Karina Malhotra, founder of Acumentice, explains why managing data correctly in the healthcare industry holds the key to Britain’s recovery from the coronavirus pandemic.
As was widely expected, we seem to be heading backwards in an attempt to move forwards and out of the COVID crisis. Despite campaigns to get us to Eat Out to Help Out, a PR drive to get Britain back to the office and mutterings of getting crowds back to sports stadia – albeit in very low numbers – we are now facing a three tier lockdown system, ‘circuit-breaker’ stops to daily routine and a constant creep upwards of both case numbers and, sadly, deaths.
A situation that has, if it were needed, underlined the importance of the Phase Three letter. This document, which went out during the summer, outlined exactly what providers need to be doing as we grapple with the virus through the Autumn and Winter which is; continue to accelerate the return to normal levels for non-COVID health services, prepare for winter pressures and actively learn from everything that happened during the first months of the pandemic. The latter of which is arguably the most vital. We’re not only about to have our resolve tested, but our capacity, planning and process measures that have been introduced throughout this pandemic.
As cases rise, there may even be a time we may need to pause elective activity again – indeed there are some hospitals where this is a very imminent reality. So as much as the Phase Three letter encourages return to pre covid activity – we need to do what is safe for the local population. To continue elective work but in new COVID-secure ways and to continue to innovate. From Einstein to Bezos, there are a myriad of quotes that point to the need to evolve, learn and do things differently, all of which are particularly apt in this situation.
This is a huge ask on already stretched services. When it comes to elective care, managing waiting lists whilst meeting the gradually increasing activity targets for the next few months is going to require a different way of working. Elective procedures encompass all of the health service’s work which is not considered an emergency. Pre-outbreak, the waiting list for elective treatments stood at 4.4 million, the highest since the referral to treatment pathways began being measured in 2007, therefore it is unsurprising to learn it is even higher now.
So, how will the NHS address a growing waiting list at a point when its resources are already under immense pressure, and do so before the window of opportunity closes with the onset of winter? One way, as reported in an exclusive by the Guardian, is that a series of hospitals will be designated as coronavirus-free zones – a significant policy shift designed to ensure the NHS continues treatment for cancer and other conditions. While there is no doubt this is a positive measure, this is only part of a possible solution.
While there are a number of variables, including clinical and physical capacity, post-COVID-19 social distancing restrictions and scheduling logistics, there is one common thread that ties them all together – data. Information from right across the health sector spectrum needs to be captured, managed and shared effectively and safely. Why? Because the NHS and its Trusts, now as Integrated Care Systems, have to be able to prioritise the most clinically urgent patients first and the only way to do this is by ensuring high data quality on waiting lists.
Historically, the sharing of data across the NHS using 21st century technology and secure systems has been far from seamless. Nowhere more aptly demonstrated a couple of weeks ago when, almost 16,000 cases of coronavirus in the UK went unreported because of a glitch caused by an Excel spreadsheet. Further evidence for this can be found in the recent call from NHS Digital Chief Executive Sarah Wilkinson who stated that the democratisation of data must be fit for purpose in a 21st Century economy. Though this will require not only better and secure systems, but public confidence and trust. It’s the modern day chicken and egg scenario.
Data at the heart of the post-pandemic world
The response to the pandemic was an immense, coordinated effort that crossed both public and private healthcare providers. While that should be applauded, it does add an additional layer of complexity when it comes to tackling elective care waiting lists, as there now needs to be additional coordination across facilities in both NHS and private hospitals. Therefore, accurate and comprehensive data on these waiting lists will be the only means to track and monitor patients whose treatments have been deferred. Without appropriate action now to manage patient data, the corrective recovery could take an enormous amount of resources and time.
With the right data (in other words, accurate and timely information), NHS and private providers can start to deploy the necessary actions they need to take in order to make the most of the window of opportunity. These include:
- Reducing the patient backlog– The issue of patient waiting lists remains contentious. The Telegraph recently reported a national review of the system is likely to send some people – many that have been waiting for elective care for some time as a result of Covid – to the back of the queue. This is an inaccurate assessment as the aim of clinical prioritisation should not be to move people up and down a ladder but to find ways of reducing the burden on providers through alternative capacity solutions and systems to ensure patients are treated in order of need.
- Integrating data management processes – Whether managing new referrals or following up with outpatients, it is important to have a clear operational and data recording process map in place. All diagnoses, prioritisation and outcome details should be recorded on Trust digital systems to support monitoring patients effectively.
- Enhancing elective care data dashboards – Most Trusts will have data quality dashboards already. What’s important now is that they are enhanced with a particular focus on all indicators that will support tracking and monitoring patients deferred during this time based on clinical priority.
- Refining data cleansing strategies – Using those data dashboards, Trusts should augment data cleansing and validation strategies to ensure any issues identified in data entry are quickly tackled.
It may seem like yet more work to do, and it is. Yet to quote the Phase Three letter, “the NHS has shown extraordinary resilience, capacity for innovation and ability to move quickly for our patients”. In order to ensure that the NHS meets the three objectives laid out in the letter, Trusts and other providers need to display that same capacity for innovation and ability to move quickly in the coming months. Effective data management is a critical part of that effort, and by realising it, any organisation, whether NHS England, a local Trust or a private organisation, can ensure the best chance for recovery.
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