Mobile Mental Health EPR a European First

Mental Health services are rarely seen as being on the glamorous side of information technology in healthcare but a groundbreaking Dutch project has shown the benefits of providing mental health professionals with the very latest in mobile technology.

Backed by the specialist Robert Fleury hospital in The Hague, a project to develop mobile electronic patient record (EPR) project has shown the benefits of the technology and became one of the first mobile wireless applications in Europe based on General Packet Radio System (GPRS) technology

Ton van Werkhoven, a trained nurse turned health ICT consultant, was external leader for the mobile EPR project. He told E-Health Insider the Mobile Mental Health EPR was set up to provide better synchronisation between the Robert Fleury hospital and nurses providing outreach care in the community.

"When nurses visit patients in their homes they have a big need for information on schedules, appointments and the patient’s record," said van Werkhoven. But under the existing system they had to go back to the hospital to fill in the electronic record, requiring a lot of travel.

The aim of the mobile EPR project was set up to provide better co-ordination of community mental health services, more up-to-date records and enable mental health nurses to spend more time visiting patients rather than having to return to base to fill in records.

Under the project, which began in September 2001, a group of five mental health nurses and a psychiatrist were provided with Compaq iPAQ pocket PCs (donated by Compaq), linked to a GPRS phone using Bluetooth technology. This provided them with wireless access to, and the ability to enter data into, the full EPR in the community.

“”We were the first commercial GPRS site in Europe," said van Werkhoven, who praised the speed with which wireless solution provider UniXS Solutions moved to deliver a mobile version of the electronic patient record system within three months."

The project focused on a patient group which were traditionally difficult to deliver co-ordinated care to in the community. "Care avoiders are a special group of patients, who don’t see themselves as patients and mental health nurses must often convince them they need care," explained van Werkhoven.

Because theses patients often lead chaotic lives maintaining an up to date record for them has traditionally been difficult. A mental health nurse may be contacted by the police in the morning following a complaint about a patient from a neighbour, and then in the afternoon the police may call again but deal with another nurse was unaware of the earlier incident.

"So there would often be a lack of information, and sometimes they made decisions that were not good as they were not aware of their colleagues’ earlier contact," said van Werkhoven.

In addition to providing more co-ordinated care the mobile EPR system has delivered significant time savings equivalent to 2-3 extra patient contacts per nurse a day. This was a significant benefit as nurses previously saw 4-7 patients a day and the hospital gets paid for each contact.

The system has also been well received by the nurses themselves.” The iPAQ and GPRS is very sexy for them,” said van Werkhoven, "The nurses and physicians say they like it very much and it is making their work much easier."

Over the next two months the system is due to be extended to 25 nurses and psychiatrists, with the number reaching 50-60 by the end of the year.

And van Werkhoven is confident that the technology will soon be adopted much more widely. "Within a few years we’ll see a lot of mental health institutions using this technology," he predicted.

Ton van Werkhoven will be presenting on the Robert Fleury Mobile mental health EPR project at Mobile-Health Europe , Maastricht, The Netherlands, 14-16 April, 2002.