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Good Morning . I am Clive Stringer, Deputy IT Director at Kings College Hospital in London. This is my colleague Steve Groves. We are going to talk about how we have imlemented Docman Rerral management solution at kings in order for us to move to a paperless environment and to give patients a single point of access for referral enquiries. This is the old main Edwardian entrance to King's College Hospital in Sunny Camberwell London
This is the main entrance of the new bit of the hospital opened around 10 years ago
Hardware can be one of the most difficult things to decide upon Space – places to store and charge Users – ward based and / or visiting teams, numbers during peak times Drug rounds – do they use drug trolleys or pod lockers? COWs or integrated drug trolleys?
mHealth Symposium 2013 Colin Sweeney
IntegratingmHealth atKing’s CollegeHospitalColin SweeneyDirector of ICT
Agenda• Background of King’s and our EPR• Why do we need to be mobile?• Examples of projects requiring mobility– What is good/ what is not so good• Examples of devices we have tried• Obstacles and issues
King’s EPR Milestones• 1999 Implemented pilot of the initial EPR vision• 2002 Completed roll out of orders and results as first stage of EPR• 2000-2 Discharge notifications and TTA drugs• 2003 Replaced old IRC PAS with i.PM• 2004/5 PACS• 2005 First attempt at inpatient prescribing• 2007 Moved i.PM to CSC as part of iSOFT7• 2009 Inpatient noting• 2008-2010 Inpatient prescribing roll out
Vision and TacticsOur VisionA single point of access to information aboutindividual patients in electronic real-time formatHow do we get there?An EPR is a Strategy not a System
What does that mean?Choose&BookPACSRISSpecialtysystemsPathologyKCHdevelop-mentsi.CM/EPRPICUTIEE-Rost-eringE-PSBTheatresi.PM/PASMaternityData Ware-house/ABCFinanceScore-cardsE-LearningESRPharmacyA&ENHS MailNNBPayroll
Why do we need to be mobile?• Ward and drug rounds go to the patient• Data is best captured in real time with thesource present• People expect it• Examples of projects– Results review– ePrescribing– Continuation notes– Vital signs– Blood Tracking
Why do results need to be mobile?• Information required by the bedside• Actions can be progressed without delays• Information can be shared with the patient• Ward rounds in some specialties are veryquick
Paper• Handheld• Lightweight• Ultra portable• Low cost• Wipe clean or easilyreplaceable• Easily placed on drugtrolley• Clearly visible• Reliable• Easy to use
Computer on WheelsHandheld Lightweight Ultra portable Easy to push. Bedside careLow cost £1400 + VATPC additional costWipe clean oreasilyreplaceable Most parts wipe clean oreasily replaceableEasily placed ondrug trolley COW & Drug trolleyrequiredClearly visible 19 inch screensReliable 4 to 6 hours of battery lifeSome battery issuesEasy to use Standard PC setupKeyboard & mouse
Mobile Clinical AssistantHandheld Lightweight 1.5 kgUltra portable Bedside careLow cost £1700 + VATWipe clean oreasilyreplaceable Most parts wipe cleanEasily placed ondrug trolleyClearly visible 9 inch screensReliable 3.75 hours battery lifeIssues with hangingEndpoint encryptionEasy to use x Pen and virtual keyboarddifficult for some users.
Ruggedized LaptopsHandheld Lightweight But can get hot and feelheavyUltra portable Bedside careLow cost £1700 + VATWipe clean oreasilyreplaceableSome parts wipe cleanEasily placed ondrug trolleyThe keyboard sticks outcovering part of the drugtrolley.Clearly visible 10.2 inch Small screensReliable 4-6 hours battery lifeEndpoint encryptionEasy to use Keyboard useful
Touch Screen LaptopHandheld Lightweight But can get hot and feelheavyUltra portable Bedside careLow cost £1800 + VATWipe clean oreasily replaceableSome parts wipe cleanEasily placed ondrug trolley Keyboard rotates andused as a tablet.Clearly visible 12.1 inch screensReliable 6-8 hours battery life(with battery slice)Endpoint encryptionWireless issuesEasy to use Keyboard & Touchscreen
Computerised Drug Trolleys (Large)Handheld Lightweight Heavy to push when fullUltra portable Close to bed ends.Low cost £1400 + VATPC additional cost.Wipe clean oreasily replaceable Most parts wipe clean oreasily replaceableEasily placed ondrug trolley Integrated drug trolleyClearly visible 19 inch screensReliable 4 to 6 hours of battery lifeEasy to use Standard PC setupKeyboard & mouseToo large for some users
Computerised Drug Trolleys (Small)Handheld Lightweight Easy to push when fullUltra portable Closer to bed sideLow cost £1400 + VATPC additional cost.Wipe clean oreasily replaceable Most parts wipe clean oreasily replaceableEasily placed ondrug trolley Integrated drug trolleyClearly visible 19 inch screensReliable 4 to 6 hours of battery lifeEasy to use Standard PC setupKeyboard & mouse
Laptop TrolleysHandheld Lightweight Easy to pushUltra portable Can go most areasLow cost £350 + VATLaptop additional cost.Wipe clean oreasily replaceable Most parts wipe clean oreasily replaceable. Anti-microbial keyboard screen.Easily placed ondrug trolley But useful if medication isby the bedside.Clearly visible 15 inch screensReliable 4 to 6 hours of battery life(with 9-cell battery)Easy to use Standard Laptop setupKeyboard & mouse
iPadsHandheld Lightweight But can get hotUltra portable Can go most areasLow cost £400 + VATWipe clean oreasilyreplaceable Most parts wipe clean butissues with cleanersEasily placedon drug trolleyClearly visible x Small screensReliable 8+ hours of battery life.Different set upEasy to use x Overlay keyboard not builtfor Windows applications
iPod touchesHandheld Fits in pocketLightweight VeryUltra portable Can go everywhereLow cost £125 + VATWipe clean oreasilyreplaceable Most parts wipe clean butneed casesEasily placedon drug trolleyClearly visible x Very small screensReliable 8+ hours of battery lifeEasy to use x Overlay keyboard not builtfor Windows applications
Concerns• Paper is easier/quicker to use?• The number/variety of devices required• No one device meets all our needs• Dependence upon a reliable, stable andhigh performing network