Feature: Small team at hospital trust has developed apps to support very different elements of patient care
One of the good things about mobile apps is that they are often developed by small teams for a specific purpose for a specific community – but often have the potential for a much wider take-up.
West Suffolk NHS Foundation Trust may be doing this for the health service, with a couple of initiatives yielding positive results with the possibility for use on a wider scale; and they are focused on very different elements of healthcare.
A small team in the trust has developed apps to support medical photography and manage the movements of porters around the hospital and has ideas about further developments.
West Suffolk’s deputy CIO Liam McLaughlin says it received a boost for its digital efforts in being chosen by NHS England as one of its global digital exemplars. While this was focused on an electronic patient record system rather than app, the funding helped to expand its already mature digital footprint and encourage it to investigate other projects.
“Not all the work we’re doing has been under the exemplar umbrella, but it’s fair to say the money looks after some things and enables you to do other exciting things,” McLaughlin says.
The prompt for developing the photography app came from plastic surgeons having said for a few years that they would value a mechanism to record images of patient’s problems and the impact of surgery, and to support their conversations with patients. It was also in response to a Care Quality Commission audit that had criticised the trust’s use of digital cameras and practices such as leaving images on memory sticks.
It had access to the NDL MX mobile application platform, that can take information from internal systems for feeding into mobile apps and in turn receive updates from the devices that use them. McLaughlin says this works on a script type language that makes it easier to build the apps, rather than requiring the deep coding to do it from scratch.
This gave it a starting point for working with a small team, with two senior developers and a student placement from the University of East Anglia.
Images and RPA
They developed an app that makes it possible for clinicians to take images and, combining with a robotics processing automation (RPA) platform, upload them directly to the patient record, held on the servers in the trust’s data centre, without being stored on the phone.
It takes in the patient identifier, provides tools for capturing high quality images, has 256-bit encryption and a feature through which the patient signs with a digital pen to confirm they are giving consent for the process. This has made it possible to take images from the hospital’s wards and theatres and share them across the trust.
The app has now been used by doctors, nurses and allied health professionals in the hospital for about 12 months, quickly extending beyond plastic surgery to departments including podiatry, ophthalmology and other outpatients. It has also been picked up by occupational health therapists for use in patients’ homes.
“We’ve seen there has been a latent demand to take photos but previously difficult to do,” McLaughlin says. “It’s made it easier so a lot more photos are being taken. It’s encouraging to think it’s used in situations beyond what we originally expected.
“Anecdotally we have impressive stories of time savings in A&E, notably for patients sent to the burns unit at Brookfield Hospital in Chelmsford. They said it used to take up to three hours, but it’s down to about three minutes for the same process.
“Equally one of clinicians in ophthalmology has said it saves a couple of hours a week in uploading photos.
“Overall the feedback is that it is really transforming.”
It is now aiming to adapt it to advanced forms of photography such as endoscopy and to video, hopefully for implementation by the middle of next year, and to make it available to optometrists in its region. McLaughlin said it has also been talking with a few other NHS trusts about the possibility them taking up use of the app, for which West Suffolk owns the intellectual property.
The other initiative has been described as “Uber for hospital porters”, an app that can be used by the trust’s team of porters and the theatre management to support the efficient movement of patients around the building. The drive for it came from the need to minimise the delays for a relatively small team, to save them from wasted journeys to collect patients who are not ready, or from going to operating theatres and test rooms that are not ready.
A job with details of the patient and their location on the site is posted to a porter, who when picking them up verifies their identity and records that they have picked up on their smartphone through the barcode on their wristband.
“We paid particular attention to working with theatre porters to developing the app,” McLaughlin says. “They had an input into its design and it was a very useful exercise inworking together.
“Some screens provide visibility of what’s happening with the porters themselves, but also the people on the wards can see the status of which patients are due to be called next. The wider visibility is proving to be valuable.
“It has been live for nine months, and although we are a small hospital with about 12 porters in rotation, we’re at the point where we’re not sure what we would do if it wasn’t in use.
“What’s critical in operating theatres is to see where people are. A 10-minute delay could lead to rescheduling, but this enables porters to see it immediately and they could divert themselves to pick up the next job.”
The app could be more value for hospitals with much larger sites and numbers of patients.
Ideas for other apps are under discussion – McLaughlin cites a possibility of one through which staff give consent for their photos to be used on social media – although none have yet reached the business case stage. But he says the two existing initiatives have provided the momentum for West Suffolk to do much more in the field.
“It’s breaking ground for app development in healthcare,” he says. “It’s given us the confidence that we can deliver these things.”
Image: West Suffolk Hospital entrance by Panchard, CC BY-SA 3.0