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Enhancing care in the community with mobile technology

Enhancing care in the community with mobile technology

This is an update on a story featured in our Quality Account for 2014/15 [view more about enhancing care in the community with mobile technology]

What are the current issues with providing care in the community?

Waitemata DHB allied health staff (such as dietitians, occupational therapists, physiotherapists, social workers and speech-language therapists) provide a fundamental service to patients in the community.

Some of the issues faced by community staff include:

  • not having immediate access to patient’s medical history
  • having to return to their work place to complete their paperwork and to update a patient’s clinical record
  • limited access to current technology including new education and therapy tools for their patients
  • lack of alternative methods to interact with their patients

What are we trying to achieve?

We wanted to deliver better, more efficient and effective care for our patients in the community. Mobile technology has been used by community health teams in New Zealand and overseas and has been shown to increase the amount of time that community health teams can spend with their patients; enabled staff to better manage their workloads; and improved overall patient experience.

Our goals are to:

  • introduce new ways of interacting with our patients and our patients' information
  • provide patients and staff with access to the patient’s medical records in real-time in the patient’s home to improve the clinical interaction
  • reduce time our staff spend travelling and writing notes

What have we done?

Following an initial successful pilot, we have now provided all 116 of our community allied health clinicians with an iPad mobile device. Our clinicians represent 10 different professions in both adult and paediatric services. There are also two community nurses trialing an iPad.

Allied health clinician using an iPad at a patient's house

Approximately 95% of our community allied health clinicians are using their iPad daily as part of their work. The iPads are used for a variety of activities including:

  • managing emails, calendars and appointments
  • writing patient notes
  • using Facetime to communicate with other clinicians or with patients
  • downloading images to support discussions with patients, eg therapy equipment

Breakdown of community allied health clinicians using mobile device
Breakdown of community allied health clinicians using mobile device

Did we make a difference?

Feedback from clinicians

Clinicians have told us:

Allied health clinician

"I use the iPad to read and write/send emails. I use the calendar to know where I am going, and book appointments when I am out and about."

"As a speech therapist I have downloaded images of everyday items (eg vegetables, shopping items) to help a patient choose items to make a shopping list. We also used the pictures to practice naming and writing."

"I often use the iPad to show pictures of equipment, especially complex equipment or housing modifications. We don’t carry pictures around, but now can easily pull them off the internet to give patients a better understanding what we are talking about."

"I use pictures on the iPad to show patients the muscles e.g.in hand/legs to show them what muscles we are working on in physiotherapy and why."

"I often do my notes while on the road in between visits which makes it easier to get notes done and don’t get distracted. Also clears my head so I don’t need to hold on to info and do notes for 4 patients at the end of the day."

"The iPad is worth its weight in gold in so many ways: writing notes, google maps for home visits, booking appointments from patients homes, viewing other therapists appointment times during home visits. It’s just great and very convenient. I couldn’t do without it now!"

"I use Facetime to call a therapy assistant when they are with a patient so that I can review progress, offer suggestions etc without needing to leave the office."

Feedback from patients

As part of our patient experience survey we also included questions about whether a mobile device was used as part of their community visit. If a device was used, patients were asked if the pictures/ information/ resources shared using the device helped them to better understand their health and visits.

Did pictures / information / resources help you understand your health and visits?

Patient feedback on whether resources shared on mobile device was useful

Patient comments: 

Patient comments on mobile devices

Where to from here?

We will continue to monitor how the iPads are used and what this means for our patients and clinicians until December 2016 and will complete a report in February 2017 about our findings.