Trust enhances business reporting using Ardentia’s Activity Flow Analytics

Hosted solution enables referral patterns to be tracked and assessed, supporting robust business planning

George Eliot Hospital NHS Trust has deployed Ardentia’s Activity Flow Analytics (AFA) solution to gain full visibility of patient referral patterns from local practices, improve business reporting and enable more effective management.

The Trust provides medical, surgical and maternity care to a population of approximately 250,000 people in Nuneaton, Bedworth and the surrounding areas. Now implemented, Ardentia’s AFA solution will play a key role in helping the Trust retain its market share and offers managers a more effective method for evaluating referral data to support robust business planning.

The solution provides data from any supplier or provider, showing where patients have been referred from and to which hospital or clinic the referral has been made. AFA also highlights any gaps in healthcare provision to indicate where improvements can be made to optimise referral flows. Ardentia’s system has replaced the Trust’s previous solution, which was felt not to be robust enough for its future needs.

Heather Norgrove, Commercial Director at George Eliot Hospital NHS Trust said:

“It is very important for us to be able to retain our market share, and if we are failing to do this we like to react quickly to make the necessary changes. Ardentia’s AFA allows us to accurately track and assess our referral patterns and perform quick analysis to confirm our market position, which reveals where improvements can be made. We chose AFA for its in-depth reporting capabilities, flexibility and competitive pricing against alternative solutions.”

Ardentia’s AFA is a fully-hosted service that requires no implementation. The solution has an intuitive, browser-based GUI that visualises and geographically maps referral volumes, and enables clinicians and managers to drill down into referral data by speciality, HRG, location, patient age and gender, and time period. This helps in understanding referral flows and case mixes in detail, and supports analysis of how these patterns change over time.

The solution helps healthcare providers discover where local GP practices are referring specific acute care cases and why, enabling them to develop services more strategically and maximise income.

Case Study: Patient Level Costing

Background

Southampton University Hospitals Trust provides local hospital services to some 500,000 people living in Southampton and South Hampshire, and specialist services such as neurosciences, cardiac services and children’s intensive care to more than three million people in central southern England and the Channel Islands.

The Trust is also a major centre for teaching and research in association with the University of Southampton and partners including the Medical Research Council and Wellcome Trust.

The Trust’s 7,500 staff treat more than 115,000 inpatients and day patients every year, including 40,000 emergency admissions; they see 350,000 people at outpatient appointments, and deal with around 85,000 cases in the emergency department.

Providing these services costs more than £800,000 every day, and therefore robust financial management is essential to the effective running of the Trust.

The challenge

The decisions that really determine a trust’s financial performance are taken by clinicians, be this the choice of treatment, drug or prosthesis; these decisions all make a difference to whether a hospital runs at a profit or a loss.
The challenge Southampton faces is how to ensure robust financial management while continuing to provide the highest levels of care. The Trust’s goal is to operate as a business-like organisation, with efficiency, financial control and robust management, and as a result to drive up the quality of patient care.

To achieve this requires clinical and finance staff to work together, in order to meet the joint objectives of financial control and care quality optimisation. The challenge Southampton faced was that clinical and management engagement was there, but that they did not have the right tools in place for the job.

The Trust had previously been producing static reports on a service line reporting model, in order to see how departments were performing, and to get an understanding of profitability. However, the limitation of the static reporting is that it did not give staff the ability to drill down further to interrogate data and get the specific information needed to help deliver real improvements, change, and increased profitability.

The solution

The Trust has deployed Ardentia’s Patient Level Costing solution, a comprehensive financial reporting solution developed to meet the real needs and management challenges faced in the NHS, and to help drive change and improvement in healthcare delivery.

The solution is built on actual costs allocated down to patient level, and is fully interoperable with existing in-house information systems, enabling finance and management staff to make the most of existing trust data and the work already done to generate reference costs. In addition, the solution generates service line reports
as well as patient-level costs, helping the Trust to meet the requirements of Monitor.

By taking financial information down to the patient level, the solution creates a link between clinical managers and the finance department to enable evidence-based management, meeting the dual goals of robust financial control combined with care quality optimisation.

The Ardentia solution has been rolled out to all 50 specialties within the Trust, and the goal is to ensure all clinical, management and finance staff are using the system, in order to deliver care that is both effective and cost-effective.

The benefits – A more dynamic approach to financial management

Static reports give trends, top-level info and statistics, but they only show so much. Finance staff and clinical managers need to have the ability to drill down and analyse the specific costs incurred at a patient level, such as ward days and theatre time, and they need to do this for a number of reasons.

Firstly, they need to be able to evaluate the fixed costs incurred by departments and consultants for specific procedures, to get an accurate benchmark figure for the cost of care, and how this compares with the income received.

This data can then be used as a tool for ongoing improvement, serving as a benchmark from which to develop more accurate costings for the future, and also alerting the Trust to individual high costs and enable staff to investigate why they occurred.

According to Fiona Boyle, finance manager at Southampton University Hospitals Trust:

“The ability for clinicians and managers to be able to drill down to the patient level is so important and so critical, because their performance, efficiency, profitability are all measured on the data we have.”

“Staff need to have the reassurance that this data is accurate, and also, crucially, the ability to verify this. They need to be able to drill down to the patient level to see the specific costs incurred, and the treatment delivered, as well as the income received.”

“Patient level costing gives us an altogether better understanding of the business of healthcare.”

A real driver for change

The PLC solution is helping to deliver constant improvement within Southampton, and is being used to help identify where improvements can be made, to ensure best value and efficiency.

Importantly, it’s also about learning from departments and consultants who are performing particularly well, looking to make these examples of best practice, and sharing this information across the Trust.

In this way, the patient level costing data generated is used by managers to evaluate the best clinical procedures to take, and the likely outcomes, in order to meet the dual objectives of financial control alongside the highest level of patient care.

The PLC solution has helped to improve overall data quality within the Trust. Data collection is now more integrated, and captured in a single location. Enhanced accessibility has led to higher quality data and more of it, which has in turn benefited staff Trust-wide.

With high quality patient level data as a base line, reporting throughout the trust as a result is more accurate and more reliable. Clinical coders are getting access to better data, which in turn is also improving service line reporting, delivering constant improvement.

Planning for the future

Patient level costing is one tool within the decision making process; it makes the organisation better informed, and give people the information to make autonomous decisions, based on accurate data and evidence.

The patient level costing solution from Ardentia has been well received by top-level management and senior clinicians within the Trust, supporting evidence-based decision making and ensuring strong financial management.

Patient level costing will give the Trust better quality data and more of it, in order to plan effectively for income, costs and resources and allow for more accurate modelling and forecasting. Better information on past trends and current activity enables better more informed modelling for the future.

Mid Yorkshire Hospitals NHS Trust Turns To Ardentia for Business Intelligence

Improved access to data enables more effective management and better patient care

Mid Yorkshire Hospitals NHS Trust has deployed a complete business intelligence solution from healthcare business intelligence specialist Ardentia to improve data quality, enhance Trust-wide reporting and enable more effective management.

The Trust employs over 7,000 members of staff to serve the communities of Wakefield District and North Kirklees, with an annual budget of £330 million. Operating across multiple sites, the Trust sees an average of 2,500 people pass through outpatients and Accident and Emergency each day and carries out over 235 planned procedures.

To help it better monitor its business performance and delivery of patient care, the Trust wanted a tailored business intelligence system that provided a central source of clinical data, allowing clinicians and managers to make more informed decisions to further improve healthcare provision and optimise financial management.

After assessing the available options, the Trust went through a tendering process and selected Ardentia to help it develop a robust business intelligence system that would meet its needs.

James Rawlinson, Assistant Director of IT at the Trust said:

“It’s critical that clinicians, managers and other stakeholders can easily access and use the information we have in our systems to better plan how healthcare can be delivered and make sure GPs feel assured in allocating resources across a health economy. As a provider, we are receiving a growing number of queries regarding this information and Ardentia has provided us with a complete business intelligence system that enables us to manage those queries, obtain in-depth data quickly and easily, and support robust business planning.”

“Here at the Trust, we wanted to drive organisational agility and efficiency using the technology as a key enabler, allowing clinicians to view and record information with minimum effort, at the point of care.”

The Trust’s Ardentia solution comprises a HealthWare data warehouse, Patient Level Costing solution and Theatres reporting module, specifically designed to help NHS managers and clinicians better manage operating theatre utilisation.

Prior to the deployment, managers and health professionals at the Trust relied on data published in a range of different sources, making the retrieval and updating of records slower and impeding the ability to develop a picture of trust wide performance.

The Ardentia solution enables the Trust to gain quicker, more effective access to data and eliminates any inconsistencies between different data sources, allowing managers and clinicians to make informed decisions. The Trust can also access detailed cost breakdowns, identifying areas where efficiency can be improved or savings can be made, without compromising the quality of patient care.

South London Healthcare NHS Trust chose to deploy business intelligence tools from Ardentia in order to support merger activities and help improve Trust performance.

Quality Data from Multiple Systems

South London Healthcare NHS Trust was formed in April 2009 as a result of the merger of Bromley, St Mary’s Sidcup and Queen Elizabeth, Woolwich.  The newly formed Trust serves a population of over one million people, employs over 6000 staff and has an annual budget of more than £400 million, making it one of the largest NHS hospital Trusts in the country.

To support unified and coordinated management within the new enlarged Trust, and to improve the quality and quantity of clinical and management data, the Trust deployed Ardentia’s Data Warehouse, Pathway Manager and NetSearch solutions.

User dashboards give senior management and clinical managers a clear indication of how the Trust as a whole as well as specific departments are performing against the key performance indicators set, to ensure timely intervention if needed.

Tracy Ross Senior ICT Project Manager at the Trust said: “Better quality data is crucial to the smooth running of all Trust operations, and the Ardentia solutions will help us to improve reporting, in order to meet Department of Health requirements.

“We chose Ardentia because of their experience of pulling together multiple systems across multiple sites, in order to create a standard and unified reporting solution for staff to access the clinical and management data needed to make timely and informed operational decisions.”

Prior to the merger, all three Trusts were running their own separate data management systems, which were not interoperable.  The Ardentia reporting solutions provide a single, unified view for information across all three Trusts, enabling staff working at any site to access the information they need on clinical activity, patient pathways, finance and staffing resource.

The Trust will be using Ardentia’s Pathway Manager tool to ensure timely access to care and help the Trust meet the 18-week wait referral to treatment requirements.  Previously, patients needing treatment at the different hospitals were discharged and then readmitted, but in the new enlarged Trust patients are transferred between sites.  Pathway Manager supports real-time reporting, giving clinicians an accurate overview of where patients are on their pathway of care, to help avoid any potential breaches.

The solutions will also help the Trust to meet its Payment by Results requirements by giving managers a more accurate indication of the cost attached to care delivered, and the income received.  This will play an important role in helping the Trust to operate on a robust business footing.

Ashford & St Peter’s NHS Trust has reported on the success of business intelligence solutions developed jointly with Ardentia, which have reduced Referral to Treatment times and ensured more timely access to care for patients.

Pathway Manager Improves 18-Week Wait Performance

The customised business intelligence solution has significantly improved 18-week wait performance, with 95% of all patients treated within the 18-week timeframe, up from 59% two years previously.

Andrew Davies, Information Consultant at Ashford & St Peter’s Hospitals NHS Trust explained: Ardentia’s Healthware Manager generates an email-based waiting list template highlighting patient progress within their pathway.  This is then automatically sent to healthcare managers within the different departments, alerting them to potential RTT breaches at an early stage, and exposing the root cause so they can manage care delivery effectively.

“The Trust now has a powerful tool to interrogate data and to drill down to access specific patient data to aid clinical decision-making.  Better quality data, and more of it, has given us improved visibility of patient pathways and progress, enabling us to improve care delivery and successfully meet RTT and other reporting requirements.”

Ashford St Peter’s information team worked with Ardentia to link its own in-house pathway analysis database with Ardentia’s Cassius and Healthware Manager, using the systems to report on the inpatient, outpatient and A&E contract data collected and then to send it to the Secondary Usage Service.

The collaborative route gave the Trust a reporting solution customised to meet its exact operating requirements.  The intuitive user interface, functionality and flexibility of the Ardentia tools have improved access to data and made it easier for staff to collect and report data.

The Ardentia solution also allows staff to drill down through the email to access patient records using NetQuery, in order to get detailed data on specific patient cases.  The system enables staff to access the forms needed to allow record validation, streamlining the process of managing patient pathways.

In addition, the Trust now benefits from a centralised data repository which can be used Trust-wide to create the reports needed to ensure evidence-based decision making and robust business management.

Staff from departments across both Trust sites can access the web-based centralised data centre to access the information they need for operational performance reports, and can drill down to access information on Trust performance for cancer treatment, MRSA and A&E targets, as well as RTT and other reporting requirements.