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Mobile investment toolkit: important considerations

Important considerations in the delivery of mobile technology for healthcare professionals.

Toolkit overview

This toolkit summarises the success factors, process steps and important considerations in the delivery of mobile technology for healthcare professionals.

It will help Chief Information Officers, Chief Clinical Information Officers, commissioners, providers and their teams to use mobile technology to improve quality for patients, increase productivity and deliver efficiency savings through transformation at the point of care. It will also support provider organisations in achieving the goal of being paperless by 2020.

The toolkit combines intelligence and resources from deployments with input from project teams and benefits experts. It is designed to be independent of any specific development methodology such as Agile or Prince.

See the executive summary for an outline of strategic drivers, example mobile opportunities and potential return on investment in professional use of mobile technology.

Process and stages

The toolkit follows an ordered process based on stages to analyse, decide and deploy mobile solutions.

Toolkit priniciples

  1. Review the organisational and mobile success factors identified in the Mobile Project Examples.
  2. Analyse your current digital maturity, benchmark your progress against the success factors. Understand emerging mobile technology trends. This is central to  developing your mobile vision and defining your strategy.
  3. Work with users to prepare a clear and fully supported business case for your mobile solution.
  4. Work with business change managers and suppliers to benchmark and implement changes in working practices with users to realise the benefits.
  5. Linked resources include tools, templates, Mobile Project Examples and checklists.

Success factors: organisational

Providers, subject matter experts and users identified organisational capabilities and considerations as crucial to success:

Leadership

Clear leadership and sponsorship at board level is critical, together with ownership of clinical leaders and effective clinical engagement. Organisations need the willingness and capacity to change, as well as robust programme and project governance with staff that have the knowledge, skills and experience to deliver.

Change management

Organisations need to have change-management skills, an understanding of workflows and processes, and have a stable and committed workforce. Effective stakeholder engagement and continuous staff training are crucial.

Ownership across the organisation

All staff need to feel that they are part of, and own, the change. Frontline clinicians and administrative staff should be involved in defining the change and the needs of patients should be at the core.

Digital maturity and infrastructure

Focus on mobile as a way to improve productivity. Consider how a mobile solution could increase utilisation of existing systems and the level of integration needed. Consider national systems and services that could support the requirements.

“Changes like this need ownership and engagement of frontline staff from the start.”

Trust Chief Executive

“There needs to be a common goal of evidence based patient care to make the journey smoother and implementation more successful.”

Trust Chief Executive

‘Infrastructure and standards are critical to promote interoperability and effective use.’

Read the report: The adoption and use of digital health and care record systems.

Supplier relationships

Organisations need a clear and credible approach to procurement and contract management with access to the right skills and expertise. Success requires a sound, flexible contract that enables rapid response to change and the development of a close strategic working relationship with suppliers.

Releasing the benefits and continuous improvement

A clear and credible approach to benefits management, with the capability to support the scale of change, is required. Organisations should be committed to continuous improvement recognising that

  • change needs to be implemented incrementally
  • it takes time
  • the effect of the change should be measured

 On-going evaluation and training as well as integration into overall organisational transformation plans are important.

Success factors: mobile

Solution usability

Mobile working software requires a sound infrastructure, ease of use for staff, compatibility with the workflow of the organisation, as well as interoperability. Work with the suppliers and users to test and validate the solution.

Device selection

It's important to consult early with users over device selection - ensure options for devices meet the needs of users and work well with your chosen software solutions.

Adapting to connectivity

Design for on-line and off-line working as appropriate. Work to understand the local connectivity map and where roaming or other solutions are required. Work across your commissioning area to make use of all Wi-Fi access points such as GP practices.

Information governance, safety and security

Ensure that you have the right specialist input to safeguard data, maintain staff and patient safety and produce a secure solution.

“Having users directly involved in the design and rollout of our solution has helped to ensure it is usable at the front line.”

Clinical Nursing Lead

“One size does not fit all. We are now offering people a choice of a bigger laptop/screen to accommodate different types of use and working habits.”

IT manager

Analyse

Your strategy and mobile vision will be defined by:

  • analysis of current digital maturity
  • benchmarking against the success factors
  • understanding emerging mobile technology trends

Establish mobile vision

Why

The mobile vision describes your desired future state for use of mobile technology and can be shared with confidence by leaders and project teams.

How

The mobile vision should be based on analysis of emerging trends and available technology, and created and validated with important key stakeholders  - such as project executives, clinical leaders and users.

What

The vision summarises what the organisation wants to achieve with mobile technology.

 

Define strategy

Why

Align to strategic transformation projects and ensure there is leadership and clinical commitment.

How

Evaluate potential benefits and costs of options to achieve the mobile vision with stakeholders. Strive to enable professionals to spend more time with patients, improve productivity and save costs.

What

The strategy summarises the specific scope and how the goals of the mobile vision will be achieved.

Establish mobile vision

Ensure your organisation is committed and a shared vision is defined and supported by leadership.

Essential activities

  1. Consult stakeholders to define a mobile vision of how the use of mobile technology can support the organisation strategy and business/service objectives (to-be).
  2. Establish a broad baseline of current digital/mobile capability within the organisation (as-is).
  3. Assess important suppliers, the mobile market and emerging trends to understand strategic options for achieving the mobile vision.

Considerations and tips

  1. Leadership - the case for mobile working and technology has a strong evidence base which should be referenced when working with leadership and senior stakeholders to develop the mobile vision.
  2. Digital maturity- the level of digital maturity, infrastructure and capabilities is part of NHS England digital maturity model.
  3. Supplier collaboration - consult with your solution/software suppliers to understand and assess their mobile products. Work collaboratively and discuss requirements to confirm alignment with their mobile roadmap.
  4. Stakeholder consultation: prepare a short (2 page) stakeholder briefing pack that summarises the mobile opportunity/vision that is specific to your organisation/context. Use this with workshops and one-to-one meetings to share and refine the mobile vision.

Tools and templates

Visit the Mobile Technology Investment toolkit resources page on the NHS Digital website for:

  • mobile project examples
  • national resources and guidance
  • benefits profiles examples
  • benefits dependency map examples

Progress checkpoint

  1. Mobile capability baseline established.
  2. Mobile enabled vision defined with key opportunities identified and prioritised.
  3. Existing suppliers are engaged and supportive.
  4. Senior Internal stakeholders are engaged and supportive.

Next steps

  1. Consider what is needed to build on the mobile vision to create a robust and achievable strategy.
  2. Consider what governance will be needed to progress the work.
  3. Identify stakeholders that could be supportive of, or challenge, the mobile vision and strategy.

Tip

If your organisation is not ready to progress it’s important to agree the reasons why and define a roadmap. This might include interim solutions or small scale pilots.

Define strategy

Define an organisational strategy for mobile working.

Essential activities

  1. Establish governance and leadership. Using the mobile vision as the mandate, form a ‘project group’ to define the strategy.
  2. Identify, analyse and map stakeholders in terms of power and influence.
  3. Build the strategy iteratively by evaluating and refining its objectives, scope, benefits and delivery options with input from stakeholders.
  4. Work in partnership with suppliers to ensure the project can be completed in line with their solutions.

Considerations and tips

  1. Leadership - ensure strong leadership and governance is in place. Link to existing change and transformation programmes that promote the use of mobile technology.
  2. Digital maturity - when assessing current and future mobile capabilities, consider the level of digital maturity, the APIs required, interoperability, infrastructure and support/services.
  3. Stakeholder consultation - stakeholders should analyse and contribute to the strategy to achieve buy-in. Present the strategy through meetings and workshops. Ensure the strategy is ‘agreed’ by the leadership team.
  4. User mapping - map user types to technology and segment user groups. Consider a survey of current mobile usage.
  5. Supplier relationships - develop strategic supplier relationships to input/evaluate options, understand any contractual impacts, and how to work in partnership.
  6. Benefits analysis - when assessing benefits, form a working group to ensure benefits can be achieved and affects on current workflow and change are quantified.
  7. Quantify costs - understand the costs of the investment in terms of technical infrastructure, software and support options available.

Tools and templates

Visit the Mobile Technology Investment toolkit resources page on the NHS Digital website for:

  • benefits realisation plan template
  • user to device mapping tool
  • community mobile working ROI Calculator

Progress checkpoint

  1. Agreed strategy for mobile working with future capabilities and road map defined.
  2. Benefits quantified with dependency map and benefit profiles defined.
  3. Stakeholders consulted with strong support from stakeholders and leaders.

Next steps

  1. What are the main business requirements for mobile technology and support/service?
  2. What are the trade-offs between the major mobile platforms?
  3. What areas and which users will the change affect most?

 

Tip

Involve HR early to ensure they understand and can advise on the possible impact on staff – such as job specifications, staff safety and working patterns.

Tip

Be cautious and realistic in terms of ambition. Delivering significant change all at once is much more likely to encounter challenges. Consider a phased strategy with logical landing points that build momentum.

Decide

A clear and fully supported business case is a building block to delivering a mobile solution.

Prepare business case

Why

The business case summarises costs and benefits for the mobile technology initiative and enables validation of the approach by stakeholders.

How

In developing the business case, mobile technology requirements should be developed with users and validated with suppliers. The affects of business change and costs should be identified. See the business case and requirements resources for help.

What

The business case summarises the cost and benefits based on the requirements defined to deliver the strategy.

Procurement

Why

Work with commercial specialists to ensure value for money from mobile technology. Ensure the most efficient and effective procurement route is used.

How

Evaluate procurement options for the mobile products and services required. Work with suppliers to ensure value for money. See the procurement resources available.

What

Procurement involves detailed evaluation of products, prices, product selection and contractual negotiation.

Prepare business case

Define requirements and prepare business case.

Essential activities

  1. Consult stakeholders to ensure that you have agreement to invest and implement the business case.
  2. Define business requirements, working collaboratively with suppliers, local change leads and users.
  3. Refine and quantify benefits and define business change impacts and implications.
  4. Assess critical hardware, software and support and evaluate commercial options and appropriate procurement routes.
  5. Prepare and approve investment case (business case).
  6. Consult stakeholders to ensure that you have agreement to invest and implement the business case.

Considerations and tips

  1. User/service led requirements – identify business change owners to define requirements, benefits and change plan.
  2. Validate benefits - work directly with users to validate benefits based on changes to working patterns.
  3. Platform and devices – understand user requirements through device evaluation. User evaluation of software and devices may take time. Core systems such as email should be compatible with preferred mobile platform.
  4. Security of data - evaluate requirements against NHS Information Governance and security guidelines. Use appropriate safety assessment. Medical devices should be considered in line with guidance.
  5. Infrastructure – consider interoperability. Ensure infrastructure is adequate, such as VPN, Wi-Fi access, bandwidth impact.
  6. Mobile network - mitigate network challenges by roaming across networks or mapping hotspots to enable connection.
  7. Centralised management - work with ICT to select mobile device management software. Consider whether end-users will be able to install personal applications or use their personal devices?
  8. Support and maintenance - support costs for mobile can be lower than PCs but consider the replacement/refresh cycle. Consider changes to service level agreements if appropriate.

Tools and templates

Visit the Mobile Technology Investment Toolkit resources page on the NHS Digital website for:

  • ward information management business case template
  • benefits approach
  • community mobile solution business case template
  • device selection considerations
  • community mobile solution requirements checklist

Progress checkpoint

  1. Requirements defined and total cost of project estimated.
  2. Benefits refined and validated with high-level business change plan agreed.
  3. Business case prepared and approved.

Next steps

  1. Identify skills, capabilities and capacity (project team) for procurement and implementation.
  2. Work to identify the main procurement and implementation risks.
  3. Define who the service leads/stakeholders are who will champion the project. Identify and work with those who are likely to challenge and resist change.

Tip: allow sufficient time.

Do not underestimate the amount of time it takes to evaluate possible solutions with users. Ensure that you allow sufficient time to minimise the risks to user adoption.

Tip: confidence in use of the EHR.

The full benefits of mobile working can only be realised when use of the clinical system and electronic health record is mature in the organisation. If users are not confident in use of their clinical system there will be challenges with user engagement and training.

Procurement

Ensure all costs are considered and achieve value for money through appropriate procurement routes.

Essential activities

  1. Validate the business need and undertake market analysis to help identify potential suppliers.
  2. Define a sourcing strategy and procurement route.
  3. Consult the market and put tenders out to engage suppliers with a panel of clinical, technical, legal/commercial teams.
  4. Negotiate with suppliers to finalise contracts.
  5. Manage contracts to ensure value for money and resolve any issues.

Considerations and tips

  1. Value for money - consider procurement routes including OJEU and public sector reductions in shared business services and Crown Commercial procurement mechanisms.
  2. Platform and devices – evaluate device costs based on development, services and licencing. Consider allowing staff to use their own device or explore staff ownership to reduce cost. Allow funds for peripherals, breakages and replacements.
  3. Software and infrastructure – ensure software purchased (such as Enterprise Mobility Management or EHR licences) fit your strategy and check licence agreements for additional mobile costs.
  4. Mobile network – negotiate the cost of connectivity with your service provider based on increased usage. It may be possible to negotiate extra devices or changes to your contract.
  5. Centralised management – review support contracts to ensure 24 hour rapid devices swap and support. Consider full life cycle costs in your financial model - insurance, replacement and refresh.
  6. Support and maintenance – evaluate service, procurement, and support options in terms of value for money.
  7. Refresh – budget for renewal of devices in 3-5 years to ensure ongoing operational benefits.

Tools and templates

Visit the Mobile Technology Investment toolkit resources page on the NHS Digital website for:

  • what to buy exemplar list
  • procurement routes overview
  • mobile device management considerations (EMM/MDM)

Progress checkpoint

  1. Procurement routes agreed.
  2. Products evaluated based on value for money and strategic fit.
  3. Clinical, technical and legal/commercial teams agree on the suppliers selected.
  4. Contracts in place to support your mobile working strategy and deployment.

Next steps

  1. Agree contracts and timelines with suppliers.
  2. Work with suppliers to agree implementation of your mobile working strategy.

Tip: licenses

Ensure licenses for existing systems include mobile usage to avoid any additional charges.

Deploy

Work with business managers and suppliers to benchmark, then implement changes in working practises with users.

Implement

Why

Benchmarking organisational readiness and having a clear rollout plan with user agreement are critical to success.

How

Validate user acceptance of the solution prior to full rollout. Ensure that appropriate business and supplier support and training are available to support adoption.

What

Produce an appropriate implementation plan with supporting policies, training, benefits realisation plan and change procedures.

Optimise

Why

Continuous improvement is an important part of ensuring that the solution is used and further benefits are identified.

How

Provide continuous support for users and partner with users to identify further benefits.

What

Complete a post-implementation review to identify challenges and opportunities. Ensure benefits tracking and reporting is operational.

Implement

Ensure the organisation is ready to deploy and that benefits can be achieved.

Essential activities

  1. Staff engagement to ensure all staff who will be affected by proposed new ways of working are aware early in the project.
  2. Record current processes and measure benefit metrics prior to go-live and validate with stakeholders.
  3. Develop and validate future state processes and benefit realisation plans with stakeholders.
  4. Work with all stakeholders to gain agreement to the implementation plan.

Considerations and tips

  1. Business change - make sure operating procedures are in place to ensure services are able to adapt to the new ways of working.
  2. Benefits owners – identify managers within affected services to take responsibility for achieving the benefits and establish governance of benefits.
  3. Rollout approach - consider a flexible approach, identify high priority pilot areas. Talk with users to create standard operating procedures to ensure deployment is successful.
  4. Configuration - configure devices to appropriate security levels and register to users. Decide if software updates will be pushed or pulled by users and automate configuration and set up.
  5. User freedom - decide on the level of user access and personal use, such as music, photos and access to app stores.
  6. Mobile use policy - ensure all users have read the mobile use policy and help to resolve queries.
  7. User acceptance - test solution usability and connectivity prior to wider rollout to ensure business continuity.
  8. Training and support - ensure policies and procedures are in place to manage loss/damage and remote wipe devices for security. Ensure training and deployment support is in place, such as floor walking, follow up sessions or rapid device swaps.
  9. Suppliers - suppliers should be available to provide intensive support and collaborate on changes against predefined SLAs.

Tools and templates

Visit the Mobile Technology Investment toolkit resources page on the NHS Digital website for:

  • clinical deployment guide
  • benefits realisation plan template
  • current state process map example
  • standard operating procedure example

Progress checkpoint

  1. Benefits plan and baseline established.
  2. Staff trained.
  3. Solution configured and tested.
  4. Support arrangements in place.
  5. Policies, and standard operating procedures (SOPs) defined.
  6. Continuity plan agreed.

Next steps

  1. Optimise solution.
  2. Continue to measure and track the effects of the change in ways of working (benefits management).
  3. Identify and address any barriers that are restricting use or the level of benefit realised from the change.
  4. Undertake a post-implementation review

 

Tip: recruit change champions

Identify change champions or clinical super-users to be ambassadors for the change and to provide support to staff during rollout of the new ways of working.

Optimise

Ensure that the change is embedded and benefits are being realised.

Essential activities

  1. Measure and track the benefits of the change to working practices.
  2. Identify and address any barriers affecting the results.
  3. Ensure that the change in ways of working are fully embedded.
  4. Undertake a post-implementation review for the project.

Considerations and tips

  1. Realise the benefits - ensure on-going benefits management with the appropriate governance.
  2. Communication - staff communications are central to the project and your communications team must be involved from the start. Consider developing case studies to describe the impact of the change internally and externally.
  3. Operational performance - review performance and use of the technology on a regular basis.
  4. Staff input and collaboration - consider staff surveys as a mechanism to collect feedback on the effectiveness of the technology and its affect on individuals’ ways of working.
  5. Operational ownership - work to embed change and agree operational ownership.
  6. Support staff - provide “refresher” training as required and continue to provide support to staff in the use of the technology.
  7. Innovate with users - hold user workshops to identify further opportunities to streamline workflow.
  8. Monitoring and safety - monitor device usage and ensure that any apps used meet safety and assurance criteria.

Tools and templates

Visit the Mobile Technology Investment toolkit resources page on the NHS Digital website for:

  • benefits realisation plan template

Progress checkpoint

  1. Solution deployed.
  2. Post Implementation Review completed.
  3. Continuous tracking of benefits addressing any barriers.
  4. Establish a user group to evaluate future options.

Next steps

  1. Continue to track benefits.
  2. Develop a continuous improvement approach to the use of mobile devices.
  3. Continue to monitor software upgrades and device compatibility to ensure a reliable service.
  4. Hold user sessions to explore opportunities for development of productivity tools.

Tip: look to collaborate

Explore opportunities to collaborate with local innovators such as Academic Health Science Network’s and app developers. Work with services to identify opportunities to utilise existing apps available in app stores with appropriate governance.

Mobile project examples

These examples highlight how mobile technology can make use of electronic health records and enable staff to innovate and streamline workflow.

Going mobile with health records

Image of a paramedic using a tablet computer

Strong leadership required to gain commitment.

Work closely with staff to support delivery of benefits.

Empower your workforce by using mobile devices at scale

A female paramedic exiting a rapid response vehicle, carrying a rucksack, bag and paperwork

Improve communication and IT literacy.

Enable further productivity through business tools and apps.

Innovative use of mobile technology

A female nurse looking at a computer screen

Clinicians have the opportunity to innovate using apps and device features to realise efficiencies.

Innovative way to access national Spine services

A virtual image of a tablet computer showing a digital health record

NHS Digital developed a prototype secure mobile health app for the iPad that allows authorised health and care staff to view patient data held within NHS Digital national Spine services in a new and innovative way.

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Last edited: 21 May 2019 10:14 am