NHS Western Isles is a Ready Organisation

Nurses able to visit 5000 more patients a year – thanks to digital pens

The NHS Western Isles covers an archipelago of islands located 40 miles off the North West coast of Scotland, stretching some 130 miles from the Butt of Lewis in the North to the Isle of Barra in the South. The area is home to just over 26,000 people, widely dispersed in no fewer than 280 individual locations. The remote geography and an aging population, requiring care for a range of conditions including diabetes and heart disease, presents a unique challenge to NHS administrators organising healthcare services for the community.

Mobile frontline staff are a vital lifeline

Reaching a GP or hospital can be difficult, time consuming and potentially dangerous for some patients, especially in the winter months, so the NHS’s mobile community teams provide a vital lifeline for the elderly and infirm in need of care. But even though approximately 30% of community staff time was spent travelling to and from appointments, and a similar amount spent directly with patients, more than 40% of staff time was spent inputting and processing the data resulting from each visit.

Managers at NHS Western Isles knew that if they could find a quicker and more efficient way of gathering and disseminating information from each contact with patients, staff would have more time available to carry out more visits each day, to the benefit of all concerned.

A unique digital solution enables better patient care

Nurses were provided with special digital pens and paper forms printed with a unique dot pattern. Two built in cameras read the pen stroke and the position of the dots and converts the handwriting into digital data, which is then transmitted via Bluetooth to a smartphone for secure submission to the NHS Western Isles server – and can also be saved onto the patient’s PC.

It means that patient notes can be updated on each visit and kept at the point of care, usually the patient’s own home, without the nurse having to travel back to their base to access various systems and input notes into a computer. A barcode, which is also scanned by the phone, links the written information captured on the pen to the electronic patient record – making them immediately and accurately available to other appropriate healthcare professionals such as GPs, consultants and other hospital and community based staff.

NHS Western Isles eHealth Project Officer Christine Chlad explains: “This means that staff don’t have to input the same data into different systems. This reduces the amount of time a nurse spends on administration and data entry, frees up more time to spend with patients and enables more visits each day. It also speeds up the sharing of patient information with other health professionals and improves the speed with which follow up actions are instigated. This can only improve the quality of care we provide and reduce unnecessary hospital admissions, which are a major upheaval for elderly patients in particular.”

Martin Hall, one of the community nurses, continues: “The fact that everything is recorded in the patient’s home means we spend more time with them rather than driving back to the office to spend hours re-typing information. Also, having the latest information available in seconds from the point of care means any of my colleagues can see in an instant what was done, why and when – from a community nursing perspective you can’t put a value on that.”

The simplicity of the system, using what look like ordinary pens and paper, is also important for a proportion of patients who can be uncomfortable with the use of laptop computers and other technology, which can create a barrier between staff and patient. Trust between nurse and patient is critical – and the digital pens don’t jeopardise that trust, in fact they enhance it. On top of being able to spend more time with nurses, the patient can retain a copy of the records, providing reassurance that information is accurate and up to date

Delivering savings, and 5000 more patient visits

The digital pen project was funded through the Scottish Government’s £70 million Change Fund, set aside in 2010 for new community-based health and social care services for older people. The initial project covers the five Community Nurse Teams across the Western Isles and 60 pens were ordered for this first phase. “For an investment of around £68,000, we calculate that we will make non-cash releasing savings of £83,000 each year and enable our staff to make more than 5,000 more visits to patients each year. That’s a remarkable result,” adds Christine.