon

rmills@nhs.net

11 Jul 07 11:07

thanks for your reply. Glad your organisation appreciated the encryption requirement, the application chosen to use for the trrial didn't offer encryption and the CfH people involved with were totally unaware of it and quite prepared to go ahead without it. Their next solution was a totally offline version of the application - on unencrypted devices - obviously ruled out too.

Several members of the team insisted that the smart card encrypted sessions rather than being an authentication device which was a little worrying. The project was still deemed a success as they had proved the concept - nurses would like to access systems and records remotely. Unfortunately the local staff who engaged weren't quite as happy to have wasted so much time or been teased with a range of devices they wouldn't get to use.


4

Credit Where Credit's Due

12 Jul 07 14:07

Leon/Cathie - We may not be there any longer but our legacy lives on.

Jenny & Co. - Well done, great work, a pity you don't get a mention in the article. Steve Prince


5

NHS Experts (we do have some!)

13 Jul 07 10:07

"A team of experts from within Dell, Intel and Vodafone developed the wireless laptop solution for the NHS."

Not quite correct. The wireless solution had been developed by the Health Informatics Service prior to the pilot. But nevertheless Dell and Intel helped with the development of an excellent pilot which is now likely to start being rolled out on a larger scale in Nottinghamshire.


6

Safety police

fredy36uk@hotmail.co.uk

15 Jul 07 21:07

I just hope the nurse in the picture has pulled off the road when doing this :) !!

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