Systems integration, network technology, telecare

Taking patient care in the community to the next level

Connecting and mobilising local healthcare resources

David Astley

The NHS Connecting for Health programme has created the IT and networking building blocks for a more flexible and patient-centric health service at a national level. Community of Interest Networks (COINS) have enabled local health services to bring the advantages of modern technology to the community they serve. Local healthcare providers within the NHS — ranging from GPs to departments spread across large hospital campuses — now have access to next generation local (LAN) and wide-area networks (WAN). These networks enable medical staff within the area to electronically share, securely integrate and access the patient information they require anywhere, at anytime.

Whether healthcare professionals are in the operating theatre, at a patient’s bedside or in consulting rooms, a high speed network ensures they have fast and resilient access to centralised medical records and national applications such as the picture archiving and communications system (PACS). This enables high definition images such as scans and X-rays to be viewed on screens and compared with previous pictures at the touch of a button.

Securely linking medical centres and dispensing pharmacies, enabling centralised patient records to be accessed confidentially, can also help to reduce the scope of human error when prescribing medication. Prescribing and dispensing mistakes prompt one in 16 hospital admissions and cost the taxpayer an estimated £354 million a year. However, by automating the process, systems can check a patient’s medical records before releasing prescriptions.

To improve communication across hospital campuses, many trusts are combining VoIP with hybrid IP/mobile handsets. These couple an internal extension with an external line under a single number, so that calls can be intelligently routed over the network. Consequently, medical staff are easier to locate, call-back delays are reduced and communication and productivity are improved.

Wireless communications badges take mobile communications a step further. Underpinned by the network, badges are now being deployed in some accident & emergency departments so that staff have can be contacted as and when they are needed.

Tagging your assets — and your patients

While instant access to staff and patient information is essential for providing the highest standard of patient care, today’s hospital administrators are also faced with the challenge of keeping track of valuable medical equipment and ensuring that maintenance schedules are met. Hospital-wide wireless networks and the right network foundation can facilitate radio frequency identification (RFID) tagging.

As well as preventing the theft of equipment, which has an obvious impact on patient care standards and capital drain, specialised medical equipment can be quickly located no matter where it has been stored on the hospital campus. RFID-tagged assets can also be cross-matched with maintenance schedules to ensure that equipment is kept in working order.

Moving patient care beyond the bedside, an RFID tag incorporated into hospital wristbands and connecting back to clinical systems could also give hospital staff instant visibility of where a patient is on the campus when their heart rate or blood pressure drops to a critical level.

Although a long way off in terms of deployment, RFID technology could, in principle, also be deployed to help combat hospital infections. While levels of MRSA have been reduced by more than 60% in recent years, the government wishes to further reduce the number of cases. Should a patient with an RFID-tag contract MRSA, hospital staff could identify where they’ve been and who has been in contact with them so they could help prevent the bug’s spread.

Telemedicine: The future of healthcare

As technology continues to progress and ‘joined-up thinking’ is more readily adopted across the NHS and local governments, patients will increasingly receive treatment in their own homes — where they are often happier and recover faster.

The network will lie at the heart of home-based care as WiFi-connected sensors will be used to track subtle health parameters — from glucose levels to ECG and dialysis data. Secure broadband links from the patient’s home would then transport this prioritised data directly into the COIN where it can be examined and analysed by the relevant ward or monitoring centre.

Not only is the patient frequently happier convalescing or being treated at home, but remote observation helps to ease pressure on hospital beds. It was recently reported that Norfolk and Norwich University Hospital had up to 82 beds at a time occupied by patients who no longer needed to be in an acute hospital. However, a lack of community care meant they were unable to leave.

Similarly, bed-blocking was an issue highlighted by a review carried out last year for the Welsh Assembly Government. According to the report, approximately 600 patients in Wales were using hospital beds when they were declared medically fit as they had no where else to go.

Having the technology in place to support 24-hour monitoring also has huge implications for assisted living and could help ensure that people with diseases, such as dementia, could remain in their own homes and receive the required level of care.

The reality of healthcare 

The reality is that healthcare technology has dramatically progressed and a number of trusts are starting to experiment with new and innovative applications. However, while the basic technology building blocks and foundations are in place, we are still a long way off from delivering healthcare in the home that mirrors the sophistication of clinical care received in hospitals.

The social and regulatory challenges surrounding who is responsible for providing and monitoring care in the home and how such care can be sufficiently regulated have still to be resolved. Many applications have also got to go through further phases of development before they are ready for deployment. However, when the necessary decisions have been made by the government and the applications have the green light, the network will be ready and waiting to be used.

David Astley, Head of Health and Emergency Services at ntl:Telewest Business.