Changing healthcare and improving services with new mobile health app

The Oxygen app provided secure access to the following data sets at the point of need, to help inform clinical decisions:

• Personal Demographics Service (PDS)
• Summary Care Record (SCR)
• Child Protection–Information Sharing (CP-IS)

The Oxygen app used a proof of concept access and authentication solution that provided secure and authorised access for mobile devices. This approach removed the need to physically authenticate using an NHS Smartcard. NHS Digital conducted a 3 month pilot with 50 clinicians using the Oxygen app in an acute hospital, community services and a mental health trust. This case study summarises the experiences of pharmacists using the Oxygen app in the acute hospital.

Hospital pharmacists support the medicines reconciliation process for patients during an inpatient episode of care, in collaboration with the patient and other healthcare professionals. To achieve this effectively and safely they need access to the patient’s current medication and history. Medicines reconciliation ensures that medicines prescribed on patient admissions correspond to those taken before admissions. This process involves a discussion with patients or carers using primary care records (NICE/NPSA 2007).

The Oxygen app displays the medication elements from the SCR, which draws this information from the GP care record.

Common challenges

Inaccuracies in patient drug history may occur in hospital settings because:

• the capture of current medications is not always prioritised as part of medical clerking
• the local electronic patient record (EPR) system is not available at the bedside/point of care
• the local EPR is not integrated with national datasets, creating additional burden on the pharmacist to access a variety of systems

Other methods of access to nationally held data were available to some clinicians in the pilot, but relied upon access via fixed position desktop computers, which may not be ideally situated

Benefits

1. Using the Oxygen app to access the patient’s current GP record uploaded to the SCR helped to save time reviewing the patient’s medication and history. An additional 5 minutes per patient was saved, over and above the use of SCR on a desktop PC.
2. It enabled the pharmacist to spend more time engaging with the patient directly - at the point of care - to understand their medication experience and the medicine prescribed, and address any concerns the patient may have. The impact of this direct interaction contributed to improving the patient's immediate and long term experience.
3. Using the mobile device meant pharmacists did not need to find an available desktop computer and log in and out of the clinical IT system, and the substitution of the NHS Smartcard with the tablet saved users a significant amount of time.

The pilot proved the concept and potential value of using data held nationally whilst also providing valuable data and insight for the future.

The importance of, and demand for, secure mobile authentication is significant. NHS Digital is developing secure non-NHS Smartcard authentication solutions for mobile platforms for use by approved developers and organisations.

NHS Digital aims to develop a dynamic app-development market – to help create the environment where innovative, safe and well governed technical solutions are available to address health and care challenges.

NHS Digital continues to explore how the information we hold can help front-line health and care practitioners to carry out their duties safely and efficiently. We are also investigating where information held nationally, and accessed at the point of care, can provide additional benefits and lead to better patient outcomes.

We are working to ensure our products and services are relevant and up-to-date as digital infrastructure matures across health and social care.

We are interested in your views and want you to help shape our work. If you have an idea about how mobile access to national data could be used differently to achieve excellent care, or you would like to tell us about your needs as a developer or supplier of mobile solutions, please get in touch by emailing: [email protected].