Bleep-Bleep A complex problem as posted by Carl Reynolds and Wai Keong was solved at #nhshackday by Malcolm Newbury, Simone Avossa, Joe Hughes, Tim Knowles, Sean Radford, Francis Wong, Geoff Hall and Doug Livingstone(from another team grabbed in the last half an hour!) :photos here

The integrated Cloud - mobile service solution was developed over the weekend and came in the top three.

Here is the text of my #nhshackday googlegroup post: All in common with others, I feel the need to try and summarise the achievement of the Bleep Bleep project team #NHSHackday. Please chip in, if I miss out any details chaps. The problem space was first elaborated online by Wai Keong , Carl Reynolds, and Francis Wong, who described the chaos and wasted effort caused by the urgent need to communicate with colleagues, the proliferation of different communication devices and inevitable permanence of pagers within hospitals. Tim Knowles, Francis Wong and Geoff Hall provided the clinical leadership and data structure for the project and Andy Broomfield helped with deisgn and presentation. Bleep, Bleep project solved two problems in the space of 24 hrs: - giving clinicians up to date phone, pager and email details of all relevant contacts within the clinician's community of interest, so that they could make a call without having to look up or request details from a third party (ie the switchboard) - providing the ability to log and add meta data to the call, which provides call analytics, location, priority, purpose, call back details etc. It did this by addressing the interoperability of three software components:

Bleep, Bleep managed to get the first 3 components fully operational, integrated and tested by making changes to an individual's pager number on the CRM, which then found its way to my iphone in seconds. We would have got the whole thing working by 3pm on the first day, if I'd done a bit more homework on the CiviCRM API. The REST API is great, but the documentation is a little fresh, so it took quite a bit of trial, error, and reimporting of data to figure it out. When we did finally figure it out on the second day, in the temporary absence of Joe Hughes, we had to scrounge some iphone developer expertise from other teams and got terrific help from Doug Livingtone and Luke McNeice (l.mcneice@kainos.com). We updated the CRM profile of our token user with a new pager number and watched the iphone app get updated by our software: superb. We didn't manage to actually get to the point where we made calls to trigger the workflow application, - we would have needed another day for that. But hey - were were pretty elated with the results and proud to win an Award. We are now looking to reconnect as a team and get a working prototype up and running soon. Thank you #NHSHackday!

Here is the text of the emails posted by Carl Reynolds, Wai Keong and Francis Wong:

Hi there guys, I've been reading these emails with great interest, there are some really interesting ideas and it is clear NHS HackDay is going to be a great success! I'm a NHS doctor, surgical SHO and self-confessed geek having previously run a run a web-hosting company and led a number of techie projects. Although I'm not really a coder, I'm really excited at the prospect of improving patient care through IT/tech innovation. Anyway I'll get straight to the point... I think the switchboard app idea is a fantastic one - having worked at several different hospitals over the years, I really wish I'd had it. I'm a great believer in keeping things simple and I think this app has the potential to be immediately useful to a large number of people without a need for difficult organisational change. I think it would be great it worked with LDAP, etc however I think the real beauty of hospital numbers is that they are very static. Bleep numbers remain the same, department phone numbers rarely change, and the only people who have secretaries or offices are generally long-term staff (consultants, etc). All it would take to transcribe the useful numbers in a given hospital would be a motivated individual with a few hours in hand. I think opportunities to revamp the messaging/bleep system are really interesting however undoubtedly much more challenging, not to mention complicated by the fact all of the hospitals I have worked in have very patchy mobile phone coverage. Personally I love Whatsapp and Twilio and it would be interesting to see what could be achieved using these kind of services. Re the switchboard app I've attached my take on the problem as a document and a few iPhone mockups that I made to try and illustrate my ideas. I'd be very interested to hear what you guys think! Cheers, Francis

Carl:

I'll add a couple of supporting docs there based on my experience in A&E.

Some overlap with:

1. Switchboard is a bottle neck, directory app that takes and saves hospital telephone number as base and allows extensions to be collected and shared

2. Hospital wiki app with sync and for offline use and version control and security could serve as communication platform for resferral/ handover/etc, I want to do asynchronous communication that is transparent to reduce the need for chasing and support professional development and facilitate load balancing.

But captures the pain much better.

I was just thinking that a mobile app that handled a directory of extensions nicely would be very cool. i.e you put base number for hospital in then add directory numbers as you get them

On Mar 18, 12:28 am, Wai Keong :- Looking after a patient in hospital is a team effort involving multiple people from different departments, 24 hours a day.

In most hospitals up and down this country, the tools for this job are the humble pager (aka the ‘bleep’) and the wired telephone; as it has been for the last 30 years! Indeed, being given a bleep marks your initiation into the world of a junior doctor.

Let’s say you want to speak to John from cardiology about a patient. You will need to:-

  1. Find out John’s bleep number.
  2. Call the operator if you don’t know his number
  3. Find a telephone nearby that no one is using.
  4. Bleep John. The number would usually be [number to activate system][John’s bleep number][your telephone extension]
  5. Put the phone down and wait.
  6. John’s pager goes off.
  7. He interrupts whatever he is doing.
  8. He needs to look for a phone that no one else is using.
  9. He rings your extension
  10. SUCCESS! - You are connected.

This above process could easily be repeated 20-30 times a day per person. I hope you can appreciate that at every step of the way, something can go wrong. Let me give you examples.

  1. Find out John’s bleep number. *<— from memory? from the Intranet? From a piece of paper of the wall? Hope that it has not changed?*

  2. Call the operator if you don’t know the number *<— Put on hold, busy operators, does not have the number!, gives you multiple numbers to try*

  3. Find a telephone nearby that no one is using. *<— This could be next to you, 20 metres away, 50 metres away?*

  4. Bleep John. The number would usually be [code to activate

    system][John’s bleep number][your telephone extension] *<— Hope you have not forgot the code*

  5. Put the phone down and wait. *<— Hope that no one else rings the phone, hope the phone is not needed urgently, can’t do anything else whilst waiting*

  6. John’s pager goes off. *<— hope he hears it, this may not be the only bleep he has received within minutes of each other*

  7. He interrupts whatever he is doing. *<— He could be speaking to a patient, be in the toilet, he does not know how important the call is, he might be on another call!*

  8. He needs to look for a phone that no one else is using. *<— This can be very far away*

  9. He rings your extension *<— Hope you are still there, hope the phone is not engaged*

  10. SUCCESS! - You are connected. *<— You realise that John was not the person you needed after all, he gives you another person’s name –> Repeat steps 1-10*

Hospitals buy the latest gadgets for robotic surgery, spend £££ on expensive chemotherapy and multimillion pound scanners, and yet we put up with stone-age technology to connect the people involved in delivering healthcare.

This process drains our energy, increases our stress levels, and ultimately impacts our ability to care for our patients safely, effectively and efficiently.

The continued reliance on such antiquated technology is a symptom of a much larger problem of the chronic neglect and underinvestment in attempts to understand and do something about the way healthcare professionals communicate with one another in the process of delivering care.

With the amazing tools available to us today, surely the time has come to retire the venerable ‘bleep’.

Someone want to have a go???

YES PLEASE !!


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Bleep-Bleep (last edited 2012-06-06 20:08:10 by Malcolm Newbury)