mHealth Symposium 2013 Colin Sweeney

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  • Good Morning . I am Clive Stringer, Deputy IT Director at Kings College Hospital in London. This is my colleague Steve Groves. We are going to talk about how we have imlemented Docman Rerral management solution at kings in order for us to move to a paperless environment and to give patients a single point of access for referral enquiries. This is the old main Edwardian entrance to King's College Hospital in Sunny Camberwell London
  • This is the main entrance of the new bit of the hospital opened around 10 years ago
  • Hardware can be one of the most difficult things to decide upon Space – places to store and charge Users – ward based and / or visiting teams, numbers during peak times Drug rounds – do they use drug trolleys or pod lockers? COWs or integrated drug trolleys?
  • mHealth Symposium 2013 Colin Sweeney

    1. 1. IntegratingmHealth atKing’s CollegeHospitalColin SweeneyDirector of ICT
    2. 2. Agenda• Background of King’s and our EPR• Why do we need to be mobile?• Examples of projects requiring mobility– What is good/ what is not so good• Examples of devices we have tried• Obstacles and issues
    3. 3. King’s Background
    4. 4. King’s Background
    5. 5. King’s EPR Milestones• 1999 Implemented pilot of the initial EPR vision• 2002 Completed roll out of orders and results as first stage of EPR• 2000-2 Discharge notifications and TTA drugs• 2003 Replaced old IRC PAS with i.PM• 2004/5 PACS• 2005 First attempt at inpatient prescribing• 2007 Moved i.PM to CSC as part of iSOFT7• 2009 Inpatient noting• 2008-2010 Inpatient prescribing roll out
    6. 6. Vision and TacticsOur VisionA single point of access to information aboutindividual patients in electronic real-time formatHow do we get there?An EPR is a Strategy not a System
    7. 7. What does that mean?Choose&BookPACSRISSpecialtysystemsPathologyKCHdevelop-mentsi.CM/EPRPICUTIEE-Rost-eringE-PSBTheatresi.PM/PASMaternityData Ware-house/ABCFinanceScore-cardsE-LearningESRPharmacyA&ENHS MailNNBPayroll
    8. 8. Why do we need to be mobile?• Ward and drug rounds go to the patient• Data is best captured in real time with thesource present• People expect it• Examples of projects– Results review– ePrescribing– Continuation notes– Vital signs– Blood Tracking
    9. 9. Results Review
    10. 10. Images
    11. 11. Why do results need to be mobile?• Information required by the bedside• Actions can be progressed without delays• Information can be shared with the patient• Ward rounds in some specialties are veryquick
    12. 12. Drug ChartsElectronic Prescribing
    13. 13. EPMA – What is it good?• Prescribing process the same as orderinga test• Legibility• Availability• Administration monitored• Analysis/audit available• Decision support• Safety
    14. 14. Continuation notes
    15. 15. Continuation notes - Good• Legibility• Availability• Easy to use• Meets national standards• More structured
    16. 16. Vital Signs
    17. 17. Vital signs – good• Easy bedside entry• Calculates Early warning scores• Draws graphs• Accessible from wherever• Nurses extremely positive – want to usetools for more
    18. 18. Blood Tracking• Need to identify patient positively• Need to ensure that the blood product isright• Need to record who administered theproduct• Need to print labels at source
    19. 19. Hardware
    20. 20. Paper• Handheld• Lightweight• Ultra portable• Low cost• Wipe clean or easilyreplaceable• Easily placed on drugtrolley• Clearly visible• Reliable• Easy to use
    21. 21. Computer on WheelsHandheld Lightweight Ultra portable  Easy to push. Bedside careLow cost  £1400 + VATPC additional costWipe clean oreasilyreplaceable Most parts wipe clean oreasily replaceableEasily placed ondrug trolley COW & Drug trolleyrequiredClearly visible  19 inch screensReliable  4 to 6 hours of battery lifeSome battery issuesEasy to use  Standard PC setupKeyboard & mouse
    22. 22. Mobile Clinical AssistantHandheld Lightweight  1.5 kgUltra portable  Bedside careLow cost  £1700 + VATWipe clean oreasilyreplaceable Most parts wipe cleanEasily placed ondrug trolleyClearly visible  9 inch screensReliable  3.75 hours battery lifeIssues with hangingEndpoint encryptionEasy to use x Pen and virtual keyboarddifficult for some users.
    23. 23. Ruggedized LaptopsHandheld Lightweight  But can get hot and feelheavyUltra portable  Bedside careLow cost  £1700 + VATWipe clean oreasilyreplaceableSome parts wipe cleanEasily placed ondrug trolleyThe keyboard sticks outcovering part of the drugtrolley.Clearly visible  10.2 inch Small screensReliable  4-6 hours battery lifeEndpoint encryptionEasy to use  Keyboard useful
    24. 24. Touch Screen LaptopHandheld Lightweight  But can get hot and feelheavyUltra portable  Bedside careLow cost  £1800 + VATWipe clean oreasily replaceableSome parts wipe cleanEasily placed ondrug trolley Keyboard rotates andused as a tablet.Clearly visible  12.1 inch screensReliable 6-8 hours battery life(with battery slice)Endpoint encryptionWireless issuesEasy to use  Keyboard & Touchscreen
    25. 25. Computerised Drug Trolleys (Large)Handheld Lightweight  Heavy to push when fullUltra portable  Close to bed ends.Low cost £1400 + VATPC additional cost.Wipe clean oreasily replaceable Most parts wipe clean oreasily replaceableEasily placed ondrug trolley Integrated drug trolleyClearly visible  19 inch screensReliable  4 to 6 hours of battery lifeEasy to use  Standard PC setupKeyboard & mouseToo large for some users
    26. 26. Computerised Drug Trolleys (Small)Handheld Lightweight  Easy to push when fullUltra portable  Closer to bed sideLow cost £1400 + VATPC additional cost.Wipe clean oreasily replaceable Most parts wipe clean oreasily replaceableEasily placed ondrug trolley Integrated drug trolleyClearly visible  19 inch screensReliable  4 to 6 hours of battery lifeEasy to use  Standard PC setupKeyboard & mouse
    27. 27. Laptop TrolleysHandheld Lightweight  Easy to pushUltra portable  Can go most areasLow cost  £350 + VATLaptop additional cost.Wipe clean oreasily replaceable Most parts wipe clean oreasily replaceable. Anti-microbial keyboard screen.Easily placed ondrug trolley But useful if medication isby the bedside.Clearly visible  15 inch screensReliable  4 to 6 hours of battery life(with 9-cell battery)Easy to use  Standard Laptop setupKeyboard & mouse
    28. 28. iPadsHandheld Lightweight  But can get hotUltra portable  Can go most areasLow cost  £400 + VATWipe clean oreasilyreplaceable Most parts wipe clean butissues with cleanersEasily placedon drug trolleyClearly visible x Small screensReliable  8+ hours of battery life.Different set upEasy to use x Overlay keyboard not builtfor Windows applications
    29. 29. iPod touchesHandheld  Fits in pocketLightweight  VeryUltra portable  Can go everywhereLow cost  £125 + VATWipe clean oreasilyreplaceable Most parts wipe clean butneed casesEasily placedon drug trolleyClearly visible x Very small screensReliable  8+ hours of battery lifeEasy to use x Overlay keyboard not builtfor Windows applications
    30. 30. Concerns• Paper is easier/quicker to use?• The number/variety of devices required• No one device meets all our needs• Dependence upon a reliable, stable andhigh performing network
    31. 31. My current image of the future
    32. 32. Any Questions?ColinSweeney@nhs.net

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