East of England Ambulance Trust Blazes Trail with Innovative Mobile In-Vehicle Patient Information Application

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Early success of NHS IT revolution, system relies on Pentax PocketJet 3 thermal printers, seamlessly integrated into pilot

The National Health Service (NHS), established in 1948, is one of the largest public health services in the world. To get some idea of its scale, the NHS is said to be the worlds third largest employer, after the Chinese Army and the Indian railway system and is also the second largest user of IT in the world after NASA.

A key part of the NHS modernisation plans are its ambitious National Programme for IT (NPfIT), estimated to be the largest civilian IT programme in Europe. This is a massive ten-year 7.2bn programme aimed at bringing the very latest modern computer systems into the NHS, in order to transform patient care and services. Eventually these computer systems will connect some 100,000 doctors, 380,000 nurses, and 50,000 other health professionals.

A special body called NHS Connecting for Health has been given the central role in the procurement and management of a range of key IT suppliers, which have been given special responsibility at a regional level (Local Service Providers, or LSPs) while other providers race to deliver innovations like universal electronic patient care records.

These records will eventually allow patients to be treated better and quicker as information is kept in a secure but easily accessible electronic format. For the first time, information about patients will be mobile - as patients are themselves - and not remain in filing stores in the buildings where treatment or care has been received. A vital part of making this all work is the emergency response and ambulance service, which is the first port of call on a patients journey if they are being rescued from an accident or rushed to hospital.

In East Anglia the early shape of such a system is becoming clear thanks to the pioneering work of major systems integrator Accenture, working with East of England Ambulance Service NHS Trust.

Vital information safely delivered

The East of England Ambulance Service NHS Trust came in to existence on July 1 2006, and is one of the largest of its kind in the England, covering around 7,500 square miles with a combined population of six million. It covers the six counties of Bedfordshire, Cambridgeshire, Essex, Hertfordshire, Norfolk and Suffolk and is a combination of the three existing services in the area, Beds & Herts Ambulance, East Anglian Ambulance and Essex Ambulance.

It was the former East Anglian Ambulance that was the main development centre for a special ambulance-based mobile computing system that uses GPRS to help link paramedics seamlessly with local hospitals.

What we are starting to do is get vital patient information entered the second the ambulance arrives, in a secure form, says Ian Arbuthnot, IT Manager at the East Anglian Ambulances part of East of England.

The system uses a specially ruggedised handheld computer that paramedics can tap data into at the patients side. Once docked back in the vehicle, the information is beamed ahead so that it is accessible by A&E via a Web browser interface ready for when the patient arrives.

This is going to mean incredible efficiency in terms of collecting and storing patient information and will soon dovetail into the NPfITs main electronic care record application as it comes on stream, Mr Arbuthnot points out. They replace a lot of manual form filling which could be very inaccurate as well as time-wasting, he adds.
Why do we need that in-vehicle print option?

The system is already three months into its pilot, with 75 vehicles now equipped with the new technology, a figure set to grow to 300 by the end of the year.

The devices based on Panasonic CF-18 hardware and using the Lifenet EMS package from supplier Medusa dont just act as electronic notepads. They also contain a growing set of medical care literature that can be used by patients as well as key forms and other material.

So its important that literature can be printed out in the vehicle if necessary, as well as (when needed) a back up of the patient information if there is a break in connectivity with the main system. This is where the Pentax Technologies highly portable Pentax PocketJet 3 is playing its part.

We had been looking for a suitable printer to complete the in-vehicle set up for some time, he recalls. We eventually determined thermal printing was the best basic technology for us, but then we struggled to find the right supplier that could meet all of our specialist needs.

The search, luckily, didnt take too long as the team at East Anglia soon discovered RGI Mobile Solutions, a major partner of Pentax in the UK. Mr Arbuthnot characterises the relationship as a true partnership, detailing just one aspect of how RGI and the Trust have worked well together:
A true partnership

We had some issues with the Windows operating system with the handhelds. We found that there were problems when we moved from dock to dock as the system tried to find each local printer anew, which it didnt need to do and which wasted time. The solution the supplier soon came up with was that it was able to effectively put the same unique identifier on each printer in the fleet so that the problem just went away overnight.

So far the PocketJet 3 has performed absolutely to requirement, he goes on. In the first few months of operation we have had about three laptops come back with some kind of problem not a single printer has been reported as non-functioning.

Such levels of reliability arent just nice to have they are vital. We dont have the luxury otherwise, he says frankly. If a printer breaks down we would have problems as we are such a big Trust area. We could be back and forth for six hours across the counties tracking down the problem and for that time wed have an operational ambulance out of use. We chose a printer that had to be able to operate very, very well in what is something of a hostile environment, and I am glad to say we seem to have made the right choice.

Conclusion

Mr Arbuthnot is careful to point out that the printer is expected to be a major back up, not to be used every day. The reaction of the crews has been very positive. We had to explain that if you are used to 24 page a minute laser deskjet printer output a portable thermal printer is going to seem a bit slow! But the guys have got used to that and it has been accepted now as a highly useful piece of kit.
 
What is the next step for East of England Ambulance Service NHS Trust and its vehicle-based patient information system? We are confident we are working here with a major early success of the whole NPfIT project, and that in a year and a half this kind of application will be being seen in Trusts across England and Wales, he predicts. And a major and highly dependable part of that welcome scenario is bound to be the trusty Pentax PocketJet 3 printer.

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