Our recent post covered the news that Leeds medical school students have been given an iPhone to support their studies. Innovative? Yes, but not the first of its kind in the UK.
The Wales Deanery have previously evaluated the use of PDAs, but took this a step further last year with the iDoc project. This breakthrough scheme has been running for over a year now, which provides all F1 doctors with the following:
- a HTC Ty Tn ii devices running with Windows Mobile operating system
- an 18 month network agreement with Hutchinson 3G (aka “3″)
- 1Gb data transfer per month
- unlimited SMS per month (a fair usage policy of 3000 texts applies)
- 75 cross network minutes per month
- a SD memory card with Medhand‘s Dr Companion (17 titles including BNF and OHCM)
- Unlimited Skype to Skype calls
The stated purpose of the iDoc project is to:
“optimise both care of patients and provide just in time learning for Foundation training in Wales”
Expanding this further, the project clearly seeks to:
- Support continued learning through point-of-care access to authoritative reference texts (i.e. not Wikipedia!)
- Improve communication within and between health care teams
- Encourage greater and better use of technology by junior doctors, to raise overall productivity
- Ultimately improve patient care and outcomes
- Usage of the devices and text books was not mandatory. A proportion of eligible doctors have taken delivery of the device (exact figures tbc).
- Supply issues restricted take up initially, with some doctors choosing to purchase their own device rather than wait for the iDoc device to arrive.
- Attitudes amongst end users differed from those that bought in immediately to those that were more cautious.
- Reasons given for not using the service include: preferring to carry a different device, the risk of theft, and a lack of pockets to carry the device (even though they were provided with a holster and clip).
- £446,000 was raised from the Welsh Assembly to fund the project to support 340 doctors – approx. £1,300 per doctor
- The devices, network connections and reference texts were all provided free of charge – the only cost to the doctors involved was to pay £5 per month for insurance. This was deliberate to foster a degree of ownership and to encourage regular usage.
Beyond supplier issues that plagued that start of the project, it proved difficult to use the devices within the existing NHS Wales infrastructure, primarily due to IT administrators’ security concerns. At present, the devices do not support access to Trust email outside of the hospital environment, and access to intranet sites is not comprehensive.
Incentives to support usage of devices at the point of care is important. Experience from the trials has shown however that offering free devices was not necessarily the right model to drive adoption, as a financial relationship (“this costs me something so I should use it”) proved important to ensure devices weren’t just kept in drawers and never touched again. Training in getting the most out of the hardware and software was also critical.
The HTC Windows phone proved a great platform for accessing information resources through the Medhand Dr Companion software. The speed of information retrieval was on a par with desktop machines, if not better, and the size of the screen was superior to most alternatives. However to get the full potential from these devices as communication tools requires clearing a number of security hurdles, that have so far proved elusive in Wales. Ring-fencing communication within a suitable security environment would clearly unlock further productivity and patient safety gains.
For a wider introduction to the project, the devices and bundled software, please see this video by Dr Mark Stacey.
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