St John Ambulance officers embrace BYOD
850 ambulance officers have now been issued an iPad that they can also take home with them, and while there may be a bit of Angry Birds playing going on, the iPads have made patient data capture and sharing infinitely easier.
It might seem a bit strange that today’s ambulances, equipped as they are with the latest in life-saving medical devices and electronic navigational aids, still carry paper-based records for patient data, but that was the case until about two years ago for St John Ambulance in WA.
The not-for-profit organisation, which has held the licence to provide ambulance services in the west for close to a century, had for many years used A3-sized forms that the ambulance officers manually filled out after attending to the patient.
These forms included all of the essential information on the patient, and at the end of each shift were sent to St John’s call centre in Perth’s Belmont, where the data was eventually typed into its patient management and billing system and an invoice produced. And at the hospital, emergency staff had to pretty much start from scratch, opening a patient file and entering the information all over again.
The obvious solution was an electronic patient care record (ePCR) and St John Ambulance decided to design one in-house that fitted in with the organisation’s way of doing things. The challenge was, how would the officers in the field use this new system? iPads turned out to the answer.
In an innovative project, St John and NEC designed a touchscreen program for the iPad, allowing the officers to enter patient data straight into the ePCR while also allowing real-time access to the information by both the receiving hospital and central command.
And while more rugged tablets were initially considered for the field, it turns out that iPads are tougher than they look, according to NEC Australia’s general manager for strategy and service, Saul Sabath.
“One of the most interesting statistics and something we were quite blown away by ourselves, is that of 850 devices that we’ve got in the field at the moment, only eight of them have failed and one of those got driven over by an ambulance,” Mr Sabath said.
“Less than one per cent failure rate is more than better than the industry standard, so kudos to Apple in producing a device that can withstand a relatively high degree of use.”
NEC began working with St John Ambulance over two years ago on this project, just after the iPad was first released, although the two organisations have had a relationship for over a decade. NEC has long been a service provider to St John Ambulance, helping the organisation with much of its Microsoft technology.
So it made sense for the two to work together again when St John decided it needed to develop its own ePCR and the various interfaces to it. There were several goals behind the new system, one of which was improving the efficiency of data capture, and another to speed up back-room processes such as invoicing.
“St John’s traditional business model called for an A3 sheet of paper that had been used for many years,” Mr Sabath says. “The idea is that the ambulance officer, while in the ambulance, once he’s assisted the patient with any care that needs to be provided, at the conclusion of that they take out a big A3 sheet of paper and a ballpoint pen and they write a whole heap of detailed information.
“It is all captured in a manual format and at the end of the shift that piece of paper is typically sent into their call centre in Belmont. The depots are all spread out in the metro and regional areas, and there’s often a two-week time delay for the manual data entry of that paper-based information into their core system.
“There are a couple of problems with that, and one is financial. Patients who are collected by an ambulance receive an invoice, and the delay in getting from the data entry to actually getting the invoice coming out is in weeks. One of the benefits of the electronic patient care record is that it is instantaneous, so you can shorten the cash flow recovery cycle of when the invoice goes out and the ability to collect.”
The other major benefit is of course accuracy and quality of data capture, Mr Sabath says. In the field, information is hurriedly written and further errors often occur when handwritten notes are typed into an electronic system. “There is a human error element; that’s just life and there’s not much you can do about it.”
Historically, the information written on the form was not even shared with the receiving hospital, he says.
“It was just posted back to the call centre. It sounds silly in this age of electronic health records and so on that fundamentally the process still is that the hospital staff start from scratch. One of the objects of this system is that this is now minimised.
”Another benefit is that the information to the hospital and the other care providers is available instantaneously. So in the whole eHealth supply chain, the very first entry is to distribute that information instantaneously.
"That opens up a whole range of opportunities for other care providers to take advantage of that information and make better care decisions, because the information is now freely available.”To read the full story, click here for the November 2012 issue of Pulse+IT Magazine.
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