Journalist Mark Say looks at how care workers in the UK, empowered by mobile technology, are providing better service in the community
Mobile technology is providing the NHS with opportunities to develop a new dimension in healthcare, supporting a shift away from the hospital and GP surgery to provide operational efficiencies and raise the quality of care by making professionals more responsive to patients.
There are plenty of signs of it being a national trend. At the centre, the government has provided £100 million to England’s NHS for 2013-15 to support the adoption of mobile technology under the Nursing Technology Fund, emphasising the future importance of remote access to records, capturing clinical data at point-of-care and remote interactions between clinicians and patients. It is also becoming apparent at a local level: recent months have seen tenders such as NHS 24 in Scotland seeking apps for mobile devices to support elderly care and Central London Trust aiming to equip staff with mobile devices under its transformation programme.
There is evidence of the advantages mobile technology can provide. The Bristol Clinical Commissioning Group (CCG) has given an example, enabling patients with chronic obstructive pulmonary disease or chronic heart failure to provide relevant data on their conditions through mobile devices. In July, community matron Chris Stevens told the Bristol Post it had allowed professionals caring for the patients to spend less time on routine monitoring, more with high risk patients, and to be more proactive when an intervention was needed. Also, the CCG released data showing that, over a month, patient contact with community nurses was reduced by 26%. Over six months, phone contact with GP practices went down by 60-100% and face-to-face contact went down by 48-68%.
Another project has been run by Blackpool NHS, which has given its team of district nurses tablet computers to access records from patient’s homes, providing the data to support their work and giving them more time with patients. It helps them to identify any concerns instantaneously and take action to prevent problems and better manage chronic conditions.
Responsive to patients
The common theme is that mobile devices can give professionals more time with the patients who really need their support, making them more responsive and improving the quality of care.
The potential is further increased by the development of mobile apps, available for iOS and Android devices, for monitoring and providing advice on a wide range of conditions, including diabetes, oncology, cardiovascular and optical problems. These can make healthcare workers more flexible in carrying out some tasks in patients’ homes that previously required a hospital visit.
Other organisations have shown how mobility can deliver financial savings. Northern Devon Healthcare Trust has provided one example with its ComPAS project, which involved providing staff with more than 800 tablet computers to input data from patients’ homes. It cost £370,000, but last year the trust reported that it had saved £750,000 through making better use of its employees’ time and being able to collect data at no extra cost.
Mobile technology also opens up the potential for a big increase in homecare. Patients will be equipped with devices to fill out treatment and symptom diaries and monitoring equipment that can send data over the internet. Clinicians and nurses will be able to access patient monitoring ports to keep an eye on crucial data and receive alerts when necessary. This can make more patients less dependent on visits and give the professionals extra time with those who need more direct care.
All of this is creating a trend in which the NHS is increasing its investment in mobile technology. Stephen Roberts, managing director of public sector IT analyst firm Kable, says that, with the Nursing Technology Fund available and pilot projects on clinical mobility running in rural areas, organisations will spend more on laptops and tablets. “The bulk of NHS ICT spend comes from acute care, where we’re observing ramped-up investment in wireless networking platforms to support roaming clinical and administrative staff in larger hospitals,” he says. ”Technology on the whole is getting closer to the patient.”
Research by Kable has shown that reducing costs and improving frontline efficiency are the top business priorities for NHS organisations. In May and June of 2014, it surveyed 200 public sector officials, mostly from IT departments, on what they saw their priorities to be. Among the results 79% of NHS respondents emphasised cost savings as a priority and 74% highlighted increasing frontline worker efficiency. The survey also highlighted that many respondents saw mobile technology as a key driver to achieving those priorities. In response to the question of what factors are most important when implementing mobile solutions, pricing and value came out on top at an average of 9.0 on a scale of 1-10; but the need for appropriate security accreditations is almost as high at 8.9. This is not surprising, given the sensitivity of health records and the fallout facing any organisations suffering a loss or data breach.
This makes it clear that the excitement around mobile technology has to be tempered by the financial realities and practical demands. New devices and software are offering plenty of options to take healthcare into communities, but the NHS has to work within its spending limits, and senior managers will have to make a convincing business case for individual investments. The big factor in favour will be the potential for savings. In the shorter term, organisations can reduce the need for support in data entry, and cut the time that healthcare professionals spend in travelling between patients and hospitals. In the longer term, they will be able to reduce their property estates as more care is delivered within communities.
There is also the argument that helping patients manage their conditions at home can reduce the demand for urgent and expensive interventions. Bringing these factors together is going to increase the move towards mobility in healthcare.
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