Rehabilitating IT

Innovative IT is opening new opportunities to disabled patients at the Royal Hospital, writes Karl Cushing

Innovative IT is opening new opportunities to disabled patients at the Royal Hospital, writes Karl Cushing

The innovative use of IT is central to the work done by the staff at the Royal Hospital for Neuro-disability, a medical charity based in Putney, south-west London.

The hospital cares for patients with severe disabilities resulting from brain damage and neurological diseases such as multiple sclerosis and Huntingdon's disease. It uses technology to help rehabilitate patients by stimulating cognitive, visual and perceptual skills. IT is also used for communication and provides patients with a valuable link to the outside world.

As a charity, the hospital is reliant on donations for much of its technology and resources are always stretched. Previous appeals for equipment have been relatively successful and the hospital now has a healthy stock of PCs and laptops (although it is always on the lookout for 21in monitors).

What it really needs now is specialist equipment such as balance trainers and environmental control systems that enable patients to be independent in operating televisions, radios, lights, etc. An added benefit of environmental technology is that it is less labour-intensive, freeing up staff for other tasks.

More tailored software is also needed. According to Jane Bache, the hospital's occupational therapy technician, most companies that specialise in cognitive rehabilitation software design it for children. This can be quite patronising for adult patients. Bache suggests that perhaps such software could be developed by students as a research project.

Another area where the hospital can be helped is maintenance. At present it does not have a maintenance agreement for its therapeutic computers and call-outs are very costly. So any companies or individuals willing to donate maintenance time would be very well received. But, ultimately, what the hospital really needs is to find a backer or sponsor who will help to support its technology programme.

Providing the services it does with the remit it has is expensive and resources are finite. One area where cost savings could be made is the Internet. Although it is a valuable communication tool, offering Internet access soaks up valuable funds that could be used elsewhere.

Years of struggling on shoestring budgets have led to a cult of inspiration at the hospital. "Our engineer is a complete whiz," says Bache. Engineer Gerard Cullen is constantly faced with problems that require innovative solutions. Cullen has also created a variety of specialist switches and mounting systems which a disabled person can use to control everything from a wheelchair to a computer.

One patient might require an expanded keyboard with a large screen and a tailor-made tracker ball. Another will need to operate a computer using a single switch activated by a head movement. Needs are constantly changing as patients come and go.

Cullen is currently working on a fully automated wheelchair simulator, which will be able to store patients' information and "remember" seating positions. This will enable the hospital to provide specialised wheelchairs using the NHS wheelchair database - funds permitting.

From September the hospital will roll out its assistive technology assessment service into the community under the name Compass. This will place an increasing burden on the hospital's support staff.

"This has huge potential for both us and our patients," says Gary Derwent, Compass' co-ordinator. "But support is key." Derwent says the hospital would love to be able to control users' PCs remotely in their homes. At present, someone from Compass has to travel to the user to sort out problems, many of which are relatively simple and could be done remotely.

In response to the idea that money could be better spent on other areas, Derwent says that, for the hospital's client group and the level of disability involved, technology is paramount. "Technology can be the difference between staying in the hospital and getting back home," he says, "It can be the key to independence."

Bache adds that IT can be "a very good equaliser". She points out that, with a bit of tweaking, everyone can use the same programs, and in chatrooms everyone is the same.

She also emphasises the motivational aspect of technology and how it can catch people's imaginations if applied well. "What we really stress is that it improves quality of life," she says.

But for Bache, although seeing the level of technology available and how it can help the patients is very exhilarating, it can be a double-edged sword. "It is exciting but also incredibly frustrating," she says. "You know the technology is there but you don't always have the resources and the money to acquire it."

Can you help the Royal Hospital?
Central to the Royal Hospital's plans to bring its IT systems into the 21st century is the aim of installing a secure link between its network and the Internet.

Although the Royal Hospital is internally networked it is currently reliant on standalone equipment to access external e-mail and the Internet. As access to the Internet is a vital element for this research-oriented hospital, the secure link is urgently needed. But, according to the Royal Hospital's IT department, it will not be able to set up the link unless it acquires the following equipment:

1. To set up a secure Internet gateway the hospital needs an E3-compliant firewall (for 200 users) such as Cisco Pix; a router; a lease line 512Mbytes; and a commercial ISP

For scanning mail it needs IBM Netvista or equivalent, along with an anti-virus mail-scanning system such as Minesweeper

3. A high-volume NT server; presentation software such as Dreamweaver (for 50 users); and a content management system such as Alaire Spectra are required for the intranet server

4. A low-profile NT 4.0 server, such as HP's Lpr 700, and Web management software such as Websense are needed to help set up the proxy server

5. A low- profile NT 4.0 server to help set up the e-mail server, along with Microsoft Exchange 5.5 or similar.

If anyone is able to provide any of this equipment, some time or expertise, please contact Maddie Argyle in the Royal Hospital's fundraising department on 020-8780 4563.

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