As care continues to shift further away from the hospital environment to a more local setting, it has never been more important to find innovative solutions to boost productivity for staff working in the community. Yet, as profound technology advances continue to revolutionise the way we conduct our lives, from online banking to Internet shopping, it seems that the NHS is failing to keep up.
I believe an effective community care model is the backbone of a high-performing health care system. By treating patients in their home and reducing hospital admissions, community care diminishes costs and offers a much-improved quality of life for the patient.
However, increasing demand from old and frail patients living with complex and chronic long-term diseases is placing a strain on the system and putting frontline staff under enormous pressure. A lack of funding in primary care, a shortage of nursing skills and a failure to integrate NHS health systems has left many services across the country varying widely in performance and productivity. Frontline workers are also spending more time dealing with paperwork, than caring for their patients.
This must change, and I believe community nurses and the tools of mobile technology are the key to that change. Community nurses are passionate about their job and want to do what is best for their patient. They are frustrated that paperwork, bureaucracy and poor technology are taking them away from what they joined the health service to do.
The community worker’s job is complex. They often have to deal with large amounts of information, such as their daily appointment schedule, the location of visits, and what tasks need to be completed. Any supporting technology must therefore encompass a frontline worker’s entire workflow. It is about taking the pressure off, creating more capacity so they can get more done. Just as the patient should be at the centre of the health professional’s world, so should the frontline health worker be the focus of a technology support system.
In the past, NHS managers may have tried and failed to implement fundamentally flawed technology, and perhaps found frontline staff resistant to, or uneasy about, change.
One of the major issues is that too much attention is being spent on recreating the office environment in the field, rather than working with community nurses to understand the real issues they face on a daily basis. Managers and IT staff tend to prioritise access to patient record systems, yet this is just part of what a community worker needs.
There has also been a huge push in the use of laptops or browser-based approaches, which often fail to realise the full potential of remote working, and in fact, may even add to the burden of a frontline worker. A laptop can create a physical barrier, which impedes communication, can often be expensive and bulky, and start up and shutdown times can be slow and cumbersome.
Mobile solutions that focus on back office supplier-based systems will also inevitably be oriented towards their own software, which makes them inherently limited. Frontline workers end up with a different mobile app for each system and no way to integrate each process, leading to repeated access and frustration for the user.
However mobile working technology that provides frontline staff with access to all the information they need for today’s demanding care requirements does exist and has already been deployed with great success at Bristol Community Health. Clinicians there can, at the point of care, access up-to-date information quickly and conveniently, capture patient information accurately and securely, and monitor patient outcomes much more effectively. Instead of making unnecessary journeys to the office or filling in large amounts of paperwork, nurses can spend more time delivering quality care to their patients in the most appropriate setting.
Clever mobile technology can help to improve communication between community staff and acute care, bridging the silos within the healthcare system. Patients will be increasingly diverted away from A&E and community teams can work with hospital wards to speed up patient discharge. The entire workings of primary care can be revolutionised by a simple mobile solution.
As the challenges of an overstretched NHS continue to grow, frontline workers will be pushed to the limit. It is therefore essential that health managers urgently look at providing community staff with innovative app-based mobile solutions on a tablet or smartphone, which support them in their role. Only then can we reshape community health services, reduce time spent on administration, and radically improve care.