Transcript Document

What’s data got to do with it?
Dr Frances Elliot
SNUG National Users Conference
Perth, 16 September 2014
“Measure what can be
measured, and make
measurable what cannot be
measured.”
Galileo Galilei (1564-1642)
Quality drives what we do
Mutually beneficial partnerships between
patients, their families and those delivering
healthcare services which respect individual
needs and values and which demonstrate
compassion, continuity, clear communication
and shared decision-making.
There will be no avoidable injury or harm to
people from healthcare they receive, and an
appropriate, clean and safe environment will
be provided for the delivery of healthcare
services at all times.
The most appropriate treatments,
interventions, support and services will be
provided at the right time to everyone who
will benefit, and wasteful or harmful variation
will be eradicated.
2020 Vision
Everyone is able to live longer healthier lives at home,
or in a homely setting.
We will have a world-leading healthcare system where we have
integrated health and social care, a focus on prevention,
anticipation and supported self management.
When hospital treatment is required, and cannot be provided in a
community setting, day case treatment will be the norm.
Whatever the setting, care will be provided to the highest
standards of quality and safety, with the person at the centre of
all decisions.
There will be a focus on ensuring that people get back into their
home or community environment as soon as appropriate, with
minimal risk of re-admission.
ROUTE MAP TO THE 20:20 VISION
12 Priority Areas for Action
Quality of
Care
Health of the
Population
Value &
Financial
Sustainability
Early Years
Innovation
Health Inequalities
Efficiency & Productivity
Prevention
Workforce
Primary Care
Integrated Care
Safe Care
Unscheduled and
Emergency Care
Person Centred Care
Care for Multiple and
Chronic Illnesses
The challenges
• Demographic change
– Population
– Workforce
•
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Complexity of care needs
Widening health inequalities
Cost of variation
Cost of harm
Fiscal constraints
How do we know what good
looks like?
• We start with the evidence of what works
(SIGN, NICE guidelines)
• Donabedian taught us we need to pay attention
to the structure and processes of delivering care
if we are to produce good outcomes (S + P = O)
• But increasingly we are able to look at specific
outcome data to see what actually happens to
people (QOF, national audits, surgical outcome
data)
We’re only just beginning…
“Computers and other digital
devices are doing for mental
power – the ability to use
our brains to understand
and shape our
environments – what the
steam engine and its
descendants did for muscle
power. They’re allowing us
to blow past previous
limitations and taking us into
new territory.”
The power of data - multimorbidity
– The majority of over-65s have 2 or more conditions, and the majority of over-75s
have 3 or more conditions
– More people have 2 or more conditions than only have 1
People living in more deprived areas in
Scotland develop multimorbidity 10 years
before those living in the most affluent areas
Mental health problems are strongly associated
with the number of physical conditions that people
have, particularly in deprived areas in Scotland
Primary Care data is important
• It tells us about the conditions that affect
our population
• Helps us understand the burden of
disease and treatment
• Important for informing health and social
care policy
• Guides us to what we need to do to tackle
this burden
So what has this meant?
• We now have specific policy activity in
Scottish Government to consider how we
support individuals with multiple long term
conditions live well
• We have developed a policy framework to
join up our thinking
• We are finalising an action plan which will
guide Health and Social Care Partnerships
on what they can do locally
So what’s next for GP data?
High-Level Objectives
• To provide a secure national, Scotland wide,
GP data extraction service
• To provide a service to facilitate analysis of
GP data to meet the intelligence requirements
of GP practices, NHS Boards, Research and
the Scottish Government
• The service will include robust information
governance to satisfy patient requirements for
safe processing of information
Project Board Membership
Dr Libby Morris
Chair / GP
Dr Alan McDevitt
BMA (SGPC Chair)
Dr Miles Mack
Deputy Chair (Policy) RCGP
Frances Mair
Health Informatics Research Advisory Group
Dr Paul Miller
SCIMP (Clinical Lead)/GP
Philip Couser
NHS National Services – Public Health & Information Services
(Director)
David Thomson
Scottish Government, Deputy Director of Primary Care
Emily Jefferson
Farr Institute
Dr Neil Kelly
SNUG/GP NHS Dumfries & Galloway
Graham Gault
NHS Board eHealth Leads representative
Dr Michelle Watts
NHS Board Primary Care Leads representative / NHS Tayside
Julie Falconer
eHealth Strategy
Marion MacLeod
Scottish Practice Management Network
John Stirling
Disability Fife
Jim Walker
RCGP Scotland P3 Patient Group
Deliverables
• IT Infrastructure
– GP Practice Data Extraction/Reporting Solution
(Procured)
– ‘Safe Haven’ Environment for Data Storage/Management/
Access (NSS ‘in-house’)
– Secure Transport Mechanism
• A National Information & Intelligence Service
• Implementation of Information Governance Framework
– Scrutiny body and processes
• Communications/Engagement Plan
– A structured campaign to inform the public / GPs
IG Framework
Key Elements
• SPIRE Steering Group (IAG)
– Oversee SPIRE and its development
– Scrutinise all new proposed data extracts/linkages
– Chaired by Frances Elliot (Deputy CMO)
• Practices can choose which elements they want to
participate in
– QOF
– Bespoke extracts (possibly recurring)
– National dataset
• Patients will be able to opt-out of any PID being
extracted through SPIRE
Benefits Summary
• Practices
– Local Reporting/Audit Functionality/Data Quality
– Standardised IG & approach to data extraction
– QOF National Reporting Mechanism (2015/16)
• Health Boards
– Enhanced Service reporting
– Local service planning/evaluation (incl Health & Social Care
Integration)
– Utilisation of NSS data linkage capability
• National
– Policy development / National Statistics
– Public Health Surveillance
• Research
– Data Linkage
GP Pathfinding
Set of Practices to
• Explore & develop how GPs can benefit
– from SPIRE solution functionality
– wider range of NSS products
• Help to develop publicity/comms
strategy/materials
• ‘Critical friends’
• Champions
• IT Testing
• Development/Testing of training
What we can learn from “Big
Data”?
Knowledge of what affects our population at
locality level not just at national level
Harnessing outcomes data to drive further
improvements in care and treatment
Using data to drive improved clinical
decision making using clinical decision
support systems
The ability to personalise medicine for
individuals
All our data matters – help us
use it wisely to benefit all.