Supporting Clinicians and Managers to Drive Change Together: Unlocking Data

1. Supporting Clinicians and Managers to Drive Change Together: Unlocking Data

2. Supporting Clinicians and Managers to Drive Change Together: Unlocking Data NSW Health Symposium, 2014 Thursday 19 June 2014 Dr Teresa Anderson Mr Charlie Farah CE, SLHD Director, Performance SLHD Dr Gabriel Shannon, AM Mr Alfa D’Amato Staff Specialist Orange Health Deputy Director, ABF Taskforce Dr Rohan Hammett Deputy Secretary, Strategy and Resource

4. Clinicians and managers Other Districts SLHD Ministry DATA MINING AND ANALYTICS Other States ACI CEC Ambulance Service

5. The holy grail: access to timely, accurate data

6. Limitations of Current System • Labour intensive • Limited data able to be reviewed • Unable to respond to different needs of different departments • No real time access to data

7. Limitations of Current System • Time consuming • Inefficient • Disengagement of clinicians – “too hard” • Labour intensive • Limited data able to be reviewed • Unable to respond to different needs of different departments • No real time access to data

8. Why STARS? • We can’t manage what we can’t analyse/monitor • Managing processes in real time • Efficient insight into data • Combines and manages multiple sources of data

9. Data Source Collections • Data Collections: • Non Admitted Patient Data • Feeder Systems: • Pathology • Imaging • Pharmacy • Prosthesis • Blood • Operating Theatre • Data Collections: • Admitted Patient Data • Emergency Department Standalone Clinical Databases • Incidents related to: • Falls • Medication • Pressure Ulcers • Data Extracts: • Overdue Patients (Weekly) • Financial Class (3 times a Day) • NEAT (Daily) • Orders and Results

10. What does STARS offer clinicians & managers? • A tool to help: • increase our collective knowledge about our services • identify clinical variation / reduce unwarranted clinical variation • strengthen / implement ‘best-practice’ models of care, & monitor outcomes • improve clinical outcomes

11. What does STARS offer clinicians? • Real time access to a huge amount of data • User driven and flexible design • Link to clinical databases

12. STARS Implementation • Strong governance • Managed by the Performance Unit • Focus groups for individual application development • Review of applications/functions used at other healthcare facilities (internationally) • Data access and security • Resources

13. Governance Clinicians: Medical / Surgical / O&G JMOs Nursing and Allied Health Mental Health Managers: Chief Executive Senior Executive General Managers HIMs

14. Take Home Messages STARS • New innovative data management system • Tool to identify and interrogate clinical variation • Needs clinicians and managers to work together for it to gain maximum benefits • Will only be as good as its data inputs and its users • For successful local implementation needs • adequate resources • educated, engaged clinicians and managers • clear governance structures and processes already in place

15. Where we are now:

16. District led

17. Specialty / Clinician driven

18. STARS demonstration

20. -78.24

21. The ABM Portal provides: Eg. ED, acute, non-admitted • Comparisons of activity, costs and prices for • The ability to benchmark costs and LOS performance

22. The ABM Portal provides: A tool to assist in evaluating the efficiency, efficacy & appropriateness of health service delivery in order to review and improve care and practice, leading to better patient outcomes.

23. Who provides the patient and cost data? Who uses the patient and cost data? LHD, SHN and MoH staff LHD/SHN staff ABM Portal Updated every 6 months • Used for: • State Price • Peer benchmarking • Monitoring clinical variation • Examples of data input systems: • eMR • Oracle • FirstNet • MH-OAT

24. DRG – E65B Chronic Obstructive Airways Disease without complications or comorbidities Major Hospital Peer Group All Major Hospitals Average length of stay = 4.93 days All Major Hospitals Average cost/NWAU = $4,338 Orange Hospital $4,799 Ave cost per NWAU 4.31 days average LOS 134 encounters

25. DRG – E65B Chronic Obstructive Airways Disease without complications or comorbidities Clinical Variation Orange Hospital Orange Hospital Peer average = $190 Peer average = $194 Orange average= $514 Critical Care Pathology Orange average= $359 Critical Care Pathology Orange Hospital Orange Hospital

26. Single Patient Journey – Patient in Orange Hospital Total Cost: $60,010 Hospital avoidance care Following respiratory illness - 9 visits over 3 months NON-ADMITTED Acute $39,512 ED $17,877 ACUTE NAP $2,621 Chronology of patient treatments EMERGENCYDEPARTMENT Patient had5 inpatient episodes for COAD

27. Three recommendations for state governments: • Set the right price for hospital care • Provide the right information • Manage the system in a way that doesn’t weaken price signals, and encourages underperforming networks to improve (p.5)

28. Activity Based ManagementTransparency These new tools provide a very rich source of patient activity and information, which fosters transparency and accountability across the healthcare system.

29. Activity Based ManagementPatient Journey We can now follow the patient journey across the health system. By analysing and integrating services, we can optimise patient care.

30. Key Messages • Collaboration is the critical success factor • Clinicians have to be involved early in governance and app design • System needs to be fast and accessible • Need the processes for data review to already be in place • Education is critical • Focus on understanding and explaining variation • Set clear expectations regarding data review, feedback and accountability

31. ABM PORTAL & STARS For more information, live demonstrations of the ABM portal and the STARS programs are available to try out outside.