Using Microsoft Groove to co-ordinate services for the elderly at Eastern and Coastal Kent PCT

The stress and risk associated with a stay in hospital is particularly high for elderly patients. Yet many don’t need to be in hospital; they could be cared for in their own homes if a proper package of care was available.

Eastern and Coastal Kent Primary Care Trust is hoping to dramatically reduce unscheduled hospital admissions by using Microsoft Groove to improve collaboration among health professionals and ensure such care is in place. 

The unnecessary admission of elderly people to hospital is a serious problem for the NHS and for patients, who may have to wait on a ward while health and social care is arranged for them at home.

“Maybe they can’t wash or dress themselves, or they aren’t mobile enough to recover. In those cases, they may be admitted to hospital even though it isn’t strictly necessary,” says Professor Iain Carpenter, associate director of the Centre for Health Services Studies at the University of Kent.

“This is an enormous challenge, because it requires doctors to contact many agencies and care professionals who work in different places, and may spend most of their time in the field. Even when the doctor has reached everyone involved, each agency has its own assessment criteria and processes. It’s tremendously difficult and time-consuming.”

Groove and the InterRAI care application

Professor Carpenter hopes this process will be dramatically streamlined in East Kent with the introduction of InterRAI – a standard, evidence-based assessment and care application that can be used by health and social workers.
"Patients provide information once, rather than repeating basic medical and personal information to every agency involved."
InterRAI will be used to record patient details online and assess them using a formal set of criteria. The application will be accessible via a patient’s Groove workspace to all multi-disciplinary team members involved in each case – allowing information to be shared securely, quickly and effectively.

“The whole system is based on Microsoft Groove, which completely revolutionises what we can do,” explains Professor Carpenter. “Unlike email, it’s secure, it’s collaborative and it prompts people to perform tasks so that the process of getting together a care package becomes almost instant.”

The stages of assessment

The first stage of the process is conducted by a GP or other primary care provider, and indicates whether the patient is suitable for out-of-hospital care. If the system indicates this is possible, then the GP makes a referral to an intermediate care team coordinator who creates a Groove “workspace”, or folder, for the patient.

Then, trained staff conduct a more detailed assessment - using standardised forms that are also stored in Groove - to identify which care services are required. Because Groove stores information based on XML standards, it also has the potential for two-way integration with many other applications.

Alerting the right care worker – automatically

Once the second stage of the assessment is complete, Groove will alert the most appropriate member of the care team to visit the patient. At this stage, a full care assessment will be completed, again using forms accessed through Groove.

When that assessment is complete, and the appropriate team members invited into the workspace, Groove will automatically notify all relevant agencies and care providers, requesting the appointments needed for the patient.
"With email, you also don’t know if someone got the message, and you can’t be sure everyone’s accessing the same information."
An integrated patient care plan with goals and tasks is generated, based on the outputs of the assessment forms. Notes which track the treatment given are also included, and allow managers to monitor the quality and effectiveness of care provided.

The information involved couldn’t be sent over email because the medium isn’t secure; and different information might be mailed to different people, explains Professor Carpenter.

The medium and the message

“With email, you don’t know if someone got the message, and you can’t be sure everyone’s accessing the same information,” he says. “Groove is secure, it’s available to everyone and early feedback is that people find it very easy to use.”

As forms are completed and assessments filed, all the records created are available to any health or social care provider involved in caring for the patient – subject to them having the relevant security clearance.

The system replaces the old method of sharing notes via fax transmission. This saves healthcare workers from having to travel back to base as frequently, freeing up time for other tasks.

It also has the advantage of allowing patients to provide information once, rather than repeating basic medical and personal information to every agency involved in their ongoing care programme.

Up-to-date records, accessible anywhere

Workers in the field will be provided with laptops including 3G datacards so they can access the Groove workspaces in real time while visiting patients. “It means any actions they take, or medicines that are prescribed, will be recorded, and everyone involved will have accurate, up-to-date patient information,” says Professor Carpenter.

The InterRAI project is still in its early stages – Professor Carpenter and his team have spent a year working with Microsoft and a number of partners to carefully design the assessment process so it meets the needs of all the agencies they hope will use it.

The first users signed on to the Groove system in April 2007, with a second pilot phase involving more users running in June and July.

Another advantage of the InterRAI system is that it will allow anonymous assessment data to be collated over time. This information will be extracted into the Senectus database (which promotes the care of elderly patients through standardised assessment tools), where it can be used to improve care planning and service monitoring.

Related articles:

Getting into Groove: Microsoft Groove supports secure, collaborative working 
Introduction to XML 

Related links:

*Find out more about Microsoft Groove 2007

*Find out more about Microsoft Office Groove 2007 Server and tools for deploying Groove across an organisation

*Review a list of handy FAQs for Microsoft Groove