A mobile workforce

Walk in to a hospital today and chances are you’re likely to be amazed by the technology that’s in use. Poorly-equipped hospitals housed in imposing Victorian buildings are rapidly becoming a thing of the past. Clinicians today are not only supported by high speed broadband but are increasingly using digital devices that are portable, lightweight and powerful. Most health practitioners are effectively mobile workers even within the confines of a hospital. It is no surprise therefore, that we’re seeing the rise of personal digital assistants (PDAs), tablet PCs and SmartPhones supporting them in an array of different care settings.  

Supporting collaboration
Healthcare is rarely a straightforward transaction between doctor and patient. More often than not it’s a collaborative process; one that involves a whole range of other health and social care specialists including phlebotomists, anaesthetists, physiotherapists and many more besides. By enabling more efficient and effective collaboration, wireless technologies are driving up the quality of healthcare, and perhaps most importantly of all improving patient safety. Wireless connectivity is becoming absolutely essential in the clinical environment, allowing people to share important information in new and meaningful ways. And with new software applications supporting the convergence of e-mail, messaging, audio and teleconferencing and telephony on to single devices and platforms, health workers have more control than ever before about when, where and how they are communicating.
    
Like something straight out of Star Trek, staff at Kings Mill Hospital in Sutton-in-Ashfield in Nottinghamshire were among the first in the country to use a new communications system that allowed them to use small voice-controlled badges to talk to one another. To be automatically connected to a colleague all they need to do is simply say a person’s name, department or role into their lapel badge. The solution from BT operates over a wireless local area network (WLAN) and has numerous benefits; for example, nurses can alert colleagues to the need for a second opinion without leaving the patient’s side.
    
With healthcare professionals beginning to embrace wireless technologies we are seeing the emergence of a growing and complex mix of services. Historically healthcare has been constrained by the physical architecture of hospital buildings themselves as well as the professional interests of practitioners. But wireless technologies are helping to change this, enabling multi-disciplinary teams to work together in new and sometimes virtual ways to deliver care that’s truly centred on the needs of the patient. And this is helping to drive up patient satisfaction, by making things more convenient for them, and ensuring that they get the right healthcare when they need it.

Improving patient safety
Patient safety is a major driver for hospitals that are building up their wireless capabilities. Wireless technologies are becoming part automated systems, with bar coding helping to improve the safety of the administration of medication at the patient’s bedside as just one example. But it’s also being used to track patients during their stay in hospital. The National Patient Safety Agency has cited patient misidentification as a major risk within the NHS, and the consequences of errors can be very serious. A recent report cited 493 cases of patient misidentification among 45 Trusts, around 40 per cent of which were the result of inadequacies on patients’ wrist bands, and eight of those cases were operated on. Wireless patient tracking solutions can help by giving clinicians a much higher degree of certainty about the link between a patient and patient data. Ultimately this reduces the chances of performing operations on the wrong people, on the wrong parts of the body (which some people call ‘wrong side surgery’) or the prescription of unsuitable drugs.
    
Recently shortlisted for a British Computer Society award, the John Radcliffe Hospital has deployed an electronic prescribing system for blood products that improves patient safety and cuts out inappropriate blood prescribing. Hospital staff use bar codes and hand-held computers to improve the safety of blood transfusions and ensure that the right blood is transfused to the right patient; and the inbuilt safety check has dramatically reduced the number of nurses needed to conduct a transfusion.
    
And at Queen Elizabeth Hospital in Edgbaston specialist transplant medics in the liver transplant department have been trialling encrypted wireless technology to ensure that they can identify suitable patients on the transplant waiting list. A specially developed application allows surgeons to see the most up to date information about potential patients on their Blackberries, which is held on a secure website. The solution, which does away with the need for the surgeons to carry paper copies of the waiting lists, enhances patient confidentiality but more importantly ensures that patients with critically ill conditions receive the lifesaving operation they need.

Generating efficiencies
Now more than ever before hospitals are under pressure to find smarter ways of delivering healthcare that create efficiencies and generate savings, and wireless has an important role to play. As well as the compelling safety benefits, patient tracking systems can help to make the theatre process more efficient by helping clinicians and managers understand exactly where patients are within the process and by predicting the availability of beds by monitoring how patients are moving throughout the treatment process.
    
As well as tracking patients, wireless technologies can help track physical assets within hospitals. Knowing exactly where medical equipment is can mean that hospital staff don’t waste their time scouring the hospital for a defibrillator or phoning colleagues in an attempt to locate one. It can also mean that the equipment itself is used more efficiently reducing the need to purchase additional equipment thereby savings hospitals much needed cash. By helping to ensure resources are deployed strategically and used more efficiently wireless solutions are helping to save money that can be reinvested back in the front line of patient care.

Unleashing the potential
While wireless technology in hospitals is being mainstreamed the development of new and innovative solutions doesn’t look set to slow down yet. A new generation of wearable wireless sensors is helping doctors monitor heart rate, blood pressure, blood oxygen saturation levels, respiration, fluid status etc, by communicating data to remote central systems in real-time. We are also beginning to see the development of digestible pills that patients can swallow and which then monitor core body temperature and relay the information back from the stomach to a waist unit via RFID (Radio Frequency Identification). A Silicon Valley company is said to be testing digestible chips that attach to conventional medication and send signals to clinicians confirming whether patients have taken their prescribed medication.
 
The future
To support the next generation of wireless technologies hospitals will need to ensure they make a decent invest in their core IT infrastructure and platforms. At the moment many hospitals are trying to install their own wireless infrastructures and have encountered numerous problems including ‘blackspots’, areas that don’t have sufficient coverage which can be caused by the fabric of the building itself amongst other things; professional installations by suppliers with expertise in this field can help to overcome these issues. And while there are good examples of medical applications that can be used on mobile or tablet devices, the vast majority are simply not mobile ready just yet.  
    
But perhaps the biggest challenge of all is not technical, it’s about the people. Hospitals need to look at their workflows and practices to identify which could benefit most from wireless technologies and ensure the staff are fully consulted and can see the benefits of any proposed changes – benefits to the patients and to themselves. Simply handing out mobile devices to clinicians won’t work there needs to be adequate training and buy-in from all the relevant parties.   
    
Wireless needs to be taken seriously. These solutions need to be seen as part of a hospital’s central business strategy – as important to their future success as imaging or intervention capabilities. But ultimately hospitals are expensive and there is increasing pressure for components of the care process to be pushed out into primary care and the community. Wireless technology will help to make this a reality.