Mobile Working in Community Healthcare: A Clinician’s Account of the Benefits

Melissa Andison, @mjandison

The current climate of the healthcare is to ensure high quality care is delivered with greater productivity and at lower costs. These demands compel health services to seek better ways of working. With the industry awakening to digital solutions, mobile technology is providing some exciting opportunities for this.

In the United Kingdom, mobile working has been trialled with community nurses, allied health professionals and emergency care providers. It is the practice of carrying a mobile device such as a smart phone or tablet that has an application to allow access to an electronic health record system. It involves using the functions of a device to support patient assessment, health education and treatment. In the context of community health services, mobile devices provide clinicians with real time access to valuable information and to be able to document at the point of care.

I wish to share an example scenario of how mobile technology may help manage a critical situation.

You arrive at a client’s home and find them unwell in bed.  Also suffering chest pain. They have used their Glyceryl Trinitrate (GTN) but you suggest calling an ambulance but the client is reluctant. You explain that the symptoms might be a sign of a heart attack but the client again declines an ambulance.

After further discussion they do however, allow you to call Rapid Response Nursing. Using your digital tablet you select the loud speaker option so that the client can hear the advice. The nurse explains the team would not accept a referral to see someone at home with chest pain and recommends calling the ambulance. This time the client is more receptive after hearing this from the nurse and an ambulance is called.

Using your tablet you call the ambulance service. Again, using the speaker so that the client could hear the conversation. You’re able to use a clinical app to access the client’s health information to provide the ambulance service with the client’s information in advance.

However, while you wait for the ambulance the client describes further symptoms of head ache and nausea. Using the tablet you are able to access the internet to research the side effects of the GTN spray and feed back that it is possibly the result of using the spray but again tell the patient the ambulance is on it’s way.

The paramedics arrive and perform an assessment. You’re able to share the information you have about the client by using the clinical app because it enables access to previous electronic assessments. The paramedics advise the client they will take them to hospital for further investigations to rule out a cardiac event.

Using the clinical app you’re able to document the event at the point of care, knowing this information would be available on the electronic patient record in a matter of minutes for other teams involved in the client’s care. As you leave, you’re able to contact your manager using the tablet’s mobile phone function and report the situation and your safety at the end of the shift.

The provision of mobile working thus allowed:

–           Communicate with other services

–           Involve the client in seeking advice

–           Access essential patient information remotely

–           Research signs and symptoms on the internet

–           Document the situation at the point of care

–           Communicate with senior management

This example scenario highlights how the advances in mobile technology are providing opportunities to improve the outcomes for patients whilst making clinical practice more efficient. I hope to see more healthcare services invest in mobile working.

 

Melissa Andison is an Occupational Therapist/Interim Team Lead/Mobile Working Champion of the Westminster Community Rehabilitation Service, London. Melissa’s use of mobile technology has helped to discover new ways of working with patients, families and carers. Melissa is passionate about evidence based practice to support mobile health and has a keen interest in risk assessment and regulations of healthcare apps

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