North Tees and Hartlepool NHS Foundation Trust is an integrated hospital and community services healthcare organization serving around 400,000 people in Hartlepool, Stockton, and parts of County Durham. Services are primarily offered from the University Hospital of North Tees (Stockton-on-Tees) and University Hospital of Hartlepool, with support from a wide range of community-based services.
The Beginning
In 2014, the National Health Service (NHS) eProcurement Strategy mandated the use of GS1 barcoding standards for all NHS Acute Care Trusts in the UK by 2019. While the retail sector had used this standard for many years at the time, its use in the UK healthcare sector had only recently caught on. Several factors, including a push to reduce NHS costs as well as patient safety crises like the PIP breast implant scandal, brought attention to the technology as a possible solution to many NHS challenges.
NHS initiated the Scan4Safety program to increase efficiencies and improve the quality and safety of care across England’s healthcare system. Six NHS trusts were selected to test the technology, which attaches universal barcodes to medical supplies and equipment as well as the patients, nurses, and doctors who use, order, and interact with those supplies. At each stage of the process, clinicians scan the barcodes to record the people, place, product, and process—from procurement to patient care.
North Tees and Hartlepool NHS Trust turned to J2 Interactive to help implement a GS1 barcode solution for their 600-bed acute hospital. With an eight-week turnaround deadline, necessary for meeting important funding and incentive deadlines from NHS, J2 helped the Trust create an open-source solution.
What J2 Developed
While it may have been simpler to turn to the hospital’s legacy electronic patient record (EPR) provider, the Trust wanted to build their own solution that could be easily replicated, distributed, and integrated with the existing systems already in use at their facilities and the wider NHS. They wanted to develop a vendor-agnostic open-source application that could be used across the NHS to help eliminate information silos and reach a range of care settings.
J2 quickly went to work, combining our experience in barcoding and integration with our agile approach to application development and clinical workflow improvement. Through a close partnership, the team delivered a production-ready app in under two months and on budget. This finished app supports both key clinical workflows and meets the Trust’s demanding technical standards.
CareScan+ and COVID-19
Healthcare organizations around the world have adapted processes and technologies to meet the new challenges presented by the COVID-19 pandemic, including how they monitor supplies. In the United Kingdom, North Tees and Hartlepool NHS Trust immediately identified the obstacle of tracking the use and location of non-invasive ventilators. Leaders at the Trust realized they could repurpose the existing CareScan+ solution that they developed with J2 Interactive.
After North Tees identified the need to track non-invasive ventilators, they collaborated with J2 to adapt the application—all within a week. The care team had already assigned each portable ventilator a unique barcode that staff could scan every time the machine was allocated to a patient, removed for cleaning or maintenance, or put back in storage. Now, whenever hospital staff requires the device, they have access to a simple, online dashboard that shows the location and usage of every ventilator in the hospital.
While other barcode scanning solutions developed for the NHS and elsewhere are bolted onto existing software designed for an altogether different purpose, J2 explicitly developed CareScan+ to facilitate the barcode capture process and the workflows related to it. The app is agile and flexible enough to expand, scale, and be applied to many workflows, allowing it to address the needs that can arise during the global pandemic.
How the Application Works
Using a small handheld scanner no larger than a smartphone, a clinician first enters their credentials, then scans the barcode on their badge. Once the Trusts’ Active Directory authorizes them, they can scan the next item used in the care event, such as a patient wristband, another staff member’s badge, or medical product.
The app walks the user through various verification and advisory screens to select the right medical procedure, confirm the patient’s information and consent, and view any important information about the product, including recalls or expiration dates. The app records each scan, allowing for further querying of what was involved in the care event.
Unexpected obstacles can occur while someone is doing a scan—a needle dropped on the floor, an IV bag split open, a nurse called away to an emergency mid-procedure, etc. To manage these unforeseen events, J2 built the application to time out when a user is idle, enabling new users to pick up a task where another has left off, and allow the recording of wasted products.
What’s Next?
CareScan+ was built with flexibility and scalability in mind. Therefore, it can be used throughout the Trust and in other organizations to track devices and equipment during the pandemic and beyond. As new use cases arise, the software allows for new workflows to be quickly designed and deployed to support hospitals, care teams, and the patients who depend on them.
