Why clinical insights not budgets hold the key to value-based healthcare

electronic health, electronic patient records

How NHS leaders can bring big data to heel for new models of care

Right now, NHS managers and clinicians are under phenomenal pressure to make huge efficiency savings while improving the value of services to patients, and many in the NHS see integrated care as the answer. I believe that even before we get there, the first step is to find innovative ways to drive up the value we deliver in all clinical and commissioning decisions – and the key question we need to answer is: How?

Well, if you consider that every single thought, action, treatment plan, decision and interaction generates some form of data, the answers NHS leaders need are likely to be sitting in the masses of patient records, emails, discharge letters, scans and patient notes that litter every clinician’s ‘in tray’ and ‘inbox’.

The challenge is to collate that data in a meaningful, structured manner that makes it readily accessible to decision-makers, while protecting individual patients’ privacy. But that’s only the start. Even when a clean data repository has been created in which different types of information have been translated into digital formats, can decision-makers extract the answers they need. By using sophisticated methods that easily allow them to model treatment outcomes per different patient groups, clinicians and managers can gain transformational answers. These include the ability to evaluate investments versus the value of potential outcomes, to investigate the efficacy of different management plans, or predict demand as well as innumerable other insights.

Only by using these outputs can NHS leaders make real decisions of value. Why? Because only then will the wisdom and experience of clinicians and senior management be further substantiated by solid evidence.

Case in point: Heart and lung specialist care 

The Royal Brompton & Harefield Foundation Trust is a great example – showcasing how big data can be transformed into actionable evidence that delivers real-world value. As a specialist heart and lung centre, the Trust had accumulated vast quantities of clinical data over many years.  The trouble was it spread across over 400 data systems and 20 critical clinical data sets.

What Chief Clinical Information Officer, Cliff Morgan, and CIO, Joanna Smith, wanted to do was capitalise on this wealth of information to deliver services better suited to the individual needs of each patient. They knew that evidence-based decisions that could draw on all available data sets were essential in achieving this goal – and they came to SAS for the necessary analytic support.

What happened?

We built a Clinical Data Warehouse (CDW) for the Trust, which is a central store of all data and built a layer of privacy over the top to maintain patient confidentiality and privacy.  

Using our analytics tools, clinicians can now interrogate this data pool to reveal correlations that were previously unknown. Before our solution went live, if a cardiologist wanted to assess something like the relationship between prescribing certain antibiotics and the outcome, he would have required three or four junior doctors to review some 400 case notes on paper! Now the hospital can perform such analyses in less than 5 minutes. 

In future…

The evidence that SAS analytics can deliver will add further value in decision-making, allowing clinical leaders to help prevent diseases as well as cure them, finding new ways to add value by integrating care and delivering it in a patient-centric way. So, in fact, our kind of analytics can help you take the first step on the journey to fulfill the Five Year Forward View. 

 David Downing, Director of Health, SAS UK

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