Buckshaw Village Surgery
Mobile Computing Solution Transforms the Management of Anticoagulation Treatments
Buckshaw Village Surgery (Chorley, Lancashire) offers a comprehensive range of clinical services to patients in the area. It is located in the vicinity of the Award-winning Buckshaw Retirement Village and offers its patients access to appointments, prescriptions and care records online. Buckshaw Retirement Village provides independent and assisted living accommodation, alongside a range of services and amenities, all delivered in professionally managed community setting.
Having worked with Stirling University, who are the market leaders in dementia-friendly design, Buckshaw offers a highly specialised service designed to support people with dementia and their families.
Challenges
Buckshaw Village Surgery aims to provide the highest quality of healthcare services to patients in the area. A large proportion of these patients are elderly, many with dementia. The previous pathway for anticoagulation treatment would include unnecessary handling of patients in clinics, delays
in analysis and the prescription of medication. This pathway required patients to travel to the nearest acute, phlebotomy or anticoagulation
clinic. A venous sample was taken on a first come first served basis, sent to the pathology for analysis and the patient sent home. The patient’s yellow dosing book stayed with the clinic and the INR result entered, before being mailed to the patient or GP. The patient was then called to the GP Practice. On collection of the prescription, the yellow book was returned to the patient, providing their daily dosing schedule and warfarin medication was dispensed. This process was repeated as dictated by the patient needs, taking between 3 and 5 days.
Solution
The deployment of a comprehensive mobile computing solution enabled the delivery of a domiciliary, single point of care service. The process time is reduced significantly, and the solution allows for a simple and cost effective pathway.
The mobile working solution is based on a Motion C5 Tablet PC, running a full EMIS Web client with Electronic Prescribing enabled, linked with the INRstar decision making software, alongside a mobile diagnostic tool for measuring INR results. Healthcare Assistants can now visit patients at home, carrying a mobile diagnostic device and a Motion Tablet PC running INRstar and EMIS Web. The simple thumb prick is taken at the patient’s home, and can be analysed in real time, with the result providing an instant dosing schedule for the patients yellow booklet, and an update for the clinical record. The Healthcare Assistant is able to provide a daily warfarin medication regime, which is authorised remotely by a responsible GP. Medication is electronically requested and prescribed, with clinical records updated in real time.
Thanks to the smart capabilities of the Motion Tablet PC, the pharmacy receives the prescription, dispenses it, and delivers it to the patient. Equipped with a mobile label printer connected wirelessly to the Motion C5 Tablet, the Healthcare Assistant is able to print off labels with a correct and up-to-date warfarin dosage schedule. This negates the need to handwrite this into the yellow booklet, hence eradicating clinical risks further.
Walk-In Service
Early 2016, Buckshaw Village Surgery saw the launch of three new purpose-built surgeries for the delivery of multi-care services to its residents. Since then, patients can visit the “drop-in” clinic for the administration of their anticoagulation treatment, using the same technology as the mobile solution used at the patient’s home.
Being able to use the same hardware for both the surgery based drop- in sessions and domiciliary home visits ensures maximum use of the new hardware giving a greater return on investment.
Commenting on the solution, Brian Hann, Business & Operations Director said:
"As an organisation, we have seen massive reduction in handling times and associated costs since the introduction of this solution. It has allowed us to reduce clinical risk significantly and compliance to warfarin medication has vastly improved. Service costs have been reduced too, eradicating the previous double handling of patients, and the faster process ultimately means that staff are more productive and patients given a greater quality of care.
The solution is extremely flexible to our needs. We are an expanding Primary Care provider with currently four locations, with strategic plans to grow further in the next two years. A multi-organisation requires a IT solution that is transferable between locations. The ease in which we are able to move the hardware between site, linked with INRstar’s central web hosted system access make this solution future proof for our need and the needs of our patients.
Having a solution that allows our clinical team to carry out domiciliary care visits, and then use the same hardware once in a one of our multiple locations for the delivery of our drop in clinics provides maximum flexibility, and importantly reduces our costs. We consider this solution an excellent return on our investment."
Benefits
In allowing the management of the anticoagulation medication to be delivered either through a “drop-in” clinic, or at the patient’s home, a greater flexibility is given to patients.
For vulnerable elderly patients, many suffering from dementia, the ability to deliver treatment in an environment in which they feel comfortable and safe is an important consideration. In enabling Healthcare Assistant to manage the anticoagulation treatment process at the patient’s home means greater convenience for patients, and a much less invasive procedure. Taking treatment and assessments to the patients also results in a much greater quality of care.
In delivering a shorter and more effective process, time savings are considerable too. The fact that medication is available within 4 hours and can be delivered to the patient improves warfarin compliance. The real time decisions and instant prescribing method improves the service patients receive as well as the quality of clinical treatment.