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Mobile Healthcare: How secure mobile devices can improve patient carewithin the NHS
Press reports on the impact of IT on the NHS emphasise implementation delays, softwarefailures and cost over-runs. The presentation by the April speaker for the IET London Network, Savoy Place Section made a welcome change with a fascinating insight intowhat the medical world can gain from recent developments in mobile telephony.The talk was preceded by excellent refreshments and a real chance for the audience to getto know one another under the watchful eyes of past Presidents in the Common Room.The Council Chamber was the venue for the presentation itself. A large audience,consisting of both members and non-members, including representatives from many branches of the medical profession, enjoyed the talk. It was delivered at a cracking pace by Dr. M. Rajarajan, Director of the Internet Systems Engineering Programmes at theCity University, London where he leads research in bio-photonics and web servicessecurity. He is also the co-founder of AspiData, a company specialising in novel mobile-health security protocols.Savoy Place Section Chairman Xenophon Christodoulou introduced the session andhandled the questions in nimble style. The post-lecture wine reception was in theMembers’ Lounge, giving the audience ample time to continue discussion in a relaxedatmosphere.Dr Rajarajan emphasised the importance of inter-operability in health care and the needfor security standards. “ For me”, he said, “‘mobile healthcare’ means portable,unobtrusive devices to collect and organise medical data”. Examples include pagers,Blackberrys, WiFi connections as well as Internet telephony, Bluetooth and smart phones.He added that increasing pressure from government has led to too few hospital staff, bothmedical and nursing, to manage too-high a work-load, resulting in a poorer quality of careand ahigher chance of medical errors.Recent developments in IT (and access to wireless technology, in particular) haveallowed for vastly-improved access to patient data and for the processing of clinicalrecords closer to the point of decision. Mobile access to information can minimise physical as well as time constraints for medical care, enhancing users’ mobility withoutincreasing geographical constraints.The use of Mobile technology has significant advantages. For administrators, electronicarchiving reduces the need for paper records (and the associated administrative work-load), whileaccessto up-to-date patient information is made far easier, sensitiveinformation can be readily authenticated and the number of routine jobs reduced.
 
Improved access to both information and staff through extensive wireless networks, viamobile terminals, using cordless phones, MDAs (Mobile Digital Assistants), PDAs andwireless laptops can improve co-operation and communication. The result? Higher  patient security through always-updated records. Mobile wireless devices are enteringhospitals and other health-care environments, increasing productivity and reducing thechance of medical error.For practitioners, there is no longer a need to rely on memory.While on the move, theycan reach a wide range of internet-based resources, as well as the traditional on-line data- bases such as Medline or the British National Formulary (BNF). Consultants, GPs, nursesand other authorised professionals are now able to share patient information whileconsultation and symptom-analysis may be provided at a distance. Medical procedurescan be demonstrated through video links as medical staff automatically identify and alertcare-givers of irregular activity by patients living in wireless-equipped homes.Patients are now far-more health-conscious and more inclined to take a proactive,individual approach to their health,for example, researching symptoms through the Web.On the other hand, new technology, including wearable computing (microchips, RFIDsensors and mobile technology) and the possibility of monitoring and treating patientsanywhere, anytime at the touch of a button, is allowing health care to become more pervasive. It permits patients to enjoya normal active life, instead of being stranded inhospital; those with chronic diseases can now maintain a good quality-of-life,monitoringtheir health status without the need to visit a surgery. Dr Rajarajanexpressed concernabout confidentiality and data integrity: appropriateformats are needed for encryption keys, electronic signatures and anonymisation – “standards are the key to everything,” he said. “Today’s medicalsystems have proprietary security standards which restrict their wider applicability
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And key to everything is theneed for standards to ensure devices are compatible.“Cross-border communication is now a real issue”, he said. The new harmonised Europerequires effective transfer of information from one country to another. That includeshealth records, prescriptions, referrals and results of investigations. Thus access control between health-care organisations requires the recognition of digital versions of  professional qualifications and registration. There are other questions, too. For example,the need to decide on the forms and levels of security necessary for the transfer of data between European organisations.The audience reacted enthusiastically with questions ranging from the role of smart cardsin health-care management and the encouragement of a ‘big brother’ mentality, tofunding sources, cost-benefit analysis, and access rights at accident scenes. Notsurprisingly, concerns about the impact of mobile technology on global warming werealso raised!Alas, time ran out and, with the Chairman’s encouragement, the audience adjourned totheKelvin Bar for the  post-lecture wine reception and a final discussion of the issues.
 
Ralph AdamMay 2007
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