As part of the HTN Health Tech Trends Series, we researched a variety of health tech projects making a difference across health and care and have included the projects and learnings in this article.
[8 minute read]
Southampton digitises ward rounds
University Hospital Southampton NHS Foundation Trust inhouse team has developed digiRounds, to present all patient data and information required by clinical staff to conduct a ward round.
The trust said to HTN “Crucially this data needs to be presented in a compact format that is thorough, accurate and time efficient.”
“Critical care at UHS was fully electronic and digitally advanced following the successful implementation of Metavision which, among other functionality, displayed an electronic observation chart on computers at the end of every bed which were supplemented by a dedicated ward round Computer on Wheels (COW). “
“Metavision streamlined nurses workflow but it was harder for consultants to manage patients”, the trust said. “The end of bed paper charts were taken away but this made things harder, slowed down the ward round and staff found that while they could look at the information away from patients, it was harder to manage them on the ward because the ease of access to view data was limited. The end of bed screens would be in use by nurses inputting observation data and the COW was physically too big and bulky to wheel around the ward.”
“So while Metavision worked in a keyboard and mouse environment, is was not suitable for a mobile, touchscreen tablet. “
“The solution was to create an app specifically designed for a mobile, touchscreen tablet (not a keyboard and mouse device) whereby clinicians could access and see information in a user-intuitive manner. It was crucial to remove time-consuming logins and time wasted spent looking for patient information, images and test results across multiple systems. digiRounds also targeted junior doctors on mobile phones who were looking at limited information.”
Critical care consultant Mat Cordingly has led the design and further development of the application. Cordingly is dyslexic and believes this has been driving force when it comes to the clarity of design:
“It was crucial for us not to include any unnecessary information, icons or images,” he said. “We made sure there were a maximum of seven tabs on the screen because we know that any more than this amount of tabs would lead to the user skipping and cherry picking information.”
“Within those we knew we needed to replicate the look and feel of a traditional obs chart, to keep historical familiarity and structures, basing the design very much upon the paper version clinicians are accustomed to using.”
“This allowed senior and experienced clinicians to interpret information without having to relearn different styles of charts etc. This same approach was applied to the fluid chart which, on digiRounds, is identical to traditional paper charts.”
UHS digital is now looking to increase the information digiRounds will show – it currently shows the name of every document, including EDMS docs, and the immediate future is to keep the structure and continue to present in a format which works for doctors. The trust said “This is about polishing it a every stage, not adding features for the sake of adding features.”
The next steps will see digiRounds start to allow data input in a limited format at the end of the bed. The team are researching what data elements would work well at the end of the bed, for example, clinicians would be able acknowledge results and add a job plan for ordering tests at the bedside.
The future vision is to standardise the key elements of digiRounds which would work as a platform for other NHS trust systems.
“digiRorunds makes being a doctor more enjoyable,” said Cordingly. “We are able to make a diagnosis, rather than spend time logging in, and we enjoy seeing patients more because if you can’t see the data it’s incredibly stressful.”
Lancashire digitises discharges with social care
Lancashire Teaching Hospitals in partnership with Lancashire County Council have worked together to implement an interface between two systems that allows discharge action plans to be available for Social Care immediately.
The technology (a messaging service) allows for electronic transfer of the assessment, discharge and withdrawal information from NHS organisations to Local Authorities in a way that is directly imported into social care systems and workflow, with messages also coming back from Lancashire County Council to Lancashire Teaching Hospitals.
The following systems are involved in this project:
- Quadramed-Lancashire Teaching Hospital (Message Initiator)
- LPRES -Lancashire NHS Internal facilitating system (Transfer Messages)
- ESB -Lancashire County Council internal messaging system (Transfer Messages)
- Liquid Logic -Lancashire County Council Social Care System (Receive Messages)
The trust said “Anticipated efficiencies in processing may lead to a reduction in the number of days a patient stays in hospital which benefits the Trust immensely. It also, more importantly, ensures than the patient receives the care they need as Social Services will have specific, correct and timely information at their fingertips to aid with planning and resource management.”
London North West surgeon uses app to help surgery in developing countries
A surgeon at North West London University Healthcare NHS Trust is using a phone app from Touch Surgery to help train doctors in surgical techniques in developing countries.
Abdul Ahmed, a maxillofacial surgeon at Northwick Park Hospital, uploads the step-by-step video guides to the Touch Surgery app along with advice, insights and Q&As.
Abdul said: “An instructional video is always going to be more useful than a book and the fact that more people have access to smart phones than expensive medical textbooks shows how useful it can be.”
“I’ve uploaded several videos and it’s great to be able to practically share what I do with students and fellow surgeons in countries that don’t have the same resources.”
“I also use it with trainees in the UK at the London School of Surgery prior to them dealing with patients.”
Worcestershire Health and Care pioneers mental health app
Worcestshire Health and Care NHS Trust has built an innovative app to transform mental health and wellbeing support for children and young people in Worcestershire.
The app called BESTIE, is an interactive online platform to revolutionise the way children, young people and parents get access to online help to support emotional resilience and wellbeing.
BESTIE encourages users to engage in social, physical and health-related activities. One version of BESTIE will support children/young people who are accessing mental health services, providing online resources and tools to support their specific care plans, as well as resources which help them to track their mood, goals and progress.
The interactive online platform, combines digital media, instant messaging, games and supportive help and information within an anonymous, safe platform.
The app also features a secondary platform, (CAMHS Bestie) which is only accessible to young people who are accessing CAMHS in Worcestershire. This area will allow data inputting and mood tracking, where the young people can track their progress and engage in activities delivered as part of CAMHS. Bestie will provide a digital link for children and young people directly to their clinician.
Dr Ben Rogers, Trust Lead for Psychological Interventions said “Children and young people who use our services have been telling us for years that we need to make better use of technology in healthcare. As digital natives, they have an incredible expertise in the use of online technology which can help to guide the NHS. By taking a leading role in developing BESTIE, alongside clinicians and IT experts, young people in Worcestershire have helped to create a resource that will support others to reach their potential.”
BESTIE public version has completed pilot phase and is currently being rolled out as a webapp, with the app store availability coming very soon.
A robot’ helps to reduce hospital admissions in Rochdale
A new virtual consultation system, piloted for use by the Bury and Rochdale Care Organisation, dubbed ‘Robbie the robot’, is helping residents in a Rochdale care home avoid hospital admissions.
Located at Ashbourne Care Centre in Rochdale, the system allows the Care Home Extra Support Service (CHES) (a service run by the Bury and Rochdale Care Organisation, which is one of four Care Organisations that form the Northern Care Alliance NHS Group), to use a two way encrypted video link, to provide a triage system, with nurses, physios, paramedics and other clinicians , assessing a resident’s medical needs and providing advice, assessment and onward referrals as necessary.
The device uses a high definition, mobile camera, speakers and microphone, and allows some medical monitoring devices to be ‘plugged’ in to the device, e.g. a stethoscope, allowing clinicians to perform part of a remote medical examination.
Currently the Care Home Extra Support Service helps to avoid admission for over 80% of care home residents they see. By using this device, it is expected to make the service even more efficient in avoiding unnecessary admissions by reducing response time and optimising clinician input.
Colin Carr, Nurse Community Practitioner, Care Home Extra Support said “This device is a great help in allowing us clinicians to see the patient and carry out a more thorough assessment, before making an initial clinical decision. It allows us to talk directly to the patient, and even remotely use a stethoscope to assist in examination. It is easy to use, and the residents and staff have accepted its use well. Along with the Care Home Extra Support team, it has been instrumental in preventing unnecessary hospital attendance, ambulance use and keeping residents safe and well in their home.”
Digital meal ordering system saves Morecambe Bay £26k
An innovative electronic system which allows staff on the wards at the Royal Lancaster Infirmary to order inpatient meals on the same day has reduced food wastage by an average of 49% since it was introduced in July 2018. This equates to a saving of £26,000.
Before the new system staff would have had to fill in a paper form and take it to catering staff a day in advance – this could mean that if a patient’s appetite changed meals could be wasted.
Since the system swap, 359,819 meals have been ordered on 20 wards at RLI and nine wards at FGH.
Jackie O’ Brien, Catering Manager, University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT), said “The reduction of food wastage has been staggering and something we’re really proud of. The new system has saved time for catering supervisors’ as they no longer have to count meal numbers. The new system does this automatically for them. So they have more time to better provide the services that focus on patient improvements.”
The new ordering system allows meals to ‘follow the patient’ should they be transferred to another ward, as well as providing for swift cancellations if they are discharged.
Wrightington, Wigan and Leigh first in Europe to install intelligent lighting
Wrightington, Wigan and Leigh NHS Foundation Trust has become the first NHS Trust in Europe to install energy-saving and cost-effective intelligent lighting, saving around £38,000 per year in energy costs.
A lighting upgrade saw the trust replacie existing lights with new LED luminaires, and uses lighting controls and building Internet of Things (IoT) technology from Enlighted Inc., a Siemens Company.
Each of the 612 LED fittings and sensors incorporate bluetooth beacons that transmit and receive data, establishing an Internet of Things (IoT) infrastructure across the site.
And as the Bluetooth is constantly monitoring and transmitting data, it can be used to tag and track medical equipment and assets, and for real-time space modelling.
Several visualisations providing heat mapping, motion trails, motion animation, time series and more can all be reported on, allowing the Trust to gain greater awareness of space usage – crucial when planning for future developments.
Mark Hogan, Senior Operational Estates Manager said “When Enlighted came to us with a proposition that their technology could help reduce the organisation’s environmental impact through reduced energy consumption – and at the same time introduce many other key technological tools to help with asset tracking, space utilisation and many other control functions – we were very interested.”
“All of the aforementioned tools are built into one device which means that, although initially we installed the technology to control lights, which provided a very good return on investment, we have the ability to ‘Bolt on’ at a click of a button, the other features of this all-encompassing technology.”
Greater Manchester Mental Health introduces media walls
Greater Manchester Mental Health NHS Foundation Trust houses the John Denmark Unit (JDU) a specialist National Deaf Mental Health Unit providing 18 specialist deaf open acute beds.
The target deaf patient group for the JDU is for individuals who have not been previously able to hear.
The trust said to HTN “the most technologically challenging innovation has been the recent installation of Media Wall touch screen TVs in all the bedrooms at the John Denmark Unit. Working in collaboration with the Trust’s Information Management and Technology department and external software suppliers based in Holland, we have created a bespoke system to support our patients’ requirements.”
“Every patient bedroom now has a media wall installed and the content of each individual device can be controlled by a central computer to tailor requirements to the individuals needs and maximise the systems effectiveness.”
“Creating media walls in a complex clinical environment such as the JDU was an excellent opportunity to use technology in creative and innovative ways. These media walls have access to BSL Zone, which is an internet TV channel offering a range of programmes in BSL and contain both bespoke and generic information videos in BSL along with the capability for patients to make video calls to family members.”
“Additional JDU staff have developed information in BSL specifically for these devices, to support patients, examples of this are a package explaining the Mental Health Act and the individual’s rights and deaf easy-read patient medication information leaflets.”
Dr Sodi Mann, Consultant Psychiatrist & Clinical Lead, John Denmark Unit, Manchester “The media walls have been a great innovation for our patients, connecting them to information in a way only previously dreamed of but this project is far from complete, with staff now looking to develop medication information leaflets in BSL video format.”
“Hearing patients, whatever their first language, currently have access to reference material on all medications. There is a lack of parity for deaf patients who struggle with literacy and where English is not their first language. The lack of reference material for medication in BSL is currently an issue both in the community and inpatient settings.”
“Our vision for the future is to continue to develop media wall content, specifically creating around 40 BSL videos of the most commonly prescribed medications in mental health services. These would be accessible to patients on their media, in a bespoke manner. Greater Manchester Mental Health NHS Trust will make these videos freely available to the deaf community via a JDU YouTube channel, along with other BSL material already developed”.
