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RISK MANAGEMENT


of what was happening in their patch so they could make more informed decisions about patient care.


We discovered that about 5% of patient data sat in hospitals, while the remainder was held in GP practices on a variety of un- connected legacy servers.


We extracted the hospital data by analys- ing the monthly financial recharges made to the trust, which contained all the rel- evant patient information.


The practice data proved much more time consuming. We visited dozens of practices during our first year of operation, teasing relevant information out of the practice servers, installing new software, and train- ing practice managers in its use.


The great advantage we had over bigger competitors is that GPs and practice man- agers know who we are and can pick up a phone and talk to us. They don’t have to deal with offshore engineers or salespeople whose only contact with them is down a telephone line.


The resulting streams of information we gathered from primary and secondary care were processed in a central ‘warehouse’ which analysed and cross-referenced hun- dreds of millions of records. Using those records, Health Analytics reporting soft- ware enabled clinicians and commission- ers to work more effectively.


We addressed the sensitive subject of data protection by ensuring the warehouse sits in servers inside the primary care trust.


Security safeguards provide different lev- els of access to GPs and senior PCT staff as well as an automatic tracking system which logs who looked at what information.


The system also excludes a small amount of highly sensitive information on infor- mation around sexual and child health.


At present, Health Analytics’ rapidly ex- panding LinkWell platform consists of more than 15 software modules.


These solution driven modules include budget management, data acquisition, fi- nancial management and referral manage- ment. The software is now used by mul- tiple commissioners and serves over 1.5 million people.


The speed, flexibility and attention to de- tail that LinkWell provides means GPs can get an accurate overview of their patients’ needs at the touch of a button.


74 | national health executive Nov/Dec 11


The capacity to see comparative statistics and performance compared to neighbour- ing practices, track emerging trends, review financial spend, and co-ordinate health initiatives across wider geographical ar- eas gives emerging clinical commissioning groups a clear picture of the health land- scape and the needs of its patients.


The power to analyse and then co-ordinate appropriate health solutions across whole boroughs and sectors leads to more effec- tive use of resources as well as avoiding du- plication and the financial waste of running multiple campaigns.


One area where LinkWell can make huge inroads is the more effective management of long-term conditions, such as asthma, diabetes and heart failure.


The risk stratification module can assess those most prone to hospital admission dur- ing the next 12 months by analysing their previous two years medical history and of- fering relevant intervention measures.


Risk is calculated using multiple algorithms and multiple indicators including the num- ber of inpatient and outpatient appoint- ments made by an individual, the number of times they have visited their GP, A&E at- tendances and medication.


The software has produced some surprising results.


Try the patient who went to A&E 279 times in one year; 1% of a borough’s population with long-term conditions costing the local PCT £36m a year; or the £6.5m being saved over two years by more effectively managing the treatment of patients with heart disease.


The Achilles’ heel of the NHS is the absence of an effective and all-seeing business in- formation system: but that could also be its saving grace.


State-of-the art data analysis is highlighting a surprising amount of capacity within the system. We estimate LinkWell could save the NHS £100m a year.


It’s a bold claim, but not when you con- sider the NHS is the world’s fourth largest employer with an annual budget of around £90bn.


It is important to sound a cautionary note. It’s very easy to get caught up in the raz- zamatazz and drama of data driven algo- rithms and the potential of what could be. Knowledge is a wonderful asset as long as you use it, but worthless if it sits on a shelf gathering dust.


We can give commissioners the tools and information to make more informed deci- sions, but they have to decide how to use that information to implement improve- ments in healthcare.


It’s working well in north east London and several other areas, but that is down to the primary care trust, GPs and practice man- agers consciously driving it forward.


It’s certainly a positive example of what can be achieved when people put their heads together and focus on what can be done.


Health Analytics has evolved far beyond its original intention and what can be done with our systems continues to surprise us. It’s new territory for all of us.


There has been a lot of interest in Link- Well, which culminated in a visit to Down- ing Street earlier this year, when we won a national award as part of the Government’s Innovation Launch Pad initiative.


It gave us an opportunity to buttonhole a minister about the Government’s pledge to give more opportunities for small busi- nesses to compete with larger rivals.


There is a gap between what is being said and the reality of the situation with most government contracts subject to compa- nies being on ‘frameworks.’


You can only apply to join a framework every few years but the application process is expensive, involved and labyrinthine.


As a result, frameworks are dominated by ‘the usual suspects’ – companies who have easy access to government contracts.


While that’s the way things are, we’re still confident that you can’t keep a good prod- uct down.


The NHS is going through huge organisa- tional change and a £20bn savings pro- gramme at the same time as demand for its services is rising.


It’s a time when the accountants often have the loudest voice when, in reality, it is those with vision and solutions who should lead change from the front.


Stuart Bond and Phil Wigglesworth are co-directors of Health Analytics, a Cam- bridge-based software company specialis- ing in health care informatics.


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