Abstract : Between 10 and 15 per cent of all hospital
admissions are subject to medical errors, omissions or malpractice. And,
according to the US Institute of Medicine, more people die due to medical errors
each year than from car accidents, breast cancer or AIDS. Shocking as this may
be, even more alarming is the fact that the majority of medical errors are
preventable.
Reducing medical errors is one of the aims of MOBI-DEV, a European
Commission-funded project under the IST programme that has developed a new
generation of mobile devices for healthcare professionals.
Structured around the use of PDAs enabled with a natural language recognition
system and a tool for electronic signature, linked to hospital information
systems via UMTS/GPRS and Bluetooth/WiFi wireless technologies, the MOBI-DEV
project has sought to grant healthcare professionals an unprecedented degree of
mobility both in hospitals and outside of them, while at the same time reducing
medical errors.
The conclusion of trials at medical centres in Italy, Spain and Greece last
month shows that the MOBI-DEV system can meet both those goals.
"Errors, omissions and inconsistencies often occur during the transcription of
medical prescriptions, data about administering drugs, or from the dual
prescription of conflicting medications due to a lack of on-hand information,"
Ricci notes. "MOBI-DEV can help solve these problems and that is obviously
crucial for patients."
The trials run by the University of Rome Tor Vergata, the Instituto de Salud
Carlos III in Madrid and at the Kritos Medical Centre in Rhodes, Greece, offer
indications that the use of the mobile system could significantly reduce errors
and omissions, resulting in an evident improvement in the quality of care
patients receive.
Greater efficiency "Our evaluations are in line with widely recognised international data
showing that the use of mobile devices can reduce error rates," explains Roberto
Ricci, representing Informa, the project commercialising partner in Italy.
While clearly not all medical errors or omissions are caused by the incorrect
transcription of data, a significant number are due to the cumbersome,
inefficient and time consuming paper-based systems that have been employed to
date.
For doctors themselves the advantages appear numerous, not only in reducing the
risk of errors but in saving time and boosting efficiency.
"MOBI-DEV gives you an immediate picture of the patient's information while you
are at their bedside, whether they are in the hospital or at home," explains Dr
Jacopo Legramante, assistant professor at the department of internal medicine,
University of Rome Tor Vergata. Legramante, whose team tested the system in
cardiology and urology departments, notes that MOBI-DEV allows healthcare
professionals to work faster by eliminating many of the processes and much of
the paperwork needed to record patient information and subsequently retrieve it.
"The ability to input information, prescriptions and diagnoses by voice saves
time, while consistency is improved between doctors, nurses and hospital
information systems," he says. "The more steps there are the more room there is
for mistakes, but MOBI-DEV reduces it to a one-step process."
Enabling home care Perhaps the most innovative aspect of MOBI-DEV is its ability to take
hospital information resources out of the hospital building itself at the touch
of a button - and to do so securely through the use of smart cards and digital
certificates to assure patient and hospital data is protected.
Though several medical centres in Europe and to a greater degree in the United
States have started to integrate mobile communications systems into hospital
wards and departments, the crucial area of home hospitalisation has remained
largely untouched by new technologies.
"Mobile telephones were the first step down that road, but this system will take
home care much, much further," says Dr Jose Monteagudo of the Instituto de Salud
Carlos III. "It is truly pioneering in that respect." And that is particularly
important given the changing face of healthcare in Europe, as national health
services attempt to constrain financial burdens.
Home care is significantly less expensive than hospital care - the Spanish
hospital, Gregorio Maranon, estimates as much as 400 less per patient per day -
and it frees up hospital resources to deal with more patients.
"There is a trend all over Europe toward increasing home hospitalisation,"
explains Ricci. "Since this trend is ongoing there is an overriding question:
how to provide the same level of care at home to that provided in hospitals? The
answer is mobile solutions such as MOBI-DEV."
On the flip side, hospitals save resources and money: in Greece, for instance,
according to the project's estimates, the MOBI-DEV system could result in
average financial savings from home treatment and increased efficiency of 14,000
per doctor per year.
Despite these evident advantages, barriers do remain. Healthcare institutions,
often slow and reluctant to change their organisational models and business
processes, are mostly still paper-centric. In many countries hospital
information systems are poorly developed. As a result, it is very difficult to
integrate such systems into a completely "paperless" scenario, which will
ultimately reduce errors and save time and costs. However, before this happens
the problem of giving legal value to health data managements processes based on
IT solutions should be addressed. Although MOBI-DEV with its e-signature
facility is ready for the next step, these are now at best run in parallel with
more traditional paper-based procedures, the only ones that are legally accepted
in the current framework.
In addition, many doctors, accustomed to paper-based, manual information
systems, have shied away from learning how to use new technologies. But,
according to Ricci, this will slowly change as a new generation of doctors who
grew up around computers start to replace the existing medical community.
"Our strategy to broaden the implementation of this system is very much based on
that younger generation," Ricci explains. "We believe the use of these
technologies must come from the bottom up, from the doctors themselves, and not
so much from the top down." However, even though things are changing, pushed
from the bottom, a top-down action is also needed and desirable.
Subject Descriptors : Information processing, Information
retrieval, Information transmission
Subject Index Codes : Information Processing, Information Systems
Subject Class : IT, telecommunications
Remarks : Results Entry form
Collaboration Sought : Further research or development support, Information
exchange/Training
Sources of Support : CEC
Programmes : IST
Projects : IST-2000-26402
Project Title : Mobi-Dev: mobile devices for healthcare applications
Contact Details
Contact Name : PAPAEVGENIOU, John
Position : Project Manager
Department : Poseidonos Avenue 13
Contact Organisation : Relational Technology S.A.
City : Athens
Region : ATTIKI
Region Description not available(ACHARNES)
Postcode : 17455
Country : GREECE
Telephone Number : +30-210-9889300
Fax Number : +30-210-9881449
Electronic Mailbox :
jpapae@relational.gr
