‘Concern about USB sticks used for handovers‘ article from E-Health Insider.

And as importantly the comments themselves, so you can make up your own mind:

26 Jul 07 20:16 (mary.hawking@nhs.net)

Risks in handover times

Dr Daunt is to be congratulated – and so are the Trust and the junior doctor whose USB stick was stolen for facing the problem. This is bound to be a universal problem: handover – when the care of a patient is transfered from one individual or team to another (handover in hospitals: discharges – and admissions – between secondary and primary care) is recognised as a time when mistakes are particularly likely to occur. That being so, it is inevitable – and desirable – that any new method of making the handover process more efficient will be used. I haven’t heard this particular risk – authorised or unauthorised use of removal media such as USB sticks or floppy discs to facilitate handover in Trusts – discussed before. Do any Trusts have policies on this? If not, why not? “Don’t do it” is not a policy..

26 Jul 07 22:40

And on hospital PC is worse?

Last Saturday I walked onto a ward in my hospital. The first PC was logged on as “Ward X” – there were about 25 desktop items, which were Word, Excel and Notepad files of Junior Doctors “handover sheets” – full info – name, number, diagnoses, to do lists etc. Two clicks and “print” and it would all have been in anyone’s hands – or plug in the USB stick and there it all is in portable format. Yet all the Juniors believe in patient confidentiality, and our hospital has a password protected PAS that allows storing and printing of this data. So why do they not use it? Why do they compromise patient data?

I think we need to use some disciplinary muscle to stamp this out.

27 Jul 07 03:54 (mikehitchens25@btinternet.com)

Secure Biometric USB Reader

The LME Bio biometric fingerprint reader allows for secure storage of patient identifiable data for a number of registered users and optional secure remote access to a work-based clinical system from anywhere.

(post edited by EHI)

27 Jul 07 05:26 (swilson@lockstep.com.au)

Why is anyone using USB sticks to CARRY data?

I would have thought that using USB sticks to convey patient data between healthcare workers at changeover would be deprecated on a number of grounds, not just the risk of losing unencrypted information.

Why isn’t this data available to all staff concerned on a central EHR/EMR? What needs to be copied to a stick that isn’t already available online through a terminal? If data is replicated in an uncontrolled way, the biggest risk isn’t that it could fall into the wrong hands; rather, it is that the portable data is modified and comes to diverge from the ‘original’. It is supremely important that at no time is there any doubt about the primacy of a given piece of health data.

At changeover, carers should be using a secure key (ideally a smartcard) to access definitive data online, not swapping data on an ad hoc basis through portable media.

Cheers,

Stephen Wilson Managing Director Lockstep

www.lockstep.com.au

27 Jul 07 10:04

Thats the whole point

Quote: Why isn’t this data available to all staff concerned on a central EHR/EMR?

Because the currebt solution is so awaful, too slow and does not provide the information needed in this manner.

The use is common, best plan would be to offer a FREE encrypted sotware utility and insist on its usage.

Because of the size and manner of usb drives, its impossible to ban them, so pointless. better to secure them.

Of course this is a totally irrelevant arguement when I see the consultant orthpaedic surgeon staggering to his car with 15 kilos of patients written notes, locking them in his unsecure car boot and driving to the private hospital to update patients who have opted out.

It’s a regular occurence and thiefs can open that car model in 6 seconds

27 Jul 07 10:43

Only the medium has changed

Thirty years ago – when I was a house officer – I kept a small notebook with to-do lists for patients identified through attaching to the page one of the stickers for putting on lab request forms. So did nearly all my colleagues.

This was neither more, nor less, secure that the use of USB sticks.

27 Jul 07 13:08

good point about the paper note book

The ex-house officer makes a good point about the historic use of written notes for hand over, but I expect his hand writing was so illegible that only another doctor could read it.

The latest answer to shift handover in the NHS, thanks to E-Health Insider:

iSoft chosen as reseller of mobile clinical assistant

Motion Computing have chosen iSoft to be the first UK-based reseller for the C5 Mobile Clinical Assistant, a rugged and washable tablet-PC style device specifically designed to provide doctors and nurses with access to updated patient records and the ability to document a patient’s condition.

Incorporating Intel’s latest wireless technology the MCA features a built-in bar code reader to enable patient wrist bands to be read, a digital camera and an RFID scanner enabling clinical users to be securely identified of drugs to be verified before being given to a patient.

Barcode scanning and RFID should directly help with improved patient identification and safety helping reduce medication errors. Bluetooth connectivity meanwhile will allow the MCA to link to patient diagnostic devices.

The device was first launched in February when prototypes were tested at three pilot sites in North California, Singapore and at England’s Salford Royal NHS Foundation Trust. iSoft was involved in the UK trials at Salford.

Marc Horowitz, iSoft’s group business development director, said: “We have seen that mobile devices achieve high levels of user satisfaction among doctors since they support decisions at the point of care. Mobility transforms care by helping doctors and care providers deliver the highest quality of care, which is beneficial for them and for patients.”

Trials of the MCA in the UK were first reported by E-Health Insider since October 2006. In the UK, Connecting for Health have been involved with development and iSoft now aim to offer the device to its 8,000 customers worldwide, both in the NHS and globally.

Horowitz added: “MCA is a major advance in mobile healthcare computing and puts computer technology into care environments safely. Having real-time clinical information to support decisions at the point of care will reduce errors and save valuable time, which are significant benefits to clinical staff and patients alike.

“To improve the quality of healthcare and staff workflow, it is vital to have timely and accurate information at the point of care.”

Motion Computing say that iSoft’s commitment to mobile technology makes them an “excellent partner.”

Motion Computing’s head of EMEA, Nigel Owens said: “iSoft has vast experience and market presence and its applications are proven and ideally suited to the MCA platform. Jointly we provide exactly what customers require by capturing information at source, reducing errors, increasing productivity, and cutting costs.”

The news has been welcomed by Connecting for Health who say the Mobile Clinical Assistant is the “missing link”.

Dr Mike Bainbridge, NHS Connecting for Health’s clinical architect, said: “It is the one thing clinicians having been looking for. The fact that we can get information with greater ease and genuinely collaborate for the first time is a major breakthrough. MCA’s features, tailored to clinical use will show some real benefits.

“The MCA is optimised to reduce risk, which is especially vital during the handover of care and at the point of administering prescriptions. With in-built barcode and RFID readers for patient identification and to validate medications, the process is simplified and the risks reduced dramatically.”

“Today technology comes to the aid of those who help others,” said Paul Otellini, Intel president and CEO.

“The mobile clinical assistant was defined and shaped by the clinicians who will use it. They have told us it will improve their decision making and patient care while easing overall workloads. This is a great example of putting innovative technology to work solving real needs.”

Motion currently charge $2200 for the unit, and iSoft anticipate selling at the retail price of £1100 or around Euros 1570.