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Enhancing care in the community with mobile technology

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 included:

  • 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 were 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?

We provided 11 community clinicians (dietitians, occupational therapists, physiotherapists, social workers, and speech-language therapists) with iPad mobile devices for a trial period.

The iPads were set-up with:

  • secure access to medical records which enables clinicians to make more informed decisions and to complete their medical notes whilst in the community
  • applications (apps) to be used for patient education and therapy
  • Skype (video-conferencing) to allow an alternative method of patient contact with patients who had access to Skype

During the project we conducted:

  1. time and motion studies to assess whether clinicians were able to save any time
  2. clinician experience questionnaires in relation to the use of mobile devices and Skype in the community
  3. patient experience questionnaires in relation to the use of mobile devices and Skype in their homes

Did we make a difference?

The overall results of the use of mobile devices and technology in the community project were threefold:

  • improved patient experience
  • improved clinician efficiency
  • increased job satisfaction and clinician well-being

Enhanced interactions with our patients

The majority of patients reported improved experiences when a mobile device was used in their home as part of their clinical interactions. Patients felt reassured that their medical information was more secure and better managed; and that clinicians were using their time better.

Patient feedback on using mobile devices in their home - information more secure


With improved access to medical information in the community, patients perceived that they were provided with faster and more convenient care.

 Patient feedback on using mobile devices in their home - faster and more convenient care


The use of apps helped patients to better understand their health conditions and therapies.

Patient feedback on using mobile devices in their home - better understand their health conditions and therapies


 Patient feedback about use of iPad for appointments
Patient responses to the statement ‘The iPad made my appointment better’


Improved experiences and efficiencies for clinicians

  • By completing documentation in the community, each clinician was able to save approximately half an hour per day, and could increase their time spent face-to-face with patients
  • Clinicians experienced greater job satisfaction and well-being due to the flexibility that a mobile device provides for completing tasks while in the community
  • Clinicians valued being able to access a broad range of education and therapy applications on the devices to enhance their clinical interactions with patients

Feedback on alternative method of patient contact (Skype)

  • Patients receiving speech-language therapy via Skype were able to achieve their therapy goals, although some reported variation in the quality of their calls
  • Clinicians reported significant savings in travel time as a result of using Skype
  • Both patients and clinicians rated their comfort levels with Skype as very high

Results from patient feedback on speech-language therapy via Skype
Results from patient feedback on speech-language therapy via skype


Where to from here?

We hope to expand the use of mobile devices in community allied health so that all clinicians and patients have the opportunity to benefit from the gains.

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