Accident and emergency doctors in three English hospitals are using mobile BI to access patient test results data, leading to more efficient patient care. Two are in the Midlands and one is in Surrey.
Ecommnet, a mobile software development company based in Newcastle, worked with Oasis Medical Solutions, based in Battersea in London, to deliver the system, which is based on Sybase technologies SQL Anywhere for data management and Afaria for secure device management.
Ecommnet developed a way to deliver the test results component of Oasis’s Patient Administration System (PAS) to iPhones. Some 30 hospitals in the UK currently use the PAS.
“[The mobile system] provides the right information to the right people at the right time so that they can make decisions," said Robert Campbell, managing director of Ecommnet, describing the business intelligence implementation. Here “the consultants can identify those patients whose results are out of kilter so that appropriate action can be taken.” Its use is “principally but not entirely A&E.”
Ecommnet developed the iPhone-based application in seven days, in time for a health care trade conference earlier this year.
“We take a complex understanding of a back-end database [in this case Oracle]. We can see what the core bits of data really are and translate that to something that will work on a mobile device, with a small screen,” he said. In this case one goal was “to present the information sensibly to clinicians. It had to work simply for the consultants, so we had to think like them.”
Campbell knew users wouldn't have constant connectivity as the data was moved between the PAS back-end Oracle database and the iPhones. That meant the system needed a reliable store and forward capability.
Sybase's SQL Anywhere’s provided a rapid store and forward database and data synchronization platform.
"By using SQL Anywhere, we were able to delegate the issue of data transmission between the mobile device and the back-end database to Sybase technology, instead of having to spend a lot of time that we really didn’t have to get that communication working," Campbell said, in a Sybase case study article.
In the system, doctors receive patient test results, which are identified on a screen in a scrollable tabular format. They are able to review results and mark them as being reviewed. That action is then transmitted to and reflected in the Oasis Oracle database.
Campbell said he can see potential for similar applications on mobile devices oriented toward patient discharge, which should free up resources, such as beds, to increase throughput. There is clinician demand for the applications, he said, but the “stumbling block tends to be the powers that be in the hospital. They see a mobile phone, they see a toy, they see a security risk.
“But security is sandboxed within the application itself, and user authentication is tied back to the Oracle database. The Sybase tools encrypt the database and the underlying communications are also encrypted.”
As for the iPhone, Campbell said: “to scale out to nursing staff the costs might be prohibitive, so Android might [if cheaper] then be used. You could do the development within a few days because the underlying technology would be the same.”
He maintained the implementation is “very unusual in that other applications we are seeing in health care are not as direct as this. And integration with a PAS is unusual in the UK.
“Making rapid decisions on the move is the point of this. Getting to a terminal in a hospital is inconvenient, as is carrying around lots of paper.”
On future similar projects his company would “engage more directly with the end user with in-your-face prototyping and agile development. We just didn’t have the time to do that this time.”