Hospitals to replace bedside charts with iPads

Hospitals to replace bedside charts with iPads

Nurse Julia Knight at Oxford’s John Radcliffe Hospital tries out the new iPad-based early warning system for patient monitoring Picture: OX64145 Jon Lewis

Consultant intensive care's Dr Peter Watkinson, nurse Julia Knight, human factors scientist Dr Lauren Morgan, director of IT John Smith, chief clinical information officer Dr Paul Altmann and Prof Lionel Tarassenko, professor of electronic engineering

From left, Bhulesh Vadher, the clinical director of pharmacy and medicines management, Dr Paul Altmann, the chief clinical information officer, and the integration architect Dr Payam Mohaghegh with the pharmacy robot. Picture: OX64144 Jon Lewis

First published in News
Last updated
Herald Series: Photograph of the Author by , Health reporter, also covering Kidlington. Call me on 01865 425271

BEDSIDE charts are to be replaced by computer tablets such as iPads at county NHS hospitals in a move towards a digital era.

Hospital bosses said the scheme – to be rolled out with up to 500 tablet devices throughout the year – will save time and improve safety.

Doctors and nurses currently use paper charts to record and assess vital signs like heart rate and blood pressure. If they need advice from a doctor, the chart has to be taken to them or consultants have to visit the ward. But under the scheme – devised with Oxford University – staff will input data that can be read at another iPad or tablet via a staff wi-fi network.

The computer programme will also calculate a score based on the vital signs, a process previously done manually.

These are then compared to records of similar patients’ vital signs to help medics better predict when someone is deteriorating.

Oxford’s John Radcliffe Hospital, the Churchill Hospital and Nuffield Orthopaedic Centre and Banbury’s Horton General Hospital will get the tablets.

They are currently going through final trials at the Churchill’s haemotology, oncology and Geoffrey Harris (respiratory, diabetes and endocrinology) wards, but £550,000 granted to the trust from the Department for Health’s £260m Safer Wards NHS Technology Fund, will allow the scheme to be rolled out across all adult wards across the trust.

Dr Peter Watkinson – who helped devise the scheme – said: “Doctors can be immediately aware of the data instead of the patients being hidden by being on paper in a ward.

“You are trying to prevent patients from deteriorating badly by picking things up early, such as a cardiac arrest that could be avoided.”

Under the paper system, time gaps were “very variable”, stretching from hours to minutes, said Dr Watkinson, a clinical researcher in critical care medicine.

Already some 3.8 million patient records are stored at hospitals and a storage facility at Upper Heyford, near Bicester.

He said: “If you look at how a hospital works at night, one doctor will be looking after several wards.

“A nurse will want to ring up a doctor to say ‘I am concerned about this patient’.

“They can now have both a conversation whereas previously the chart was on the ward.”

Electronically linking vital signs to other records will show which patients are among the “most abnormal”, he said.

“Other patients in a similar situation are the best model to show when you are falling out of the normal area for that group of patients.”

Other vital signs include temperature, respiration rate and the level of oxygen being received.

Research assistant and A&E nurse Julia Knight said: “Bits of paper would go missing and charts would go somewhere else. It means more time at the patients’ bedside.

“Previously you had a paper chart and you are trying to get someone to review the patient and it is only in one place that is difficult for people working across different areas.”

University Professor of Electrical Engineering Lionel Tarassenko, who has led the project, said: “The new system will help nurses, who work in busy, high-pressure environments, care for patients more efficiently and effectively.

“The traditional chart-based method of recording vital sign data is susceptible to errors in both recording and analysis of vital signs.”

He said it is a “major step towards the digital hospital in which all sources of patient information are linked and all healthcare staff are interconnected”.

Prof Tarassenko said: “This can only have a positive impact on patient safety.”

Major development costs have been saved by Oxford University Hospitals Trust – which manages the sites – working with the university.

Another project involves cutting prescription turnaround times by allowing doctors to enter a prescription at the bedside when it will automatically be processed by a ‘pharmacy robot’.

This means that when a doctor on the ward, or in outpatient clinics, prescribes medicine for a patient to take home, it will be prepared, packed and dispatched automatically by the robot.

Comments (14)

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9:10am Sat 4 Jan 14

fishstew says...

to me this seems expensive. also the eduroam wifi is flaky at the best of times. where is the NHS getting the money from where it could be spend better on curing people not on Crapple iPads
to me this seems expensive. also the eduroam wifi is flaky at the best of times. where is the NHS getting the money from where it could be spend better on curing people not on Crapple iPads fishstew
  • Score: -87

9:28am Sat 4 Jan 14

lil_miss_ME says...

fishstew wrote:
to me this seems expensive. also the eduroam wifi is flaky at the best of times. where is the NHS getting the money from where it could be spend better on curing people not on Crapple iPads
It must cost a fair amount to print all the paper charts, and then they have to be securely stored and eventually disposed off.......and get easily lost. Yes computer systems may fail, but they can have the paper back up, but in this day and age this seems sensible to me! Kids are starting to be given iPads and computers in schools instead of work books.......so in years to come the doctors and nurses will be a lot quicker and efficient recording details on an iPad than they will flicking through piles of paper and recording things manually!
[quote][p][bold]fishstew[/bold] wrote: to me this seems expensive. also the eduroam wifi is flaky at the best of times. where is the NHS getting the money from where it could be spend better on curing people not on Crapple iPads[/p][/quote]It must cost a fair amount to print all the paper charts, and then they have to be securely stored and eventually disposed off.......and get easily lost. Yes computer systems may fail, but they can have the paper back up, but in this day and age this seems sensible to me! Kids are starting to be given iPads and computers in schools instead of work books.......so in years to come the doctors and nurses will be a lot quicker and efficient recording details on an iPad than they will flicking through piles of paper and recording things manually! lil_miss_ME
  • Score: -129

9:44am Sat 4 Jan 14

fishstew says...

Warning Do not click on the link on comment number 2 by "RitaHRobinson" it is a spam/scam link
Warning Do not click on the link on comment number 2 by "RitaHRobinson" it is a spam/scam link fishstew
  • Score: -82

9:56am Sat 4 Jan 14

Danny A says...

Apples are not the only fruit.
Apples are not the only fruit. Danny A
  • Score: -95

10:13am Sat 4 Jan 14

fishstew says...

fishstew wrote:
Warning Do not click on the link on comment number 2 by "RitaHRobinson" it is a spam/scam link
they removed the link. i wasnt having a pop at little_miss_me who actually had some very good points to my first post :-) if you are reading this little_miss_me i apologise if it looks like that
[quote][p][bold]fishstew[/bold] wrote: Warning Do not click on the link on comment number 2 by "RitaHRobinson" it is a spam/scam link[/p][/quote]they removed the link. i wasnt having a pop at little_miss_me who actually had some very good points to my first post :-) if you are reading this little_miss_me i apologise if it looks like that fishstew
  • Score: -78

11:53am Sat 4 Jan 14

bicesterlady says...

It's a great idea.. If it works & it's reliable.

Would be a massive waste of time if they end up duplicating it by keeping paper records too.
It's a great idea.. If it works & it's reliable. Would be a massive waste of time if they end up duplicating it by keeping paper records too. bicesterlady
  • Score: -78

8:41pm Sat 4 Jan 14

Andrew:Oxford says...

bicesterlady wrote:
It's a great idea.. If it works & it's reliable.

Would be a massive waste of time if they end up duplicating it by keeping paper records too.
That would be dreadful.

It's disgraceful that the NHS still relies on so much paper. If I or anyone collapse on the street, a paramedic should be able to scan my fingerprint and obtain an instant medical summary to assist.
[quote][p][bold]bicesterlady[/bold] wrote: It's a great idea.. If it works & it's reliable. Would be a massive waste of time if they end up duplicating it by keeping paper records too.[/p][/quote]That would be dreadful. It's disgraceful that the NHS still relies on so much paper. If I or anyone collapse on the street, a paramedic should be able to scan my fingerprint and obtain an instant medical summary to assist. Andrew:Oxford
  • Score: -23

11:29pm Sat 4 Jan 14

lil_miss_ME says...

fishstew wrote:
fishstew wrote:
Warning Do not click on the link on comment number 2 by "RitaHRobinson" it is a spam/scam link
they removed the link. i wasnt having a pop at little_miss_me who actually had some very good points to my first post :-) if you are reading this little_miss_me i apologise if it looks like that
:) no offence taken!
[quote][p][bold]fishstew[/bold] wrote: [quote][p][bold]fishstew[/bold] wrote: Warning Do not click on the link on comment number 2 by "RitaHRobinson" it is a spam/scam link[/p][/quote]they removed the link. i wasnt having a pop at little_miss_me who actually had some very good points to my first post :-) if you are reading this little_miss_me i apologise if it looks like that[/p][/quote]:) no offence taken! lil_miss_ME
  • Score: -124

11:32pm Sat 4 Jan 14

lil_miss_ME says...

Andrew:Oxford wrote:
bicesterlady wrote:
It's a great idea.. If it works & it's reliable.

Would be a massive waste of time if they end up duplicating it by keeping paper records too.
That would be dreadful.

It's disgraceful that the NHS still relies on so much paper. If I or anyone collapse on the street, a paramedic should be able to scan my fingerprint and obtain an instant medical summary to assist.
I only meant resort back to paper for when system goes down.....not duplicate everything. Obviously I guess there needs to be some back up so,me where, somehow to access data when system is down, but as you say duplicating everything is totally pointless!
[quote][p][bold]Andrew:Oxford[/bold] wrote: [quote][p][bold]bicesterlady[/bold] wrote: It's a great idea.. If it works & it's reliable. Would be a massive waste of time if they end up duplicating it by keeping paper records too.[/p][/quote]That would be dreadful. It's disgraceful that the NHS still relies on so much paper. If I or anyone collapse on the street, a paramedic should be able to scan my fingerprint and obtain an instant medical summary to assist.[/p][/quote]I only meant resort back to paper for when system goes down.....not duplicate everything. Obviously I guess there needs to be some back up so,me where, somehow to access data when system is down, but as you say duplicating everything is totally pointless! lil_miss_ME
  • Score: -124

1:30pm Sun 5 Jan 14

yabbadabbadoo256 says...

Wonder how many will "Vanish" when the Agency staff change shifts?
Wonder how many will "Vanish" when the Agency staff change shifts? yabbadabbadoo256
  • Score: -183

6:36pm Sun 5 Jan 14

Andrew:Oxford says...

yabbadabbadoo256 wrote:
Wonder how many will "Vanish" when the Agency staff change shifts?
The "Agency staff" earn a far higher rate than the regular staff in the NHS.

The Socialists are currently planning legislation to ensure that agency staff in general are not paid any less than full time staff.

That should be balanced off legislation to stop agency staff being paid any more than full time staff within the public sector...
[quote][p][bold]yabbadabbadoo256[/bold] wrote: Wonder how many will "Vanish" when the Agency staff change shifts?[/p][/quote]The "Agency staff" earn a far higher rate than the regular staff in the NHS. The Socialists are currently planning legislation to ensure that agency staff in general are not paid any less than full time staff. That should be balanced off legislation to stop agency staff being paid any more than full time staff within the public sector... Andrew:Oxford
  • Score: -22

8:01pm Sun 5 Jan 14

Jwb947 says...

Having had three consultants appointments over five days, this week, the second being at a seperate hospital, computer records can only help reduce th frenetic activity involved in ensuring in ensuring notes are in the right place at the right time.
Having had three consultants appointments over five days, this week, the second being at a seperate hospital, computer records can only help reduce th frenetic activity involved in ensuring in ensuring notes are in the right place at the right time. Jwb947
  • Score: -22

9:27pm Mon 6 Jan 14

profgeof2000 says...

US hospitals - at least in ones I have visited in Florida, used computers that are brought into patients rooms. Have not seen paperwork on patient in years. Is UK really that far back - like still in the 70's!!!
US hospitals - at least in ones I have visited in Florida, used computers that are brought into patients rooms. Have not seen paperwork on patient in years. Is UK really that far back - like still in the 70's!!! profgeof2000
  • Score: -64

10:38am Wed 8 Jan 14

## Nonny Mouse ## says...

But why iPad's in particular? There are lots of more flexible and CHEAPER tablets on the market.
But why iPad's in particular? There are lots of more flexible and CHEAPER tablets on the market. ## Nonny Mouse ##
  • Score: -44

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