Overview:
In a unique blend of the old and the new, innovative Australian specialist orthopaedic surgeon Dr George Murrell has worked with Motion Computing’s tablet PC technology to create a cutting-edge paperless medical practice in a renovated old church in southern Sydney.
Dr Murrell is the Director of the Orthopaedic Research Institute at St George Hospital and a Professor at the University of New South Wales, dividing his time between academic work, conducting and supervising research in his specialist area of shoulder surgery with his students and Fellows; and seeing patients.
Several months after leaving all paper and patient files behind in May to move into the teaching practice’s newly renovated premises, formerly Kogarah’s Presbyterian Church, the combination of the old church and mobile modern technology is a total success story.
The beautiful old church was built in the 1920s after its congregation expanded beyond the original next door 1800s building, now also renovated to incorporate offices, medical suites and a café. However its congregation dwindled over subsequent years. Seeing the building for sale directly beside St. George hospital where his research laboratory is situated and close to his day surgery 100 metres away, Dr Murrell and his wife bought the church as a shared premises for both his practice and her dermatology practice.
A former Oxford University Rhodes Scholar, Dr Murrell’s commitment to leveraging mobile tablet technology continues his medical and academic career’s innovative and forward-looking approach, which has seen his team win over 30 international medical awards, with his fellowship program attracting surgeons and patients from around the world.
Challenge:
The challenge for Dr Murrell and his entire team was to replace the office’s existing filing system. “Previously patients filled out a pink form on their pain and specific problems. Fellows or students then transcribed by hand onto a green form the patients’ responses on their functions, strength and range of motion. I then reviewed those files with the patient before decisions on surgery or treatment.”
The decision to commit to a 100% paperless office was backed by allowing for no filing space at all in the new premises. “It was difficult for the first week or two but well worth it once we were over that initial barrier. The space we’ve saved from approximately 15,000 patient records, each file nearly an inch thick, has been used for more exam rooms and teaching areas.”
Solution:
Searching for solutions to support his paperless initiative, Dr Murrell found an Australia review site that was very positive about Motion tablets and which recommended Australian distributor Paul Nowicki at Secure Agility, Australian owned Systems integration and networking specialists.
“Paul was great, he provided a high level of personalised service and also provided me with an evaluation tablet for several days so I could test out the technology,” said Dr. Murrell.
As an early adopter researching online for both tablet PCs and software platforms, Dr Murrell searched for available Australian software before finding fully integrated server-based solution VIP.net in New Zealand from Houston Medical (.net), which focuses on supporting specialist consulting practices. Dr Murrell made contact in late 2008 with managing director Derek Gower of Houston Medical.
“Derek let me access his server in New Zealand over the internet and begin to design forms and test his software. When we went ahead, Derek was very responsive; he and Houston’s Australia manager Warren Goertz made several follow-up visits to us. They have been hands-on and provided great service in comparison with larger, more impersonal firms.”
“Secure Agility installed the wireless system for us to make sure the tablets could be used everywhere, including our day surgery 100 metres away,” added Dr. Murrell. Secure Agility helped with the design of the wireless infrastructure for the project, drawing on their familiarity with organisations where mobility is essential to operations, such as hospital emergency department trolleys and other environments that can’t be constrained by location.
Dr Murrell wanted a mobile tablet solution that all users could walk around with and use flexibly. “The VIP.net software provides drop-down menus, so you’re not keyboard dependent. We have the choice of using keyboards and a docking station, which we have in the teaching areas.”
Multiple people can now access patient information simultaneously and files cannot get lost as they’re now hosted on the server. Just 100 metres away, the day surgery where Dr Murrell carries out 95% of his operations has tablets plugged into the practice’s wireless network to access records on the server, eliminating the need to carry large files and X-rays down the road.
At any time, several people can be working with the tablets, with patients in the front desk area filling out their information; and staff working in the teaching area. With X-ray facilities also incorporated, the team can view reports either using the docking stations, or on one of two regular PCs with keyboard systems and wide 36” screens, also used to easily see ultrasounds reports and X-ray images.
Patients receive a tablet upon entry to fill out their form by simply checking a box with convenient tablet input. The VIP.net forms guide patients through questions, prompting them to pick and rank a question about their pain and symptoms. “They get more specific when using the technology, also now we are quickly building pop-up prompts that remind patients to go back, if they’ve skipped a question. On paper forms, many patients wouldn’t fill out all of the information but now we can get more complete forms.”
Fellows now use a tablet version of the previous green forms, with software that can either check boxes or write numbers. This makes sharing and utilizing the information much more convenient and has eliminated the errors often associated with manual data transcription.
Results:
Dr Murrell’s practice now functions in real time, with improved accuracy and efficiency across a wide range of areas for all medical and office staff.
Dr. Murrell added, “We collaborate better with patients, viewing and showing them their results on the large screens. The quality of information received from patients is much better and more reliable. Because we don’t have to transcribe it twice, it also saves time for the patient. We also use that same information to send reports and letters back to the patient’s referring doctor, so that information is immediately usable by them as well.”
Dr Murrell said another benefit was being able to view patient records at home or in remote locations. “I can provide care and access information no matter where I am. In theory I could be in a conference overseas, go to the Internet, see the records and give quick feedback and directions to my office staff, fellows or students, who can also look up any data by just logging into their server, without having to come into the practice.”
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Consulting room, with TABLET PC and large LCD display
About Dr. George Murrell
George A C Murrell, MBBS (Adel), MD (UNSW), DPhil (Oxon)
George Murrell is Director of the Orthopaedic Research Institute at St George Hospital and Professor at the University of NSW. He graduated from Adelaide University and was the 1984 South Australian Rhodes Scholar. At Oxford he completed a DPhil (PhD) and was awarded the Royal College of Surgeons Arris and Gale medal.
He spent a year in Cambridge teaching before completing his orthopaedic training at Duke University, USA, followed by a two year fellowship in sports medicine, shoulder surgery and research at the Hospital for Special Surgery, New York, where he gained a National Institutes of Health First Award, and an American Orthopaedic Association North American Travelling Fellowship.
Professor Murrell specialises in shoulder surgery and has a special interest in arthroscopic methods to repair and restore damaged ligaments and tendons.
His team has won over 30 awards for their work and his fellowship program attracts surgeons and patients from around the world.
www.georgemurrellshoulders.com.au
About Motion Computing
Motion Computing is a leading provider of integrated mobile computing solutions, combining world-class innovation and industry experience so professionals in vertical industries such as healthcare, field sales and service and government can use computing technology in new ways and places.
The company’s enhanced line of tablet PCs, mobile clinical assistants and accessories are designed to increase productivity for on-the-go users while providing portability, security, power and versatility. Motion combines those products with services and unique vertical market knowledge to deliver robust solutions – platforms, peripherals, services and wireless – customized for the needs of a particular industry.
For more information, visit www.motioncomputing.com.au
About Secure Agility
Sydney-based Secure Agility are experts in designing WAN, LAN, Wireless Networking and IP Telephony solutions.
They specialise in technology services for products leveraging top reliability and performance, with proven expertise in defining provisioning for network management systems and network integration to manage the commercial aspects of project deliveries and network based project deployments.
www.secureagility.com
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