An application or “app” that has been developed after doctors joined forces with software developers in the first ever NHS “hack day” is set to bring a much needed technology boost to the “bits of paper” handover system currently used by most hospitals when doctors change shifts.
Colin Brown, the doctor on the team that took first prize at the hack day at the end of May,1 said that he had been pondering the idea for an electronic means of exchanging information at handover for a while. He was keen to take part in the day because getting together with experts in computer technology seemed like a logical step, he said.
“At the moment handover relies on lots of bits of paper on which doctors write notes or instructions about tasks and then juniors stuffing them in their back pockets. Then there are patient lists that juniors have to update in an Excel spreadsheet or in Word. There is no way to generate this electronically,” said Brown, currently an NHS fellow at the Health Protection Agency during a year out from his job as academic fellow in infectious diseases at St Thomas’ Hospital in London.
“The first part of our task on the hack day was to explain the current system to the software developers, and we had to keep re-explaining it because they were so incredulous at the systems used by most trusts.”
The app, which can be downloaded onto computers as well as mobile phones, uses a feed from the hospital’s electronic medical records to provide doctors with a list of all their patients and allows them to create task lists and update patients’ records.
The team behind the application believes that it has the potential to save the NHS more than £3.6m (€4.6m; $5.7m) in time savings, a calculation based on cutting five minutes from the time that 10 000 junior doctors spend each day on handovers. However, the potential gains for the NHS are much larger.
“Handover will be much easier,” said Brown. “Juniors won’t have to trawl through 15 bits of paper that other doctors have written, and the app will eliminate the potential to leave confidential and sensitive instructions about patients lying around, so [will] improve confidentiality.
“For supervisors there are benefits too, as we will be able to log on anywhere in the hospital and check whether a particular test that has been requested has actually been carried out. There will be no more chasing up juniors by bleeping them and then waiting for them to call back.”
If a patient appears on several lists—such as at a clinic in the hospital and as an inpatient—each team will be able to see what tests have been ordered and the results, saving time and avoiding duplication, he said.
Paul Wilson, managing director of New Context Scotland, a software consultancy that was involved in developing the winning idea, said that the application would be free and easy to download and install by any NHS hospital trust. “Our solution will reduce the errors that occur during shift handovers and when patients move between departments. We estimate that this innovation has the potential to save £3.6m worth of time—time that can then be devoted to frontline patient care,” he added.
The company is currently working to get the product beyond the proof of concept stage, and a prototype is being tested.
The winning team also included Adrian Mowat, from New Context Scotland, Eckhard Schwarzat, from the healthcare informatics company Value Decision, and Rob Dyke, from Tactix4, a software development company.
Cite this as: BMJ 2012;345:e5162
You can take part in the app development process by registering at https://www.pivotaltracker.com/projects/561741.