University Hospital Coventry and Warwickshire: putting satellite communication to use in public health
The University Hospitals Coventry and Warwickshire NHS Trust (UHCW) is one of the largest teaching hospitals in theUK. Located in the English region of West Midlands, the UHCW comprises the University Hospital of Coventry and theHospitalofSt CrossinRugby, serving a population of over a million people.
The Breast Screening service at UHCW is part of the National Breast Screening Programme (NHSBSP). It provides a free breast screening service for women aged between 47 and 73 with the aim of finding breast cancers at an early stage, even before any symptoms appear. The breast screening (mammography) consists of a 4 view X-ray examination, and lasts between five and ten minutes, while the whole visit takes no more than fifteen minutes. Early detection increases the chance of a successful recovery. Indeed, it is estimated that breast screening saves 1,400 lives each year in England.
To increase chances of detecting breast cancers at an early stage, the Breast Screening Service at UHCW uses two mobile vans, equipped with screening units, which stand in front of well-frequented locations, like supermarkets or leisure centres for ease of access. Eligible women are invited to attend for screening every three years, and receive test results directly to their home within two weeks of the screen.
Until recently, the images and clinical paperwork were transported by car on a daily basis by a staff member. The clinical images were downloaded onto an encrypted hard disk for transportation. This procedure entailed challenges in terms of patient data security, speed of turnaround, requirement for a courier and lack of live administration systems. To overcome some of these hurdles, while also moving forward to a paperless system, the mobile vans were connected via 3G to the hospital network system allowing a live administration system to be used, but not allowing transfer of images.
A paperlite environment was then attempted, however, as the 3G connection would drop out quite often due in part to the weak network coverage at the mobile vans’ locations, a different and more resilient solution was needed to efficiently sustain a paper free screening environment.
The satellite solution
In December 2012, the UHCW Breast Screening Service was invited by RedFoot Technologies to test a satellite connection on the mobile vans within the framework of the ESA-funded Mercury project. The mobile vans were equipped with a satellite antenna, which allows the sending of screening tests directly to the hospitals. The satellite connection ensures a secure online access to the hospital intranet, while supporting the transmission of screening patient data back to the remote units. Moreover, the system includes pre-packaging of the images and embeds indelible GNSS data into the patient medical records, for date and location identification.
After completion of the Mercury project, the UHCW decided to keep the service by contracting RedFoot directly The decision followed a cost-benefit analysis of the service, showing that the satellite-based system was cost-neutral for the Coventry service when compared to the previous system, which included the costs of a courier and a car to physically collect and transfer the tests from the vans to the reporting centre.
The satellite connection enables significant time-saving, since the tests are available for the radiologists and reporting radiographers by the following morning after the screenings are performed. It ensures that no clinical data is lost during the transfer to the hospitals; it grants a secure connection for the staff working on the mobile vans, and it is also environmental-friendly, since it avoids the use of polluting vehicles for delivery of the tests.
“The introduction of a telemedicine service via satellite improved the effectiveness of the breast cancer screening programme carried out by the UHCW and heads towards a paperless/paperlite working environment, with positive consequences on the hospitals workflows and on women’s health.” Sharon Hoffmeister, Superintendent Radiographer, Breast Screening Unit, University Hospitals Coventry and Warwickshire