Case Study

Access in the Community – Citrix provides the diagnostic link for the University Hospitals of Leicester NHS Trust

Covers Citrix MetaFrame Presentation Server, Web Interface, Secure Gateway, providing easier access to real time data and increased staff productivity.

Introduction

University Hospitals of Leicester NHS Trust comprises three acute hospitals based in Leicester: Glenfield Hospital, Leicester General Hospital and Leicester Royal Infirmary. The three hospitals joined together to form the Trust on 1st April 2000 to meet the increasing demands for providing better healthcare. The Trust is one of the largest acute teaching hospitals in the United Kingdom, with nearly 10,000 staff, an annual operating income of approximately £416 million, serving a population of just under one million people.

In a continuous drive to improve the quality of care provided to patients, the IM&T Directorate, Clinicians and Nurses embarked on a project to realise the benefits of providing mobile connectivity to hospital systems. The aim of the project was to provide real-time access to hospital systems to nurses providing treatment in the patient’s home, and telemedicine facilities for on-call Radiologists to diagnose head injuries from their homes during the night.

	The solution provided is both scalable and secure, it will enable us to deliver applications to clinical staff ... in real time wherever they are
	Dave Rose, IM&T Technical Architect, University Hospitals of Leicester

Defining the Solution

Initially the IM&T Directorate carried out user requirement analysis of the Renal Department working processes with the home visiting team. The conclusion was that (GPRS) General Packet Radio Service would best align the community staff’s working processes to improve patient care and support the streamlining of administrative tasks.

Coral Graham, the lead for the renal home care team, using GPRS to connect to their Renal system explained "we were confident that GPRS would provide positive benefits in treating patient care, once the staff had used the service and the many initial doubts were overcome."

The IM&T team also investigated a proposal by the Imaging Services Department which would allow Senior Radiologists to access Computerised Tomography (CT) scans using a laptop via Asymmetric Digital Subscriber Line (ADSL) connected to the hospital network using a virtual private network (VPN).

Delivering the Solution

The team worked with Centralis, a Citrix Managed Consulting Provider, to setup and test a Citrix solution delivering clinical and administration systems over the LAN, GPRS & ADSL.

Dave Rose, the IM&T Technical Architect explained the reasons for selecting Centralis "I was aware of Centralis and their considerable expertise in this field and invited them to propose a solution which met our present and future needs using a scalable solution based on Citrix. The solution provided is both scalable and secure, it will enable us to deliver applications to clinical staff irrespective of distance, in real time wherever they are."

Centralis worked with the team to build a server farm based on Citrix MetaFrame Presentation Server, plus Web Interface and Secure Gateway servers for secure browser delivery of applications. Key to the success of the project was the involvement of BT in providing the GPRS solution. The GPRS solution chosen was NHSnet Remote, BT's dedicated wireless solution for the NHS that enables users to remotely access clinical and business applications over NHSnet using a secure wireless link. The service is fully approved by the NHS Information Authority's Security Board.

Initial tests using GPRS proved that it was possible to access patient information real-time, while providing treatment in the home. This improved the service to patients, as it is was possible to examine historical data and get access to the most up to date patient information. Staff could also schedule blood reports on-line, providing a more responsive service in the home.

Connectivity via ADSL was provided by Cable & wireless using their VPN secure access system over an internet connection, after fine tuning the web application which provides the CT scans it is now possible to view multi-slice images of patients head injuries in remote locations.

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	We see Centralis as one our key technology partners, working together to provide a solution which will deliver real benefits in patient care
	Dave Rose, IM&T Technical Architect, University Hospitals of Leicester

Benefits of the Solution

The main benefits of the GPRS solution, which is currently in the process of being rolled out, have been to enhance the quality of care provided in patient’s home. Nursing staff are able to spend more time with the patients and have access to real time data which improves patient management. Staff also benefit because they no longer have to print off and carry large printouts with blood results for each patient.

The trust has also benefited through being able to make staff more productive, as travel to and from the hospital is reduced, and the preparation time for each visit is reduced by hour. These time savings allow the nursing staff to spend more time on patient care, and still increase the number of patient visits they can undertake each week.

The main benefit of the ADSL telemedicine project is that the consultant Radiologist can now make an informed assessment of the condition of a patient using CT scans provided to them in their own home on a laptop. This eliminates the time taken for the Radiologist to travel to the hospital to view the CT scans before offering advice, these savings in time can make a big difference to patients with potentially life threatening head injuries.

Durgesh Parmar, the Technical Business Analyst at UHL, stated "We see Centralis as one our key technology partners, working together to provide a solution which will deliver real benefits in patient care."

Conclusions

Citrix Access Solutions have enhanced the IM&T Directorate’s robust infrastructure to support mobile connectivity. Bill Remmer, the trust’s IT Manager concludes: “Citrix is seen as technology which would take the trust forward in terms of applications and hardware deployment, because it provides the ability to connect to over twenty five different clients incorporating mixed environment. No longer do we need to replace PCs and hardware in the usual life cycle of 3-5 years. Citrix will also provide the ability to provide easy access to the hospitals systems to the UHL satellite clinics across the region.”

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