Around the world, hospitals and healthcare systems face increasing financial pressure. In the UK, the Nuffield Trust estimates that even with pay restraint, financial pressures will continue to grow well beyond funding over the next five years. The ‘funding gap’ will only close, the Trust estimates, when chronic conditions can be better managed, emergency readmissions reduced, and productivity increased.
But what has this to do with data? Most hospitals hold a vast amount of data: about patients, referral patterns, and treatment patterns. And most of them don’t really use this data, often because they don’t know what to do with it, or how it can help them to deliver better services at lower costs.
So how can managing data better increase productivity? Well, for example, because of concerns about data protection, hospitals and community healthcare often share information by hard copy, or in limited amounts: an x-ray here, a test result there. Not only is this slow, but each ‘share’ requires someone to take the data from one system, and enter it into an email, letter or other ‘shared system’, all of which takes valuable staff time. While protecting sensitive data is vital, if banks can manage sensitive information, so can healthcare organisations. ‘Quick wins’ on security would include removing group log-ins, and preventing one person from giving access to all clinic staff “to make everyone’s life easier”. Instead, staff need quick secure access ‘at the point of need’ to each patient’s data, authorised at senior level or by the patient.
How about managing chronic conditions? Better data sharing would not only reduce time spent, but could also avoid the need for repeat tests and diagnostics. While most people are aware of the cost of a CT or MRI scan, far fewer consider the cost of unnecessarily ordering or repeating a ‘cheap’ blood test. If results were available for anyone who needed them, there would be no need to “just order it again”. For patients with chronic conditions, seeing multiple clinicians, this is particularly important. When this issues is coupled with the slowness of ‘hard copy’ data sharing, it is clear why these patients often have to undergo multiple unnecessary tests.
How can better use of data improve readmission rates? The Nuffield Trust has produced a tool to help clinicians estimate which patients are most at risk of emergency readmission, often those with chronic conditions. However, estimating risk accurately is only the first step to managing readmissions. Clinicians then need to focus resources and effective interventions on the patients most at risk. Ideally, the savings made by reducing readmissions will fund the cost of the interventions, especially since the data is already available. The Nuffield Trust even has a tool to help estimate ideal cost per intervention.
Better data management and intelligence is not rocket science, but these few examples demonstrate that it is essential if healthcare systems are to live within their means over the next decade and beyond.