The birth of DigiRounds
digiRounds allows clinical teams to see the patient information they need during the ward round, in a format that is concise and quick to use using a hand held mobile device.
Ward rounds are an essential part of inpatient care and patients are reviewed by consultants, with assistance from junior doctors, senior nurses and other clinical staff. The care for the rest of the day is decided here. This includes how clinicians assess the patients’ health, decisions on further investigations, and whether the patient is ready to go home.
digiRounds has been developed in-house between clinical staff and UHS digital. Critical care consultant Mat Cordingly is a fundamental and key player in the meticulous design and further development of the application. Cordingly is dyslexic and believes this has been driving force when it comes to the clarity of design.
“It was crucial for us not to include any unnecessary information, icons or images,” he said. “We made sure there were a maximum of seven tabs on the screen because we know that any more than this amount of tabs would lead to the user skipping and cherry picking information. Within those we knew we needed to replicate the look and feel of a traditional obs chart, to keep historical familiarity and structures, basing the design very much upon the paper version clinicians are accustomed to using. This allowed senior and experienced clinicians to interpret information without having to relearn different styles of charts etc. This same approach was applied to the fluid chart which, on digiRounds, is identical to traditional paper charts.”
digiRounds is designed for end of bed use – a digital window at the end of the bed. Tablets work better when you are mobile and are designed to work for touch – hence digiRounds was designed to work from the ground up – knowing this was going to be used by touch. The data is presented in a way doctors “learnt to be a doctor” and allows pattern recognition and problem solving. It is built beautifully with touch and the ability to scroll back in time.
Cordingly worked together with UHS digital – Nilesh Patel, technical solutions manager, Ian Brewer, head of IT and Ryan Beecham to bring this together under a strict timeline and prior to winter pressures.
Then chief operating officer Dr Caroline Marshall pushed for the obs chart and drugs chart to be brought together on ipads and to replace paper at the end of the bed. Marshall organised the GDE funds to buy iPads and pushed them out to the teams last November.
digiRounds here and now
digiRounds is great example of integration and grabs data from databases within the trust from all systems and presents the data in a standardised digiRounds view.
The next release of digiRounds will give users the ability to log in from their own home and allow them to gently review all patient data ready for handover. Trialing a home login has seen positive feedback from intensive care unit consultants who have felt the benefit of being able to read, review and process patient information in a timely manner, away from the ward environment and without onerous login procedures.
UHS digital is looking to increase the information digiRounds will show – it currently shows the name of every document, including EDMS docs, and the immediate future is to keep the structure and continue to present in a format which works for doctors. This is about polishing it a every stage, not adding features for the sake of adding features.
The next steps will see digiRounds start to allow data input in a limited format at the end of the bed. The team are researching what data elements would work well at the end of the bed, for example, clinicians would be able acknowledge results and add a job plan for ordering tests at the bedside.
The future vision is to standardise the key elements of digiRounds which would work as a platform for other NHS trust systems. Doctors would be able to move between trusts and access different systems without having to relearn how to assess patient information. Using digiRounds has saved staff significant time when they are doing their ward rounds, allowing them to spend more time with their patients.
“digiRounds makes being a doctor more enjoyable,” said Cordingly. “We are able to make a diagnosis, rather than spend time logging in, and we enjoy seeing patients more because if you can’t see the data it’s incredibly stressful.”
"digiRounds is the most amazing application. It has changed the way I work." Dr Ashwin Pinto, Consultant Neurologist