ST STPs Ps an and d Cl Clinical inical Eng ngagement agement - - PowerPoint PPT Presentation

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ST STPs Ps an and d Cl Clinical inical Eng ngagement agement

July 21, 2014

Dr Mark Davies European Medical Director

24th May

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STPs - changing the language

Exam questions are changing …

• Organisations

Populations

• Secondary uses

Primary uses

• Backward looking

Predictive

• Activity insights

Value

• Operation efficiciency

Allocative efficiency

• Secondary care SUS

Integrated data set

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Population health management is an approach to managing health and well-being that incorporates total care costs and outcomes. It provides insight and improvement opportunities for both populations and individual citizens.

Population Health Management

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Individual Level Stratification Population Modelling Improvement Opportunities Predictive Analytics Delivery Assurance Population Health Platform :

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A joined up view

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Courtesy of Bill Runciman, APSF – Extracted data from AHRQ 2006 report, USA

Improvement opportunities

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Core Principles – What is Value?

Value =

Health outcomes Cost

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February 2014

Source: Outcomes Based Healthcare, adapted from Alliance (Scotland): We’ve Got to Talk about Outcomes, June 2013

OUTPUTS

Cake Blood results, scan results, weight measurement, examination results

PROCESSES

Following the recipe, adding in ingredients, mixing Blood pressure check, blood sugar test, X-Ray, weight, assessments

INPUTS

Ingredients, mixing bowl, recipe book Staff, training, buildings

OUTCOMES

Happy child Cake tastes good No food poisoning Good quality of life Getting back to work Able to self-manage Prevent complications Less pain

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www.outcomesbasedhealthcare.com

Types of Outcomes

Source: Outcomes Based Healthcare

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Stratification partitions the distribution of risk scores in any population This is crucial in determining thresholds of risk at which specific actions should (or shouldn’t) be taken, and which resources should be targeted Stratification will only ever consider one outcome at a time

Risk Stratification

Hig igh Hig igh Hig igh Hig igh Hig igh Hig igh h Hig igh

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Resource Utilisation

• 8
• 6
• 4
• 2

2 4 6 8 10 12 0.05 0.1 0.15 0.2 0.25 0.3 0.35 0.4 0.45 0.5 0.55 0.6 0.65 0.7 0.75 0.8 0.85 0.9 0.95

£ Million Risk cut-off value

Cost of Intervention Savings from falls prevented Net savings Net savings lower 95% CI Net savings upper 95% CI

Based on Surrey Risk Model

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Uniformity Equality

Is individual stratification unfair?

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• Risk Pyramid showing number of people by quartile / deckle of risk
• GIS map shows substantial number of patients at medium risk of fall

in area zone x.

• Consider putting a health promotion stand in zone x

Risk Stratification in Practice - Public Health

Map by risk group

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How information is the foundation of an STP

A care system that focuses on the whole population. Services should be organised for the population not just the patient who presents. A care system that understand the interdependency of services Optimising services using tailored interventions with segmentation A care system that learns. Using value to incrementally improve quality and safety of care and address variation in clinical practice. Adult to Adult Relationships. Patients and professionals working in partnership. Through sharing knowledge between the two, there is a balance in power.