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Patientline’s Communication System – It’s Enough to Make You Sick

It has previously been thought that allowing the widespread use of mobile phones inside hospitals could have a detrimental effect on medical devices, and as such National Health Service trusts around the country banned them outright on hospital premises.

However, a 2006 study in the British Medical Journal found that they affected only 4% of medical devices, and only at a distance of less than one metre – a smaller percentage and distance than the ‘walkie-talkie’ handsets already carried by hospital staff. In light of this, the Health Minister said that he could see “no reason for trusts to have an outright ban on mobile phones”, and advocated the removal of it – especially as the majority of hospitals have mobile base stations on their roofs already!

This April saw no change in stance on the ban, and Patientline – the only current supplier of “hospital bedside entertainment and communication” systems – has announced a 160% hike in phone charges from bedside phones.

For those unaware of what Patientline provide, here’s a brief summary: you get a touch-screen monitor providing television, (aggressively censored) Internet browsing, a variety of radio stations and – most importantly from a patient’s point-of-view – a telephone. This monitor is touch-sensitive and hangs on a mechanical arm for easy storage beside hospital beds. The majority of NHS trusts around the country are ‘locked-in’ to exclusive contracts with Patientline, and cannot offer an alternative to patients for many years to come.

Currently, outgoing calls cost 26p per minute, whereas incoming calls range from 39p per minute (off-peak) and 49p (peak)! To watch television for a day you need to part with £3.50 while Internet access will set you back £2.20… an hour. To compensate for this price-hike however, Patientline promised to make available a £2.90 flat charge, enabling users to listen to the radio, surf the Internet and watch TV for one day. This package has not materialised.

Now don’t get the wrong idea; I’m not writing this to show how patients and their families are being exploited for monetary gain due to the privatisation of hospital facilities – although this is a important point – what I’m more interested in is how the technology this system employs is being incorrectly used.

Put simply, Patientline’s current telephone network is digitally switched the ‘classic’ way, just like at home with lots of wires (hidden in the walls). Where is the advantage in this, where was the cost analysis, and where is the intelligence? With every bedside system already connected to the Internet, who decided that it would be resourceful to use this method of communication? Who decided against VoIP (Voice over IP, the technology behind Skype, etc.), or didn’t suggest it in the first place?

I’ll be the first to admit that VoIP has some serious QoS issues, and to get around some of the inherent drawbacks you need a high quality, high bandwidth network – but when this is already in place (as it is in hospitals using the Patientline system), network latency is low and packet loss is barely existent. I would be willing to bet a lot of money that the Patientline system could offer a pretty impressive wired, VoIP solution. The cost benefit? To patients the price would be the same as the Internet charge… amounting to a 91.5% reduction in cost, and for Patientline the reduced costs would undoubtedly mean increased usage.

However, with the call to remove the ban on mobile communications in hospitals, there is the further possibility of being able to offer wireless services to patients. Offering WiFi connectivity akin to that of The Cloud in London’s ‘Square Mile’, wireless VoIP phones and WiFi enabled-devices could be distributed to patients to offer a cheap – yet profitable – viable alternative to Patientline’s proprietary, closed system.

There are many other advantages that a wireless solution could have for hospitals in this country though. This platform-independent, device-independent, cheap and “non-physical” solution can be deployed many times faster than a wired system and without the need to disrupt a hospital’s workings. Once implemented, the ongoing, working costs of the system are minimal, and charging users even a moderate fee for usage would easily cover these expenses. As for upgrading the system; the price to do so would be almost non-existent compared to a wired solution!

With this proven technology becoming available for patients and the visiting public, it wouldn’t be long before the hospital would want WiFi and VoIP for its staff. With security consideration, another WiFi network could easily be created for hospital staff, enabling technicians, nurses, doctors and consultants to carry a portable VoIP-enabled handset making them available constantly for emergencies when in the hospital (rather than the rather ineffective paging system). Tablet PCs for staff would also allow them instant access to patient data – and a myriad of other required records – when face-to-face with patients.

The technology already exists, and with hospitals are already implementing the technology in the US, it won’t be long ’til the same is happening in the UK for patients, their families, and the staff of the NHS. It’s the next logical step. Before Patientline won their numerous exclusive contracts with NHS trusts around the country, the UK National Computing Centre actually recommended wireless and VoIP as the technology for a 21st century hospital’s staff and patients. For the few progressive hospitals in the UK who have already invested in and implemented wireless technology, the successes are well-documented, but the technology is still only available exclusively for staff and patient tracking.

I understand that Patientline is a business and that they need to recoup their investments after setting up these systems (estimated at £1m per hospital), but I do wonder if their business model is a good one and whether or not they are using their existing infrastructure in the most efficient, cost-effective way possible. Charging more isn’t necessarily the way to bigger profits; using technology intelligently and offering competitive alternatives will allow this… with or without a lifting of the mobile phone ban. To survive, Patientline need to future-proof their systems before another company comes in and steals their business from under their feet.

Note: There are some recent (June/July 2007) developments in the Patientline saga. See my new post, Patientline: In Need of Financial Treatment

Hospital Phone Charge Rises 160% – BBC | TimesOnline
Patientline Tech News at The Register
Californian Hospital Offers Patients and Visitors with WiFi – Net News
WiFi and VoIP in Healthcare (2005) – UK National Computing Centre

3 Comments

  1. Posted May 9, 2007 at 16:03 | Permalink

    “If Patientline had set out deliberatly to upset sick people and nursing staff they have succeeded spectacularly”
    Peter Troy in The Northern Echo today

    Update. The link below is important.

    http://www.lloydmorgan.co.uk/2007/05/04/patientlines-communication-system-its-enough-to-make-you-sick/

  2. June Crowe
    Posted May 29, 2007 at 07:35 | Permalink

    Excellent article.
    I hope you have been following Peter Troys excellent campaign as I have.
    It will be interesting to find out the demise of Patientline in a years time.
    It was a good concept at the outset but poorly planned and instigated.

  3. tony wilding
    Posted April 28, 2008 at 10:07 | Permalink

    One minor inaccurancy in this article.

    No costs are incurred when listening to the radio as this is provided free, so no subcriptions are required. The payment cards are pay to view tv and/or enable phone or access the internet.

    However to hear the radio, patients will still need to register their receivers with the patientline centre. This inital registration call is also provided free.