Dr Alasdair Corfield, Dr Dave McKean and Dr Paul Campbell, Emergency Medical Retrieval Service
Applied technology in an aero-medical critical care retrieval service
Using new technologies to cheaply and effectively organise and interpret health outcomes data - for better design of community health activities and to improve patient decision making.
Ten percent of the Scottish population live in a remote or rural area, more than one hour away from a hospital with an emergency department or intensive care unit. The Emergency Medical Retrieval Service (EMRS) is a service within the UK providing aero-medical critical care transport and retrieval to these remote and rural areas of Scotland. Due to the complex needs of a dispersed population being cared for by a large group of rural clinicians with variable experience, robust guidelines on patient management are important.
EMRS has developed standard operating procedures covering all aspects of the service but the challenge has been to ensure the information is communicated and disseminated. In 2009 an app was developed for use on mobile devices to give clinicians realtime access to clinical information when managing patients and important logistical information, such as aircraft access and weather. This information is now available regardless of location.
The aim of this project is to develop the app to expand access to point of critical care clinical information to ERMS team members and rural clinicians with realtime information, such as ICU bed availability.
Currently aspects of the service are conducted through manual paperwork. Further development of the app means that realtime data can be captured by clinicians rather than manually after the event while maintaining data integrity.
The app will be expanded to enable the ERMS clinical team to have remote access to the intensive care bed status database. This process is also currently conducted manually by telephone which can be time consuming.
The effectiveness of the app will be measured by frequency and pattern of use during patient retrieval, user uptake, user surveys and incidence of adverse events due to technical issues. The feedback will be incorporated into a future version of the app.
Overall patient mortality rates will be compared with national benchmarks.
External evaluation of the introduction of EMRS demonstrated an additional 8 lives saved per 100 patients.
Use of the app has led to improvements in decision making for team members and smoother, faster movement of patients, and high levels of clinical governance and quality of care. The app has caught the attention of international and UK retrieval services who are trialling it.