Clinical Efficiencies for Ward Based Computing Matthew Douglas mHealth Consulting Canice McKee Lincor Solutions
Hospital Perfect Storm Focus on Patient Experience Reduced Income Medical Inflation Do More with Less Aging Population NHS Structural Changes Need to Reduce Length of Stay Increased Accountability Patient Empowerment Performance Targets
Better Data Improved Outcomes Enabling Technologies Clinical, Management and Financial Information
What the NIMM doesn’t tell you Enabling Technologies Clinical Information National Infrastructure Maturity Model
Review of technology on wards London Acute Hospitals, Future Market Trends in Ward Based Computing (2007).
Clinical Imperatives for Ward Based Computing • Support for the way that clinicians work • Clinician involvement in the planning process • The ability to handle structured and unstructured data • Access to comprehensive complete medical information • Rapid response, not more than 1 second • No queues, an adequate supply of hardware • Single sign-on • Voice and video • Robust devices • Cleanable, no spreading of infections • Wireless and portability London Acute Hospitals, Future Market Trends in Ward Based Computing (2007).
Clinical Computing Clinical Information Enabling Technologies Single Sign On Desktop/Laptop Virtual Desktop • EPR • OCS/e-Prescribing • Group Scheduling • PAS • Pathology • Pharmacy • Radiology • PACS • EDM • Vital Signs Monitoring Bedside Computing Pervasive session that follows the clinician as they go about their work Bed management Cleaning tasks Meal Ordering BYOD
Patient Services Entertainment & Communications Services Telephony & Video Calls Virtual ward rounds for doctors Patient Monitoring Patient Information/Education Satisfaction Surveys Meal Menus/Ordering Pain Management Environment control • Telephony & Video Calls • Integrated to Trust exchange • Skype functionality for friends and family • Television • Radio • Internet • Games • Music • Talking Books Full flexibility for revenue generation as decided by the Trust.
The Bedside Terminal • Fixed Device • Always there when you need it • Minimised infection risk • Usable by: • Patients • Doctors • Nurses • Admin Staff • Integrated with hospital systems • Access to all patient data • Access to lab results • Access to administrative apps • Bed Management etc • High Speed, Secure Network
Ward Computing – The Potential to Deliver Patient Portal Information Medication Access Surveys Bed Status Management Education Patient Information Dietary Management Translation Services Ward Efficiency Connectivity Patient Discharge Patient Well-being Entertainment Nurse Call Room Integration Clinical Integration Patient Monitoring HIS Access Room Environment Vital Signs Monitoring Medication Management Clinical Access Nursing Dashboard
Business Case • In Summary • 600 bed site • 3000 staff • 60% clinical • 40% clerical • Includes: • Purchase of bedside computing solution • Single signon • Password self-service • Smartcard deployment • Virtual desktop (Citrix) • 75% peak load • Professional services • Working efficiencies • 15 mins/WTE = £1,042,355 pa. • Reduced travel = £31,159 pa. (2% of staff) • Improved clinical data quality = £42,000 pa. • Bed management = £51,328 pa. • Entertainment revenue = £195,458pa. (£1.19pcd) • Advertising revenue = £205,313pa. (£1.25pcd) • Capital investment of £2,538,079 + VAT • ROI in 2 years and surplus of £3,817,886 in year 5.
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