May 22, 2020
Healthcare Data is made available too late to inform operational and clinical decisions. We must talk about timeliness as well as interoperability.
In recent years, the focus on healthcare data has been with the interoperability of clinical systems. The COVID-19 crisis, however, has highlighted another problem: our healthcare data is not timely, and it is arriving too late to inform operational decisions.
This is most publicly shown by the different measures of the COVID-19 death toll. The daily death toll announced each day is calculated from those who died in the last 24 hours as well as updates on previous days going back months. ONS then adds death certificate information with a delay of about a month. It is not possible to make properly informed operational and policy decisions when the best data is a month old.
Although the above is high profile, it is about aggregate data informing systems level decision-making. Similar challenges are faced throughout the health system, and often with a more direct impact on individual patients and their health outcomes. Let’s look at three specific cases where the unavailability of timely data is failing our healthcare system and patients, and explore the benefits which could be realised if it was available;
Before COVID-19, one of the major issues in the NHS was ambulances waiting outside A&E. While the cause of this is multifactorial, a notable issue is the lack of timely data allowing ambulances to go to another hospital to reduce waits. Looking at the daily reported data it becomes clear that, on a given day, within 30 minutes’ drive of a hospital with long ambulance waits is another with shorter waits. However, by providing detailed A&E load data in real-time to ambulances, it would be possible to send patients to the A&E where they can be seen soonest rather than one where they arrive soonest. This data exists today but is not collated, so is insufficiently presented to those charged with making such potentially life-saving decisions.
Nursing and Residential Care
Discharging patients from hospital can be challenging, especially if there are limited nursing or residential care beds available nearby. Social workers and regional managers, however, often have a view of bed availability which is both limited and not accurate in real-time. This means that social workers must call around to find spare beds.This also means that it is impossible to proactively manage the supply of beds by, for example, asking some homes to increase their number of nursing beds to cope with a short-term spike in demand. Timely, accurate data would make it possible to respond to changes in demand and get patients out of hospital faster.
In many specialities it is common to see patients at regular intervals, say every 3-6 months, to see how they are getting along. These appointments, however, will almost always be at the wrong time. Either the patient will now be ok and the appointment is wasted, or they have been deteriorating for some time and the appointment is too late. By converting to a system where patients continually feed back how they are doing will help to avoid this. This can be achieved through regular questionnaires, monitoring of metrics (such as activity levels), or by allowing patients to engage with clinicians directly when they have concerns. We can then ensure that patients get seen in the right place at the right time and prevent wasted appointments. This provides obvious benefits to both individual patients as well as the overall capacity of the healthcare system.
The above are all problems which can be solved by focusing on the timeliness of the data. Often this data has already being collected.
Valtech have been operating at the heart of the UK Public Sector since 1999, delivering award-winning services in healthcare and wider public services that we all rely on as patients and citizens. We ensure that decision-makers get the right data at the right time to help their organisation work as efficiently and effectively as possible.
About the author: James has worked across healthcare, as a doctor, strategy consultant and now designing solutions for Valtech’s healthcare clients. He has seen first-hand the issues facing the health ecosystem,from the lack of timely data preventing strategic and tactical decisions, through to poor user interfaces and slow logins preventing clinicians doing their job.