Royal District Nursing Service (RDNS) is the largest and

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1 RDNS gains more client time with Mobile Computing Platform It has provided RDNS with a measurable increase in functionality. The combination of the HP Tablet PC, Windows XP and Office XP has delivered a mobile solution which enables our travelling nurses to use all the tools that they have in the office, but they can now do it in Royal District Nursing Service (RDNS) is the largest and oldest provider of home nursing and healthcare services in Australia, employing approximately 1,000 district nurses from 20 centres around Melbourne. However, RDNS needed to replace its four-year-old system of over 500 mobile units with new technology that would deliver nurses and patients improved and increased contact, whilst capturing operational data and maintaining patient records. With a platform nearing the end of its replacement cycle, and a commitment to delivering improved healthcare services aided by mobile technology, RDNS required a robust and scaleable solution. Ian Cash General Manager of Information Service RDNS CUSTOMER PROFILE BUSINESS SITUATION SOLUTION BENEFITS Royal District Nursing Service RDNS needed to replace its fouryear-old system of over 500 mobile (RDNS) is Grounded in the principles of care and compassion, RDNS is an units with new technology that independent not-for-profit would deliver nurses and patients organisation, delivering 24x7x365 improved and increased contact, nursing care to around 8,000 people whilst capturing operational data in their homes, schools and and maintaining patient records. workplaces, at any one time. With a platform nearing the end of its replacement cycle, and a commitment to delivering improved healthcare services aided by mobile technology, RDNS required a robust and scaleable solution. assisted in the selection and implementation of the winning combination of Hewlett Packard Tablet PC, running Windows XP and Office XP. Nurses dial up central administration servers using GPRS technology, which enables the nurses to start from home each day, dialling in and collecting information, sending s and receiving updates. RDNS can now transmit operational data and patient information to nurses in the field far more effectively than with previous systems. The solution is delivering more patient contact hours and reducing travel requirements for a field staff of up to 900 nurses.

2 Office XP provides the nursing staff with a whole lot more functionality. I think the greatest selling point is the fact that it is basically a mobile technology that delivers everything they had in the office, but they can do it in Simon Pearce Technical Product Manager With a patient base distributed around Melbourne and the surrounding areas, RDNS controlled field operations from regional centres, where each morning nurses would go to pick up their jobs for the day. Traditionally, this was done with a paper-based system, with a record card kept for each patient to capture details of past visits and treatment history. The nurses would collect their patient records for the day, and proceed from the centre to the first patient s home. There they would provide the necessary health care, and then enter details on the patient s card, which would then be taken back to the centre. The district nurses of RDNS have been operating in the field with mobile technology since Initially, Apple Newtons with GSM technology were deployed, until 1998 when Apple announced they were to be made redundant the following year, forcing a reconsideration of the mobile computing platform. Sharp s PV-5000 (running Microsoft Windows CE and integrating with their Windows NT operating system) was the chosen successor for the next four years. Ian Cash, General Manager of Information Services at RDNS, says: The organisation has always been an early adopter of mobile technology, but our search has been ongoing for a solution that could provide greater functionality in the mobile environment. The nurses needed to have access to a range of applications, as well as a system for capturing workflow data to be used later in operational analysis. In 2002, with the existing platform nearing the end of its replacement cycle and user requirements exceeding the capabilities of the existing system, RDNS realised it needed to migrate to a new operating system and hardware platform. Initially, the solution was to be used by 500 nurses in the field, eventually scaling up to serve the full 900 staff. The system needed to be robust, yet easy to use and not perceived as intimidating by the patients. Microsoft Certified Gold Partner,, had a long-term business relationship with RDNS and was commissioned to oversee the upgrade of the product and operating system for use in the field. Simon Pearce, Technical Project Manager at says, Mobile products in these conditions are exposed to a great deal of punishment. We were looking for a reliable system with which the nurses were already familiar, with a preference for touch screens rather than keyboards. provided specialist consulting in the design and commissioning of RDNS mobile solution focused on the wireless technologies. also assisted in the process of selecting the winning combination of Hewlett Packard Tablet PCs, running Microsoft Windows XP and Office XP. The system is designed to enable constant connectivity via either wireless LAN within the building or GPRS at all other times. The GPRS capabilities enable the nurses to start work from home each day, dialing in and collecting information, sending s and receiving updates. They turn on the device, start up the application and put in their login details. The server downloads their schedule, including details of which shift they are working on, the geographical area in which they are working, and information about their clients, says Pearce. During the working day, the nurses collect details about actions and procedures carried out onsite, as well as departure, travel and arrival times. The nurses are able to carry out real-time searches on patient histories, and can examine records of past treatment methods whilst they are actually with the patient.

3 Office XP delivers in-field administration results Microsoft Office has key applications used in patient management, providing one of the major reasons for upgrading to Office XP. Says Pearce, Office XP provides the nursing staff with a whole lot more functionality. On the old platform, they could run limited versions of and word processing software, but the functionality wasn t really sufficient to encourage full usage. I think the greatest selling point is the fact that it is basically a mobile technology that delivers everything they had in the office, but they can do it in Operating system integration ensures that data is current Nurses have the option at any stage during the day to refresh their schedules, reflecting changes throughout the day. Real-time record updating will be introduced in the near future. At the end of the day, after visiting a series of patients, either externally to the office or from within one of the centres, the nurses upload all the information they have gathered straight into the operating system in head office, states Pearce. Partner Details Microsoft Certified Partner, Systems, specialises in providing comprehensive IT information management solutions and counts amongst its clients a wide range of blue-chip corporate and medium-sized enterprises. With RDNS, s role included developing an appropriate technology selection process, which involved running user workshops to test a range of devices. Nurses were able to trial the technology and rate the different options available against each other. A team installed the technology at each centre and implemented the communication systems. RDNS upgraded from a GSM-based communication technology to a GPRSbased system on the Vodafone network. also supported the upgrade from the older hand-held computing devices to the Tablet PCs, and the release of the new software. The solution delivers a completely mobile application framework for the RDNS occasionally connected users. It utilises Windows XP Professional Tablet PC Edition, SQL Server, CMS 2002, Visual Studio C++, Microsoft Office, Microsoft Outlook, and Exchange has deployed CMS 2002 for the RDNS intranet and will deploy other CMS systems for nurses to use offsite in the medium term. The patient care application is written in C++ using Visual Studio and delivered with Office XP on Tablet PC s using the GPRS mobile network. has also developed a SQL Server based data warehouse and reporting system. Access to daily workflow details enables the RDNS to monitor the effect of the introduction of this technology and the actual increase in the number of primary care hours provided. Remote integration brings increased patient time Cash expects to gain greater human resource efficiencies, initially through the reduction of office and travel time. Prior to nurses starting client visits, they needed to travel into an office to carry out administration functions and get their schedule, then start visiting clients. At the end of the day, it was back to the office again. Consider what happens when we remove the need to commute to the centres every day, he says. Using the wireless and GPRS capabilities, coupled with remote access via Windows XP, nurses are able to start from home, dialling in and checking their schedules, and downloading patient records at the start of the day. The removal of the need to travel into the centre each day has resulted in a direct The nurses love using Office XP on the tablet platform, has been involved in providing this kind of technology to a range of our clients, but in this case, I am particularly struck by how much they like it. They generally seem to love the Tablet PCs. There are real smiles on their faces about them. Simon Pearce Technical Project Manager

4 increase in available care time. Over the last year, RDNS provided 481,000 hours of care. This capability is expected to increase by up to 2,500 extra hours per week. Data entry and integrity improved Prior to the use of mobile solutions, client data was written on forms, and then entered at day s end or later, leaving scope for error and data loss. Previous solutions were not able to deliver the benefits of real-time, direct data entry and retrieval, which improve data integrity and administrative efficiency whilst reducing paper trails. RDNS nurses are now able to achieve this in one step; as well, they are able to create forms and referrals on the Tablet PC itself. The introduction of the Tablet PCs with the added functionality of Microsoft XP and Office has delivered a winning combination to RDNS, enabling it to complete the rollout of the technology by nursing staff has also been successful and the feedback positive. The nurses love using Office XP on the tablet platform, Pearce says. has been involved in providing this kind of technology to a range of our clients, but in this case, I am particularly struck by how much they like it. They generally seem to love the Tablet PCs. There are real smiles on their faces about them. Customer benefits realised An unforeseen advantage of this combination was the removal of a distraction between patients and nursing staff, as typing and mouse usage whilst recording data presented a physical barrier for patient-nurse interaction. We have a lot of elderly clients who found traditional notebook technology to be intimidating. The Tablet PC opens up just like a folder or a book, says Cash. Nurses are able sit with patients and hold it like a clipboard, jotting notes using stylus and touch screen, rather than attaching a standard keyboard. This reduces the perception issues that arise with the introduction of foreign technology into patient s homes, he adds. RDNS nurses are able to use the wireless communication mode both in the regional centres and in the field. From a user point of view, this means that the nurses don t have to be aware of where they are as the communication works as if they were I the office at all times, as long as they are in network range. The technology provides a connection to RDNS operating system, which includes , the intranet, and specific workplace systems, 24 hours a day, Pearce says.

5 Microsoft Windows XP Tablet Microsoft Office XP Microsoft SQL Server Microsoft Visual Studio C+ + Microsoft Exchange Server Microsoft Outlook Microsoft CMS 2002 Partner Software for the Agile Business For more information in Australia, call the Microsoft Information Centre on To access information using the World Wide Web, go to: For more information about products and services, call (03) , enquiries@datum.com.au or visit the Web site at: Microsoft Corporation. All rights reserved. This case study is for informational purposes only. MICROSOFT MAKES NO WARRANTIES, EXPRESS OR IMPLIED, IN THIS SUMMARY. Microsoft, Windows, SharePoint and InfoPath are either registered trademarks or trademarks of Microsoft Corporation in the United States and/or other countries. The names of actual companies and products mentioned herein may be the trademarks of their respective owners. Date Published: October 2003

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