mobile ehealth devices : progress and potential midis and mobile information delivery within the...

Mobile eHealth devices : progress and potential

“MiDIS and mobile information delivery within the community”

Purpose:A brief look at the challenges within mobile service delivery and how NHS Tayside are looking to meet user expectations of a community based mobile solution suitable for MiDIS consortium partners.

Version 0.4

Tayside eHealth

Finlay StewartHead of Development Services for eHealth in NHS Tayside

“Introduction and background”

Janice CaithnessProgramme Manager – MIDIS Consortium

“Utilising what currently exists”

Barry McGannTechnical Design Lead - NHS Tayside

“Multi platform mobile delivery”

Introduction

Introduction and background

• It’s easy, just do it; PC World, banking.

• User expectation (personal)– Need access to internet stuff, – signal lost / poor, – switch off / look out window / have coffee.

• User expectation (NHS service)– Need access to everything,– it’s not fast enough / unreliable,– can you fix it please.

Introduction and background

• Security; you are being over cautious.

• User expectation (personal)– public domain information,– personal data (banking),– their data; exposed under their control.

• User expectation (NHS service)– clinical data,– shared by multiple people,– other peoples data; exposed outwith their control.

Introduction and background

• Two key areas that we have to consider;– critical service over nice to have,– increased impact of personal data loss.

• Need to - design with mobile in mind– Fife; BYO device– FV; changing working practice– Ayr & Arran; scoping of offline forms

• A successful mobile solution will be based on these principles not just utilising new Tablets/Smartphone's.

• Test of change (*4) – Janice & Barry

NHS Tayside

Community Mobile Working

Test of Change

Janice Caithness

MiDIS Consortium Programme Manager

Test of Change (1 & 2)

• To support Community Nursing NHS Tayside are undertaking Tests of Change for solutions to provide Remote Access to NHS Tayside Web based systems.

• The aim of this project is to test the solutions, present findings and make recommendations for future solutions.

• The Community Nursing staff provide feedback on each solution within each phase.

Test of Change (1 & 2)

These solutions provide lookup and data entry capabilities • Access to MiDIS & NHS Tayside Clinical Portal• 2 Laptops and 4 iPAD’s were issued to

Community Staff over 2 sites • 17 members of Staff are involved in these Tests

of ChangeDependencies

• 3G coverage

Evaluation of TOC1 & TOC2

• Test of Change 1 has been completed following a 2 week trial. Feedback has indicated that the laptop solution is fairly cumbersome and accessing to the systems often proved difficult.

• Test of Change 2 has been completed following 4 week trial. Feedback has been more positive.

Feedback

Out of 155 Visits laptops were used 51 times (33% of visits)Laptop was used and recording in the system successful on 25 occasions (49% successful recording)

Out of 345 Visits iPADs were used 213 times (62% of visits)iPAD was used and recording in the system successful on 165 occasions (77% successful recording)

Feedback

Was connectivity (3G) an Issue?

Do you feel the laptop improved

working processes Overall Comments

Yes No

Long time to load, page not always available. Quite heavy to carry especially if doing INR's etc or if taking other supplies to patients homes.

Yes No

I could see the benefits of using mobile devices but not this one. Too long to load. Certainly increased our Face to Face time. Also quite heavy to carry when we had other equipment.

No No

The laptop took to long to load and was very heavy to carry around. If it could be left on it would be better but kept timing out. The dongle sticks out so was frightened of breaking it when moving about.

Did you find 3G connectivity an issue?

Do you feel the iPAD improved working

processes Overall Comments

No Yes

Used the user guide initially, but once familiar with iPAD found it very easy to use. Made life much easier accessing Clinical Portal if patient not known or registered with the practice.

No Yes

Good for using OOH's when working remotely. It has taken a while for me to get used to touch screen but getting better as time goes on. Having the iPAD is definitely a plus.

No Yes

No problem after the glitches in the middle of the trial. Very good & very easy to use. Patients interested as to why we ask certain questions and are curious about the paperwork we need to do. Does make the visit longer but the we can get more info from the patient during chat.

Current Developments

• In addition to the Laptop and iPAD Tests of Change we are working on developments which would provide a more “store and forward” approach.

• This will enable users to record data and then synchronise that data back to the required system. This would circumvent the issues with 3G coverage.

Digital Pens Mobile MiDIS

Test of Change 3 - Digital Pen

MiDIS forms

Developm

ent of

Inte

rface

(API)

to

retu

rn th

e data

to

What are we doing?

20 Digital Pens -Synchronisation of the Pen upon return to base

Test of Change 4 – Mobile MiDIS

• Testing suitability of NDL development platform

• Mobile application with MiDIS integration• Native application, offline/online

capability

Test of Change 4 – Mobile MiDIS

AWI MiDIS API MiDIS DB

NHS Tayside Data Centre

Container

Online/Offline

Evaluation and Review

• All tests of change will be evaluated.

• Recommendations for Future Solutions and requirements to implement a production service.

Further Information

Tracey WynesseHealth GMS Team – NHS Tayside

tracey.wyness@nhs.net

Finlay StewartHead of Development Services for eHealth

NHS TaysideEmail: finlay.stewart@nhs.net

Janice CaithnessMiDIS Consortium Programme Manager

Email: janice.caithness@nhs.net

Barry McGannTechnical Design Lead - NHS Tayside

Email: barry.mcgann@nhs.net