A Blackberry application that cost £150,000 to develop has saved the Portsmouth NHS Trust £220,000.
The application, which allows midwives to write-up case notes using a digital pen, has halved the amount of time they spend on patient administration.
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"There is no physical duplication of information, so there are no errors from data recapture or lost or stolen files, so there is a lower risk of litigation," says Richard Sargent, who led the project for the trust.
"The system is simple, natural, easy to use and a wild success among the 130 Portsmouth midwives who are using it. This is because they pretty much designed it," he says.
The system has allowed midwives to cope with a greater workload without an increase in headcount, saving taxpayers money, Sargent says.
The Blackberry application allows the physical notes to stay with the expectant mother while the formatted data, time and date-stamped, is sent to the midwife's Blackberry via Bluetooth. The Blackberry transmits the encrypted data to the trust's IT patient record system, where they are stored and can be printed as a PDF document.
This system means that the hospital has data available on pregnant patients in near real time. This means doctors can monitor the health of the mother and baby more closely, present statistics instantly and respond to trends.
Hospital staff can use the Blackberries to send midwives details of their next patient and their medical records. The built-in GSP system can also provide navigation information.
The Blackberry conforms with government document management requirements with no significant change to the midwives' and hospitals' current working practices, said Sargent.
The patients' notebook has gone through several iterations, rising from 76 pages to 96 as physicians have added more data fields. The hospital plans to extend the notebook further to deal with post-natal as well as pre-natal care.
Sargent realised the potential of the Blackberry when he saw a digital pen being used to capture data during a conversation with O2, his mobile network supplier. "Can you adapt that?" he asked.
He gave a short presentation to heads of department. The midwives were the first to volunteer for a pilot project.
The project brought together talent and resources from the midwives, BlackBerry maker Research in Motion, digital pen supplier PaperIQ, form designer GraphNet, and O2. The system rolled out 18 months later.
The secret behind the success is its simplicity, says Sargent. The forms are designed so that the midwives can mostly simply tick boxes.
The camera in the pen captures the x and y coordinates of dots printed on the form to correlate them with fields in the SQL database that drives the patient record system. It can also capture block capitals and script, which the system then translates and formats into machine-printable fonts.
Sargent is now exploring other uses for the system. One enhancement will provide extra security for midwives, who often work alone in sometimes dangerous conditions.
A user-activated adaptation to the form will get the midwife's Blackberry to send a secret alert to the hospital which can then use the phone's GPS location to direct emergency response teams to the site. Following the alert, the hospital will also be able to switch on the midwife's Blackberry so that it can listen to what is being said in the room.
Other hospital departments are looking at the system. These include critical care and clinical care, and it would be ideal for medical staff to capture data as they made their rounds of the wards, Sargent said.
Sargent is now discussing a pilot for the trust's emergency department, and is fielding calls from other trusts and even from Canadian hospitals.