The benefits of Using AHP Data Standards

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The benefits of Using AHP Data Standards

• Margaret Hastings MBA (Dist) FCSP
• Clinical Information Lead NHS GGC
• AHP eHealth Lead
• Clinical Service Manager Physiotherapy West
  Dumbarton CHP

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Allied Health Professionals and other Technical
departments - new patients and total attendances
(non-inpatients, non-day patients)
Homepage  Information and Statistics  Data
Developments  AHP and OTD activity
The information presented is a simple summation
of quarterly data returned in aggregate form by
boards.  In general, the figures supplied by
boards comprise activity provided by
hospital-based services.  Care provided in the
community is excluded except where that care is
provided by hospital-based staff (an example is
the chiropody figures, which exclude information
on community-based staff).  This is not thought
to be universally the case, however, and it is
possible that recording practice may vary between
some boards, as for certain AHP specialties.  For
this reason, the figures are better viewed as
indicative rather than precise counts of activity
and any conclusions drawn from use of these data
should take this into account.
http//www.isdscotland.org/isd/collect2.jsp?pConte
ntID1358p_applicCCCp_serviceContent.show
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www.datadictionary.scot.nhs.uk
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AHP Pathway Summary Dataset
Scheduling Messaging
Assessment Proforma
Care Plan / Interventions
Discharge

• CHI Number
• Demographics (Structured Name, Postcode,
  Registered GP Practice, Gender)
• Profession
• Referral Reason
• Referral Source
• Referral Type
• Referral Date

• Health Problems
• Aetiology
• Objectives
• Caseload Status

• Date Complete
• Outcome
• Discharge Type

• Referral response
• Date

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Standards for
Patient Profile
Problem Identification Pathways, Delivery
Clinical Profile
Benefits - Safety, Experience, Performance
Evidence
Record structures Standards, Terminology,
Identification
Confidentiality, Identification
IT
Metadata,message structures
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Standards aid
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Uses of AHP Summary Dataset

• Referrals by 1000 population
• Caseload by 1000 population
• Cases by disease groups
• Cases by health problems
• Demand management
• Capacity management
• Case management
• Outcome analysis
• Clinical Effectiveness
• Research

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Census Reports 2006

• Summary (January )
• 80 response rate
• Total caseload on 14/9/05 was 844,000 cases for
  every 6 people in Scotland 1 was a current AHP
  case
• On census day 1 contact for every 89 people in
  Scotland

• Waiting Times (July)
• 2,609 AHP waiting lists in Scotland
• 1 in 50 people waiting for AHP 1st contact
• 12 people waiting for every AHP in Scotland
• 94 of all patients seen within 18 weeks

• Describing AHP Cases Service Evaluation (Sept)
• Clinical data describing 39,895 cases was
  provided - 95 could be classified to ICF
  ICD10 OPCS4
• The NCDDP AHP Data standards could be
  recorded by the AHPs.
• AHPs have very little overlap in the problems
  they work with most of the top ten words used
  to describe conditions are unique to that
  profession.

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Demand, Capacity and Queues in AHP services

• Demand - all requests or referrals into the
  service. Need to know target population AHP
  referral norms patient pathways referral
  protocols
• Capacity all resources required to do the work.
  Need to know Role profile - clinical sessions
  professional sessions management sessions No.
  new pats / clinicians Leave profiles
• Activity is the work done and depends on Case
  Complexity Case Weighting Care Plan Delivery
  (includes care setting) Interventions
• Queues result when demand has not
• been dealt with, resulting in backlog.
• Measured by waiting times

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Benchmarking Referrals
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population on Rx
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Describing Clinical Care

• Objective (AHP Data Standards)
• Health Problem or Issue (ICF)
• Aetiology (ICD10 / OPCS4)
• Caseload Status or Outcome (AHP Data Standards)
• Associated Professional Role
• CHI number
• Service Base
  

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Referred Problems by ICF
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Benchmarking Physio service in a CHP
2 week time diary described 324 cases in 5 Health
Centres 3 domiciliary teams and 1 rapid response
team.
Rapid Response patients had more diagnoses and
health problems recorded
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Top 10 Diagnoses
Census
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Caseload Status
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Rehabilitation Model
Multiple Diagnosis Complex Health, Social
Problems
MDT
4 - Intensive multi-agency, care management
3 - Complex care managed by lead prof.
Multiple Diagnosis Health, Problems
DOMI
2 -Basic Support
Out Patient
Few Diagnosis Health, Problems
1 -Self Managed Care
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International
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More Standards
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Embedding Data Standards in Clinical Practice
Remember the burden and costs of data collection

• Use Data standards
• Structure record
• Mandate key data indicators for secondary uses
• AHPs need training in Coding and Classification
• AHPs need clinical systems to record structured
  clinical data which will output summary
  information!

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Benefits

• Clearer understanding of AHP case mix
• Right clinical resource can be matched to case
  complexity
• More real time clinical audit, evaluation and
  research
• Service information derived from clinical
  recording
• Demand, Capacity, Workload and Workforce data
  available to service
• Improved patient care