Best Information through Regional Outcomes (BIRO): a decentralised - PowerPoint PPT Presentation

S e s s i o n I I R e d u c i n g U n w a r r a n t e d G e o g r a p h i c a l V a r i a t i o n t h 1 1 : 0 0 - 1 3 : 0 0 , 1 5 A p r i l 2 0 1 6 Best Information through Regional Outcomes (BIRO): a decentralised approach for the secure integration of performance indicators and the automated analysis of practice variation Fabrizio Carinci Professor of Health Systems and Policy School of Health Sciences, University of Surrey Member of the OECD Expert Group on Health Care Quality Indicators f.carinci@surrey.ac.uk

Reporting on medical practice variation F a b r i z i o C a r i n c i

Measurement vs Routine Monitoring S y s t e m P r o j e c t F a b r i z i o C a r i n c i

Choosing the reference model F a b r i z i o C a r i n c i

An inspiring statistical refmection Complete Combinations of Sample Levels of Covariates Same results ! F a b r i z i o C a r i n c i

EU BIRO and EUBIROD projects B I R O p r o j e c t ( 2 0 0 5 - 2 0 0 9 ) E U D G - S A N C O c o - f u n d e d p u b l i c h e a l t h p r o j e c t i n d i a b e t e s “ t o p r o v i d e E u r o p e a n h e a l t h s y s t e m s w i t h a n a d h o c , e v i d e n c e a n d p o p u l a t i o n - b a s e d d i a b e t e s i n f o r m a t i o n s y s t e m ” E U B I R O D p r o j e c t ( 2 0 0 8 - 2 0 1 2 ) E U D G - S A N C O c o - f u n d e d p u b l i c h e a l t h p r o j e c t i n d i a b e t e s “ t o i m p l e m e n t a s u s t a i n a b l e E u r o p e a n D i a b e t e s R e g i s t e r t h r o u g h t h e c o o r d i n a t i o n o f e x i s t i n g n a t i o n a l / r e g i o n a l f r a m e w o r k s a n d t h e s y s t e m a t i c u s e o f t h e B I R O s y s t e m i n 2 0 E u r o p e a n c o u n t r i e s ” F a b r i z i o C a r i n c i

BIRO fundamental principles S y s t e m . F e d e r a t i o n o f n e t w o r k s s h a r i n g a c o m m o n d i s t r i b u t e d h e a l t h i n f o r m a t i o n i n f r a s t r u c t u r e R e g i o n . A n e t w o r k i n t h e s y s t e m s h a r i n g a h o m o g e n e o u s s e t o f s t a n d a r d i z e d d e fj n i t i o n s f o r t h e c o l l e c t i o n o f h e a l t h i n f o r m a t i o n S t a t i s t i c a l O b j e c t . E l e m e n t o f a d i s t r i b u t e d i n f o r m a t i o n s y s t e m c a r r y i n g e s s e n t i a l d a t a i n t h e f o r m o f o n e o r m o r e e m b e d d e d a g g r e g a t e c o m p o n e n t s , s p e c i fj c a l l y d e s i g n e d t o p r o d u c e a s u m m a r y o u t p u t f o r a p o p u l a t i o n o f i n t e r e s t D a t a s o u r c e . U n i t w i t h i n a r e g i o n c o n t r i b u t i n g t o t h e s y s t e m t h r o u g h t h e t r a n s m i s s i o n o f s t a t i s t i c a l o b j e c t s t o t h e h i g h e r l e v e l B o x . S t a n d a r d i z e d s o f t w a r e i n s t a l l e d i n e a c h d a t a s o u r c e t o g e n e r a t e s t a t i s t i c a l o b j e c t s f r o m l o c a l d a t a F a b r i z i o C a r i n c i

Data sources vs population-based analysis “Active” OUTCOMES Patients People (Centre) with INDICATORS Diabetes Catchment Numerator Area -------------------- Denominator Total Population (Region) DATA F a b r i z i o C a r i n c i

The BIRO approach 1 1 R e v i e w y o u r p r o b l e m : c o n s t r u c t a n e v i d e n c e - b a s e d f r a m e w o r k 2 2 D e s c r i b e t h e d a t a s t r u c t u r e o f y o u r n e t w o r k 3 3 A g r e e o n r e p o r t i n g t a r g e t s : s p e c i f y r e p o r t t e m p l a t e s 4 4 C o n d u c t a P r i v a c y I m p a c t A s s e s s m e n t 5 5 I d e n t i f y t h e b e s t i n f o r m a t i o n s y s t e m a r c h i t e c t u r e 6 6 S p e c i f y y o u r d a t a d i c t i o n a r y 7 7 D e s i g n a n d i m p l e m e n t a l l s o f t w a r e 8 8 A n a l y s e d a t a a n d d i s s e m i n a t e r e s u l t s 9 9 T r a n s f e r t e c h n o l o g y 10 10 E v a l u a t e , i m p r o v e a n d u p d a t e F a b r i z i o C a r i n c i

T h e s t r u c t u r e o f d i s e a s e r e g i s t e r s : i d e a l v s r e a l F a b r i z i o C a r i n c i

F a b r i z i o C a r i n c i

F a b r i z i o C a r i n c i

The BIRO system http://www.eubirod.eu L o c a l G l o b a l T r a n s m i s s i o n L i n k e d D a t a b a s e # 1 M a p p i n g B I R O S t a n d a r d S t a t i s t i c a l A n a l y s i s L o c a l R e p o r t G l o b a l . . . A g g r e g a t e R e p o r t T a b l e s L i n k e d D a t a b a s e # n F a b r i z i o C a r i n c i

Applying BIRO in the EUBIROD project: National decentralised automated reporting I T A L Y : B I R O i n s t a l l e d i n N = 8 c e n t r e s ; S . E . = S t a t i s t i c a l E n g i n e D A T A B A S E S O F I N D I V I D U A L R E C O R D S S T A Y WI T H T H E O R I G I N A L D A T A C U S T O D I A N Italian Society of Diabetology Italian Central S.E. Report Engine Centre Report Regional Aggregates Repository of EU Central Italian Aggregates Report Engine (Statistical Objects) Statistical Objects from other countries F a b r i z i o C a r i n c i

EUBIROD Report (2012) 8/2/2012: New BIRO Release 2.1.12 15/2/2012: Collection of statistical objects closed 21/2/2012: EU Report available (N=79 indicators) 13 Days from Software Release to Online Publication of the results ! F a b r i z i o C a r i n c i

G l y c a t e d H a e m o g l o b i n ( H b A 1 c ) N = 1 6 8 , 9 4 8 E U B I R O D D i a b e t e s R e p o r t 2 0 1 2 Type 1 Type 2 Other Type F a b r i z i o C a r i n c i

Application of the BIRO approach to the NEO system in the Matrice project (Agenas 2011-2014) h t t p s : / / g i t h u b . c o m / a g e n a s / n e o Open Source Tools A g g r e g a t e adopted C e n t r a l G l o b a l w w w S e r v e r R e p o r t D a t a b a s e E n g i n e S t a t D a t a L H A s I n d i c a t o r L i n k a g e ( R e g i o n s ) L o c a l R e p o r t E H R s H E S . . . NEO The shaded data architecture is based on the BIRO system Software (2005-2012, see www.biro-project.eu, www.eubirod.eu) F a b r i z i o C a r i n c i

N e o o u t p u t s h t t p s : / / g i t h u b . c o m / a g e n a s / n e o F a b r i z i o C a r i n c i

w w w . b i r o - p r o j e c t . e u EUBIROD Diabetes Report Diabetes w w w . e u b i r o d . e u O E C D H e a l t h I n f o r m a t i o n I n f r a s t r u c t u r e , H o s p i t a l P e r f o r m a n c e B e n c h m a r k i n g User Technical w w w . b r i d g e - h e a l t h . e u F a b r i z i o C a r i n c i

Wa t c h t h i s s p a c e ! B I R O h t t p : / / w w w . b i r o - p r o j e c t . e u E U B I R O D h t t p : / / w w w . e u b i r o d . e u N E O h t t p s : / / g i t h u b . c o m / a g e n a s / n e o E U B I R O D N E T WO R K h t t p : / / w w w . h i r s - r e s e a r c h . e u / e u b i r o d . h t m l T h a n k s f o r y o u r a t t e n t i o n Guildhall clock, Guildford, Surrey, UK F a b r i z i o C a r i n c i