Govroam — a story of the NHS and WiFi

Me, the NHS and WiFi

WiFi in the NHS has become a bit of a soap-box subject for me, as the advent of the Internet has seen almost all of the current and reliable information resources migrate from books and journals to online websites and webapps, which is great for learning and staying up-to-date — except when you’re deprived of an Internet connection.

It has to be WiFi. 3G/4G ain’t gonna cut it

Quite often, I find myself working somewhere without access to the WiFi (it’s worth noting here that there is always WiFi present, it’s just that in many hospitals clinicians aren’t deemed important enough to have access). I can sometimes get by, sort of, with mobile data. But many clinical environments — for example modern steel-framed PFI hospitals — have poor or absent mobile signal within them (meaning mobile 3G/4G data won’t work reliably) so without access to WiFi, clinicians are cut off from vital online resources for best practice.

It’s not even about accessing electronic patient records via WiFi

Right now, I know of nowhere in the NHS that has a sufficiently mature clinical information system (or Electronic Patient Record — EPR) to enable a clinician to access the patient record through their own mobile device through WiFi [and just to pre-empt those comments saying ‘I can dial in with a dongle on my Thinkpad’ — no, VNCing in on a laptop doesn’t count, it’s slow, it’s clunky, it’s death by abysmal User Experience].

Why would we send our NHS clinicians to do battle with disease and ill health, without giving them access to the vital weapon of current, evidence-based, peer-reviewed knowledge?

So what ‘resources ‘are we trying to access? We’re supposed to be working, not playing on the Internet, right?

These days, we’re seeing medical students being educated via Skype and recording their progress in ePortfolios like Moodle . We’re teaching new procedures to junior doctors using YouTube, which gives them an important first overview of a procedure, making them much better prepared for the formal 1-to-1 hands-on instruction that follows .

Some WiFi backstory

Back in 2013 I did a very simple online survey to find out what the status of access to WiFi is across the whole NHS, and the headline figure was that around 20% of respondents had access to free WiFi in their place of NHS work. Disappointing.

It has to be Roaming. Single-organisation WiFi ain’t gonna cut it.

Imagine an NHS in which clinicians can roam to neighbouring NHS organisation to see specialist patients, and can remain connected to their familiar systems throughout. GPs would be able to attend a case conference at the local authority’s social care offices, and still access the patient’s record.

The benefits of fluid cross-organisational collaboration between Police, Fire, Ambulance, Social Care, Local Government, Central Government, Hospices, GPs, Walk-in Centres, Hospitals, Libraries, and others will lead to innovation that is as yet unimaginable.

Govroam — like Eduroam, but for all the public sector

When I first heard about govroam as proposed in the UK by Jisc, I thought: ‘That’s exactly what we need in the NHS’. The eduroam model, which has been proven to a) work, b) be cheap, and c) scale internationally, seems to be ideal. With pressures on the public sector as they are, we need something low-cost, reliable, and open. Not an expensive commercial sector disaster.

For the record, despite agreeing to guest-blog for Jisc, I’m not a closed-minded govroam fanboi — I’m completely open to other suggestions for how federated roaming WiFi could work.

And as long as it does work, at a cost that public sector can afford, then I’m ambivalent about how it’s delivered, whether this be public or commercial. Right now though, I think I would need to hear some extremely powerful arguments against govroam for it not to be a natural choice.

OK — so what do I do about this?

* If you’re someone with responsibility for NHS IT, then ask your clinical colleagues what they need from an NHS WiFi service. In particular, what benefits would be had from access to roaming WiFi. How would this change their practice? Make sure what your organisation is providing will meet these needs.

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Marcus Baw

Marcus Baw

#HIT100 NHS GP | Clinical Informatician | Ruby & Python dev | co-founder NHSbuntu & openGPSoC | Freelance Health IT