Transcript Using Information to Support Long Term Conditions Management

Grampian SNUG Meeting
24 March 2015
Bill Boyd
SPIRE Project Team
SPIRE - a New
National Service
• Secure, flexible Scotland-wide GP data extraction & reporting
system:
– bespoke data extracts or support National Dataset
– Mechanism for QOF data extraction (2016/17)
• National service to facilitate analysis of GP data:
– to meet the intelligence needs of
• GP practices, NHS Boards, Research, Scottish
Government, …
• Robust information governance satisfying patient needs
around safe processing of data
IG Framework - Key Elements
• Practice participation in SPIRE is voluntary
• Practices choose which extracts they want to take part in
– Consent may be to recurring extracts eg QOF
– Managed through SPIRE Local
• Patients can opt-out of any PID extract through SPIRE
– Public Engagement Campaign – benefits and opt-out
– Opt-out recorded on clinical system via new Read Codes
– SPIRE PID extraction excluded opted out patients
• SPIRE Steering Group (Independent Advisory Group)
– Oversee SPIRE and its development
– Scrutinise all new proposed data extracts & linkages
– Includes GP (SGPC/RCGP) & patient reps
– Building on and linking with PAC
Data Extraction &
Reporting Mechanism
(supplied by MSDi)
SPIRE Local – Reporting Database
Contains all extractable data items of interest
Synchronised with clinical system
All extracts/queries run on reporting database
as opposed to the clinical system
Extracts split into highly sensitive data items
(patient identifiers) and ‘other’ prior to transport
SPIRE Central
Data Query / Extract Design
Testing
Deployment
Scheduling
Audit Trail
Report Builder
User account management
SPIRE Local
Data Extraction
Deployment/scheduling of queries designed centrally
Consenting mechanisms for practices & patients
Pseudonymisation (PID)
Data extract viewing
Audit trail
Local Reporting/Audit
Deployment of centrally designed queries/reports
Display in graphical or tabular format
Dashboard functionality
Data Quality /Reporting Module
SPIRE & QOF
• NO Impact on current QOF payment system
• Pathfinder practices already involved
– Testing V30 in 8 GGHB, 1 Lanarkshire sites
– Will extend to other HBs later
• Parallel running through 2015/2016
• Possible switch-over to SPIRE in 2016
• Only when Fit For Purpose
SPIRE Safe Haven
•Sensitive fields (patient identifiers)
stored separately from ‘payload’
•Strict access control – access to
only what is required for an approved
purpose
•Access to pseudonymised data the
‘norm’ otherwise ‘an exception’
•Disclosure control
•User access audit trails
•Data retention
•Some extracts staged prior to
transport to other secure NSS
reporting systems eg HPS
National Dataset
• Phased approach
• Still to be agreed by SPIRE Steering group
– Content
– Purpose
• Wide range of user needs
– Aggregate & pseudonymised patient-level data
– Demographics / Read Codes / Prescriptions / Encounters
• Populated and maintained by regular data extracts
• Accessible through a Datamart
Bespoke Extracts
• Specific query for specific user(s) for specific
purpose
– Aggregate or pseudonymised patient-level data
– Defined cohort / exclusion criteria and query format
• SPIRE Steering group approval needed for each
• Accessible through flat file in Safe Haven - separate
linkage to reference files and analysis
• Will be GP-demand led using acceptance testing of
SPIRE by GPs
SPIRE (primary care) Service Team
Staffed by data analysts & data managers
Customer-facing
Utilise /manage SPIRE Central
Management of data extracts
Data analysis & visualisation
Working with eDRIS team on research
requests
Working with HPS
SPIRE GP Pathfinding
Involves a set of Practices to:
• Explore & develop how GPs can benefit
– from SPIRE solution functionality
– wider range of NSS products
• Help to develop publicity/comm’s strategy/materials
• ‘Critical friends’
• Champions
• IT Testing
• Development of Training
• Over 90 practices registered
• Payment – activity based (agreed number of sessions)
Pathfinding
Current Activities
QOF
• Involved in the testing of QOF version 28 & 30
Public Engagement & Communications Workshops
• Develop Public Engagement Campaign & materials
SPIRE Local: Reporting Functionality Workshops
• Series of regular workshops 19/02, 26/02, April, May
– Demonstrate the reporting function in SPIRE Local
– Discuss proposed standard reports for GP Practices to be
available when SPIRE goes live
– Review the 5 reports considered most valuable; and give
direction about the priority of the remaining 10
Timescales
• Software rolled out across Health Boards from July
2015 to March 2016
• Growing number of bespoke extracts in system
• Monitor acceptance of the different extracts by GPs
• Will use Pathfinders for understanding extracts and
sign up
Reporting:
Some Potential Areas
Directed Enhanced Services
– Influenza & Pneumococcal
Scheme
– Minor Surgery Scheme
HB Audits e.g. COPD & CHD
National PC indicators
Patient Safety Programme
Local Enhanced Services
Risk Stratification
Public Health Surveillance
Polypharmacy
– ILI and ARI monitoring
Repeat Prescribing
– Vaccine uptake / efficacy
KIS and palliative care coding
Learning Disability Monitoring
HIS Quality markers
Practice Demographics
Multimorbidity
GP Revalidation
Locality Planning (Health &
Social Care Integration)
GP Workload Analysis
GP data –
Intelligence Requirements
GP Practices
• Practice populations characteristics
• Quality of care and safety
• Patient outcomes (No. referrals, urgency, treated / referred back, attendance
frequency)
• Comparative information
• Audit & Local Reporting (eg enhanced service provision)
• Data Quality
• Risk Stratification
Health Board Level
Service planning and evaluation
Local ‘whole system’ analysis
Locality Planning (Health & Social Care Integration)
Patient pathways
Comparative Information
National
• Public Health Surveillance
• Evidence base for policy development
• National Payments eg QOF
Researchers
• Anonymised / identifiable data sets for research
• Linked datasets
The Public
• National Statistics on the provision of primary care
Further Information
Website: www.spire.scot.nhs.uk
Email: [email protected]
Twitter: @SPIREScotland