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The Information Revolution: saving money, saving lives > ~

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The information revolution: saving money, saving lives
Thursday, November 25, 2010

Providing better access to NHS data would add invaluable knowledge to our understanding of health services and how we can make them increasingly effective and efficient, says Roger Taylor, who believes it could lead to many more lives being saved

Data can tell us many things. It can tell us how many people are dying in hospitals or how many people are claiming benefits. But data with analysis can break down those crude statistics and tell us really useful stuff such as the effects of a change in policy. Analysis tells us the stories behind the data.

Take for instance Tom Wainwright and Robert Middleton at the Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, who used data analysis tools to find out that they halved the length of stay for more than 2,500 patients with hip and knee replacements by introducing an enhanced recovery programme. The average length of stay fell from 7.8 days to 4.1 days and there was no increase in the rate of complications or readmissions.

Health Secretary Andrew Lansley has recently introduced new legislation recognising the cost to the NHS of read-missions. The Royal Bournemouth analysis shows how data can help recognise improvements in the quality of healthcare for patients and save the NHS money.

One might also look at how the NHS treats patients suffering from a heart attack. A recent Dr Foster report shows that investment in gold-standard treatment for heart attack patients has resulted in lower costs to commissioners. Primary angioplasty – the use of a catheter to clear blocked arteries – is known to have better short-term survival rates than traditional thrombolytic treatment, which uses clot-busting drugs. While provision of angioplasty is initially more expensive, over three years the average saving per patient, due to decreased complications, increases and reaches £1,659 at the end of the period.

The additional good news is that primary angioplasty services are being rapidly expanded and the Department of Health aims to have primary angioplasty services in place across 95 per cent of England in 2011. This is good, strong evidence-based policy.

One key structural change within the NHS, and one the evidence shows should be embraced, is the movement of care out of the hospital and into the community. Hospitals are expensive places to treat patients and are certainly less comfortable or convenient for the patient than their own home.
Sophia Christie, CEO at Birmingham East and North (BEN), decided to introduce more care at home following research which highlighted the potential for the NHS to save millions of pounds in this way. Six months on, the figures are promising and robust. NHS BEN now has almost 300 patients on the end of life homecare pathway and all patient deaths bar one have been in their place of choice. Patient and carer satisfaction is high, with an average score of 98 per cent. BEN has more than doubled the savings it was forecast to make at this stage and is now looking to expand the service.

Dr Foster's mission is to harness the power of information to improve services and people's wellbeing. A culture of open government is essential in the provision and accurate interpretation of data. Although an information revolution has been promised by the coalition government, there are still many data sets that are kept inaccessible to all but a handful of government analysts.

There are a number of data sets where greater access would add invaluable knowledge to our understanding of health services and how we can make them increasingly effective and efficient. For example there is much that could be done with the Cancer Registry, the National Joint Registry and National Clinical Audit data to understand the efficacy of cancer care and other treatment on the NHS and to increase the quality of analysis around the services offered. It could lead to many more lives being saved through redefining services – only at this stage we just don't know.

We still do not have any proper idea how many medical errors occur or how many patients die from complications such as DVTs because we are failing to use the existing data systems effectively.

In primary care and social care there is a need to use data to track how well our GPs are performing or the efficacy of public health messages. However the real benefit of such data would be in tracking the patient's journey across primary and secondary care (from the GP surgery to the hospital admission) which would give us a clear understanding of how effective the health service is for the individual patient. Moves to give patients ownership of their own records and of devolving power downwards should be coupled with the patient's ability to properly understand those records.

Moving beyond health we should be freeing up data on benefits, education, crime and policing. By connecting the information surrounding those services, the power to reform them – in the most effective and evidence based way, to meet the challenge of the internet age – would be huge. As the 2020 Public Service Trust report into responsible data sharing shows, citizens expect public services to meet their changing needs for safe, online, personal and instant access to information. The release of data is surely the most effective way to meet this challenge.

Roger Taylor is director of research and public affairs at Dr Foster Intelligence
Venceremos! We Will Win!
Sacramento, California
"Those who make peaceful revolution impossible, make violent revolution inevitable." ~ President John F.Kennedy ~ c/s

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