Patient care goes mobile with technology

7 Jul 2003

While the nation’s health service comes under increasing scrutiny, it’s business as usual for many of the local authorities, which, in the case of the North Western Health Board (NWHB), means continuing to innovate and push back the boundaries of what technology can do.

The board has a mobile computing system for its public health nurses (PHNs) that was selected to exhibit at an eHealth Ministerial Conference, Exhibition and Awards ceremony in Brussels recently. The project was the only one selected from Ireland and was one of only 30 projects selected in Europe for the event.

The public health nursing service in the NWHB provides a broad-base service aimed at meeting the personal health and social needs of individuals, families and communities in the region. The service is delivered by 90 public health nurses at primary, secondary and tertiary levels and spans the spectrum of treatment and care, health promotion and education.

The majority of PHNs in this region operate within rural communities. Some 90pc of their work takes place in their client’s home, with the remainder being carried out at health centre clinics.

Bernie Davey, ICT project manager with the NWHB, explains the system: “The mobile computing system is currently deployed to PHNs in Donegal, one of the two community care areas in the region. It runs on a handheld device — the Hewlett-Packard (HP) Jornada. The database on the PDA [personal digital assistant] replicates with a backend SQL Server database across a dial-up link.”

The system is being supported by HP as an industrial partner with the NWHB. The application has also been deployed to be device independent and is being ported to the HP iPaq, according to Davey.

The first phase of the system went live at the end of 2002 and the possibility of the system being used for other professional groups is being examined. The system enables PHNs to record client details, treatment and services, and provides remote online access to client information, thus supporting better decision making and enhanced client care, according to Damian McCallion, director of information systems, NWHB.

PHNs will also use the system to schedule appointments and record travel and expenses. Management reports detailing nursing activity by client group are automatically generated by the system. This eliminates the administrative overhead for the PHN of manual record keeping and reporting. It also provides managers of the service with the necessary information to assist service planning and resource allocation.

According to assistant director of public health nursing Margaret Hynes, who also seconded the project, the initiative will bring enormous benefit to the public health nurses and the patients they serve.

“On average 20pc of the PHN’s time was spent on record keeping and administration. The three main returns that PHNs had to complete were a monthly return, a mileage and expenses return and an annual return. The annual return alone could take one working week to complete,” she says. “The system produces these returns automatically, providing significant time savings that can be used for direct patient activities. The target reduction in administration, once the system has bedded down, is 8pc. This will ultimately equate to an additional 540 hours per week available for direct client care.”

According to McCallion, the Department of Health’s National Development Plan funded the project. “Phase one, inclusive of hardware costs, has a budget of €200k. Funding was also secured through the EU Fifth Framework Programme to integrate a common patient identification component that was developed in the Professionals and Citizens Network for Integrated Care. This is an open source project with Denmark, Greece and Northern Ireland.

“Plans are already being developed for phase two of the project,” McCallion adds. “This will encompass detailed assessment and care planning information and an aids and appliances module. Consideration is also being given to integrating the public health nursing client database with the core client database used for all community services in the [health] board.”

Other community-based professionals, such as community psychiatric nurses, have also expressed an interest in using the application.

Regarding the e-health awards in Brussels, McCallion, who presented a paper at the conference, is proud of NWHB’s achievement. “There was a lot of interest in the application among the 700 participants at the conference. Among the visitors to the NWHB stand was Ivor Callely TD, Minister for Services for Older People at the Department of Health, and David Byrne, Ireland’s only European Commissioner. Erkki Liikanen, the European Commissioner for the Information Society, was also interested in the way in which nursing staff are using technology and brought the Indian health minister to meet Margaret Hynes, the public health nurse on the stand,” he says.

By Lisa Deeney