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Mobile Healthcare: How secure mobile devices can improve patient care

within the NHS

Press reports on the impact of IT on the NHS emphasise implementation delays, software
failures 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 into
what 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 get
to 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 the
City University, London where he leads research in bio-photonics and web services
security. 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 and
handled the questions in nimble style. The post-lecture wine reception was in the
Members’ Lounge, giving the audience ample time to continue discussion in a relaxed
atmosphere.

Dr Rajarajan emphasised the importance of inter-operability in health care and the need
for 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, both
medical and nursing, to manage too-high a work-load, resulting in a poorer quality of
care and a higher chance of medical errors.

Recent developments in IT (and access to wireless technology, in particular) have


allowed for vastly-improved access to patient data and for the processing of clinical
records closer to the point of decision. Mobile access to information can minimise
physical as well as time constraints for medical care, enhancing users’ mobility without
increasing geographical constraints.

The use of Mobile technology has significant advantages. For administrators, electronic
archiving reduces the need for paper records (and the associated administrative work-
load), while access to up-to-date patient information is made far easier, sensitive
information can be readily authenticated and the number of routine jobs reduced.
Improved access to both information and staff through extensive wireless networks, via
mobile terminals, using cordless phones, MDAs (Mobile Digital Assistants), PDAs and
wireless laptops can improve co-operation and communication. The result? Higher
patient security through always-updated records. Mobile wireless devices are entering
hospitals and other health-care environments, increasing productivity and reducing the
chance of medical error.

For practitioners, there is no longer a need to rely on memory. While on the move, they
can 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, nurses
and other authorised professionals are now able to share patient information while
consultation and symptom-analysis may be provided at a distance. Medical procedures
can be demonstrated through video links as medical staff automatically identify and alert
care-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, RFID
sensors and mobile technology) and the possibility of monitoring and treating patients
anywhere, anytime at the touch of a button, is allowing health care to become more
pervasive. It permits patients to enjoy a normal active life, instead of being stranded in
hospital; those with chronic diseases can now maintain a good quality-of-life, monitoring
their health status without the need to visit a surgery.

Dr Rajarajan expressed concern about confidentiality and data integrity: appropriate


formats are needed for encryption keys, electronic signatures and anonymisation –
“standards are the key to everything,” he said. “Today’s medical systems have proprietary
security standards which restrict their wider applicability”. And key to everything is the
need for standards to ensure devices are compatible.

“Cross-border communication is now a real issue”, he said. The new harmonised Europe
requires effective transfer of information from one country to another. That includes
health 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 cards
in health-care management and the encouragement of a ‘big brother’ mentality, to
funding sources, cost-benefit analysis, and access rights at accident scenes. Not
surprisingly, concerns about the impact of mobile technology on global warming were
also raised!

Alas, time ran out and, with the Chairman’s encouragement, the audience adjourned to
the Kelvin Bar for the post-lecture wine reception and a final discussion of the issues.
Ralph Adam
May 2007
Questions regarding feasibility, cost Vs Benefit, big brother watching were raised.
One of the ideas was how do you delegate your access rights to someone when you are at an
accident scene. Also there were concerns about global warming by using too many mobiles on
earth. There was also concern on how NHS will fund this technology transfer when they are
already under budget.

Is the use of video-conferencing or other multi-media communication appropriate?

Where next?

However, the cost assumptions may reduce if the NHS can increase productivity -
through better use of information technology (IT) and more effective use of staff - and
make big progress in improving public health.

Spending on information technology should be doubled, with IT budgets protected


to prevent the money being siphoned off into other areas. Stringent central standards
laid down to ensure NHS technology systems are compatible throughout the UK.

• (1050)

Wanless Report, April 2002

Xen says:
The Post Lecture wine reception was at the Members Lounge (Kelvin Bar).
I will try to get you some photographs from the social afterwards. Also, a few
positive words about the venue would be good.
RE: Mobile health-care article:IET
From: CHRISTODOULOU, XENOPHON (XXCHRIST@CTRL.CO.UK)
Sent: 11 May 2007 13:40:40
Ralph,

Questions regarding feasibility, cost V. Benefit, big brother watching were raised.
RA asked about cards.

I will try to get you some photographs from the social afterwards. Also, a few
positive words about the venue would be good.

The Lecture was in the Main Lecture theatre where the portraits of many greats are
hanging, such as Faraday, Kelvin, etc.

Raj says:

. Yes I will be pleased to see an article on the member magazine. We can easily re-write for IET
Communications. Regarding the photos I am not sure where to find the digital library with such
photos. Can we take it from Google?? Or do we have to have our own images. Yes Xen is the
Chairman of the London Network so we need to acknowledge it.

Hope this answers all your questions. It will be nice to see something in the August issue.
Raj says:

Ralph,

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