Clinical Efficiencies for
Ward Based Computing
Canice McKee
Lincor Solutions
Matthew Douglas
mHealth Consulting
Hospital Perfect Storm
Focus on Patient Experience
Reduced Income
Medical Inflation
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
National Infrastructure
Maturity Model
Clinical
Information
Level
6
Description
Integrated Acute/Primary Healthcare
(L5 + mHealth / Telehealth)
5
Speciality support
(L3 + special clinical modules)
4
Clinical Knowledge and decision support
(L3 + knowledge bases, embedded guidelines, rules,
alerting, decision support, multi-disciplinary care
pathways)
3
Clinical Activity Support
(L2 + electronic document management, order comms,
group scheduling, results reporting, e-prescribing)
2
Integrated clinical diagnosis and treatment
support
(L1 + Master patient index)
1
Clinical Administrative Data
Patient administration and departmental systems
Review of technology on wards
✔ = complete
- = none or almost none
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Full PAS functionality
Results reporting
PACS
Order entry
Nursing notes
Changeover and rostering
CRS/EPR
Wireless
Portable devices
Staff and patient identification systems
ePrescribing including medication admin.
Procedural investigation results following examination
Vital signs entry
Vital signs monitoring
Access to emergency services, GPs
Links to social services, social care and carehomes
Access to information sources and libraries (both patient
and care provider)
Care pathways, care planning
Outcome comparison versus plan
Risk assessment and a dialogue with the patient
Consultant on call access
The intelligent bed (pressure sores et al)
Digital vital signs reporting
Medical devices mostly wireless
The electronic dashboard for each patient or ward
providing real time clinical decision support
2007
2012
2017
✔
Some
✔
Some
Some
Some
Some
Some
Few
Minimal
-
✔
✔
✔
✔
✔
✔
✔
✔
Widespread
✔
✔
Some
✔
Some
✔
Some
✔
✔
✔
✔
✔
✔
✔
✔
Everybody
✔
✔
✔
✔
✔
✔
✔
Very limited
Most
✔
-
Most
Some
Most
Some
Some
✔
Most
✔
✔
✔
Most
Most
-
-
Some
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
Enabling
Technologies
Clinical
Information
Single
Desktop
/Laptop
Sign
On
Virtual
Desktop
Bedside
Computing
Pervasive session that
follows the clinician as
they go about their work
Bed management
Cleaning tasks
Meal Ordering
BYOD
•
•
•
•
•
•
•
•
•
•
EPR
OCS/e-Prescribing
Group Scheduling
PAS
Pathology
Pharmacy
Radiology
PACS
EDM
Vital Signs
Monitoring
Patient Services
Entertainment &
Communications
Services
•
•
•
•
•
•
•
•
Telephony & Video Calls
- Integrated to Trust
exchange
- Skype functionality for
friends and family
Television
Radio
Internet
Games
Music
Talking Books
•
•
•
•
•
Telephony & Video Calls
- Virtual ward rounds for
doctors
- Patient Monitoring
Patient Information/Education
Satisfaction Surveys
Meal Menus/Ordering
Pain Management
Environment control
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
Bed Status
Management
Surveys
Patient
Information
Education
Dietary
Management
Translation
Services
Ward
Efficiency
Connectivity
Patient
Well-being
Patient
Discharge
Entertainment
Clinical
Integration
HIS
Access
Nurse Call
Room
Integration
Patient
Monitoring
Room
Environment
Vital Signs
Monitoring
Medication
Management
Nursing
Dashboard
Clinical
Access
Business Case
•
•
•
•
•
•
•
•
Working efficiencies
- 15 mins/WTE = £1,042,355 pa.
Reduced travel = £31,159 pa. (2% of staff)
Improved clinical data quality = £42,000 pa.
In Summary
• 600 bed site
• 3000 staff
60% clinical
40% clerical
Bed management = £51,328 pa.
Entertainment revenue = £195,458pa.
(£1.19pcd)
Advertising revenue = £205,313pa. (£1.25pcd)
Includes:
• Purchase of bedside
computing solution
• Single signon
• Password self-service
• Smartcard deployment
• Virtual desktop (Citrix)
75% peak load
• Professional services
Capital investment of £2,538,079 + VAT
ROI in 2 years and surplus of £3,817,886 in
year 5.
Thank You
To Learn More:
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