Defence Medical Services (DMS) provides the highest quality medical care to military personnel, specifically in remote and challenging locations. They need to establish secure and cost effective communications to enable them to access additional clinical input remotely.

Project LARA brings together several separate innovation capabilities to deliver a more coherent deployed telemedicine solution – as soon as possible. This will underpin the ability of the DMS to meet its duty of care to deployed personnel, especially in remote locations. SA Group's consultants joined the team to provide end-to-end planning, P3M project management and technical expertise.

Capabilities Employed

The Challenge

As part of the Telemedicine initiative, DMS required a suite of services that would enable up to 1,500 deployed military medical personnel to exchange advice, data and images with UK-based specialists to receive the best medical advice possible. The services included a medical messaging application, allowing instant messaging between deployed clinicians and consultants, a remote monitoring service to enable the real-time streaming of patient vital sign data and a clinical support tool to enable deployed surgeons to receive consultant-level advice via a live video feed. 

DMS also required an Agile Project Team to manage the delivery of these services using the Scaled Agile Framework. The Team had to be familiar with medical information system concepts and the MoD procurement system to deliver the services to a demanding timeline.

The Solution

SA Group provided a Business Analyst, Project Manager and Test & Trials Engineer to support Navy, Army and Air Force clinicians and Civil Servant project staff with the rapid delivery of the telemedicine capability to front-line users.

Business Analysis
SA Group provided a Business Analyst with extensive knowledge of military information systems, cost modelling and military procurements. The Analyst captured User Requirements in the form of User Stories and Use Cases for all capabilities. This was conducted through extensive user workshops across Joint and single-Service medical organisations. Additionally, existing clinical processes were modelled to identify opportunities for improvement to processes using technology, and to develop coherent and detailed Statements of Requirement and Business Cases that enabled the successful procurement of all three capabilities.

By having a consistent and detailed set of guidelines and stories, any proposed changes at the system requirements level were mapped and either accepted or rejected against user requirements to ensure delivery of compliant solutions and manage change.

Project Management
SA Group's qualified Agile Project Manager was responsible for coordinating the development and testing activities for all the telemedicine capabilities, as well as implementing governance, control, and change processes in order to manage reporting, communication, and change. SAFe 5 methodology (Daily Stand-ups, Kanban, Timeboxes etc) was used to track progress to ensure that milestones were achieved in the agreed timeline. This enabled the project to achieve an Initial Operating Capability (IOC) for all three systems well within the allocated budget and challenging timelines.

Test & Trials Management
For this project our team were responsible for both verification and validation and therefore produced a Master Test and Trials Plan for each capability, complemented with a suite of appropriate test cases. During the development phase a Test Plan was produced to cover the engineering aspects, followed by the test event itself and the production of a report to facilitate the measurement of success.  For validation, the Test and Trials Manager produced Trial Plans so that Military Units could validate the capabilities without the need for a dedicated Trials Unit as this can be a limited resource with long lead times. This approach was consistent with the Agile nature of the project and key to the acceptance process.

The Result

SA Group delivered improved medical communication and information systems that significantly enhanced patient care. This was achieved by thorough requirements capture and management activities including stakeholder, project, cost and benefits management. Additionally, technical assurance, communications, system integration and test and acceptance were crucial to the agile delivery.

Our team delivered a secure medical messaging application for use on personal and MOD phones. The application made use of an innovative, public-hosted AWS cloud solution and delivered a medically tailored WhatsApp-type messaging system for 2000 users. Since the introduction of the Medical Messaging application, the time taken for deployed clinicians to receive specialist advice has reduced from a matter of days to hours or minutes in some cases. As a result, the quality of care the clinicians are offering patients has improved significantly, and the service had become a key part of the clinician's armoury.

Additionally, the team have enabled deployed clinicians to transmit vital patient data in real time, providing the information that specialists in the UK need to guide patient treatment. The data can be added to the patient's medical record to assist with future treatment.

An augmented reality, surgical reach-back system is incorporated within this, allowing deployed surgeons to stream live video back to UK-based specialists for support and guidance.

The full suite of capabilities has now been used on a real operation for the first time, and we're proud to continue work on this important project. Click here to find out about phase 1 of this project.

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