Western Isles using eHealth to take care to patients in remote and rural environments

Published: 22 April 2009

Western Isles NHS Health Board provides for a population of 26,500 people who live on a 140-mile long chain of nine islands. Some 79 per cent of the population live in remote and rural circumstances and life expectancy is the third worst in Scotland. MARY SMITH, Family Health Nurse and NMAHP eHealth Lead, describes some of the eHealth activities supporting care in this area.

Results from a recent Nursing, Midwifery and Allied Health Professionals (NMAHP) eHealth Capability and Capacity Survey, undertaken across Scotland, provide "indicators of success" and examples of good practice to ensure NMAHPs contribute to the realisation of the benefits of eHealth.

The process of completing this survey was a very useful exercise for us in the Western Isles. The section entitled "Management of Knowledge" enabled us to look at how we use technology to access and share the information necessary to provide safe and effective care to patients.

All areas in the Western Isles have Internet and Intranet access, and both are well used by staff to access information to aid decision making, research and study.

Improving access

The Intranet provides links to a variety of resources including the eLibrary, Manual of Clinical Nursing Procedures, Joanna Briggs Institute, British National Formulary and Scottish Intercollegiate Guidelines Network (SIGN). A Learning Resource Facilitator helps staff access the physical and electronic libraries, providing computer skills training when required.

Courses available online include Online Recording and Assessment System (mandatory for all involved in the blood transfusion process), Cleanliness Champion and Delivering Patient Safety.

Video conferencing equipment is available in Stornoway, Uist and Barra. NMAHPs use it to facilitate attendance at meetings and conferences in the Western Isles and on the mainland, and to communicate with colleagues and local or mainland consultants.

Some examples of good practice

  • Speech and language therapists use video conferencing for urgent assessments between planned consultant visits. A scoping procedure is carried out in Stornoway by the speech therapist and the information is transmitted to the mainland ENT consultant who also interviews the patient.
  • Digital camera images are used by podiatrists and the tissue viability nurse for enhancing shared care communication and monitoring progress. The images used by podiatrists are saved on to Tynedale Electronic Patient Record System. Patient consent is obtained before taking and storing images.

Currently a policy is being developed to cover issues such as consent, use and transmission.

The NHS Western Isles makes good use of two of NHS Scotland's national eHealth solutions. The Picture Archive Communication System (PACS) enables images taken in one area to be viewed by consultants across Scotland (if their organisation has also subscribed to PACS). This saves printing and transferring images.

SCI-DC (Scottish Care Information - Diabetes Collaboration) is used by the diabetic multidisciplinary team to record patient information. It ensures all members of the team have access to comprehensive and up-to-date patient records.

Spreading the word

NHS Western Isles is an early implementer for data sharing. We are currently able to receive child protection messages from our social work colleagues and are working towards an electronic Single Shared Assessment.

The Health Information Project Western Isles (HI Project) website provides up-to-date, jargon-free information on conditions, procedures and lifestyle. It also provides contact details of support groups, agencies and useful websites. The information is available in a variety of languages, including Gaelic, on request. It is well used by all age groups and there is evidence that, with help, people without computer skills are accessing the information.

It is essential to have the appropriate policies, protocols and training in place to ensure safe and effective use of technology that aids communication between the local multidisciplinary team and mainland consultants.