1. Smart Healthcare Live – Mobile and Wireless Healthcare Colin Sweeney - ICT Director Ben Fidler – EPMA Team Leader King’s College Hospital NHS Foundation Trust

2. Mobile and Wireless healthcare Background The issues The current solutions The future?

3. King’s Milestones 2002 Implemented and rolled out orders and results as first stage of EPR 2002 Discharge notifications and TTA drugs 2005 PACS 2005 First attempt at inpatient prescribing 2009 Inpatient noting 2008-2010 Inpatient prescribing roll out

4. King’s EPR – current functionality Patient summary data Results and reports including images Requests and referrals (Order sets) Take home prescribing and discharge notifications Documents (Clinic letters and full discharge summaries) Document imaging Various Data capture and forms Clinical Noting Inpatient prescribing

5. Results

6. Clinical Notes

7. Images

8. Drug Charts

9. Issues 2-3 desktop PCs per ward Lots of pertinent information Requirement is at the bedside Must therefore be mobile Don’t want to log out and in every time

10. Electronic Prescribing and Medication Administration at Kings Pilot Nov 2008 – Busy general medicine ward. May 2009 began trust rollout June 2010 – 10 Wards actively using EPMA. Paper drug chart has been replaced with electronic chart. Wireless device requirements vary from ward to ward Technical ability of ward staff vary from ward to ward 30 wards to go!

11. Paper drug chart Handheld Lightweight Ultra portable Low cost Wipe clean or easily replaceable Easily placed on drug trolley Clearly visible Reliable Easy to use

12. Computer on Wheels Handheld  Lightweight  Ultra portable  Easy to push. Bedside care Low cost  £1400 + VAT PC additional cost Wipe clean or easily replaceable  Most parts wipe clean or easily replaceable Easily placed on drug trolley  COW & Drug trolley required Clearly visible  19 inch screens Reliable  4 to 6 hours of battery life Some battery issues Easy to use  Standard PC setup Keyboard & mouse

13. Mobile Clinical Assistant Handheld  Lightweight  1.5 kg Ultra portable  Bedside care Low cost  £1700 + VAT Wipe clean or easily replaceable  Most parts wipe clean Easily placed on drug trolley  Clearly visible  9 inch screens Reliable  3.75 hours battery life Issues with hanging Endpoint encryption Easy to usexPen and virtual keyboard difficult for some users.

14. Ruggedized Laptops Handheld  Lightweight  Ultra portable  Bedside care Low cost  £1700 + VAT Wipe clean or easily replaceable  Some parts wipe clean Easily placed on drug trolley  The keyboard sticks out covering part of the drug trolley. Clearly visible  10.2 inch Small screens Reliable  4-6 hours battery life Endpoint encryption Easy to use  Keyboard useful

15. Touch Screen Laptop Handheld  Lightweight  Ultra portable  Bedside care Low cost  £1800 + VAT Wipe clean or easily replaceable  Some parts wipe clean Easily placed on drug trolley  Keyboard rotates and used as a tablet. Clearly visible  12.1 inch screens Reliable  6-8 hours battery life (with battery slice) Endpoint encryption Wireless issues Easy to use  Keyboard & Touch screen

16. Computerised Drug Trolleys (Large) Handheld  Lightweight  Heavy to push when full Ultra portable  Close to bed ends. Low cost  £1400 + VAT PC additional cost. Wipe clean or easily replaceable  Most parts wipe clean or easily replaceable Easily placed on drug trolley  Integrated drug trolley Clearly visible  19 inch screens Reliable  4 to 6 hours of battery life Easy to use  Standard PC setup Keyboard & mouse Too large for some users

17. Computerised Drug Trolleys (Small) Handheld  Lightweight  Easy to push when full Ultra portable  Closer to bed side Low cost  £1400 + VAT PC additional cost. Wipe clean or easily replaceable  Most parts wipe clean or easily replaceable Easily placed on drug trolley  Integrated drug trolley Clearly visible  19 inch screens Reliable  4 to 6 hours of battery life Easy to use  Standard PC setup Keyboard & mouse

18. Laptop Trolleys Handheld  Lightweight  Easy to push Ultra portable  Can go most areas Low cost  £350 + VAT Laptop additional cost. Wipe clean or easily replaceable  Most parts wipe clean or easily replaceable. Anti- microbial keyboard screen. Easily placed on drug trolley  But useful if medication is by the bedside. Clearly visible  15 inch screens Reliable  4 to 6 hours of battery life (with 9-cell battery) Easy to use  Standard Laptop setup Keyboard & mouse

19. What next? Panel PCs? iPads? Wall mounted laptops?

20. Mobile Equipment Equipment Computer On Wheels (COW) Mobile Clinical Assistant Ruggedized laptops Touch screen Laptops Computerised Drug Trolleys Laptop Trolley ?

21. Thank you for listening Any questions? Ben.Fidler@nhs.net 020 3299 9000 Ext: 7584 colinsweeney@nhs.net 020 3299 3211