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Mobile Working for Healthcare Professionals


About Tracline

Tracline is a leading provider of IT solutions to UK healthcare services. Since 1999 we have been designing tailored IT packages to meet the specific requirements of organisations across the health sector. As Catalist-accredited healthcare specialists, we understand the value of working with our customers to identify the best technologies, to fit individual organisational objectives and budgets. From infrastructure design and planning to technical support, project management and lifecycle fulfilment services, with Tracline your organisation gets complete, yet customised technology solutions. Our “Business Value Approach� enables us to become part of your project delivery team, jointly create project initiation documents and together realise ROI models. As a result, over the last five years, Tracline has become the leading supplier of mobile working solutions to both hospital and community NHS Trusts.

Our twin objectives?

To provide the best possible user experience for mobile workers with the highest quality outcome for the patient.


Dorset Healthcare Foundation Trust has been working with Tracline for over 10 years now. During that time, Tracline have provided not only the IT hardware required to keep us moving forward with the times in a competitive manner, but also a level of service and reliability that has allowed us to trust in their ability to keep servicing us effectively and efficiently now and into the future. Their attentiveness to our needs and ability to adapt means we can call on them whenever necessary, and be assured of their support... Nigel Rodgers, MBA; CEng; CITP; FBCS; FCMI; FIHM; FRSA Head of Information Technology, Dorset Healthcare University NHS Foundation Trust


Welcome to Mobile Working With the emergence of wireless networking and handheld devices designed specifically for the health market, mobile working already offers huge benefits to staff across a range of clinical scenarios. These benefits are immediately obvious when mobile devices are used directly with patients. In the wireless hospital Mobile Point of Care (MPOC) solutions are dramatically improving clinicians’ workflow on the wards and improving patient care with greater speed and accuracy of information: • Vital sign recording, including alert triggering, offers greater patient safety and can free-up beds quicker. • ePrescribing results in a significant reduction in medication errors. • eRequesting delivers faster access to clinical records at the bedside means patient safety improves as clinicians can deal with events more effectively. • Summary care records - GP letters and emails can be processed immediately, allowing faster patient discharge. In the community For primary care organisations, mobile working is a pragmatic solution, enabling community health workers to access patient data wherever they are. Detailed information is now available to them while they are with the patient, whether that is at their home or on the move. Patient records no longer need updating at a central location every day, offering huge efficiency savings and improving patient care.

A comprehensive selection of MPOC case studies and HealthExec films documenting MPOC success stories, can be found on our website: www.tracline.co.uk

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• Adverse events cost the NHS about £500 million a year in additional days spent by patients in hospital. • These avoidable adverse events costs the NHS (UK) £.1.1 billion per year • The 10.8% of patients with an adverse event will each require an average of 8.5 additional days in hospital • Despite recording vital signs, there was a failure to recognise critical deterioration and/or no action in 47% of cases.

“ Work is something you do, not somewhere you go” Trevor Wright, Deputy CIO Yorkshire NHS • Enable people to work when and wherever they need to • Reinvest scant resources back into frontline patient services • Enable staff to improve their personal productivity and efficiency • Better access to information enables improved continuity and provision of care • Greater staff satisfaction, empowered and energised workforce • Provide rapid access to personal, professional and regulatory development • Improve patient and staff safety • Save Money – strong ROI business case


Barriers to mobile working

Case Study

With the business case for mobile working well-established, why isn’t everyone using it? In many cases a reluctance to embrace mobile working is due to a poorly organised evaluation or pilot programme. Assessing the impact of a new mode of computing across an entire organisation or department, requires professionals to evaluate the clinical and financial benefits in tandem. The absence of a clear business plan, setting out the steps a Trust can take to ensure success is likely to result in failure such as: • Pre Implementation problems • Training • Network Infrastructures • Strategy Formulation • Clinician Support • Workflow methods • Unskilled implementation managers Overcoming the barriers Tracline has successfully deployed MPOC projects in over 100 NHS Trusts. It is by utilising this experience in mobile working, that we are able to advise and consult with Trusts on how to achieve a winning formula. From building the business case to assisting with the selection and testing of mobile equipment, Tracline works with its customers to develop measurable pilots and support the deployment of full-scale mobile working solutions. The cultural challenge from the technology is wrapped up in a cultural shift to changes to work-methods and patterns, Identifying champions is absolutely crucial, with Tracline’s Training services we can ensure your projects succeed and help your staff feel empowered.

Success, and what it looks like The potential benefits are compelling: the UK government estimates the public sector alone could save up to £336 million a year through mobile working*. These savings would be generated through reduced office and transport costs, efficiency savings, service improvement and improved data quality.

eRequesting and sample collection Royal Brompton & Harefield NHS Foundation Trust is the largest specialist heart and lung centre in the UK and among the largest in Europe. Since introducing MPOC, they have enhanced record keeping as the new system eliminates paper requests. The process starts with an automated blood collection system at the patient’s bedside. Patient information is entered into a Motion Medical Clinical Assistant (MCA) device that is in direct contact with laboratory computers. A pneumatic tube transport system physically moves the samples at high speed directly from the bedside to the laboratory. A label for each sample container is then printed at the bedside but only after a sample collection and patient wristband ID check via the device. With Tracline’s MPOC system in place the Trust now makes more efficient use of staff time, ward space and revenue investment.

Current adoption largely involves the utilisation of smartphones and tablet devices. However, the real financial and time saving benefits come from tailored solutions supporting the worker on the move. Source: ‘The rise of mobile and flexible working in the public sector to 2015’ www.kable.co.uk/reports

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Tracline Services

Mobile Working Consultancy Service The big question for most professionals in the health sector is ‘how do we get more from less?’ Mobile Point of Care (MPOC) is fast becoming the answer across both primary and secondary healthcare. Why consultancy? The vast majority of large-scale clinical information system implementation projects fail to achieve the projected benefits used at the time of procurement to justify the capital investment. While 40% are never completely implemented. Very often Trusts approach mobile working with little or no practical experience of deploying mobile devices. As such, these projects very often result in delays or fail to deliver any real benefits. In most cases, understanding the scope of the project at the outset will lead to significant cost and medical improvements, once the project is up-and-running. Tracline’s consultancy approach is to work with a Trust to establish and document the business reasons for implementing an MPOC strategy. The service framework is taken from the Intel Digital Health Business Value approach, designed specifically to measure the business benefits and ROI in a working hospital. Tracline have further developed the approach to reflect current NHS hospital infrastructures and strategies.

How it works The service comprises a two-part process: 1 Business consultancy which operates alongside the relevant Trust staff to identify and document the business justification of mobile working for the Trust 2 Technical consultancy which documents the suitable mobile solutions and develops a proposed project plan for the Trust to implement.

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Siemens Healthcare have been working with Tracline for the past 7 years. A key feature of working with Tracline is their excellent understanding of the needs of the healthcare environment, and a commitment to work with you to scope and specify solutions that meet your local needs. The Tracline team are always helpful, responsive and reliable. This, together with a competitive approach to pricing, makes them an ideal supplier organisation to work with. Garry Marshall, IT Services Manager, Siemens Healthcare

Business Consultancy Identifying the business rationale of mobile working across individual parts of the organisation

Technical Consultancy

Technical design workshop for MPOC devices: Device selection criteria, including models and specifications

Establishing a baseline position for measurement Discovery of device application(s) compatibility Documenting the Trust’s specific mobile working return-on-investment factors

Device configuration – user authentication, encryption, setup, power management

Identifying medical and clinical baseline measures Identification of preferred modes of data entry – stylus, touch, keyboard, voice

Documenting the process for evaluation

Accessories and deployment – docking, wall mount, carts, cars, cases

Pre-pilot performance verification: Wireless network survey Implementation schedule Staff training schedule Proof Of Concept design workshop Equipment/staff support Infrastructure

Points of reference to existing business plan(s): Case studies

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Tracline Services

Mobile Working in the Wireless Hospital In the modern hospital environment everyone, from patients to clinicians, is on the move. But does the supporting technology move with them? There is already a huge range of mobile devices for hospitals, typically handheld computers and smartphones. However, without being designed specifically for acute healthcare environments, it is rare that a single device can fulfil all needs. Healthcare-specific mobile devices broadly fall into three categories:

1 Clinical use Most often these devices are required at the bedside or on the move. In these situations, there is a need for a hygienic, disinfectable device. A specifically-designed healthcare device known as Medical Clinical Assistants (MCAs), designed on an Intel blue print should offer a smartcard and security encryption as well as barcode scanning for wristbands, patient identification, asset tracking, and correct drug doses. With many other features included It has become the only device worldwide to fit the needs of clinicians. Examples of MPOC in action: • Vital sign recording • ePrescribing • eRequesting • Taking Specimens • Patient record at bedside • Patient discharge • Wrist band scanning 2 Administration Administrative devices can be required on the ward or in clinics. In the past, notebooks were the preferred option. However, a new breed of tablet PCs can deliver the required levels of computing power and battery life that undertake the rigours of a busy environment, which work with clinicians to achieve the best patient outcomes. Examples of MPOC in action: • Patient surveys • Discharge summaries • Office productivity emails 3 Phone and email These devices are typically used by consultants across a range of clinical scenarios, helping to reduce the amount of office space required and minimise issues associated with multi-site working. Examples of MPOC in action: • Mobile contact via vocera, skype • Receipt of patient summaries on the move

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Delivering an MPOC managed service for hospitals

Case Study

For NHS Trusts or private hospitals that need to outsource the mobile working project in its entirety, Tracline can provide a fully-managed option. This service includes on-site technical resource and project management to design and test the proposed solution, supply and implement equipment, train users and provide ongoing support for infrastructure. Managed Service

The managed service proposition includes: A specialist technical project manager responsible for service delivery Implementation of a technical design workshop Training users to work with the new mobile solution Implementation of a pilot, with nominated users and delivery areas Deployment and roll-out scheduling Regular site visits following deployment to ensure successful staff uptake Provision of survey software to monitor staff uptake and address any issues Optional next-day mobile device swap-out service

ePrescribing in ICU University Hospital Birmingham has transformed the safety of drug prescribing with an innovative Prescribing, Information and Communication System (PICS), delivered on Tracline’s Motion C5 MCAs. With over 640 Motion MCAs, clinicians can now administer drugs at the patient’s bedside, which has improved accuracy and helped to significantly reduce the number of medication errors by guiding staff at the point of care. The system also supports clinical decision-making to prevent undesirable actions, and benefits include legibility and a reduction in the duplication of drug charts. In its review, the Trust found that 400-450 potential errors were prevented every day by delivering this advance decision support at the point of patient care. They have improved the financial efficiency of the service in many ways. Notably the Trust also saved 10% of the overall drug budget within ICU.

Provision of support hotline to address non-hardware technical issues

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Tracline Services

Primary Care Mobile Working

How can nurses, doctors and community healthcare workers see more patients, reduce transport costs and provide improved patient care while accessing accurate and instant information? With the right equipment in place and right training for users, the business case for mobile working in the community is beyond doubt. Selecting that equipment and initiating mobile working is where Tracline can help. Dedicated community mobile health worker solutions Many Trusts understand the potential benefits of mobile working, allowing users to access the Trust network and N3 spine while outside the hospital. Bringing patient data into the community can improve patient care, increase productivity and reduce errors and turnaround times. However, implementing mobile systems is complex, and many factors need to be considered to achieve a cost-effective, rapid, reliable and secure mobile service.

Tracline’s “Mobile Health Worker” for primary care staff Tracline have partnered with the leading mobile specialist hardware providers to provide a managed services suite called the “Mobile Health Worker”, which has been designed to meet the needs of community clinicians through: • The supply of all mobile devices which are tested to be fit for purpose • A gold build commissioning service • Customised support, including 24-hour swap-out • Access to a 3G/HSDPA wireless network with additional optimised GPRS • Secure connectivity to the Trust network and N3 spine • Full staff training and project management Benefits to the Trust, staff and patients include: • Improved efficiency for clinicians with more home visits and improved data accuracy • Better work-life balance for staff, as flexible working means reduced stress on the job • Better patient experience from more time with patients in their own environments • Reduced errors and improved patient safety • Reduced admissions to hospital • Cost-efficiencies

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As an Approved Social Worker… I have been able to use RiO at home to read more about the clients… even after work; I used to go to Sutton hospital to make entries, I don’t have to do that now as I can assess notes anywhere.

Equipment choice

Case Study

In most cases, Tracline will recommend a choice of convertible tablets. For mobile staff, they offer the power of a notebook but are fast-on, touch-optimised and provide handwriting recognition for ease-of-use. Selection of the appropriate device will take into consideration the enterprise software employed by the Trust to ensure there are no obstacles to implementation or Integration. Our in-depth knowledge and experience of the best mobile devices available can assist your decision-making and we can then help you pilot and prove your planned service. Network communications The selection of airtime providers will often depend on which carrier has the best coverage in your area. To have the best chance of success, our managed service – Mobile Health Worker – covers each element of the mobile network contract. Managed services and consulting Tracline can tailor, with various partners, a full solution that provides guaranteed success. In a growing market we already have over six years’ experience of providing mobile solutions within the NHS. This means Tracline is able to deliver insight and robust guidance to ensure your project is implemented smoothly and to plan.

A new patient record system The South West London and St George’s Mental Health NHS Trust patient record system RiO was not being used in real-time. As a result, staff overheads were high and productivity suffered. Following a successful pilot of a virtual private network which gave users access to real-time records via a mobile tablet device provided by Tracline, the Trust extended the roll-out to 1,000 users. The implementation was monitored for success and a user survey found that 89% of users considered their mobile device to be ‘very useful’. Of the 43% who had used the device alongside a patient, 93% said the patient perception of the device was positive. Furthermore, just over 80% of Trust staff agreed that it had made them more productive and over 65% said it had improved their work-life balance. “When clients aren’t in for home visits, or visits do not last as long as you anticipated, you get work done between appointments.” 82% of users also agreed that the device reduced their need to travel back to the office. From the date of implementation, the Trust saw a positive change in the number of contacts seen and a reduction in the number of ‘un-outcomed’ appointments. “As an Approved Social Worker… I have been able to use RiO at home to read more about the clients… even after work; I used to go to Sutton hospital to make entries, I don’t have to do that now as I can assess notes anywhere.”

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IT solutions from Tracline

Discover more about our range of device, data and security technology Device configuration

Tracline Data Optimiser (TDO)

Whether it is wireless hospital working or mobile community healthcare, once the most appropriate mobile devices have been selected, Tracline will work with your IT team to build and configure all the required software and settings.

While cellular network speeds are improving, coverage remains variable, so users may only be able to receive a 3G or GPRS connection, which can make application response slower.

We are then able to provide each and every machine pre-configured and ready to go, dramatically reducing time to deployment and the workload on your local IT resource.

Using state-of-the-art optimisation technologies, Tracline is able to offer a data optimisation solution that can provide a dramatically improved performance to users, even on a basic GPRS connection. This ensures users are able to continue to work at an acceptable speed, no matter what connectivity they have.

Device swap-out service To ensure users get optimum continuity of service regardless of potential device failures, like software corruption or hardware faults, Tracline are able to provide a next business day device swap service. This means that your users can report a fault and have a replacement, pre-configured device delivered directly to them the following day. At the same time, the faulty unit is collected and returned to Tracline for assessment and repair, saving you money compared with keeping spare pre-configured devices on-site.

Tracline Mobile Hotspot (TMH) Trying to get a signal for a mobile phone away from a network hotspot, such as in a patient’s home, can be difficult. The same issue can occur when trying to use a cellular data connection with a laptop. Tracline’s small, lightweight and portable cellular router offers the solution these issues. The router – roughly the size of an average mobile phone - can be placed anywhere within the patient’s home to provide the best possible connection for mobile devices. It then provides a personal wireless network that provides secure access to Trust systems. Since it is not locked to a particular provider’s network, the Trust can choose the best airtime provider(s) for their area. Tracline Security Agent (TSA) TSA is a software based solution that enhances streamlines and simplifies the use of both contact and contactless smartcards, which give the user secure access to the mobile device and the Trust’s systems. For ease of use, once authenticated, the smartcard can be removed from the device and still provide secure access to applications. When used with a mobile device, after a set period of inactivity, the smartcard will turn off the screen to ensure personal information is not seen and the device is effectively ‘locked’. To unlock it, the user simply enters their four digit PIN number and the device is returned to its full working state, including direct access to previous applications.

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Case Study

Case Study

ePrescribing and error reduction

‘Tough book’ MPOC

Chelsea and Westminster NHS Foundation Trust’s decision to embrace ePrescribing with robotic dispensing, was encouraged by the National Programme for IT and the Audit Commission’s ‘Spoonful of Sugar’ report, which advocated automation as a means of improving patient outcomes.

A typical day for a Cornwall and Isles of Scilly clinician would see them drive miles to order equipment for patients, chase medical results and consult with other colleagues. Travelling back and forth between GP surgeries, community and acute hospitals and pharmacies, in between visits to individual patients, meant they would see an average of 9 patients per day.

During its pilot phase, 77 users evaluated 9 different mobile devices with tailored use cases and a matrix of requirements, ultimately selecting Tracline’s Motion C5 MCA for use at the bedside. The survey found an 11% reduction in the severity of statistically-significant errors. It also found no serious errors when ePrescribing was used, in comparison to one serious error in handwritten prescriptions. With mandatory checking and decision support built-in to the system, the study also showed that ePrescribing reduced the likelihood of prescribing a medicine when the patient had a known allergy by 77%.

Tracline worked with Cornwall and Isles of Scilly Community Health Services to improve efficiency by introducing a faster way of sharing information between these practitioners and their patients. The provision of ‘tough book’ mobile devices - PCs designed for healthcare that are portable, powerful and robust - has given clinicians secure access to the medical systems they need, wherever they are. Without needing to return to the surgery, hospital or pharmacy, following Tracline’s introduction of the tough book, clinicians have been able to visit up to 11 patients over the course of a single day and still submit or access records. This has resulted in a 22% increase in productivity, more time with patients, a reduction in transport costs and a greater continuity of service.

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Working with us

The Tracline Managed Services Agreement The Tracline Managed Service Agreement (MSA) is an all-inclusive, cost-effective solution for equipment provision, which can also be used to encompass additional services and support. Our MSA means your Trust and staff benefit from continual access to the latest technology that will deliver enhanced clinical efficacy and financial improvements: Operational benefits of an MSA • Based on a revenue payment stream and not a fixed budget, you get greater flexibility in budget planning. • Regular maintenance and simplified equipment upgrades, ensure critical and non-critical equipment operate continually, reducing waiting times and increasing overall efficiency. • Our MSA is vendor-independent, removing cash-flow restrictions and enabling us to work alongside your trusted suppliers. Financial benefits of an MSA • MSA payments are made from the Trust’s revenue rather than capital budget, nullifying Capex charges, depreciation and inflation. • Tracline can provide assistance with VAT management and, in the majority of cases, can achieve a full reclaim in association with MSA payments. • Legacy equipment can be simply added to the MSA meaning you can effectively manage everything under a single MSA, designed to suit your individual requirements.

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The HPA employs just over 4,000 staff, based in over 80 sites, and successfully managing the logistics of such a contract would have been a very challenging operation for any company. Tracline has coped with this challenge admirably and the HPA is very happy with the level of service provided by Tracline over the past three and a half years. Brian Ward, IT Project Office Manager, Health Protection Agency


Get in touch

Tracline (UK) Limited Grosvenor House, 1 High St, Edgware HA8 7TA.

Tel: 020 8952 7770

www.tracline.co.uk


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