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Bell, who previously worked for companies in several sectors, joined North Bristol NHS Trust six years ago. "It was a bit like stepping back 20 years in IM&T when I first joined," he told Kable's Mobile and Wireless Healthcare conference in Manchester on 24 February 2009.
"I think the trouble is a lot of people in the NHS look for examples within the NHS," he said. Other sectors, such as firms running warehouses, already make extensive use of technologies such as RFID tagging: "Suppliers to the healthcare market are so immature compared to other markets I've been in."
"We live in a mobile world. Healthcare just hasn't caught up yet," Bell said. "One thing I find bizarre in the NHS is that most people don't have a mobile phone," or if they do, they don't use one for work. "We get to the NHS, and we've got a three year old computer and we can't move it, and we can't get a mobile phone signal in South Gloucestershire or North Somerset."
The trust, which employs 8,500 people at sites including Southmead and Frenchay hospitals in Bristol, had 1,000 personal computers when Bell joined, only half of them connected to a network. It now has 4,500 PCs, all networked.
But although computing in general has advanced, Bell says this is not the case for wireless technology. "I think we're right at the beginning in healthcare, in how we are going to use mobile and wireless technology," he told the event.
From camera to PDA
As part of the redevelopment of both its main sites, North Bristol plans to use wireless technology in a variety of ways. Bell said this will include giving security guards access to camera output through personal digital assistants. As well as helping with conventional security tasks such as keeping thieves out, he thinks it will be invaluable for keeping patients in.
Bell said that elderly dementia sufferers could also be tagged, along with physical assets such as beds. Tagging, along with wireless access to cameras, would help stop such a patient from wandering outside in winter and freezing to death: "I want to save her life," he said.
He also called for increased use of telecare, both at home and at NHS sites, citing personal experience of what the current shortcomings. He has taken his son to one hospital (not within his own trust) 10 times to treat a condition, but six of those appointments could have taken place remotely, while others could have used an NHS building closer to home. North Bristol has been involved in trials in which speech and language therapy is provided to patients across the south west of England at home, or at GP surgeries, through IT.
He added that his trust is looking at personalised booked parking spaces for patients arriving, to ensure there are spaces for those who need them. The hospital to which he took his son had no parking facilities at all, with the nearest three-quarters of a mile away – "a long way on crutches for a boy of eight".
Bell said that sometimes technology advances have been stifled by internal politics. For example, with a wireless network it is possible to issue porters and nurses with small communication devices, so they can be called directly by clinical staff or patients. But sometimes their managers don't like these, as the devices mean they lose some power.
Bell said that trusts have to exchange their experiences of using technology directly, but did not expect much help from NHS Connecting for Health: "If it goes into a black hole in the centre, into CfH, I challenge whether any of us will learn from the experience," he said.
North Bristol aims to introduce electronic patient records by 2012, and hopes its main new hospital will be fully electronic when it opens in 2013. "Obviously we're not relying on the National Programme (for IT) to deliver the necessary," Bell told the conference. "We're hopeful they will at least help us implement the software."
But he said that the health service's problems with technology went beyond the failings of any single organisation. "The problem with the NHS, clinicians especially, is they haven't been taught to write a business case," he said, even when that case is very strong as with mobile and wireless technology. "The financial and operational case is so self-evident, we are almost in danger of not making it."
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