Mobile eHealth devices : progress and potential MiDIS and mobile information delivery within the community Purpose : A brief look at the challenges within mobile service delivery and how NHS Tayside are looking to meet user expectations of a community based mobile solution suitable for MiDIS consortium partners. Version 0.4 Tayside eHealth

Finlay Stewart Head of Development Services for eHealth in NHS Tayside Introduction and background Janice Caithness Programme Manager – MIDIS Consortium Utilising what currently exists Barry McGann Technical Design Lead - NHS Tayside Multi platform mobile delivery Introduction

Introduction and background Its easy, just do it; PC World, banking. User expectation (personal) –Need access to internet stuff, –signal lost / poor, –switch off / look out window / have coffee. User expectation (NHS service) –Need access to everything, –its not fast enough / unreliable, –can you fix it please.

Introduction and background Security; you are being over cautious. User expectation (personal) –public domain information, –personal data (banking), –their data; exposed under their control. User expectation (NHS service) –clinical data, –shared by multiple people, –other peoples data; exposed outwith their control.

Introduction and background Two key areas that we have to consider; –critical service over nice to have, –increased impact of personal data loss. Need to - design with mobile in mind –Fife; BYO device –FV; changing working practice –Ayr & Arran; scoping of offline forms A successful mobile solution will be based on these principles not just utilising new Tablets/Smartphone's. Test of change (*4) – Janice & Barry

NHS Tayside Community Mobile Working Test of Change Janice Caithness MiDIS Consortium Programme Manager

Test of Change (1 & 2) To support Community Nursing NHS Tayside are undertaking Tests of Change for solutions to provide Remote Access to NHS Tayside Web based systems. The aim of this project is to test the solutions, present findings and make recommendations for future solutions. The Community Nursing staff provide feedback on each solution within each phase.

Test of Change (1 & 2) These solutions provide lookup and data entry capabilities Access to MiDIS & NHS Tayside Clinical Portal 2 Laptops and 4 iPADs were issued to Community Staff over 2 sites 17 members of Staff are involved in these Tests of Change Dependencies 3G coverage

Evaluation of TOC1 & TOC2 Test of Change 1 has been completed following a 2 week trial. Feedback has indicated that the laptop solution is fairly cumbersome and accessing to the systems often proved difficult. Test of Change 2 has been completed following 4 week trial. Feedback has been more positive.

Feedback Out of 155 Visits laptops were used 51 times (33% of visits) Laptop was used and recording in the system successful on 25 occasions (49% successful recording) Out of 345 Visits iPADs were used 213 times (62% of visits) iPAD was used and recording in the system successful on 165 occasions (77% successful recording)

Feedback Was connectivity (3G) an Issue? Do you feel the laptop improved working processesOverall Comments YesNo Long time to load, page not always available. Quite heavy to carry especially if doing INR's etc or if taking other supplies to patients homes. YesNo I could see the benefits of using mobile devices but not this one. Too long to load. Certainly increased our Face to Face time. Also quite heavy to carry when we had other equipment. No The laptop took to long to load and was very heavy to carry around. If it could be left on it would be better but kept timing out. The dongle sticks out so was frightened of breaking it when moving about. Did you find 3G connectivity an issue? Do you feel the iPAD improved working processesOverall Comments NoYes Used the user guide initially, but once familiar with iPAD found it very easy to use. Made life much easier accessing Clinical Portal if patient not known or registered with the practice. NoYes Good for using OOH's when working remotely. It has taken a while for me to get used to touch screen but getting better as time goes on. Having the iPAD is definitely a plus. No Yes No problem after the glitches in the middle of the trial. Very good & very easy to use. Patients interested as to why we ask certain questions and are curious about the paperwork we need to do. Does make the visit longer but the we can get more info from the patient during chat.

Current Developments In addition to the Laptop and iPAD Tests of Change we are working on developments which would provide a more store and forward approach. This will enable users to record data and then synchronise that data back to the required system. This would circumvent the issues with 3G coverage. Digital Pens Mobile MiDIS

Test of Change 3 - Digital Pen MiDIS forms Development of Interface (API) to return the data to What are we doing? 20 Digital Pens - Synchronisation of the Pen upon return to base

Test of Change 4 – Mobile MiDIS Testing suitability of NDL development platform Mobile application with MiDIS integration Native application, offline/online capability

Test of Change 4 – Mobile MiDIS AWIMiDIS APIMiDIS DB NHS Tayside Data Centre Container Online/Offline

Evaluation and Review All tests of change will be evaluated. Recommendations for Future Solutions and requirements to implement a production service.

Further Information Tracey Wyness eHealth GMS Team – NHS Tayside Finlay Stewart Head of Development Services for eHealth NHS Tayside Janice Caithness MiDIS Consortium Programme Manager Barry McGann Technical Design Lead - NHS Tayside