Stone Computers

Cardiff and Vale Health Board go flexible with Stone

Cardiff and Vale University Health Board was established in 2009 through the amalgamation of three NHS organisations in the Cardiff and Vale of Glamorgan area.

The Board supports a population of around 445,000 people living in Cardiff and
the Vale of Glamorgan, providing public health and community care services that
are used by the whole of Wales.

The Challenge

The Cardiff and Vale Health Board, having deployed the PARIS Electronic Patient Record system to over 4000 staff in its Mental Health and Community Services, were then faced with the challenge of ensuring that the data kept on the system was up-to-date, accurate and available when and where it was needed most.

With nearly 500 users across services, Cardiff & Vale needed a way to connect all tiers of Child Health and District Nursing with the PARIS record - including Health Visitors, District Nurses and Paediatric nurses.

Phill Edwards, Mobile Working Project Lead for Cardiff & Vale explains: "Previously, our community nurses would go out to see patients in their homes and be left with a double administration task. They would hand-write notes whilst out in the field - then have to return back to base to input them on to the PARIS system. The efficiency of the model was poor."

There were also challenges with regards to ensuring nurses could still enable their duty of care - whatever the circumstances. For example, in extreme snow, the nurses may not have been able to get in to the admin base to download or upload patient data.

Cardiff & Vale identified they needed to make the process more flexible, reduce the admin burden on nurses and enable access to the latest patient data on the move - all whilst having the ultimate goal of improving the quality of care as the primary objective.

Mobility and flexibility in the field

They began working with Stone as their preferred partner for deploying a mobile working project. In 2009, the Health Board ran an initial mobile working Proof of Concept for 20 field nurses comprising of a 12" notebook with 3G connectivity.

As Phill explains, the first pilot helped identify some issues: "With a larger footprint and screen size came issues with battery life. The devices also proved too large and heavy for some users and the 3G signal in our region from the network provider at the time was patchy. Due to the importance of the in-build 3G provision, it soon became apparent that a standard off-the-shelf offering would not give the bespoke service that we needed for our particular circumstances."

Stone worked with the Health Board to assess the variables of the Proof of Concept and address the issues. The 3G carrier needed a review to assure best performance, so the Health Board went out in to the field with a 3G signal scanning device to help map out the connectivity challenges in certain areas. Field Nurses would try the signal at the point of care, with Cardiff and Vale leaving nothing to chance - testing all 6 of the UK's major signal carriers.

Attention then turned to the device. With the challenges around the size and weight of the device, it was identified - by clinical review - that a Windows-based Netbook would be a more suitable fit for the Health Board. Again nothing was left to chance as part of Cardiff & Vale's rigorous project evaluation. 6 different netbooks of varying screen size, keyboards and batteries were evaluated - with the Health Board finally settling on a Samsung netbook with 02
connectivity.

The Solution

Stone worked with Cardiff and Vale to then deploy a second Proof of Concept. Deploying devices to 50 staff over three months, the Health Board conducted extensive consultation with members of the pilot to gather qualitative feedback on whether the project was demonstrating improvements to patient care in addition to the efficiency savings in time and cost.

Stone has provided over 400 devices to date with an in-car charger for Cardiff and Vale's cross-service nursing team. Each device features a fully encrypted data connection and staff authenticate through Citrix with the ability to save locally to
the hard-drive locked down by Stone at the BIOS level as part of the configuration and bespoke service.

Nurses now have access to real-time patient records in the field, the ability to input more detailed, high quality notes at any time - with no requirement to duplicate work once they return back to base.

As Phill points out, the project has gone on to become a huge success "Feedback from staff is overwhelmingl positive. For them, the solution is makingtheir time in the field more productive, helping to improve patient care and reducing the admin burden they face. Due to these successes, we are now looking to deploy to the remainder of our field nurses - including part-time staff.

Why Stone

"Stone have been working with data security in mind at all times. They have configured the machines so that they can't connect to Wi-Fi. They have stripped down an off-the-shelf product and customised it exactly to our requirements. It is a true ICT service."

As a project which has been developed truly in partnership with clinicians from the outset, it is now those same clinicians which are set to benefit most from the new solution.

Phill explains: "Quality of care is better as you have data to hand. Notes taken in the field are more thorough, as nurses appreciate that they will only have to undertake that task once - and that it will then be available immediately in our
PARIS system."

The department is now looking at undertaking an analysis piece of work to put some quantifiable metrics against the improvements to patient care and the associated efficiency savings the Health Board is now benefitting from.

Phill concludes: "For me - Stone's true value lies in its ability to offer bespoke configuration and fantastic support and service. Having access to a dedicated named account manager who has been on-hand to guide me through the project has been invaluable. In the handful of device issues we have had during roll-out, they have been swiftly and accurately rectified."