The time has come for health care data to be taken out of the depths of the back office and the cautious care of the analyst’s and placed under the critical glare of the clinicians and managers operating on the front line.
For too long now, the essential information and insights contained within electronic patient records and hospital data remains largely out of sight. Systems feed the data back to NHS England and the output of specialist analysts is buried in board reports. Often the only time data analysis ever given any real attention, is when a CQC visit is pending, by which time it is too late for many to learn from and act on the insights. It’s not all bad news, there are plenty of examples of good practise in evidence around the country in the use of performance information applied to patient safety and mortality reviews at a local level and the work of the NHS Improvement Getting it Right First Time programme nationally. This is an area where great strides have been made in recent years, I would like to continue the momentum and expand use of smart analysis to front line staff.
Failing to provide front line staff with access to their own information is a missed opportunity. It increases engagement and provides staff the opportunity to compare themselves with their peers, all with a view to improvement. Their own data is an invaluable resource and one all hospitals need to harness.
Within the CCG and STPs landscape, health data analysis, risk stratification and population health analysis is gaining traction as a key strategic tool to assist with;
- Identifying variation,
- Targeting interventions,
- Managing patient cohorts with long term conditions.
- Planning for winter pressures and potential challenges
- Designing and then managing Integrated care pathways
- Comparing performance on key indicators with regional and national benchmarks.
Skilful health data analysis and the ability to interpret information should now be an essential component in the tool kit of all clinical and managerial staff. It is key to assisting the NHS to meet the challenges posed by the ageing population, but still underutilised within many of our hospitals. The introduction of the STP model has opened further opportunity for all organisations to share information locally, to close the loop on early intervention and support avoidable admissions which often feel outside of the control of any one body.
As technology continues to develop, key information and insights from headline data for each department within a trust and population (whether GP, CCG or local authority) should be made available to clinicians and managers across the health and care system. Gone are the days when you needed a degree in statistics or epidemiology to interpret a graph or dashboard which were produced by analysts, for analysts. Thanks to the ground-breaking work undertaken by companies such as Methods Analytics, data platforms designed by clinicians for clinicians have emerged. At a glance, in as little as three clicks, any clinician or manager who can use a tablet or laptop, can comfortably access the key headline data from their own department, hospital, practice or LA and compare themselves with local peers or nationally across all the key indicators.
Mortality rates may continue to dominate media headlines, however managers and clinicians are increasingly aware of the importance of knowing and monitoring indicators such as: length of stay, readmissions, access rates and experience. The technology is now available and reasonably priced, making it readily available to clinicians’ managers and analysts alike.
I understand why many clinicians remain cynical about healthcare data analysis, and sometimes simply don’t trust its findings (especially if it is showing negative variations). This is partly as a result of the previous Dept. of Health driven initiatives which used data as a stick to beat hospital managers and drive targets, as well continuing issues with the process of capturing clinical activity and turning into data that clinicians recognise. That said, some hard yards have been made and some painful – not to mention expensive – lessons learnt from NHS programmes over the past years.
For the record, I am not trying to turn clinicians into bureaucrats and analysts, far from it! I simply want to empower clinicians and dept. heads to have access to the same key data that the bureaucrats already enjoy. Busy clinicians don’t have time to spend hours poring over statistics, but the opportunity to take a few minutes to understand and explore insight that is pushed to you as relevant and potentially worth investigation, and to keep themselves informed regarding how they compare to regional and national peers, would surely be of value in improving outcomes.
It is amazing to see a clinician assess information in seconds and identify its significance. Once a clinician recognises the useful impact access to this information provides, they become keen users, often best placed to identify improvements. Variation in coding quality is an issue across most NHS hospitals, and whilst not exactly headline grabbing, it is low hanging fruit for any hospital administration looking to make significant savings and improve the accuracy of their reporting… but it often takes a clinician to spot an erroneous variation in the data, and if they don’t have access, they can’t identify it. Some of the leading progressive trusts are already ensuring their senior clinicians and managers have access to this information. The irony is that it is hospitals who are struggling or in turn-around who need access to this information the most. They battle against the increasing tide of emergency admissions, limited bed availability, in addition to increasing numbers of patient cohorts with comorbidities and complex long-term conditions. It is no surprise to me to hear time and time again that a Trust in special measures has limited digital records, poor record keeping and little or no access to meaningful intelligence.
Fortunately, there is grounds for optimism here. There is a new generation of hospital managers and clinical leaders emerging who recognise the power understanding the potential insights their own data can provide; how it allows them to identify their strengths and areas that need improvement. As somebody once said… “If you can’t measure it, you can’t manage it.” Let’s put the critical information and insights into the hands of the people who can make best use of it. Surely this includes the Front-line managers and clinicians as well as the analysts toiling away in the back office.
For more information email Richard Ayres at firstname.lastname@example.org
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