Transforming Data into Actionable Intelligence: Health and Social Care Manira Ahmad manira.ahmad@nhs.net Head of Service, Analytics & Intelligence Philip Johnston philip.johnston@nhs.net Service Manager, Local Intelligence Support Team Richmond Davies richmond.davies@nhs.net Service Manager, Statistical & Info Governance
• NHS National Services Scotland delivers services critical to frontline patient care and in support of the efficient and effective operation of NHS Scotland (www.nhsnss.org) • Our services: – Blood, Tissues & Cells (Scottish National Blood Transfusion Service ) – Information Technology – Central Legal Office – Practitioner & Counter Fraud Services – Procurement, Commissioning & Facilities – Public Health and Intelligence (PHI) = ISD + HPS ISD provides a range of information, HPS provides services and information on statistical services and advice that support infections, immunisations, blood borne the NHS, its partners and wider public sector viruses, travel health, & public health
The data landscape Every week in Scotland data are collected on around : 1,000 Births 15,000 Out of Hours attendances 20,000 Screened for cancer 30,000 Hospital discharges 30,000 A&E attendances 40,000 NHS eye exams & tests 90,000 NHS dental treatments 200,000 Outpatient clinic attendances 500,000 GP practice consultations 2,000,000 Drugs dispensed
Mental Health Continuing care census Dental inspection Outpatients Hospital Admissions Substance misuse Scottish birth record GP consultations BIRTH DEATH Immunisation Maternity Cancer registry Prescribing Screening A&E Clinical audits Child health surveillance Most of our data sets offer 100% coverage
ISD – working with stakeholders • Traditionally, mainly central government, health (NHS management), publications • Public accountability – Parliamentary Questions, FOIs, regulatory bodies • Gradual expansion to other stakeholders, accelerated in recent years Some examples: • Wider ‘health’- clinicians/practitioners, other national/local health orgs • social care • Wider public (and other) bodies – Local Authorities, Community Planning Partnerships, Third Sector • Research – eDRIS/Farr
‘Actionable intelligence’ - #1 Data Our direction of travel Intelligence Translation
‘Actionable intelligence’ - #2a Analytic capabilities
‘Actionable intelligence’ - #2b • SPARRA - Scottish Patients at Risk of Readmission & Admission - quantifies risk in coming year. • SPARRA scores (%) calculated monthly for approx 4.2 million patients (80% of population) • Maximise value of anticipatory care by targeting patients most likely to benefit from interventions (medium-high risk) • First, stratify the population; SPARRA stratifies on basis of risk of hospital admission • SPARRA helps identify patients who may benefit from preventative approach & to ensure that patients are known to the relevant services
‘Actionable intelligence’ - #2c How many How many previous prescriptions? emergency admissions How many outpatient What age is the patient? has the patient had? appointments? Hospitalisation (3 years) What type of outpatient Psychiatric Admission appointments did (3 years) the patient have? Outpatient (1 year) Any prescriptions for e.g. dementia drugs? Or Emergency Department substance dependence? Any A&E Any recent admissions to (1 year) attendances in a psychiatric unit ? Prescribing the past year? (1 year) Any previous admissions for a long term condition Outcome Year (such as epilepsy? (1 year) PRE-PREDICTION PERIOD OUTCOME PERIOD
‘Actionable intelligence’ - #2d Whatever SPARRA Score Age Group Gender • An individual’s value for each • Logistic Regression is used to variable used in the SPARRA model find straight lines of best fit is multiplied by the coefficients and through all of the variables to the sum of all these are converted produces “coefficients”. (using something called the logit link...hence logistic regression) to get a value between 0 – 1.
‘Actionable intelligence’ - #2e 300 Thousands projected 250 Admisions 200 150 100 2005 2010 2015 2020 2025 2030 2035 Year
‘Actionable intelligence’ - #3 LIST - Local Intelligence Support Team Supporting Health and Social Integration Across Scotland https://youtu.be/YIVxjAm7vi0
‘Actionable intelligence’ - #4 MHAIST – mental health access MHAIST team comprises; ISD ISD • Local based analysts x 10 Child & • Central analysts x 4 Adolescent HIS Mental • Data management x2 Health • Clinical lead x1 Services HIS Psychological • Clinical leads x2 Therapies • Improvement advisors x2 • Programme support staff 1 x analyst supporting Distress x2 Brief Intervention pilot work till 2020 based in Lanarkshire.
‘Actionable intelligence’ - #5a ‘Discovery’ – tool / service Comparative information to help review, monitor and plan services and support quality improvement. Provides NHS managers and clinicians with comparative and benchmarking information to help service planning and delivery. Information at NHS Board, hospital & specialty. Drill down, incl. to individual level (approved access) Scottish and English health benchmarking data .
‘Actionable intelligence’ - #5b ‘Discovery’ – tool / service
‘Actionable intelligence’ - #6
‘Actionable intelligence’ - #7a LIST some words from our staff https://youtu.be/3fmpEQUATyQ
‘Actionable intelligence’ - #7b LIST
Transforming Data into Actionable Intelligence: Health and Social Care INTERMISSION
‘Actionable intelligence’ - #8 Number of Monthly Emergency Bed Days in Acute Specialties for People of All Ages Living in Partnership X Bed Days Planned Trajectory 9000 example: 8000 7000 helping 6000 Integration Bed Day Numbers Authorities 5000 estimate 4000 future needs 3000 2000 1000 0 Apr-15 Jun-15 Aug-15 Oct-15 Dec-15 Feb-16 Apr-16 Jun-16 Aug-16 Oct-16 Dec-16 Feb-17 Apr-17 Jun-17 Aug-17 Oct-17 Dec-17 Feb-18 Apr-18 Jun-18 Aug-18 Oct-18 Dec-18 Feb-19
‘Actionable intelligence’ - #9 example: exploratory Tableau / motion chart
‘Actionable intelligence’ - #10 LIST ‘Our Stories’ – Releasing Time To Care https://youtu.be/u_yOnj8ZQJQ
‘Actionable intelligence’ - #11a Partnership X Partnership X
‘Actionable intelligence’ - #11b Example: exploratory health & social care ‘pathways’ analysis
‘Actionable intelligence’ - #12 NSS Local Intelligence Support Team PROJECT PATHW AY LIST met with the organisations to 7 . ESS facilitate review and assess the data they held Collection of m eeting of third demographic data from and public agencies third sector at locality level to 2 . I SD check share and discuss 4 . W ork stalled: quality of Linkage of the pathw ays m ental health is a dem ographic data third sector data ‘sensitive area’ so and perm issions to statutory data perm ission tricky. using the derived Also capacity CHI Analysis lim ited and outputs 1 . Source third sector data to use CHI (Community Health 3 . I SD to set Index) seeding of these perm issions from data PKAVS Identified H&SCP to access 5 . To see if can w ork third sector public data through social care organisations to system ‘SW I FT’. participate in the Ensure appropriate Pilot study I SD continue to help governance in place to projects w ith data share and use data for clean up and linkage ISD – Information Services (NHS) perm issions ESS – Evaluation Services Scotland
‘Actionable intelligence’ - #13 LIST – ‘Our Stories’ – Accident & Emergency https://youtu.be/DBYlJkBqGxg
‘Actionable intelligence’ - #14 Day & time of arrival at emergency departments for capacity and resilience planning
‘Actionable intelligence’ - #15 LIST Some words from our local partners - https://youtu.be/M5zj644Kvfw
Open Data - #1 Open data on the public sector official statistics platform www.statistics.gov.scot
Open Data - #2 Prescribing open data on the ISD website http://www.isdscotland.org/ Health-Topics/Prescribing- and-Medicines/
Open Data - #3 The new NHS open data platform - Currently undergoing IT resilience testing before go- live
Solutions for Scotland Four major programmes : Health and Social Care Public Health Improvement integration “Create a clear set of national “Optimising and joining up public health priorities for balanced health and care Scotland as a whole and services, whether provided by streamline the current public NHS Scotland, local health landscape” government or the third and independent sectors” NHS Board Review “Review the functions of The National Clinical existing national NHS Boards Strategy to explore the scope for more “Strengthen primary and effective and consistent community care, improve delivery of national services secondary and acute care and the support provided to focus on realistic medicine” local health and social care systems for service delivery at regional level”
Questions http://www.isdscotland.org/About-ISD/Contacts/
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