Community staff in Nottingham trial wireless record access

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.”