Many trusts use mobile devices in community working, and some are seeing benefits in deploying them across the whole workforce with up to 3000 devices in use per trust. Benefits include increased morale, higher productivity and time released to care. Here we look at considerations for rolling out mobile devices at scale, the impact on productivity and staff working methods. Summarised below are important considerations, highlighting specific examples and relevant resources.
Considerations for rolling devices out at scale
Provider organisations are working towards flexible and scalable approaches to deploying mobile devices across the entire organisation. Important considerations are:
A clear focus on business benefit and identifying the appropriate devices for staff is vital. In an organisation-wide rollout project it is important to:
- ensure there is a clear mobile strategy and prioritise user groups for deployment
- benchmark the important metrics you're trying to affect prior to rollout - for example, staff morale, travel and productivity
- produce implementation guidance to ease deployment across the wider organisation, including project planning, risk assessments and resource planning
- ensure a mobile working policy is in place and work with the human resources department to accommodate mobile working in job descriptions
I.T. departments are learning about the factors that affect large deployments of mobile devices in the NHS:
Identity and certification
Ensure appropriate security principles are applied to the mobile devices and software or apps to safeguard data.
Choose the appropriate approach for the organisation: rollout to a small group of users for evaluation and testing before implementation across the wider organisation (phased approach); after which a complete and simultaneous deployment of mobile devices and the associated software across the entire organisation may be possible.
I.T. departments need to decide if software updates on mobile devices will be controlled by the user, the organisation or initiated by the platform. For large scale rollouts it is necessary to consider the logistics of configuring devices using mobile device management software (MDM). With appropriate planning and pre-configuration it is possible to deploy devices for general use to up to fifty users at a time.
Service and support
Consider how the devices will be supported and work to identify opportunities to reduce the cost, for example simple support apps or resources can be developed for common issues and troubleshooting.
Ensure the technical infrastructure can support the change being implemented and work closely with suppliers to enable rapid response to any issues.
Consider the employment of practising clinicians as champions as part of the IT department to lead clinical engagement and provide the bridge between IT and clinical practice.
It is important that staff feel confident in using their mobile device. Allowing some personal use means staff are likely to look after their devices and use them for everyday tasks. The usability of mobile solutions is vital for mobile adoption across the organisation. Preventing users from downloading their own chosen software applications is likely to reduce uptake. Some NHS trusts have taken personal use and ownership a step further and shared the cost of devices through a salary sacrifice scheme.
“Before we were issued with iPads, the majority of radiologists did not use their trust email accounts. I am now able to reach my colleagues by email, even if they are working at another site.”
Radiographer, Musgrove Park Hospital, Taunton and Somerset NHS Foundation Trust
Releasing time to care and increasing productivity
There are many ways in which mobile devices can affect staff productivity. By using devices there is the opportunity to learn new skills and improve IT literacy. See some examples below from current implementations.
Mobile access to training
Investing in skills development allows staff to learn new transferrable skills and gives access to online tools and resources. This can affect productivity by:
- reducing the need to travel off-site to learn new skills, thereby saving time for other tasks - it is also more cost effective than funding an external trainer
- increasing access of training to all staff members; those working shift patterns, staff with disabilities, permanent and fixed-term staff
- delivering training remotely and giving access to specific skills and knowledge required by teams - training materials can be quickly updated, and staff are able to choose when and where to study
Productivity and remote working
Using mobile devices and electronic patient records (EPR) can lead to increased productivity. This is because:
- staff feel happier and find a better worklife balance through mobile working with the opportunity to reduce travel time
- apps such as Skype and FaceTime enable remote consultations, which have a significant reduction on journey times and increases the number of available patient sessions - travel costs can be reduced by using remote meeting functionality
By taking advantage of the features and functions of the device and having access to apps, staff can find new ways to innovate and streamline service models.
Oxford Health NHS Foundation rolled out more than 2500 mobile devices to staff. As part of this organisation-wide rollout speech and language therapists (SLTs) are using mobile devices. They can securely and confidentially access to their local electronic health record to improve interactions with patients and enable flexible service models. The mobile devices allow:
- information to be accessed easily by SLTs to show families their child’s progress in any care setting
- SLTs to quickly and easily type up clinical notes and information, thereby saving time
- communication with staff in other services as emails and electronic diaries can be accessed easily, and FaceTime can be used in all areas
Using apps to enhance clinical practice
The medical app market is evolving rapidly and this trend is expected to continue. A Royal College of Physicians (RCP) survey showed that many clinicians are using apps in everyday practice - often using their personal mobile devices. Details can be found in the National Information Board Literature Review.
It's important that clinicians use their professional judgement and relevant guidance when considering which apps they use. If there is any doubt in terms of the quality or safety of an app, do not use it and advise all clinical staff of the concern.
The RCP has issued guidance around the use of apps in clinical practice.
In some cases, an app could be considered a 'medical device' and regulated by the MHRA. If in doubt, contact the MHRA for advice.
The National Information Board has recognised the risks around the quality and safety of medical apps. Work is ongoing to explore how these risks can be addressed.
Consider implementing local policies and guidance in relation to the use of medical apps on personal mobile devices.
Improving working practices and patient experience
Mobile technology can significantly improve working practices and care delivery. An organisational mobile working strategy, together with technology and informatics career pathways for clinicians are essential to maximise the benefits.